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How Safe Are Electronic Cigarettes? Not Everyone Agrees

The views expressed are those of the author and are not necessarily those of Scientific American.


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Ad outside NY bodega for e-cigarettes, July 2013, Photo: Laura Newman.

Ad outside a NY bodega for e-cigarettes, July 2013, Photo: Laura Newman.

My friend lit up her electronic cigarette during intermission when we were in line for a bathroom at a Broadway theater. People in the line looked at her disapprovingly. She responded quickly: “I am not smoking. It’s only water vapor.” That’s the argument that the e-cigarette industry makes, and it is clearly one that my friend wants to believe. Her response put a stop to any questions about second-hand smoke. Nobody else said anything. Maybe nobody wanted an argument on a night out for theater or maybe people knew too little to comment confidently. She waited for a bathroom stall and continued smoking.

While questions about electronic cigarettes stayed below the surface in the ladies room, they are hotly debated in the world of tobacco control and public health. There are concerns about the exact benefits and potential harms of electronic cigarettes, secondhand smoke, and air quality. Proponents see e-cigarettes as a safer alternative to traditional cigarettes, but skeptics question how safe they really are, both for users and people exposed to them as second-hand smoke. So far, they have been manufactured and distributed without oversight, data, or proof that they are a bridge to quitting more toxic cigarettes. Also, many experts question the industry line that just water vapor is released when users light up.

Product Regulation Considered

In today’s Lancet Respiratory Medicine, two commentaries put forth opposing views on the question of regulating electronic cigarettes as medical devices. Nathan K. Cobb, MD, and Caroline O. Cobb, from the Department of Pulmonary and Critical Care Medicine, Georgetown University Medical Center, Washington, DC, warn: “Without oversight or consumer safety regulations, the manufacturers of ENDS produce products that are more widely available, much cheaper, and might contain more nicotine and contaminants than competitor products manufactured by pharmaceutical companies.”

Cobb and Cobb want regulation. They frame the issue this way: “The question should be what regulatory system will get safe and effective refined nicotine products into the hands of more smokers and promote elimination of the most lethal combusted products?”

In the second commentary Peter Hajek, Director of the Tobacco Dependence Research Unit at the Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK, and colleagues, argue that regulation will stifle innovation, the development of better healthier electronic cigarette designs, and hinder competition of e-cigarettes against more toxic traditional cigarettes.

Product regulation is only one part of the story. It is what the Food and Drug Administration can address. Local governments will have to decide where people can use e-cigarettes, whether air quality statutes should issue standards.

E-Cigarette Use Patterns

Standton Glantz. University of California San Francisco, photo by Noah Berger.

Standton Glantz. University of California San Francisco, photo by Noah Berger.

I asked Stanton Glantz, PhD, Professor of Medicine at the Center for Tobacco Control, University of California San Francisco, and leading tobacco control expert, to comment on the Lancet Respiratory Medicine papers, and address concerns about the use and proliferation of e-cigarettes.

Q: What did you think about the opinions on e-cigarette regulation in Lancet Respiratory Diseases?

A (Glantz): The pieces were focused on e-cigarettes as products. They did not address what effect e-cigarettes have on use patterns. We’ve found very high levels of dual use [traditional cigarettes along with e-cigarette use]. Very few people have switched away from cigarettes or managed to use them as a bridge to eventually go off cigarettes. While many people believe e-cigarettes helped them quit smoking, neither of the available population-level studies showed such an effect. One showed e-cigarette users and nonusers quitting conventional cigarettes at the same rates, the other showed e-cigarette users being less successful at quitting.

Q: Where do the authors stand on harm reduction and addiction?

A (Glantz): The articles reflect the polarization in the public health and tobacco control communities. The optimists – the harm reduction people (in this instance Hajek et al.)– essentially believe that electronic cigarettes are much less dangerous than traditional cigarettes and so their use should be encouraged. The pessimists (Cobb and Cobb) see electronic cigarettes as an addictive drug that, without regulation, are not going to market in a way that will disrupt the primary profit stream of cigarettes, and so could end up just keeping people smoking conventional cigarettes.

There’s an assumption among the harm reduction people that if you could snap your fingers and get every smoker to switch to e-cigarettes, you’d be ahead. One problem is that you can’t do that. While the industry uses social media and the internet to present e-cigarettes as a miracle way to quit, as noted above, no independent studies show that e-cigarettes actually help people quit. They may even discourage quitting.

Q: In what camp do you put yourself?

A (Glantz): I am a realist who is driven by data. I started out agnostic on e-cigarettes. While there is not a lot of information available now, what is there is pointing to dual use and e-cigarettes impeding quitting cigarettes. All the big cigarette companies are now getting into this market. They are not going to market those products in a way that jeopardizes the cigarette market.

