Is 'Vaping' Better Than Smoking?

A growing number of smokers are turning to electronic cigarettes (e-cigarettes) to get their nicotine fix instead of smoking traditional cigarettes. Is "vaping" better than smoking? The e-cigarette industry would like us to believe that it is. But more research needs to be done, and federal regulation is needed.

The Food and Drug Administration (FDA) currently does not regulate the manufacture, marketing and sale of e-cigarettes. In New York State, they cannot be sold to minors, but other states are still trying to determine how to deal with this relatively new product. As Mitch Zeller, Director of the FDA's Center for Tobacco Products, has said, "Right now, it's the wild, wild west." Buyer beware.

E-cigarettes contain liquid nicotine cartridges. Because they are not regulated and standardized, e-cigarettes contain widely varying levels of nicotine, which is a highly addictive drug. Nicotine can be lethal if delivered in high doses. There is also no standardization of the type of liquid nicotine in the cartridges. A new study shows they contain volatile organic compounds, and the FDA has warned that e-cigarettes "contain carcinogens and toxic chemicals."

E-cigarettes can be sold without a license, so you can find them in most convenience stores, even those that don't sell tobacco products. They are sold in dozens of candy and fruit flavors (including chocolate, cola, cherry and bubble gum) that appeal to youth.

E-cigarettes are big business. This year, e-cigarette retail sales could hit $1 billion. If online sales are included, the figure jumps to $1.7 billion. Wanting a piece of the profits, Big Tobacco companies including Altria, Reynolds American and Lorillard have all announced plans to launch new or revamped e-cigarettes.

A few tobacco control advocates argue that e-cigarettes show promise because they may be less harmful than traditional cigarettes. But we've heard the "reduce risk" sales pitch before. Indeed, some current e-cigarette ads are strikingly similar to the deceptive ads Big Tobacco used to mislead people into believing they could reduce their risk by switching brands or converting to "lite" cigarettes.

Some suggest that e-cigarettes can be a valauble tool to help smokers quit. However, when the FDA tried to regulate e-cigarettes as cessation devices that delivered nicotine, the e-cigarette industry sued the FDA to prevent them from doing so. According to the Centers for Disease Control & Prevention (CDC), "There is currently no conclusive scientific evidence that e-cigarettes promote long-term cessation, and e-cigarettes are not included as a recommended smoking cessation method by the U.S. Public Health Service."

Simply put, we need additional studies to gather data on safety and efficacy as a cessation aide, and e-cigarettes need to be regulated.

In the meantime, the industry is aggressively marketing e-cigarettes, including television ads that use popular celebrities to sell them. Enticed by cheaper prices, fruit-flavors and "vaping" movie stars, we are concerned that youth and new smokers will use e-cigarettes as nicotine starter kits that could lead them to smoking traditional cigarettes and a lifetime of nicotine addiction. A recent survey conducted by the Florida Department of Health found that e-cigarette use among our youth is on the rise. The study showed that 8.4% of public high school students tried electronic cigarettes in 2012, a 40% increase since 2011.

Dr. Margaret A. Hamburg, the FDA's Commissioner of Food and Drugs, has said, "The FDA is concerned about the safety of these products [e-cigarettes] and how they are marketed to the public."

We are too. We want to protect the next generation from a lifetime of nicotine addiction.

 

9 Terribly Disturbing Things About Electronic Cigarettes

By now, you've probably seen them being smoked on the subway or in a bar -- those shiny, futuristic, battery-operated nicotine inhalers better know as electronic cigarettes that are apparently all the rage these days. Big Tobacco companies have taken notice, too, and are determined to cash in on the industry, which is expected to bring in $1.7 billion in U.S. sales this year alone, according to The New York Times.

While much is still unknown about the health risks of e-cigarettes, here's what we do know: E-cigarettes are addicting. And while they may not be as harmful as tobacco cigarettes, critics like the British Medical Association and the World Health Organisation are wary of the trend and warn of the dangers that may be associated with the smoking devices.

Here's what we do know about e-cigarettes:

1. E-cigarettes contain toxic chemicals.

A 2009 FDA analysis of e-cigarettes from two leading brands found that the samples contained carcinogens and other hazardous chemicals, including diethylene glycol, which is found in antifreeze. Last year, a report from Greek researchers found that using e-cigarettes increased breathing difficulty in both smokers and non-smokers, according to Medical News Today.

2. Kids and teens can buy them.

Unlike other tobacco products, e-cigarettes can be sold to minors in many places throughout the country. The smoking devices can also be bought legally online, according to the Wall Street Journal.

3. While cigarette companies say they don't market to kids, e-cigarettes come in flavors like cherry, strawberry, vanilla and cookies and cream milkshake.

4. Laws regulating cigarette ads don't yet apply to e-cigarettes.

TV commercials for cigarettes may be banned, but ones for e-cigarettes sure aren't, Adage points out. (The above ad for Blu eCigs features Jenny McCarthy.)

