How Safe Are Electronic Cigarettes?

Electronic cigarettes are still so new on most markets, many languages haven't yet decided what to call the users.

Should they be called "vapers," as some American smokers dub their colleagues who smoke smokeless cigarettes?

The word makes sense. If smokers are named after smoke, then "vapers" should be named after the nicotine vapor that electronic cigarettes emit instead.

Whatever one calls smokeless smokers, their number is growing rapidly.

A recent study by the British health campaigning charity Action on Smoking and Health (ASH) found that the number of people in that country who reported trying electronic cigarettes more than doubled, from 9 percent in 2010 to 22 percent in 2012.

Almost all the new users were people who already had smoked cigarettes and 40 percent of them hoped switching would free them from the usual hazards of smoking.

Those hazards include an increased risk of dying from cancer, mostly due to inhaling the tar and other toxins released by tobacco when it is burned.

How Much Safer?

But are electronic cigarettes, or e-cigarettes, really safer than smoking?

Amanda Sandford, a research manager for ASH in London, says the only tobacco product the new devices contain is nicotine.

"Nicotine, compared to tobacco smoke, is relatively benign. It is the addictive component of tobacco, of course, and that is what keeps people coming back to smoking, but the harm [in smoking] comes largely from the inhaling of tobacco smoke," Sandford says.

"Nicotine itself, once it is isolated and extracted from tobacco and just used in its pure state, is relatively harmless."



E-cigarettes, which are inhalers, use a small battery to heat a dose of liquid nicotine into mist. The mist also contains water, flavoring, and propylene glycol, a solvent for flavorings that are not very soluble on their own.

Sandford says it is still too early to know for certain the health effects of e-cigarettes because the products only arrived in Britain in quantity two to three years ago. Extensive medical testing still has to be done, leaving the door open to questions.

One question is whether people will smoke more e-cigarettes than they would conventional cigarettes because they believe they are safer, and what health risks the increased nicotine addiction might bring.

A Regulatory Issue

But a more pressing question is how to assure that e-cigarettes -- mostly imported from China and other Asian countries -- contain what they say they do.

Individual e-cigarettes have been found to contain widely varying levels of nicotine, despite using labels promising a "light" or "strong" dosage. There also can be little quality control regarding what additives are used for flavoring.

In many countries, government regulatory boards are now trying to decide how to classify e-cigarettes and assure quality standards. And as they do, a battle is developing between the new e-cigarette business and the much older conventional cigarette industry.

That battle is being fought not just over consumer loyalty. It also is being fought in courts as the new e-cigarette companies seek to get their device classified as a "tobacco product."

Ray Story, head of the U.S.-based Tobacco Vapor Electronic Cigarette Association, says that across Europe regulatory agencies tend to label e-cigarettes as a medical device or drug. That puts them under much tighter sales constraints than conventional cigarettes and helps protect established cigarette distributors from competition.

'So Sue Us!'

Story says the new business is fighting back by defying the regulatory bodies. The goal is to end up in court, where his association legally challenges how the product is classified.

"The [regulatory boards] continue to stand on the position that an e-cigarette is a drug but give us zero clarity, no factual basis, zero. So, what we then do is try to force the issue by selling the product anyway in a particular [country], which will then trigger some type of ban, or legal recourse, or criminal recourse that these regulatory agencies think they have," Story says.

"And then we will end up in court to answer to the citations they have given us for selling a product without market authorization and we then question why this particular product would fall under that category."

It is an uphill battle, and for now e-cigarettes remain substantially less common on shop shelves than conventional cigarettes.

But Story says there is growing interest among major tobacco companies in the United States in entering the e-cigarette business, should many smokers switch to the new devices.

And if the tobacco giants do so, he predicts, the world of smoking could become considerably less smoky in the future.