By: Nicholas King.
Many health professionals question the actual safety and benefits of e-cigs. We thought we would gather the evidence in one place to see if these reservations are based on any feasible foundations or part of a conspiracy to tarnish the name of electronic cigarettes for monetary gain within other industries.
Reservations About Electronic Cigarettes
The Oxford University Press published a study in 2011 on behalf of the Society for Research on Nicotine and Tobacco. An investigation conducted by Amy McQueen, Ph.D., and her colleagues from the Washington University School of Medicine consolidated the perceived benefits of e-cigs, as well as presented reasons to doubt these benefits. It has been previously proposed that inhaling nicotine without smoke is less hazardous, both for smokers and the people around them. McQueen and her team further explore this claim.
Certain studies suggest that inhaling nicotine vapor is less harmful than smoking nicotine; likewise, tobacco seems to be remarkably less hazardous when used without smoke, causing only around 2% of the negative effects associated with smoking (These were the findings of tests conducted separately by various researchers, including N. Vigneswaran and his team in 1995, P.J. Hilts in 1996, and J.P. Loennechen’s group in 2002). It has also been suggested by W. Sumner in 2005 that inhaling nicotine vapor is equally harmless to the human body.
From these studies, it is derived that the use of e-cigs is proposed to cause lesser negative effects than cigarette smoking. In a clinical model proposed by A.R. Vansickel and his team in 2010, it was found that vapers experienced benefits after their first use of an e-cig. E-cig users have thus regarded the device as a good tool to help them overcome their smoking addiction.
However, several significant factors must be considered before concluding that e-cigs are less hazardous to health than cigarettes. The 2011 study by McQueen brings to light the following facts:
- Little research has been conducted to determine how safe or practical e-cigs really are.
- E-cig manufacturers have varying standards of quality, and these products are banned in certain countries.
- The US Food and Drug Administration have discovered that e-cigs do not always indicate the accurate nicotine content.
- Even through vaping, e-cig users are nonetheless exposed to the nicotine, which can still cause the following negative effects to the body:
- Deterioration of connective tissue
- Weakened immune function
- Reduced PCD or programmed cell death, a naturally-occurring process necessary in living organisms
[McAllister-Sistilli et al., l998; Onoda et al., 2O01;Henningfield, Clayton and Pollin, 1990; Wright, Zhong, Zheng and Larrick, 1993]
- E-cig users are also exposed to other chemicals found in the nicotine solution, as well as to substances created as the device is used. A study by the US FDA in 2009 revealed that some cartridges contain small amounts of hazardous chemicals.
- Deep inhalation of the vapour may cause the rapid delivery of nicotine into the body, leading to an addiction similar to that of cigarettes [Sumner, 2005]. There is the risk of simply replacing a smoking habit with an addiction to inhaling nicotine vapor.
Studies and Surveys Conducted on Electronic Cigarette Users
Research on the actual benefits of e-cigs has so far been limited. A few studies were conducted to gain a better knowledge about electronic cigarettes; these were also intended to further understand vapers’ experiences with the device and their reasons for using e-cigs.
A French-language internet survey on Electronic Nicotine Delivery Devices was conducted, to which 81 e-cig users responded [Etter, 2010]. An English-language survey prompted 303 respondents, and yielded similar results [Heavner, Bergen, Dunworth, Nissen and Phillips, 2009]. In August of 2010, 180 vapers were gathered in St. Louis, MO, and 15 of them agreed to be interviewed about their experiences with the electronic cigarette [McQueen, et al., 2011]. The information gathered is expected to be useful for future research and clinical trials to determine whether electronic cigarettes truly are safe, effective solutions to help people quit smoking.
There is also a risk that people become addicted to vaping as opposed to cigarette tobacco. We took a look at the vaping addiction here.
Findings from the Surveys
McQueen’s team observed that several items recurred in the surveys, which may be important considerations for future research and lab tests. The following are evident from the recurring themes:
- A vaper subculture and language has emerged.
- E-cig usage requires a process of learning.
- The basic e-cig can be modified by individual users to suit their preferences. A combination of components, accessories and liquid can be added to create their own modified devices or “mods” such as box mods.
- Vapers offer each other support and information using various channels, including the internet.
- E-cig users and sellers are enthusiastic about further research and awareness. They hope for a better understanding of the device and its effects, as well as improvements on e-cig products and safety regulations.
