Electronic Cigarettes

With the recent emergence of the electronic cigarette (‘e-cigarette’) as a popular replacement for traditional smoking there is growing demand to identify if this really is a safer alternative to smoking tobacco. In 2013 there is reported to be approximately 1.2 million electronic smokers within the UK in 2013.

The e-cigarette is a battery powered electronic nicotine delivery device that looks very similar to a conventional tobacco cigarette that is capable of emulating smoking. Each e-cigarette device has either a cartridge or chamber that has liquid containing nicotine, water, glycol, glycerine and flavourings. The individual inhales the e-cigarette like a normal tobacco cigarette and a water based vapour is created through an atomiser within the e-cigarette. The visual effects are very similar to that of traditional tobacco smoking and users of e-cigarettes have identified that as being the closet alternative to smoking tobacco, available on the market today.

E-cigarettes have varied appearance from a traditional cigarette to a much larger electronic device.

Users report buying them to help quit smoking, to reduce cigarette consumption, to relieve tobacco withdrawal symptoms due to workplace smoking restrictions and to continue to have a ‘smoking’ experience but with ‘reduced health risks’.

To date there is no specific scientific evidence to definitively suggest that this is a safe alternative, however there is growing evidence to suggest that it could be a safer alternative to tobacco cigarettes (Cahna & Siegelb 2011).

Recent researchers looked at the toxicity of the vapour and liquid and has identified that the levels of toxicants are up to 450 lower than in cigarette smoke (Goniewicz et al 2012). Traditional cigarettes can contain up to 7,000 toxins many of which are carcinogenics and hazardous to an individual’s health and persons inhaling the second hand smoke.  There has been some limited research performed on vapour from e-cigarettes however this has only been animal based, this research reported that there were no symptoms or side effects following significantly high levels of exposure.

The majority of research is limited to surveys in which individuals report minor side effects which include mouth and throat irritation. Many users report a great success rate and being able to reduce or stop tobacco consumption, however many of their published studies are potentially bias due to recruiting individuals from e-cigarette websites rather than objectively tested.

In December 2013 there was government guidance with regard to the use of the product and the commencement of the product being regulated which will come into force from 2016. This will allow the e-cigarette to be prescribed by medical professionals and come under the UK medicines regulation, which has come under the guidance and recommendation from the British medical association by licencing e-cigarettes. This is likely to produce a safer product that is well regulated and is less likely to contain additives that may cause significant ill health effects to individuals.

Currently e-cigarettes do not come under the regulations related to the ‘Smokefree’ law within the UK, which bans tobacco smoking in public places such as bars restaurants, public transport and work places. However individual establishments and companies are implementing their own rules in relation to individual’s use of e-cigarettes.

Many employers are beginning to review the use of e-cigarettes within their facilities, the main concerns are related to the safety of the product. There is the possibility that some e-cigarette vapours could be a health risk to persons exposed to them, similar to that of passive smoking. There are also concerns that normalising smoking behaviours could potentially promote the use of e-cigarettes which could have a negative effect and potentially encourage individuals to start using an e-cigarette or even start smoking tobacco. Many work places are treating the use of e-cigarettes the same as tobacco smoking and ensuring that individuals adhere the same work place rules, until further evidence is available in-relation to the effects on individuals health and that of persons exposed to the second hand vapour.

Professor Robert West from Cancer Research UK was report to say that e-cigarettes are more than 100 times safer for smokers than traditional tobacco smoke. It must be remembered that there is no reported safe level of tobacco smoke and that nicotine is a highly addictive substance. E-cigarettes could be considered a better alternative to smoking tobacco; the current medical advice is that regulated and licensed nicotine replacement therapies should be considered as the first choice when individuals are considering stopping smoking.

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