May 04, 2023
Electronic cigarettes have become quite popular the last few years. But many questions remain about their safety.
"It's important for people to understand that e-cigarettes exist in a grey zone as far as regulation goes," said Stephen Thornton, MD, toxicologist and medical director for The University of Kansas Hospital Poison Control Center. "If people are under the impression there is any quality control or safety measures, they're mistaken."
We've gathered what we do know and what we don't to best address these questions.
What Are E-cigarettes?
- There are many different brands. Those brands change often.
- Most e-cigarettes are not manufactured in the U.S.
- Each brand is a bit different, but most contain:
- A battery
- A heating coil
- A vaporizing chamber
- Cartridges that fit into the chamber
The cartridges are filled with a solution commonly called "e-liquid" or "e-juice." This solution typically contains variable amounts of nicotine usually dissolved in propylene glycol or a similar solvent. Sometimes these solutions have less or even more nicotine than regular cigarettes. They're also available in different strengths and flavors. Studies have shown that the listed strengths or concentrations of nicotine in these solutions may not be accurate.
How Do They Work?
The battery heats the liquid nicotine that's contained in the cartridge. The user then inhales the vapor from the heated liquid. This process is called "vaping."
Are E-cigarettes Safe?
The U.S. Food and Drug Administration does not yet test or regulate e-cigarettes. So the makers do not have to follow any quality control guidelines or safety standards.
Right now, users of e-cigarettes have no way to know exactly what chemicals or materials they're made of. In addition, very little research has been conducted – particularly any long-term studies. What research has been discovered is alarming.
- Some cartridges contain cancer-causing ingredients and other toxic chemicals.
- Most cartridges contain propylene glycol, which can irritate the lungs when inhaled.
- E-cigarettes generate secondhand vapor, which has been shown in studies to contain nicotine, though usually at very low levels.
What Don't We Know About E-cigarettes?
Simply put, there are more things we don't know about e-cigarettes than we do.
- We don't know what materials are used to construct the tubes and the working parts of e-cigarettes.
- We don't know what chemicals or their concentration in the liquids is used in the cartridges.
- We don't know the immediate side effects or risks of inhaling the liquid.
- We don't know the long-term health effects of e-cigarettes.
- We don't know what's in the secondhand e-cigarette vapor and whether it's harmful.
In terms of cancer or lung damage, vaping with e-cigarettes might be safer than smoking traditional cigarettes because it doesn't involve burning material that causes disease.
"It's important to understand we are not saying it's safe," said Dr. Thornton. "We're saying it's safer. It's all relative risk – like choosing between jumping from a 20-foot building or a 40-foot building. Ideally, you would not do either."