Electronic Cigarettes and Your Health

The electronic cigarette does not contain the 4000+ chemicals found in normal cigarette smoke, a toxic cocktail with at least 200 poisons and 40 carcinogens that are said to cause cancer in humans. No smoke also means no second hand smoke. It is therefore not surprising that ecigs are being marketed almost universally as a ‘healthier’ alternative to the tobacco cigarette - better for you and those around you.
Most ecig cartridges do, however, contain nicotine so they are addictive and not recommended for anybody who does not currently smoke. Another main ingredient is propylene glycol, which although generally considered safe and used in many other products, has not been subjected to any long term testing whilst being used in an electronic cigarette.

 

The lack of any large scale clinical testing or general classification is proving to be a bit of a problem.
Public perception towards the electronic cigarette is overwhelmingly positive once the concept is explained but governmental reactions are varying. In Austria and Finland electronic cigarettes have been classified as medical devices, whereas in Denmark they have been banned because the type of nicotine used has not been certified by the government.

 

If you are considering switching to an electronic cigarette and are concerned about your health then unfortunately there aren’t many hard facts you can look to right now. Our best advice is to compare your current method of nicotine intake with that offered by the electronic cigarette and decide which you believe is better or safer for you.

 

At eciginfo we made our choice, and for us it really wasn’t a hard one to make. We enjoyed a smoke but weren’t happy about what it took to create that smoke. We require the nicotine but felt we could do without the ‘tar’ produced by smoking.
An electronic cigarette is an alternative to a tobacco cigarette and so in order to make a comparison we need to look a bit closer at the ingredients of each

 

TOBACCO CIGARETTES

There are over 4,000 chemicals in tobacco smoke and some of the more harmful of these are as a result of the combustion and burning process. This means that there are a lot of by-products just to get the nicotine relief

Below are just 6 of these by-products: -

• Formaldehyde – a highly poisonous, colourless embalming fluid known to cause cancer, respiratory, skin and gastrointestinal problems.
• Ammonia  -   better known for being a toilet cleaner.
• Acetone – most commonly known as nail polish remover.
• Hydrogen Cyanide – used as a genocidal agent during world War II (under the name Zyclon B)
• Carbon Monoxide- the principal component of automobile exhaust
• Tar – a particulate matter drawn into the lungs when you inhale a lighted cigarette. About 70% of which is deposited in the smokers lungs.

 

Admittedly these are some of the more infamous offenders, and their concentrations will be miniscule - but they are there and there are few that would argue against the detrimental health effects of long term smoking.
There are around 10 million adult smokers in the UK, and in a fact sheet produced by ASH (action on smoking and health) it states that around half of all regular cigarette smokers will eventually be killed by their addiction. See the fact sheet here (opens in new window).

ASH have also produced a fact sheet on ‘Smoking and disease’ which provides information on the effects of second hand smoke and the benefits of stopping smoke. Click here to see this report (opens in new window).

 

 

ELECTRONIC CIGARETTES

The electronic cigarette produces only vapour so there is no smoke or second hand smoke.
The ingredients and output of an electronic cigarette are relatively basic therefore when compared to the tobacco cigarette. Cartridges will typically contain just the following: -

• Water
• Nicotine
• Propylene glycol
• Scents and flavourings
• Membrane to suspend the ingredients

 

The two ingredients of note are nicotine (in a purified liquid form), and propylene glycol. You are likely aware of the addictive properties of nicotine, although interestingly there is some debate right now as to the effects upon your health when this substance is isolated from the other ingredients in a normal cigarette.
Propylene glycol is currently used in many food and cosmetic products as well as smoke machines. It is also used in normal cigarettes to maintain a dampness in the tobacco, but the long term effects of inhaling it within an electronic cigarette are unknown.

 

NICOTINE

Nicotine is an alkaloid found in the nightshade family of plants which includes tobacco, tomatoes, potatoes and chilli peppers. They all contain nicotine in some form, although the name it is given varies e.g. ‘solanine’ in potatoes, ‘tomatine’ in tomatoes, ‘alpha-solanine’ in aubergines or ‘solanadine’ in chillies and capsicums. Although the nicotine content of tobacco is much higher than that found in nightshade vegetables which are eaten, the practise of smoking reduces the amount of nicotine absorbed. The nicotine in a single cigarette, if taken direct into the bloodstream would be fatal.
As nicotine enters the body through smoking it is distributed through the bloodstream quickly and reaches the brain in about 7 seconds. Here it triggers a number of chemical reactions that result in temporary feelings such as enhanced pleasure; decreased anxiety; a state of alert relaxation and greater concentration.
The effects of nicotine are short-lived and it is estimated that half of its strength will have been lost after somewhere between 40 minutes and 2 hours. As the effects start to wear off smokers begin to feel edgy and agitated, this is nicotine withdrawal. Relief comes in the form of another cigarette – this is the addiction.
The addiction and relief are due solely to the nicotine and this is why NRT (Nicotine Replacement Therapy) focuses on providing the nicotine alone whilst removing the damaging effects of the tobacco smoke.

