Are e-Cigarettes Safer?

"Electronic cigarettes" or "e-cigarettes" are nicotine delivery devices that generally consist of a battery, a heating element, a power source, and a pressure switch, all embedded in a tube with a mouthpiece and a socket for cartridge insertion. The cartridge contains up to 20 milligrams of nicotine that is aerosolized using propylene glycol.

A recent article in The New England Journal of Medicine by Nathan K. Cobb, MD, and David B. Abrams, Ph.D., points out that there may be more questions than answers regarding the safety of these devices and role they play in tobacco cessation.

The major concerns are that the nicotine delivery devices are not well defined or regulated, that these devices have poor quality control, and that they have great variability in nicotine content as well as wide deviations from the content claimed on the label. Additionally, the long-term health effects of inhaling propylene glycol are unknown.

As a physician caring for LGBT patients, many of whom already have some form of lung disease from tobacco use, I am asked often about these e-cigarettes. I counsel my patients that the science has yet to bear out that e-cigarettes are safe and will deliver the promised help with tobacco cessation without causing further lung injury. Currently, the World Health Organization recommends a ban on disseminating information that suggests that electronic nicotine vaporizers are safer than cigarettes or that they are an effective means of combating nicotine addition until appropriate evidence can be provided. So while e-cigarettes may not be worse for smokers, there is little evidence to suggest they are good for anyone.