- Vapers opt to use e-cigs due to common reasons and perceived benefits (see below).
Reasons and Benefits Claimed by E-cig Users
As derived from the results of the above mentioned surveys, users claim that e-cigs provide certain advantages and benefits:
- E-cigs are believed to pose lesser health risks.
- Vapers claim that e-cigs have helped them break their smoking habit. E-cigs seem to lower dependence and craving for nicotine dramatically, even more effectively than other conventional methods.
- E-cig users have reported that inhaling the vapor provided an experience very similar to cigarette smoking, without the unpleasant odors. They have found it to be quite enjoyable.
- E-cigs ultimately cost less than traditional cigarettes and have fewer restrictions.
- A few individuals claim to have experienced improved physical health, as characterized by the following symptoms:
- Better breathing,
- Less coughing and reduced dryness in the throat and mouth
- Increased energy and stamina
- Better sense of taste and smell
- Reduced nicotine tolerance and dependence
It must however be noted that these health improvements were experienced mostly by younger users who used e-cigs exclusively.
Problems Reported by E-cig Users
As gathered from the surveys, certain inconveniences and problems exist:
- Some inconsistencies in quality have been observed in the products.
- There are no policies for e-cig user safety.
- E-cigs are more complex than traditional cigarettes and may pose certain difficulties for beginners. Aside from the fact that components may fail, malfunctioning components are neither standardized nor easily replaced, thus causing problems with incompatibility.
- Many users have found the basic e-cig kit to be unsatisfactory, requiring them to make their own modifications. As a result, these “mods” often no longer look or feel like an actual cigarette.
- Though vaping is perceived to be a less costly habit than cigarette smoking, this is not quite true for heavy vapers.
- Though various e-cig merchandise are easily purchased online, many vapers have complained that not all of those sources are trustworthy.
- There is a lack of information and research on the e-cigs and vaping.
The above mentioned surveys have determined that vapers who have used e-cigs for quite some time claim symptoms of improved health – which is common in those who quit smoking – even with continuous vaping.
E-cigs are intended to mimic traditional cigarettes, but many vapers agree that vaping is a diversely different experience from cigarette smoking. A great amount of trial and error is required in learning how to use an e-cig, which typically involves selecting the flavored e liquids, determining the additional components needed to personalize the device, and operating the device itself. Enjoying an e-cig also necessitates adapting to various products, maintaining the device and adjusting it to suit individual preferences. This complex process of learning to use the e-cig affects new users, sellers and manufacturers. McQueen also states that this is a factor that must be considered by researchers in their clinical tests, as well as by policy-makers who hope to ensure the safety of e-cig users.
Although the surveys provided a good amount of data about vaping and the vaper subculture, McQueen and her colleagues point out that further, broader study needs to be conducted on the subject.
Researchers and public health professionals advise that e-cigs must be used with caution until sufficient research has been made.
[Abrams and Zeller, 2009; Henningfield and Zaatari, 2010; Pauly et al., 2007; Yamin, Bitton and Bates, 2010]
Despite the benefits and advantages claimed by e-cig advocates, there are many apprehensions concerning electronic cigarettes, such as undiscovered health risks and a lack of quality control. Another primary concern is the possible long-term effects of vaping, which cannot be determined until after many years. Nonetheless, vapers still prefer to use the device as an alternative to cigarettes. As evident in McQueen’s study, vapers firmly believe that electronic cigarettes reduce health risks and improve the quality of their lives.
With the dearth of research, McQueen states that further studies definitely need to be conducted in able answer the following important questions:
- What are the short term-effects of vaping, including actual effects versus the perceived benefits?
- How safe is the device, and how can user safety be further improved?
- Do e-cigs produce aerosols? How much do they contribute to air pollution? How much more effective are they than cigarettes in promoting cleaner air?
- In what way are electronic cigarettes superior aids for smoking cessation? Are they really better alternatives, or will they just provide a new addiction?
- What are the health risks, especially when e-cigs are used as a permanent replacement for cigarettes?
- How can e-cigs and e-liquids be made safer and more appealing to various target markets, including non-smokers, ex-smokers and minors?
In the meantime, while limited study has been made on electronic cigarettes and vaping, McQueen has noted that e-cig users and sellers are eager to participate in further research.