In a ‘Report of the committee on safety of medicines working group on nicotine replacement therapy’ from the MHRA it states within the Executive Summary that:-

3. Inhaled nicotine is strongly addictive and stopping smoking results in cravings and withdrawal symptoms, but nicotine itself is not a major primary cause of smoking-related disease

It also states in the report:-

2.4 Use of NRT compared with the dangers of continued smoking
When NRT was introduced there were concerns about it’s safe use. However, over time and with wide- spread use, NRT has been seen to be well tolerated. This is mainly because smokers have a strong tendency to titrate their nicotine levels (regardless of source – smoking tobacco/using NRT) to reach their own “comfort zone” level. With NRT they are likely to maintain the same blood nicotine levels as when smoking but without the other, more dangerous, elements of tobacco smoke making nicotine from NRT considerably safer than that from cigarettes

You can read the full report here (new window)

 

It is worth noting that, despite the description, electronic cigarettes cannot be marketed as a Nicotine Replacement Therapy in the UK.  This requires official testing to prove that this is indeed the case before a license can be granted for it to promoted in this way. This testing has not taken place and it is an offence ‘to sell, supply or advertise a Nicotine Replacement Product which does not have a product license’.

 

The Wikipedia entry for Nicotine is quite detailed and so for further reading you can click here to go to the site (opens in new window)

Regarding the Toxicology of Nicotine it states: -

The carcinogenic properties of nicotine in standalone form, separate from tobacco smoke, have not been evaluated by the IARC, and it has not been assigned to an official carcinogen group. The currently available literature indicates that nicotine, on its own, does not promote the development of cancer in healthy tissue and has no mutagenic properties.

To be clear, Nicotine is a highly addictive substance and in a sufficient dosage a deadly poison. We are clearly not going to say that nicotine is a good thing, but there is research underway right now that have led some writers to hail it as a wonder drug.

The following is taken from an article in Wired:-

"Nicotine is highly stigmatized -- and for good reason, because the delivery system is so deadly," says Don deBethizy, CEO of Targacept. "But the drug itself and the research generated by studying its effects on the brain both show great promise for helping us improve our physical and mental health."

See the full article here

 

PROPYLENE GLYCOL

This colourless, nearly odourless syrupy liquid is derived from natural gas and it acts to provide the smoke like appearance to the vapour in an electronic cigarette and to suspend the flavour.
The U.S Food and Drug Administration (FDA) has determined propylene glycol to be "generally recognized as safe”. Currently it can be found in food products, cosmetics, medicines, toothpaste, saline solutions and fragrance oils.
Propylene glycol also has shown no evidence of being a carcinogen or being genotoxic, prolonged contact is essentially non-irrating to the skin and inhalation of the propylene glycol vapours appears to present no significant hazard in ordinary applications.
There are, however, some health warnings that you should be aware of. ‘Undiluted propylene glycol’ is minimally irritating to the eye and can produce slight transient conjunctivitis and exposure to mists may cause eye irritation, as well as upper respiratory tract irritation. More information can be found at Wikipedia (opens in new window).

The problem once again is lack of testing which means that there is very limited information available regarding the long term affects of this form of vapour mist inhalation. I will admit that we have some concerns here at eciginfo about our intake of propylene glycol, we have read numerous reports regarding its safety and experimentation on animals but there is very little that is specific to its usage in the form of an electronic cigarette. A general report on the substance can be found on the healthy-communications.com website here.

 

We do know of some smokers that have stated that they have felt adverse effects to what they believe to be the propylene glycol, and there are others that have complained of increased dehydration. Personally, we have not seen any ill effects from using an electronic cigarette ourselves but should you experience negative health effects then our recommendation would be to stop immediately.

 

CLINICAL TESTING

The only clinical testing that we have come across to date was undertaken by ‘Health New Zealand’. This research was funded by Ruyan but no test results were withheld. The report is positive, in their findings published on the 30th October 2008 they stated the following: -

Ruyan e-cigarette is designed to be a safe alternative to smoking. The various test results confirm this is the case. It is very safe relative to cigarettes, and also safe in absolute terms on all measurements we have applied. Using micro-electronics it vaporizes, separately for each puff, very small quantities of nicotine dissolved in propylene glycol, two small well-known molecules with excellent safety profiles, - into a fine aerosol. Each puff contains one third to one half the nicotine in a tobacco’s cigarette’s puff. The cartridge liquid is tobacco-free and no combustion occurs.

The full report can be read on their website which you can link to from here (opens in new window).

These results are encouraging and do put us at ease but we would like to see more clinical testing and soon.

 

Along with many of the sellers of the electronic cigarette we would advise that they should not be used by: -

• Anybody who does not currently smoke tobacco cigarettes or have an addiction to nicotine
• Anyone under the age of 18
• Women who are pregnant or breast feeding
• Anybody with a health condition for which they have been given medical advice to not smoke regular cigarettes

 

The alternative is the tobacco cigarette and there is enough known about the long term dangers of this type of smoking to make us not want to go back. The New Zealand report is very encouraging and we look forward to more clinical testing and just wish it would hurry up. Long term testing obviously can’t be hurried but the sooner it starts the sooner we shall have some results.
Here at eciginfo we have reviewed a lot of data and we are happy with our choice to continue to use the electronic cigarette as an alternative to the tobacco cigarette. We are not generally swayed by marketing statements but we are in agreement that the ecig is a ‘healthier alternative’.