Electronic cigarettes: Healthy alternative or smoke and mirrors?

Sophia Akl
18 February 2015

Above: Image © istockphoto.com/knotsmaster

There's no denying that smoking is bad for your health. But what about electronic cigarettes? Unlike conventional cigarettes, “e-cigarettes” (also called “vapourizers”) don't contain any tobacco. In fact, they don't burn anything at all and they're marketed as a safer, healthier alternative to traditional cigarettes. However, not much evidence is available to back up these claims and there are serious health concerns related to e-cigarettes. But one thing’s for sure: these devices are quickly gaining popularity, especially among teenagers.

Did you know? As of early 2015, there is no scientific evidence to support claims that e-cigarettes are safe and can help you quit smoking.An e-cigarette looks sort of like a pen. You can insert a cartridge containing a solution made up of propylene glycol (C3H8O2) or glycerin (C3H8O3), nicotine (C10H14N2), and flavouring agents. Taking a puff activates a heating element that turns the liquid solution into a vapour. The heat also sets off chemical reactions in the solution. E-cigarette stores with a wide variety of flavoured cartridges are cropping up everywhere, and there are even “vaping” cafés.

E-cigarettes have become particularly popular with teenagers. According to the US Centers for Disease Control and Prevention (CDC), the percentage of American middle and high school students who used e-cigarettes more than doubled between 2011 and 2012. This is an alarming trend, because e-cigarettes still contain nicotine, which may lead to a lifelong addiction to either e-cigarettes or conventional cigarettes. In fact, according to the CDC, over three-quarters of the students using e-cigarettes also used conventional cigarettes. The growing popularity of e-cigarettes is even more troubling when you consider that not much is known about their safety.

Safety concerns

E-cigarettes use solvents, such as propylene glycol, to dissolve the nicotine and flavouring. These solvents can also irritate the eyes, nose, throat, and lungs. They also break down and produce compounds called carbonyls, some of which are known to cause cancer. For instance, when it is heated and vaporized, propylene glycol can produce the carcinogen propylene oxide (CH3CHCH2O).

Did you know? Although they do not contain tobacco, e-cigarettes do contain nicotine, which is highly addictive. It also negatively affects human brain development, which is still ongoing for teenagers.But do the substances in e-cigarette vapour get deposited in your body, or do they just get exhaled along with the vapour? The answer lies in particle size. When you smoke an e-cigarette, you inhale an aerosol of ultra-fine particles. Because of their small size, approximately 20-27% of inhaled particles get deposited in your circulatory system and organs. This is not too different from the 25-35% of particles deposited with conventional cigarettes. This is worrisome, because these very small nanoparticles are linked to a whole host of health problems, ranging from inflammation to asthma, stroke, heart disease, and diabetes.

In addition, bacteria exposed to nicotine-rich vapours, like those in e-cigarettes, form a biofilm coating that makes them more resistant to antibiotics. A biofilm is made up of a thick, gluelike substance that microorganisms secrete to help themselves attach to a surface and to each other. By limiting the effectiveness of antibiotics, these coatings can make it harder to treat illnesses like as pneumonia.

And just like the second-hand smoke produced by conventional cigarettes, the aerosol exhaled by e-cigarette users is breathed in by bystanders. This “passive vaping” could be a significant problem, since e-cigarettes are currently allowed in many places where smoking tobacco products is not permitted.

Because e-cigarettes are relatively new, there are very few regulations related to their use. However, Health Canada has advised Canadians not to use e-cigarettes due to the lack of information about their long-term effects. Sound advice, because as they say: where there's smoke, there's fire.

Learn more!

Electronic Cigarettes (2013)

Brief introduction to e-cigarettes, including how they work and safety concerns.

E-cigarettes in regulatory grey zone: Are they banned or aren't they? (2014)
Angela Mulholland, CTV News

Health Risks of E-cigarettes emerge (2014)
Janet Raloff, Science News

News articles providing a details on health concerns and regulatory issues related to e-cigarettes.

E-Cigarettes: A Scientific Review (2014)
R. Grana, N. Benowitz & S. A. Glantz, Circulation 129

Carbonyl Compounds in electronic Cigarette vapors—effects of nicotine solvent and Battery Output voltage (2014)
L. Kosminder et al., Nicotine and Tobacco Research 16

Electronic cigarettes: human health effects (2014)
P. Callahan-Lyon, Tobacco Control 23

Scientific articles describing research into the safety and health effects of e-cigarettes.

E-cigarette use more than doubles among U.S. middle and high school students from 2011-2012 (2013)
US Centers for Disease Control and Prevention

News release on the increasing popularity of e-cigarettes, associated safety concerns, and alternative smoking cessation strategies.

Health Canada Advises Canadians Not To Use Electronic Cigarettes (2014)
Health Canada

Government alert advising against using e-cigarettes.

What is Biofilm? (2015)
Manitoba Agriculture, Food and Rural Development

The role of bacterial biofilms in chronic infections (2013)
T. Bjarnsholt, APMIS 121

Food safety website and ccientific article discussing “a new category of chronic infections caused by bacteria growing in slime-enclosed aggregates known as biofilms”, such as those that can be formed by nicotine-rich vapours.

Sophia Akl

No bio available. Note biographique non disponible.

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