Are E-Cigarettes Really A Reduced-Risk To Health?

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They are growing in popularity, Electronic Cigarettes, which are generally considered a better choice than the mainstream tobacco options, in terms of the impact on health. But are they really much better for us? A study recently posted in April 2015 evaluated the effect of the liquid vapour from electronic cigarettes on human bronchial cells. Scheffler et al conducted the research in order to give consumers some more information about choosing this currently unregulated product.

E-cigarettes are emerging products, often described as “reduced-risk” nicotine products or alternatives to combustible cigarettes. Many smokers switch to e-cigarettes to quit or significantly reduce smoking. However, no regulations for e-cigarettes are currently into force, so that the quality and safety of e-liquids is not necessarily guaranteed. ~ Scheffler

After 24 hours the researchers analysed cell viability and oxidative stress levels. E-Cigarette vapour and the pure carrier substances were shown to have toxicological effects on the cells. But this was low in comparison to the viability of cells exposed to mainstream cigarette smoke, which was significantly times lower. The oxidative stress levels of cells exposed to mainstream versus electronic cigarette was 4.5-5 times higher. It is recommended that the study is replicated to confirm the findings, but these results do appear to support the claims that E-Cigarettes are a healthier smoking option.


However, it is important to note that just because they are not ‘as bad’ as tobacco cigarettes (which we know to be extremely harmful), they are certainly not risk-free. The extent to which they are seen as ‘reduced-risk’ could be potentially misleading.

Health Impacts

Before Scheffler’s study was published, another similar body of research was made available in December 2014. Kacker et al attempted to answer the question: Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes?

They completed a review on E-cigarette vapor versus tobacco smoke, in terms of impact on human health. Their conclusions were on par with Scheffler; Based on the comparison of the chemical analysis of EC (E-Cigarettes) and TC (tobacco cigarettes) carcinogenic profiles and association with health-indicating parameters, ECs impart a lower potential disease burden than conventional TCs.

They found that E-Cigarette vapours contained far fewer carcinogenic particles than mainstream cigarette smoke. E-Cigarettes pass on an equivalent level of nicotine to the body, without increasing the white blood cell count. This means that they have the potential to lower the risk of atherosclerosis and systemic inflammation.

Electronic Cigarettes
Electronic Cigarettes

Some studies have suggested that propylene glycol (PG) vapours can cause respiratory irritation and increase chances of users developing asthma. However, in reaction to this, some manufacturers are replacing the PG with distilled water and glycerin, which is considered less of an irritant.

Do They Aid In Quitting Smoking?

A study published in May 2014 states the following:

While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking. No e-cigarette has been approved by FDA as a cessation aid. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data.

So the argument that E-Cigarettes can be used to help with stopping smoking is certainly not proven to date.

Secondhand Smoke

There is however, a saving grace regarding second-hand smoke. A study published in June 2014 by Sobczak et al evaluated the secondhand exposure to nicotine and other tobacco-related toxicants from e-cigarettes.

E-Cigarettes do not give off any vapour between puffs, but some vapour is exhaled by the user. Using an e-cigarette in indoor environments may involuntarily expose nonusers to nicotine but not to toxic tobacco-specific combustion products. It is certainly preferable to protect non-smokers from the toxic ‘combustion’ products found in mainstream cigarettes, but the effect of nicotine on nonusers needs to be investigated further. Sobczak specifically recommends caution around vulnerable people, including children, pregnant women and those with cardiovascular issues.

Electronic Cigarettes
Electronic Cigarettes

An earlier study from October 2012 also analysed the effect of E-Cigarette vapour on indoor air quality, following proposals to ban indoor the use of the new products in public spaces. Babaian et al tested four different high nicotine e-liquids, comparing with mainstream tobacco in an indoor space, 40 metres cubed. The results were as follows:

Non-cancer risk analysis revealed “No Significant Risk” of harm to human health for vapor samples from e-liquids (A-D). In contrast, for tobacco smoke most findings markedly exceeded risk limits indicating a condition of “Significant Risk” of harm to human health. With regard to cancer risk analysis, no vapor sample from e-liquids A-D exceeded the risk limit for either children or adults. The tobacco smoke sample approached the risk limits for adult exposure. 