Q: Do you agree with the harm reduction people that e-cigarettes are a safer alternative for smokers?

A (Glantz): If smokers switched entirely from conventional cigarettes to e-cigarettes, no one started smoking because of e-cigarettes, and e-cigarettes did not discourage quitting, smokers would be better off.

Contrary to marketing claims, e-cigarettes do not deliver “pure nicotine” and “harmless water vapor.” In 1986, California passed a ballot initiative known as Proposition 65, which was intended by its authors to protect California citizens and the State’s drinking water sources from chemicals known to cause cancer, birth defects, or other reproductive harm, and to inform citizens about exposures to such chemicals. Annually, the Governor must publish a list of chemicals known to the state to cause cancer or reproductive toxicity. Ten compounds that are on the Proposition 65 list have been identified in mainstream (MS) or secondhand (sidestream/SS) e-cigarette vapor (See table)

Ten Compounds Found in E-cigarette Mainstream* or Secondhand Smoke**, Also on California’s Proposition 65 List

* Acetaldehyde (MS)
* Benzene (SS)
* Cadmium (MS)
* Formaldehyde (MS, SS)
* Isoprene (SS)
* Lead (MS)
* Nickel (MS)
* Nicotine (MS, SS)
* N-Nitrosonicotine (MS, SS)
* Toluene (MS, SS)
*MS – mainstream smoke
** SS – secondhand smoke

Credit: Stanton Glantz, PhD, Adapted from Gonewicz ML, Knysak J, Gawron M, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. doi:10: 1136/tobaccocontrol-2012-050859 and Schripp T, Markewitz D, Uhde E, et al. Does e-cigarette consumption cause passive vaping? Indoor Air 2013; (1):25-31.

Q: Do you think that, based on what we know, we should ban e-cigarette use in the same places that we ban cigarettes?

A (Glantz): Yes. Even though e-cigarettes are less polluting than conventional cigarettes, they still are putting a variety of volatile organic compounds, heavy metals, fine particles and other toxins into the air. Regardless of the concentrations, there is no justification for reintroducing these toxins indoors after we spent 30 years getting rid of them.

Q: Do you think that any regulatory entity has taken the lead with a strong policy protecting the public’s health with e-cigarettes? What would such a policy look like?

Q: The FDA has the ability to regulate e-cigarettes as products and should do so. The reality is, however, that meaningful regulation is probably years away because the tobacco and e-cigarette companies (that are more and more the same companies) will do everything they can to slow it down or stop it, including through the courts.

Where you can smoke e-cigarettes is a matter for local and state governments, who are already starting to act to include e-cigarettes in clean indoor air laws.

Laura Newman About the Author: Laura Newman writes about medicine, health policy, and clinical outcomes research. She has a long-term interest in healthcare reform and what matters to patients. She has written news in health and medicine in peer-review journals, on the web, and for newsletters. Laura blogs at Patient POV, is active on twitter at @lauranewmanny, and she is especially interested in integrating patients into health reform efforts. Follow on Twitter @lauranewmanny.

The views expressed are those of the author and are not necessarily those of Scientific American.






Comments 39 Comments

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  1. 1. LilaMae 9:20 pm 07/22/2013

    Stanton Glantz is not a medical doctor. He also has a history of playing fast & loose with the facts: http://antithrlies.com/tag/glantz/

    I too want to know more about the possible health concerns of using e-cigarettes. Clearly more research needs to be done. But I’d be very skeptical of Glantz’s opinions, which seem to be rooted in ideology rather than based on sound science.

    Link to this
  2. 2. sarnold02 6:46 am 07/23/2013

    I have been using an e-cig for over a year, the difference in my health has been amazing. My doctor and my dentist have both praised the drastic improvement in my over all heath over the last year. I no longer wake up coughing and whizzing, I no longer run short of breath when I walk up stairs, and I know longer have chest pains. All in all I haven’t felt this good in 20 years. If your telling my that I should stop using them and go back to smoking, and that they should be banned because they are “bad” for you, then your are idiot and not only that, your a idiot is telling people to keep committing SUICIDE because you don’t both to research the product or the facts. Its shameful that this is even posted. E-cigs save lives, that’s a fact.

    Fact: E-cigarettes are
    ~70% Propylene Glycol (PG) and or Vegetable Glycerin (VG)
    ~14% water
    ~14% Flavoring (Lorann oils, Capella, Flavor art, Perfumer’s Apprentice, others)
    ~2% Nicotine

    Fact- e-cigs are 98-99% safer than smoking cigarettes.

