Electronic cigarettes: Not a safe way to light up
E-cigarettes are popular alternatives to regular cigarettes, but are they safe?By Mayo Clinic Staff
If you've considered trying electronic cigarettes, you might wonder if they're really a safer or healthier option or if they can they help you quit smoking. Here's what you need to know about e-cigarettes.
How do they work?
Electronic cigarettes are battery-operated devices that heat a liquid solution (usually but not always containing nicotine), turning it into a vapor that can be inhaled. They are often called e-cigarettes, e-vaporizers or electronic nicotine delivery systems. Using e-cigarettes is often referred to as vaping.
Some e-cigarettes resemble traditional cigarettes, cigars or pipes. Others look like pens or flash drives or have completely different designs. E-cigarettes can be disposable or refillable. Most use a cartridge — disposable cartridges are sometimes called pods — or have a refillable reservoir or "tank" to hold the liquid, also called e-liquid or e-juice. The liquid typically contains nicotine, flavorings, propylene glycol and vegetable glycerin.
The strength of an e-cigarette is determined by the amount of nicotine in the e-liquid and is expressed in milligrams per milliliter or as a percentage. However, studies have raised concerns that product labels don't always provide accurate information about nicotine content. Some pods contain a concentrated form of nicotine called nicotine salt. A pod containing 5% nicotine salt may have as much as 30 to 50 milligrams of nicotine, the equivalent amount of nicotine delivered in one to three packs of cigarettes.
Are e-cigarettes safe?
In mid-2019, U.S. state health departments reported more than 200 potential cases of serious lung illness associated with use of vaping devices. A specific device or e-juice hasn't been determined. These cases have raised concerns that vaping may cause lung damage. The Centers for Disease Control and Prevention recommend that people stop using e-cigarette products while the organization investigates the cause of the lung illnesses.
Because e-cigarettes don't burn tobacco, most experts agree that e-cigarettes are likely to cause fewer harmful effects than are traditional cigarettes. But some e-cigarettes may contain harmful substances, such as carcinogens, toxic chemicals and delta-9-tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana.
E-cigarettes containing nicotine aren't considered safe for adolescents, young adults or pregnant women. Nicotine can harm brain development in children and young adults into their early 20s and is toxic to developing fetuses. Children and adults have also been poisoned by swallowing, breathing or absorbing e-cigarette liquid through their skin or eyes, according to the Centers for Disease Control and Prevention.
In youth and adult nonsmokers, e-cigarette use also poses the risk of a nicotine addiction. This could lead to long-term use of e-cigarettes, the effects of which aren't known, or to the use of traditional cigarettes. Research has shown that teen use of e-cigarettes is on the rise and associated with increased future use of traditional cigarettes.
Rarely, e-cigarettes can cause severe harm. Defective e-cigarette batteries have caused fires and explosions, mostly while the batteries are being charged.
Will e-cigarettes help me quit smoking?
E-cigarettes aren't approved by the Food and Drug Administration (FDA) as a quit aid.
Studies to test whether e-cigarettes can help people stop using tobacco have had inconsistent results. Limited research suggests that using only e-cigarettes containing nicotine to quit smoking can be effective short term compared with using medicinal nicotine replacements. But there isn't enough evidence comparing the safety and effectiveness of using e-cigarettes to quit smoking and established evidence-based treatments. E-cigarettes might be appropriate only in those unwilling to try evidence-based smoking cessation therapies or who haven't had success with such therapies.
If you use e-cigarettes to quit smoking, remember that your goal is to completely quit using all tobacco products. Also, the dual use of e-cigarettes containing nicotine and traditional cigarettes is strongly discouraged.
If you're looking for help to stop smoking, there are several FDA-approved medications that have been shown to be safe and effective for this purpose. A combination of medication and counseling has been shown to work best.
Because of the unresolved safety concerns and because the research on e-cigarettes as a stop-smoking aid is inconclusive, Mayo Clinic doesn't recommend use of e-cigarettes as a way to quit smoking.
If you want to stop smoking, call 800-QUIT-NOW (800-784-8669) to connect to your state's quit line or call the Mayo Clinic Nicotine Dependence Center at 800-344-5984 (toll-free).
Sept. 07, 2019
See more In-depth
- Electronic nicotine delivery systems or e-cigarettes: American College of Preventive Medicine's practice statement. American Journal of Preventive Medicine. 2019;56:167.
- American Cancer Society position statement on electronic cigarettes. American Cancer Society. https://www.cancer.org/healthy/stay-away-from-tobacco/e-cigarette-position-statement.html. Accessed Jan. 9, 2019.
- Cullen KA, et al. Notes from the field: Use of electronic cigarettes and any tobacco product among middle and high school students — United States, 2011–2018. MMWR Morbidity and Mortality Weekly Report. 2018;67:1276.
- Soneji S, et al. Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: A systematic review and meta-analysis. JAMA Pediatrics. 2017;171:788.
- Zare S, et al. A systematic review of consumer preference for e-cigarette attributes: Flavor, nicotine strength, and type. PLOS One. 2018;13:0194145.
- What do we know about e-cigarettes? American Cancer Society. https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html. Accessed Jan. 9, 2019.
- Vaporizers, e-cigarettes, and other electronic nicotine delivery systems (ENDS). U.S. Food and Drug Administration. https://www.fda.gov/tobaccoproducts/labeling/productsingredientscomponents/ucm456610.htm. Accessed Jan. 9, 2019.
- Hajek P, et al. A randomized trial of e-cigarettes versus nicotine-replacement therapy. New England Journal of Medicine. 2019;380:629.
- Electronic cigarettes (e-cigarettes). National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes. Accessed March 13, 2019.
- About electronic cigarettes (e-cigarettes). Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html. Accessed Jan. 9, 2019.
- What we know about electronic cigarettes. National Cancer Institute. https://smokefree.gov/quit-smoking/ecigs-menthol-dip/ecigs. Accessed Jan. 9, 2019.
- Hays JT (expert opinion). Mayo Clinic, Rochester, Minn. Accessed March 14, 2019.
- CDC, FDA, states continue to investigate severe pulmonary disease among people who use e-cigarettes. Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2019/s0821-cdc-fda-states-e-cigarettes.html. Accessed Aug. 29, 2019.
- Initial state findings point to clinical similarities in illnesses among people who use e-cigarettes. Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2019/p0906-vaping-related-illness.html. Accessed Sept. 6, 2019.