Safer than smoking but questions remain

Brad Rodu, professor of medicine at the University of Louisville, who researches tobacco harm reduction, says e-cigarettes should not be banned

Electronic cigarettes have been the subject of exaggerated claims by proponents and nicotine prohibitionists alike. As with most contentious issues, the truth about e-cigarettes lies somewhere in between.

When users draw on them, battery-powered e-cigarettes typically vaporise a mixture of propylene glycol, nicotine and flavourings. The health effects of long-term exposure of the respiratory tract to propylene glycol vapour are unknown and unknowable. E-cigarette solutions may also contain hazardous contaminants at trace levels and they should be subjected to independent quality control testing.

According to a recent clinical study of two brands, “…neither of the electronic cigarettes exposed users to measurable levels of nicotine or [carbon monoxide]…” Not inhaling carbon monoxide is a good thing, but for addicted smokers, not getting enough nicotine may be a problem.

There is uncertainty about the reliability of e-cigarettes. Many e-cigarette users know that the devices sometimes don’t deliver enough nicotine to satisfy them, so some re-load cartridges with even higher doses from commercially available concentrated solutions. Concentrated nicotine is dangerous and this kind of experimentation may lead to injuries.

On the other hand, while nicotine is highly addictive, it is not the primary cause of virtually any of the diseases related to smoking. In fact, long-term consumption of nicotine is about as safe as that of caffeine.

Studies have shown that e-cigarettes suppress craving and withdrawal symptoms. This is impressive, because it indicates that e-cigarettes simulate the behavioural aspects of smoking and therefore may be successful in ways that no other smoking cessation product can match.

It’s almost certain that e-cigarette use is vastly safer than cigarette smoking, but some questions remain unanswered.  However, there is no justification or scientific rationale to ban e-cigarettes.