    Fact – Big tobacco did not invent or start the e-cigarettes, they have been around for 10 years, being used in US since 2009, they were created in china, BT just jumped on the band wagon this year.

    Fact- Cigarette’s contain 4,000 unknown chemicals including addictive tar. The liquid used in e-cigs contain 5 known chemicals, most are already used in medication (inhalers) and food, deemed “safe”. There is ancedotal evidence from over a half-million ex-smokers with personal medical tests to back up their claims.

    Fact- Electronic cigarettes came on the market around the same time as the FDA approved cessation drug Chantix, yet only one of them is responsible for hundreds of suicides and even more attempted suicides. Phizer has paid out millions of dollars in lawsuit settlements and are expected to pay out even more, yet their product is still on the market and still FDA approved.

    Link to this
  3. 3. huntershoptaw 9:47 am 07/23/2013

    “Credit: Stanton Glantz, PhD, Adapted from Gonewicz ML, Knysak J, Gawron M, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. doi:10: 1136/tobaccocontrol-2012-050859 and Schripp T, Markewitz D, Uhde E, et al. Does e-cigarette consumption cause passive vaping? Indoor Air 2013; (1):25-31.”

    So, let me read this correctly. The only evidence this guys argument has against e-cigs is from a paper “adapted” from other papers.
    1) Stanton Glantz is the Director of the Center for Tobacco Control Research
    2) One paper is from that same center, Tobacco Control
    3) One paper cannot be verified readily as is is in a hard copy form only. (Really?!)

    I’m no advocate for smoking, but from all the literature I’ve read and all the first hand experience I’ve had with e-cigs, they are a far cry better than cigs.
    The causes Glantz cites are unrealistic and are not even answers to the questions, but hypotheticals with no basis in fact. These seem to be his opinion that he’s confusing for fact.

    Lastly, the table appears to be wrong. After reading the paper referenced, it shows that .02μg of Formaldehyde as the Limit of detection and .06μg Limit of quantitation PER 150 PUFFS (their standard limit of longevity of an e-cig)
    http://tobaccocontrol.bmj.com/content/suppl/2013/03/04/tobaccocontrol-2012-050859.DC1/tobaccocontrol-2012-050859supp_table.pdf

    The information provided appears to be skewed toward e-cig hazard instead of factual data, but maybe I’m reading it wrong.

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  4. 4. pulsar vaporizers 9:56 am 07/23/2013

    E-cigarettes are
    ~70% Propylene Glycol (PG) and or Vegetable Glycerin (VG)
    ~14% water
    ~14% Flavoring (Lorann oils, Capella, Flavor art, Perfumer’s Apprentice, others)
    ~2% Nicotine

    There is ALOT known about what goes into an e-cigarette, and it is a tired argument. There have been studies released in just the last few weeks showing how helpful they are to people wishing to quit.

    Fact (anecdotal): The first time I used a e-cigarette (mine was a Buck Naked brand starter kit, but they are pretty much all the same) was the last time I used a real cigarette. I am now running several miles a day, 3 times per week, and I have lowered my nicotine intake to almost nothing.

    Link to this
  5. 5. BarbDeir 11:46 am 07/23/2013

    Stanton Glantz is a brilliant man but what research is it based on?

    Chinese e-liquids?
    Chinese e-cigs?

    No one knows he did not say he just wrapped it with a bow and said they are bad.

    What pharmaceutical company pays his research grants?

    I agree more research needs to be done. by someone not in someone elses pocket using quality products and a variety of them.

    Cigarette smoke stinks its offensive to the senses as well as the toxins emitted. Even still, they are not nearly as bad as what pours out of every single car.

    E-cigs…even bad ones as I suspect is what the findings are based on, have at up to 400 times less toxic emissions from the 10 compounds they say they discovered as per his own findings then a normal cig. what he fails to indicate is the almost 4000 other toxic compounds that are in cigarettes that are not in any e-cigs even the bad ones…

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  6. 6. letsbehonest 12:23 pm 07/23/2013

    I have a lot of respect for Stan Glantz. His dedication and passion are inspiring, and his accomplishments in the anti-smoking arena are admirable. That’s why it’s sad to see him be so wrong about ecigs. His crusade against ecigs could achieve exactly what he has spent so long fighting against – more illness and death from tobacco smoking. Unfortunately, I find his statements about ecigs to be just as intellectually dishonest as those of big tobacco. His selective use of data exposes his bias. Like most anti-tobacco advocates, he has some type of irrational emotional opposition to ecigs that clouds his thinking. They seem to love nicotine replacement as long as it doesn’t look like smoking and as long as it’s not enjoyable. Before I get dismissed as a shill for the ecig industry, let me state that I have no type of connection to the business of ecigs. However, I did successfully switch from tobacco to ecigs several years ago and I continue to reap the benefits of being smoke free.

