E-cigarettes: are they really harmless?

smoke-298243_1280I stopped for petrol on my way to work last week. As I was at the counter paying, I managed to look away from the Giant Freddo and Kinder Surprise collection to see e-cigarettes. Flavoured, coloured, very cute looking e-cigarettes. It got me to thinking, are these toy-like cigarettes any better than the cigarettes, tucked away behind the clerk with all their health warnings? E-cigarettes have been a hot topic for a while. And there seems to be quite a bit of confusion as to the health risks associated with them, even amongst us health professionals! So here's the deal with these guys:

  1. E-cigarettes are also called electronic nicotine delivery systems (ENDS) and create a vapor of nicotine or other chemicals (propolyne glycol, water, flavours) - not always in a safe form - the FDA in the USA has had to warn companies against including even more harmful solutions
  2. They have been around since 1965 but first entered the market in 2003!
  3. The vapor does not contain smoke, tar or carbon monoxide (all present in conventional smokes)
  4. Some smokers use e-cigarettes as part of a 'quit smoking' strategy and this might really help some people quit
  5. As they contain nicotine, they are still as addictive as a packet of Malboro lights
  6. Ions such as nickel, tin, iron and chromium can be vapourised from the heating of the liquid - these can be dangerous to inhale
  7. It's a little soon to know the exact health effects, but from some scientific studies, we probably know that e-cigarettes are less harmful than conventional smokes but not completely harmless, especially in those users with heart disease
  8. Those with asthma or other lung disease may have trouble with some of the chemical additives and should give them a miss!
  9. Aside from the uncertain health risk, e-cigarettes have literally blown up! Talk about lighting up!
  10. Sale of e-cigarettes are basically banned in Australia - either by outlawing them explicitly, banning sales of 'cigarette-like items' and by limiting marketing towards teens. That being said, the TGA has a method of importing a small amount of approved product for personal use. E-cigarettes that do not actually contain any chemical like nicotine can be sold, as long as they don't make any claims to be 'therapeutic'

So what does this all mean?

  • E-cigarettes may turn out to be safer than ciggies but not completely
  • Nicotine is HIGHLY addictive and a very difficult habit to kick
  • Using them to quit smoking is possible, but using normal nicotine patches/gum/vapourisers are safer
  • You can't actually buy them in Australia - ones like I saw at the servo are non-therapeutic (that is for looks alone!)

So my call? Give them a miss. Nicotine is an unforgiving master. And if you're quitting? Use the good stuff, chat to your doctor or call your Quitline. And good luck!


AHA Policy Statement. Electronic cigarettes. Circulation. 2014; 130: 1418-1436

Therapeutic Goods Administration