While you might see fewer smoking conventional cigarettes these days than you did in the past, the use of electronic cigarettes (e-cigarettes) has never been greater, and it continues to rise in an unprecedented manner. That leaves smokers and non-smokers alike to wonder: is the e-cigarette health risk just as bad as that from cigarettes? Or are e-cigarettes safe and harmless?

The argument for e-cigarettes

E-cigarettes differ from conventional tobacco cigarettes because they do not actually emit smoke and are tobacco-free. Instead, a heating element in the e-cigarette vaporizes a liquid solution that contains nicotine and other ingredients. This way, nicotine is inhaled without smoke and without tobacco itself. Many of the negative health effects of cigarettes come from tobacco smoke, which can contain over 4,000 toxic chemicals. Smoking is one of the top causes of stroke, and it contributes to diseases like COPD, cardiovascular disease, and cancer. Vaporized delivery is theoretically a much safer alternative.[1]

E-cigarettes are considered much less harmful than conventional cigarettes, but they are still able to deliver nicotine. Because of this, e-cigarettes are considered a healthy alternative to tobacco smoking, which may help to lower cigarette use substantially. They have even been considered as a smoking-cessation aid, but a lack of strong evidence makes this theory questionable.[2,3]

The argument against e-cigarettes

Just because something is less harmful than the alternative, does that mean that is healthy, or even safe, to use? Studies are beginning to find that although e-cigarettes contain fewer toxic chemicals than tobacco smoke, the vapor from these devices still contains a variety of dangerous contaminants. These contaminants include silicone, rubber, ceramics, propylene glycol, pharmaceutical medications, and metals like lead, nickel, chromium, and copper.[1,4,5] Even formaldehyde, a known carcinogen, has been found in the vapor.[6]

Proponents of e-cigarettes will point out that these contaminants are only found in trace amounts, but it is still possible that inhaling even small amounts repeatedly during the day might lead to significant negative health effects over decades of use.[3]

Toxic elements in e-cigarette vapor include those that cause respiratory problems and disease.[1] The American Heart Association states that the adverse health effects from e-cigarettes could be especially significant for people with heart disease, too.[5] Nicotine itself may have substantial effects on cardiovascular health and might raise the risk of hypertension and cardiovascular disease.[5,7]

A study in 2014 found that adolescents who tried e-cigarettes were significantly more likely to report smoking regular cigarettes, suggesting that another e-cigarette health risk might include making the smoking problem worse, not better, especially in youth.[8] E-cigarette companies sell flavors like bubble gum, cookies and cream, and gummy bear, and many people accuse these companies of marketing to children with these flavors.[1]

The bottom line

The bottom line is, we can’t yet definitively answer the question, “are e-cigarettes safe?” But many researchers are quite skeptical. There just hasn’t been enough time to study the effects of these devices over long-term use. Just because the harmful effects of e-cigarette use haven’t yet been documented does not mean that they don’t exist.

If you already smoke and don’t plan on trying to quit, e-cigarettes may be a healthier option for you, but it is hard to know yet. But if you want to quit, turn to other smoking-cessation aids, such as NAC, to help you kick your tobacco habit, and avoid e-cigarettes for this use. And if you don’t smoke at all, don’t start up an e-cigarette habit; your health can only be hurt by that, not helped.

Share your experience

Are you for or against the use of e-cigarettes? Do you use them yourself? Share your opinion on the e-cigarette health risk debate in the comments section below.

[1] J Pediatr Nurs. 2014 Dec 2. pii: S0882-5963(14)00326-1.

[2] Cochrane Database Syst Rev. 2014;12:CD010216.

[3] BMC Med. 2014 Dec 9;12(1):226.

[4] Prev Med. 2014 Oct 16;69C:248-260.

[5] Circulation. 2014 Oct 14;130(16):1418-36.

[6] N Engl J Med. 2015 Jan 22;372(4):392-4.

[7] Semin Thromb Hemost. 2014 Feb;40(1):60-5.

[8] JAMA Pediatr. 2014 Jul;168(7):610-7.