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  7. 7. Alan Selk 3:16 pm 07/23/2013

    There is only one true indicator for public health when it comes to tobacco and nicotine, and that is how many cigarettes are consumed. If there is a reduction in cigarettes consumed there will be a positive outcome for public health. The risk factors for western smokeless tobacco and electronic cigarettes are so low (about 99% less harmful then smoking) that it simply can’t be measured in population studies.

    There is abundant anecdotal evidence that electronic cigarettes are a path away from smoking. There are likely about 2 1/2 million people in the US now using e-cigs, and nearly all of them have significantly reduced there smoking, or have completely quit. As of this writing there has not been a single verified (or even unverified) instance of someone starting with e-cigs and then moving on to smoking. The idea that e-cigs will become a path to smoking is silly with no basis in facts. The evidence is overwhelming that smokers are using e-cigs to replace cigarettes.

    Tobacco harm reduction is working, and in fact is the main driving force behind the recent reduction in cigarette consumption.

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  8. 8. dziban303 4:05 pm 07/23/2013

    I started using an e-cig a few years ago and I haven’t smoked an “analog” since. I don’t know many other who vape so I can’t offer anecdotal evidence about “dual-use” other than that I didn’t have a problem at all.

    I feel much better these days–as others have said, I don’t run short of breath after exertion. I can jog again. “Smoker’s cough” is gone–always used to be a problem when I laughed really hard, but no more.

    So at this point in time I think it was a good call.

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  9. 9. ssm1959 4:55 pm 07/23/2013

    Clearly “safe” depends on definitions. Are they better than smoking tobacco; most likely. However for diseases where nicotine was the primary player there is no advantage. To the contrary these could be worse because of the presumed safety of these items by the public.

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  10. 10. Alan Selk 5:15 pm 07/23/2013

    “Clearly “safe” depends on definitions. Are they better than smoking tobacco; most likely. However for diseases where nicotine was the primary player there is no advantage. To the contrary these could be worse because of the presumed safety of these items by the public.”

    The problem with the above statement is that there are no diseases associated with nicotine. Nicotine has essentially the same health effect as caffeine, meaning there is a temporary increase in blood pressure and heart rate, but it does not cause hardening of the arteries or cancer. The presumed safety by the public is in fact true. It is the presumption that nicotine (and in fact tobacco) are the cause of diseases that is the problem and leads to confusion. It’s inhaling smoke that kills. Get rid of that and you eliminate about 99% of the harm.

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  11. 11. letsbehonest 6:48 pm 07/23/2013

    We could have a long discussion about the effects of nicotine, but the bottom-line is that the amounts consumed in tobacco, ecigs and NRT do not cause illness and are not dangerous. The problem with nicotine is that it is in tobacco, and that keeps people smoking. Nicotine by itself, in small quantities, is harmless. I can’t find any information about actual nicotine mortality other than from industrial exposure from 100 years ago or a few intentional poisonings. However, I’d be very concerned about children getting a hold of a pack of nicotine gum.

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  12. 12. Alan Selk 1:45 am 07/24/2013

    Even nicotine associated with tobacco is of little harm. The reason we know that long term nicotine use has so little harm is because of the many studies on Swedish snus that show snus users have essentially the same life expectancy as non-tobacco users.

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  13. 13. Russell Seitz 6:44 am 07/24/2013

    Thirteen years ago I editorialized against legisaltive indifference to smoker’s health by calling for the development of cigarettes as low in tar as they were high in nicotine. If Glantz and Newman were other than crypto-puritan social engineers, they would be rejoicing at an invention that virtually eliminates the pyrolytic carcinogens that arise from burning everything from tobacco leaves to toast, or roasting anything from coffee to chestnuts.

    If they fear all they list at the molecular level, they should flee in terror at the sight of a lighted candle, let alone a car.

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  14. 14. momsold 10:11 am 07/24/2013

    it took five frigging tries to get to this comment box..get it right.
    I resent the term “lighting up” as non smokers might think it implies using fire..it does not, you dont ‘light up” an ecig..its got a battery and its simply vapor. Non smokers will always think you are as one lady put it, ‘smoking one after the other’ when that is not possible. I smoked for 52 years and since I got my first e-cigarette haven’t touched another real one. my health improved, my teeth look whiter and no stinks, ashes, butts or ashtrays now [which have become candy dishes. If I will still be persecuted by the very loud minority that gets its way constantly, I shall go back to the real thing and blow the smoke in their faces.