Based on these findings it can be said that there is no risk to human health from second-hand inhalation of E-Cigarette water vapour, even indoors. This is a huge contrast to traditional tobacco smoke.

Flaws in The Cartridge

A study by Barrero-Moreno et al, which intended to look at the characterisation of mainstream and passive vapours emitted by selected electronic cigarettes, picked up an additional point of interest. Their study, published in January 2015 was also looking at secondhand smoke. Their tests were rigorous and they found issues with the products themselves, that could contribute to increased vapour emissions.The tested products showed design flaws such as leakages from the cartridge reservoirs. ~ Barrero-Moreno

E-cigarettes, the impact of vaping (using electronic cigarettes) on health and the composition of refill liquids require further research into the product characteristics. The consumers would benefit from harmonised quality and safety improvements of e-cigarettes and refill liquids.

Electronic Cigarettes
Electronic Cigarettes

Conclusion

Studies are showing consistently that E-Cigarettes impart a lower disease burden on the body than traditional tobacco cigarettes, while providing the hit of nicotine that is desired. They should not, however, be considered healthy to use.

There is no evidence to suggest that using E-Cigarettes aids in quitting the smoking habit altogether.

When it comes to secondhand smoke, E-Cigarettes have been found to significantly reduce exposure to noxious chemicals by nonusers. This is a big positive, as secondhand tobacco smoke has been linked to respiratory illness, middle-ear disease and sudden infant death syndrome amongst other issues.

There are potential improvements that can be made in the design of E-Cigarettes to reduce their emissions further.

Overall, it could be said that E-Cigarettes are a better choice than traditional tobacco, but it is important that consumers recognise that there may still be a significant risk to health and wellbeing when using these products.

What are your thoughts? Do you use E-Cigarettes? Or live with someone who does?

 

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Comments

  1. Firstly, thank you for writing a well-balanced and thought out article, I enjoyed reading it. 🙂

    “Overall, it could be said that E-Cigarettes are a better choice than traditional tobacco, but it is important that consumers recognise that there may still be a significant risk to health and wellbeing when using these products.” – driving or walking or even living in any environment where you find vehicles, factories, coal stoves/fire places is way more unhealthy and even extremely dangerous to your health than smoking or inhaling vapour from an e-cigarette or through “vaping”.

    My husband started vaping over a year ago. No more “stinkies”. He quit smoking cigarettes the same day he started vaping. Within the first couple of weeks, he stopped wheezing when climbing stairs, coughing in the mornings and his blood pressure came down to normal levels. After 3 months he started lowering the nicotine strength in his vape liquids. A huge plus point for me is that I don’t have to run around with air freshener anymore (which is harmful to the environment, pets and humans). The flavours he vapes smells nice and I don’t mind him vaping in the house as my curtains and linen don’t smell like an old dirty ashtray anymore.

    It is a bit concerning that everytime something “good” or rather better becomes available, especially if we look at alternative medicines and cures and alternatives to smoking cigarettes that companies spend thousands if not millions trying to debunk that it is better and/or safer. The amount of negative propaganda/articles that appear overnight once pharmaceutical companies and big corporations (tobacco companies) start losing revenue amazes me (not really), what is really concerning is that the public so easily accepts “research papers” as fact without doing any research of their own. Walking or driving to work in traffic is a real killer. Inhaling all that petrol and diesel fumes can surely not be good for one’s health? Yet, alternative “green” fuel is made so expensive and the red tape to get to use it is on a “forever roll”. Petrol and diesel fumes do not just affect your lungs, but your eyes and skin as well. City smog has a way to cling to your clothes that make you smell like you are living in a prehistoric hut with no windows and a fire burning 24/7.

    Sometimes one just needs to ask one self who is paying for this negative “research” and why, when a couple of hundred/thousand people can and will testify to the difference it made in their lives (and pockets).

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