Electronic Cigarettes – Are They Safe?

Maciej Goniewicz1

1Roswell Park Cancer Institute, Buffalo, NY, USA


Electronic cigarettes, also known as e-cigarettes, are devices designed to imitate regular cigarettes and deliver nicotine via inhalation without combusting tobacco. They are purported to deliver nicotine without other toxicants and to be safer alternative to regular cigarettes. Distributors of e-cigarettes promote the product as completely free of harmful substances. However, nicotine solutions used in e-cigarettes vary with respect to concentrations of toxicants, and the quality control in e cigarette manufacturing is questionable. Although a number of toxicants have been identified in e-cigarette vapors, the levels of these toxicants are orders of magnitude lower than those found in cigarette smoke, but higher than those found in Nicotine Replacement Therapy (NRT) products. Some studies suggest that vapor from e-cigarette is significantly less cytotoxic compared to tobacco smoke. One study found that after switching from tobacco to electronic cigarettes nicotine exposure is unchanged while exposure to selected toxicants is substantially reduced. Although it cannot be said that currently marketed e-cigarettes are safe, e-cigarette vapor is likely to be much less toxic than cigarette smoke. The devices likely pose less direct hazard to the individual smoker than tobacco cigarettes and might help smokers quit smoking or reduce harm by smoking fewer cigarettes. The use of e-cigarettes as a harm reduction strategy among cigarette smokers who are unable to quit, warrants further studies. Further research is needed to evaluate long term effects of switching, including the health effects of continued use of e-cigarettes.