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  15. 15. Ron Martin 9:54 pm 07/25/2013

    As an older male who was addicted to smoking – a lot – over fifty years, I found quitting very difficult. I finally tried out an ecigarette and found that it served as a great substitute.
    I have not smoked tobacco for about three years now. My health is not great, (due to all those years of smoking), but I’m doing much better now!
    I am convinced that quitting cigarettes would have been probably impossible without the ecigs.
    Purely anecdotal information, certainly, but it has worked for me.
    I was asked to NOT use an ecig in a Red Lobster in Virginia and I asked for a reason. There was none other than it was ‘restaurant policy.’ Not helpful . . .

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  16. 16. ChrisUp2Late 5:18 am 07/27/2013

    This is a deeply disturbing story. It distorts science and weakens trust in public health research and health promotion. Why would Scientific American publish such nonsense?

    Dr. Glantz grants that e-cigarettes are safer than tobacco cigarettes. Given his history of opposition to these products, that’s a start.

    When asked: “Do you agree with the harm reduction people that e-cigarettes are a safer alternative for smokers?”

    Glantz states: “If smokers switched entirely from conventional cigarettes to e-cigarettes, no one started smoking because of e-cigarettes, and e-cigarettes did not discourage quitting, smokers would be better off.”

    Let’s parse that statement… It has just three parts.

    PART 1: SMOKERS WOULD BE BETTER OFF!

    If Dr. Glantz truly believes that smokers would be “better off” if they “switched entirely from cigarettes to e-cigarettes” — and there is growing evidence to support that view — then, this would have been a perfect moment to end the interview.

    But then he goes on to claim that e-cigarettes contain “chemicals known to cause cancer, birth defects, or other reproductive harm” that must (according to California’s Prop. 65) be reported annually to citizens by the Governor. He lists 10 such chemicals. What he doesn’t say is that these same chemicals are present in government approved nicotine replacement products — and at levels higher than in e-cigarettes.

    Worse, he doesn’t mention that it is not EXPOSURE to chemicals that is important, but DOSE. Formaldehyde is exhaled with every breath taken by every human on the planet. If you want to convince anyone that e-cigarettes are harmful, find data that shows dangerous exposure levels. Otherwise, we need to outlaw breathing. Anyone can produce a frightening list of carcinogenic chemicals — you need to convince me that the levels present are harmful. There is no evidence that levels of these chemicals in e-cigarettes are of concern to human health (for the user or bystanders). This is just fear-mongering at its worst. I can understand local news hacks, but shame on Scientific American!

    PART 2: BUT NON-SMOKERS MIGHT START!

    Dr. Glantz is concerned that non-smokers might start smoking “because of e-cigarettes.” This would be a convincing argument if there were any evidence in its favor. But there is no such evidence. All of the studies to date indicate that e-cigarettes are being used by current (and typically long-term) smokers to reduce, replace, or eliminate their consumption of tobacco cigarettes. There is absolutely no evidence for any “gateway effect” for e-cigarettes. They are not cool, kids don’t use them. And if they did, they would find tobacco cigarettes disgusting. Again, Scientific American, there are published studies — check your facts!

    PART 3: AND SMOKERS MIGHT NOT “QUIT”

    The notion that e-cigarettes might somehow “discourage quitting” is actually a non-sequitor. If someone is puffing on an e-cigarette, they are not puffing on a tobacco cigarette. You can’t do both at the same time. But this raises the dreaded idea of “dual-use” — that people might use e-cigarettes when they can’t use tobacco and thereby delay or avoid quitting tobacco.

    That is certainly possible, but we really don’t have any data yet — people are busy opposing e-cigarettes before studying how they might be used. Conventional wisdom would argue that every tobacco cigarette NOT smoked is a step in the right direction for smokers. Don’t family physicians press smokers to at least reduce the number of cigarettes they smoke? Don’t we already have solid data on the benefits of cutting down? Don’t we already prohibit smoking tobacco in ‘enough’ places to discourage smoking?

    Wait! What about the dangerous “second-hand vapor”? It would be dangerous if it was dangerous, but current data suggests otherwise. (again, check your facts)

    But none of that touches on the issue of whether e-cigarettes are actually effective in reducing tobacco use. To my mind, that doesn’t matter. We don’t need to wait for randomized controlled trials, we need only agree with Dr. Glantz that smokers (not non-smokers, not children, just smokers) would be “better off” if they switched.

    You will surely see from the comments posted here that many long-term tobacco users claim to have “stopped smoking” or “substituted” tobacco cigarettes for e-cigarettes. Perhaps no one is moved by such anecdotal evidence. The newly formed “vaping community” is rife with such stories — but anecdotal evidence is unlikely to influence Dr. Glantz. Maybe all of those people would have quit smoking anyway, or in spite of this dangerous new e-cigarette? Maybe they’re deluded into thinking this new e-cig gimmick helped? Maybe they’re deluded into thinking their health has improved? Yep, it’s just another placebo effect somehow brought on by the recent foray of Big Tobacco into the e-cig market… Sure, they may be deluded, but they’re not smoking.

    Perhaps Dr. Glantz is not moved by a recent study of cessation in a group of smokers who were specifically selected because they had NO intention of quitting or reducing smoking and who were given out-dated, ill-functioning e-cigarettes, and yet many managed to quit or reduce their smoking. (Note: he has argued quite strongly against this study — please don’t take my word for it, I would encourage readers to explore this issue more fully — it doesn’t matter, they are not smoking — isn’t that the point?)

    In any case, it has become clear to me that evidence and data is not important to Dr. Glantz — nor it seems to Scientific American.

    That would be sad enough were it not for the more important public health implications. Make no mistake about it: Lives are at stake here.

    You can oppose electronic cigarettes all you like, but you need to be very careful that you are supporting not tobacco when you do.

    Link to this
  17. 17. ChrisUp2Late 5:26 am 07/27/2013

    Correction: You can oppose electronic cigarettes all you like, but you need to be very careful that you are NOT supporting tobacco when you do.

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  18. 18. Ericka 4:53 am 07/30/2013

    I guess e-cigarettes are just what what we need to lessen the trash of the regular cigarettes. However, the creators must also consider how they’re going to distribute them.

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  19. 19. cassidyt 9:40 pm 07/31/2013

    Personally I found electronic cigarettes to be way better for my health. After switching my taste buds regenerated, my sense of smell came back and after a year my lungs are almost healed. Here’s where I buy my stuff if anyone’s interested: TheWorldOfVapor.com

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  20. 20. rexfreiberger 9:36 pm 08/2/2013

    The fact we haven’t found major harmful effects YET does not mean we will. Yes, there needs to be regulation, but I strongly disagree that ecigs aren’t an effective smoking cessation product. I blog more about it at my website License To Vape http://www.licensetovape.com . I’ll have to find the link but a major study recently came out of Italy showing 66% of smokers who tried quitting with ecigs were successful. This is twice as much as the 33% that is the norm from previous studies. Facts matter, even if they are a rock in the tiger’s paw.

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  21. 21. EKeller 4:38 pm 08/4/2013

    If Glantz truly believes smokers would be better off if they switched completely to electronic cigarettes, he needs to reexamine his behavior. Exaggerating the health hazards of e-cigarettes is exactly the wrong way to go about convincing dual users to make the switch. The authors of a recent article in the journal, Psychology of Addictive Behaviors, described how misinformed smokers are about the relative risks of cigarettes versus smokeless tobacco. All smoker groups incorrectly believed snus is as likely, if not more likely, than smoking to cause all smoking-related diseases except lung cancer. They stated,”Increased knowledge of the relative health risks might give smokers an incitement to switch to snus and prompt current dual users to stop smoking completely. Awareness could be improved by tailoring information at targeted groups, for example via the health care system.”

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  22. 22. monkinsane 3:45 am 08/6/2013

    Everyone, please ignore this article, for the truth, see:

    Levels of selected carcinogens and toxicants in vapour from electronic cigarettes – http://www.ncbi.nlm.nih.gov/pubmed/23467656

    Health-related effects reported by electronic cigarette users in online forums – http://www.ncbi.nlm.nih.gov/pubmed/23567935

    Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol – http://www.ncbi.nlm.nih.gov/pubmed/23526962

    Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function – http://www.ncbi.nlm.nih.gov/pubmed/23363041

    Comparison of the effects of e-cigarette vapor and cigarette smoke on indoor air quality – http://www.ncbi.nlm.nih.gov/pubmed/23033998

    Comparison of electronic cigarette refill fluid cytotoxicity using embryonic and adult models – http://www.ncbi.nlm.nih.gov/pubmed/22989551

    Acute effects of electronic and tobacco cigarette smoking on complete blood count – http://www.ncbi.nlm.nih.gov/pubmed/22858449

    Short-term pulmonary effects of using an electronic cigarette: impact on respiratory flow resistance, impedance, and exhaled nitric oxide – http://www.ncbi.nlm.nih.gov/pubmed/22194587

    EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study – http://www.ncbi.nlm.nih.gov/pubmed/23826093

    And there are many more, see for more: http://tobaccoanalysis.blogspot.co.uk

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  23. 23. Joshjack 4:03 am 08/12/2013

    Try using an ecigarette UK for a refreshing feel, because it frees you from the health hazards related to smoking.

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  24. 24. ploevland 7:48 am 08/13/2013

    Well this is awkward, at Dampguiden (a Danish e-cig site) we regularly make our own surveys and most of them show that the majority of users quit normal cigarettes completely or reduce it to 1-3 cigarettes/day so how they come up with those numbers is hard to say – maybe we’re just different in Denmark :-)

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  25. 25. niam andrews 8:18 pm 08/17/2013

    Tougher regulation is one thing but rejecting electronic cigarettes totally is on the extreme. I would suggest reading more facts about ecigs before presenting any conclusive remarks.

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  26. 26. JustGimmeSomeTruth 4:38 pm 08/28/2013

    Yeah not a good sign that the article starts off with all this biased and misleading language about the friend “wanting to believe” and “smoking” and “lighting up her ecig.” WTF?

    And this: “showed e-cigarette users being less successful at quitting.” Whaa? That is an extremely suspect result, there’s just no way that could be… Literally any smoker I’ve turned on to e-cigs has quit completely, save one… and that exception reduced their analog use down to 5 or 10% of what they were using before. The anecdotal evidence is just overwhelming, and this assertion flies in the face of my own personal observations. Don’t believe it.

    And just in general this Proposition 65 crap is misleading because it doesn’t talk about HOW toxic these chemicals are, or what sort of exposure could be expected from e-cig use (and I don’t even really believe there are all those chemicals in any significant portion of ecigs… what was the setup they tested? How wide-in-scope was their sampling? DIY-style, or pre-filled? etc. etc.)

    I like how he says “If smokers switched entirely from conventional cigarettes to e-cigarettes, no one started smoking because of e-cigarettes, and e-cigarettes did not discourage quitting, smokers would be better off.” Well, guess what, that’s exactly what the reality is for the overwhelming majority of ecig users, so you just disproved your own supposed stance/argument. Good grief.

    One of the most frustrating threads I’ve noticed is that throughout all the “Are e-cigs safe?” nonsense there is this idea that it “encourages a culture of smoking” or somehow makes people think it’s “okay to smoke.”

    NO! On the contrary, it IS NOT SMOKING, so it DOES NOT ENCOURAGE SMOKING. Period. It “encourages” vaping at the very worst (not even sure it does that– recent study showed kids were totally indifferent to e-cigs). The word “e-cig” is unfortunate because an e-cig device and an analog cig could not be further from each other in terms of how they function. The only thing they have in common is that they deliver nicotine through inhalation (which, coincidentally, is what “Nicotrol” inhalers do as well, with most of the same substances like PG etc. and nobody questions their safety)…. other than that, it is completely different.

    And the genius of ecigs is they eliminate the SINGLE most significant obstacle to quitting, which is CHANGING THE BEHAVIOR. These puritan abstinence people like this doctor being interviewed are totally unrealistic in their expectation, and obviously don’t understand human behavior. Changing ingrained or addictive behavior is extremely difficult, and probably impossible for some. So, just as we drink fat-free milk, or eat sugar-free ice cream, you make the BEHAVIOR ITSELF healthier, thus eliminating the main obstacle of trying to change behavior.

    I find it completely immoral that doctors or officials would come out against e-cigs, or create this false “debate” or doubt surrounding them– how many uninformed smokers are they condemning to die by spreading this disinformation? It is simple common sense, there is NO DOUBT whatsoever that ecigs are FAR safer than real cigs (the question of complete harmlessness is not even a standard that any other product is held to, so it’s moot here and why should ecigs be held to that standard? Everything is harmful to some degree, even oxygen, c’mon now)… so are we really not going to encourage a safer alternative when it exists?

    People always say to me “but you’re STILL addicted to nicotine, so you haven’t really quit.” And I say, well you’re still addicted to COFFEE, and CRAPPY REALITY SHOWS, and BACON, but nobody’s giving you the business about those… And I also explain that nicotine itself isn’t what causes cancer, and so you need to think of vaporizing nicotine in the same way you think about those other indulgent pleasures that we don’t really regulate that much with laws… Ecigs reduce “being addicted to nicotine” down to the level of having a cup of coffee, or drinking a glass of wine– because that’s the SCALE of the potential harm we’re talking about here. Some sort of graph would be helpful where you’d see that you’d have to puff on an ecig for a year straight to MAYBE equal the harm of a single analog. The scale of the difference is lost with these “Are e-cigs safe?” misleading questions.

    Link to this
  27. 27. RHARLOW12 10:10 am 09/2/2013

    I don’t understand. It’s not tobacco, and its not smoking since there is no combustion. It doesn’t produce any ambient smell either. Yes, it’s a nicotine delivery device but (though I’m not a doctor) it’s not the presence of nicotine that causes all of the health problems associated with smoking traditional cigarettes. I understand that the health regulators haven’t ruled one way or the other on the safety of these, but I think most reasonable people can agree that at worst they are almost certainly far safer than traditional cigarettes. And they can even be used to help people quit smoking traditional cigarettes. You can refer a better details on here http://www.the-e-cigarette.org/

    Link to this
  28. 28. Dancig.dk 4:10 am 10/4/2013

    In the Danish market e-cigarettes are getting more and more popular … also Danish studies show that people are smoking less cigarettes when chancing to e-cigarettes and some are even stopping with both products. On http://www.dancig.dk we are only selling well tested products and e-juice produced inside EU. This way we don’t end up with people getting poisoned by lets say Chinese badly produced e-juice.

    Link to this
  29. 29. ecigarettesJak 8:57 am 10/30/2013

    Without any burning tobacco, White Cloud electronic cigarettes won’t drop ashes on the carpet or burn a hole through your car seat. Less than half the cost of tobacco cigarettes. Please-CALL 859-539-8167
    511 SOUTHLAND DRIVE, LEXINGTON KY.
    electronic cigarettes Lexington ky

    Link to this
  30. 30. Puffweb 5:26 pm 11/4/2013

    Well, it is one thing to say that we are not completely certain if electronic cigarettes are totally safe, but I think it is quite another to not admit they are better than cigarettes. I filmed a though video on the matter, would love to hear your guys thoughts. You can find it at http://www.puffweb.com/are-ecigs-safe/

    Link to this
  31. 31. CreativeLifer 2:39 am 12/3/2013

    The harm reduction model works especially well with this population. Smokers tend to be in denial and internally they are fighting off a behavioral and biological war. Working with people and not against them is awesome http://helpingquitsmoking.com

    Link to this
  32. 32. CigaretteLovers 8:04 am 12/7/2013

    I agree that there needs to be strong regulation around the sale and use of e-cigarettes but there are studies that show rcigs are an effective tool in helping people to give up tobacco cigarettes. I have written more on the topic at my website Cigarette Lovers http://cigarettelovers.com . A study recently came out of Germany showing 72% of smokers who used electronic cigarettes were successful in kicking their smoking habit. This is a significant increase in those who try to go cold turkey and even those who use other NRT products like patches, gum etc.

    Link to this
  33. 33. Anna Bown 6:20 am 01/7/2014

    Great Post! Thanks to share with me.

    http://www.uk-ecig-reviews.co.uk

    Link to this
  34. 34. Emilio6 12:42 pm 02/13/2014

    Thanks for great article. I’m smoking e-cigarettes for last 4 years and my health and lungs are perfect. No problems with sport activities like running or kick boxing. I’m waiting for more researches.
    Regards,
    Emil
    http://vapourplanet.co.uk

    Link to this
  35. 35. NicoleCarter 7:02 am 06/29/2014

    It’s a bit too early to judge whether there really are any potential health risks using e-cigs,and if YES, what are they, especially when comparing to how many people die from tobacco related illnesses each DAY. I agree that this market has to be regulated and as we know that there are certain precautions EU government has already taken so a lot is to change in 2016 and coming years.
    Nicole: http://ecigsuk.org.uk

    Link to this
  36. 36. Robert007 10:30 am 08/18/2014

    E Cigs are an alternative and there have been plenty of studies carried out by respected scientists and institutions.

    I for one have used them to great success and I wasn’t looking at quitting smoking, this is a good solution for me get my intake of nicotine.

    Link to this
  37. 37. johnsimon 8:22 am 09/22/2014

    I believe that e cigarettes represent the future of smoking and there is need for more study to donr to them. Compared to big tobacco and its body count…e cigarettes seem to offer a cheaper and better alternative like what they say in this article and on ecigarettesolutions.com

    Link to this
  38. 38. JohnYou1 2:17 pm 09/29/2014

    Great writing ever I have seen.Smoking must never be stopped but its regulation authority must take preventive actions against low quality products as well as e cigarettes.Because it is becoming popular day by day if they fail to maintain quality in future young people who will addict by http://www.ub-electronic-cigarette.co.uk/ego-c-starter-kit.html>UB eGo cig kit will lost their valuable life.

    Link to this
  39. 39. JohnYou1 2:19 pm 09/29/2014

    http://www.ub-electronic-cigarette.co.uk/ego-c-starter-kit.html

    Link to this

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