5. And e-cigarette companies are spending a TON on advertising.

Industry advertising spending increased to $20.8 million in 2012 from just $2.7 million in 2010, according to The New York Times.

6. E-cigarettes can be used in many places where smoking is banned.

Even though some studies suggest that secondhand vapor poses health risks, many lawmakers have yet to determine whether smoking rules apply to e-cigarettes, according to USA Today.

7. People think e-cigarettes can help them quit smoking.

Research published in the American Journal of Public Health indicates that 53 percent of young adults in the U.S. who have heard of e-cigarettes believe they are healthier than traditional cigarettes and 45 percent believe they could help them quitsmoking -- though there is little evidence to support either of these claims.

8. E-cigarettes aren't taxed like traditional tobacco products.

Even though cigarette consumption fell significantly as taxes went up.

9. Despite unknown health consequences, e-cigarettes are poised to make inroads with a new generation of young people.

Half of young adults say they would try e-cigarettes if a friend offered them one, according a study cited by USA Today.

Woman's shock after her e-cigarette EXPLODED when she charged it

By Snejana Farberov

A Georgia woman has invested in an e-cigarette hoping to improve her health and lifestyle, but instead she nearly lost her home when the device blew up.

Elizabeth Wilkowski, of Atlanta, plugged the Chinese-made eHit electronic cigarette into her computer to charge it up before use.

A short time later, the woman said a blast went off, rattling the walls of her Grant Park home. 

Kaboom: Elizabeth Wilkowski describes the moment when her e-cigarette exploded, rattling her entire house

Scorched: The Chinese-made eHit electronic cigarette was charging in a computer USB port when it exploded

'It wasn't a boom, it wasn't a pop... it was a Kaboom!' the shaken Wilkowski recalled to the station WSB-TV. 'I screamed… it was a real freak-out moment.'

The Atlanta resident compared the explosion to a bomb detonation, which shot 4-foot flames across her living room, scorching her couch and rug.

After overcoming her initial shock, the woman grabbed a wet wash rag to protect her hand and yanked the smoldering e-cigarette out of a USB port.

'If I hadn't had been home, I would have lost my dogs, I would have lost my cats, I would have lost my house,' Wilkowski said.

Leonard Rodda, who sold Wilkowski the e-cigarette at his store, has offered to replace it for free with a different model.

'I've only recently heard about that with the battery, and it's a low voltage so I'm surprised that anything like that would happen,' Rodda told the station.

Vapor cigarettes sold under the eHit brand are manufactured by Shenzhen Seego Technology Co. LTD, based out of Shenzhen, China. 

The company unveiled the eHit model earlier this year, boasting on its website that the device is 'using the best raw materials and craft for whole product, which is more and more popular in the market.'

The unit features 'hollow special design for atomizer and battery,' according to its description.

According to the Tobacco Vapor Electronic Cigarette Association (TVECA), there are currently more than 3.5million Americans puffing on the devices.

 

Woman says E-cigarette explosion nearly destroyed home

For more videos, please go to WSB TV

Burn marks: Wilkowski shows the scorched cleaning rag that she used to pluck the smoldering e-cigarette out of her computer

In a phone interview with MailOnline Tuesday, TVECA co-founder Thomas Kiklas said that from the video of the incident involving the Atlanta explosion, it appeared that the e-cigarette may have been mismatched with the charging device.

Another possible explanation could be that Wilkowski may have left the device in the USB port for too long and it got overcharged, according to Kiklas, who compared the smoking gadgets to cell phones or electric toothbrushes.

The co-founder of the trade association said that since 2007, when e-cigarettes first came into use in the U.S., he has heard of only one other incident in which a device exploded.

The first case happened in Florida last February, when Tom Holloway suffered severe injuries when his e-cigarette blew up in his face, ABC News reported at the time.

The 57-year-old Vietnam War veteran and father of three had all of his teeth knocked out and lost a part of his tongue. Fire officials ruled that the blast was likely caused by a faulty battery.

Kiklas insisted that e-cigarettes have an excellent track record, with more than half-a-billion safe uses so far in the U.S. and only two reported incidents in six years.

In October, the Food and Drug Administration plans to roll out a comprehensive policy to regulate the $1billion e-cigarette business, but it is expected that the new rules would pertain mostly to nicotine levels in the devices rather than matters of fire safety.

 

Are E-Cigarettes a Boon or a Menace?

Diane Cole

for National Geographic News

Published September 16, 2013

Electronic cigarettes may produce an aerosol vapor instead of smoke, but two new studies raise burning questions about their uses and risks.

E-cigs—as these battery-operated nicotine inhalers are commonly called—are increasingly popular, with a Wells Fargo financial analyst predicting that U.S. sales will double this year, going up to $1.7 billion.

Their visibility is becoming ever greater as well, with television and online marketing campaigns that feature celebrities like Jenny McCarthy and Stephen Dorff touting the pleasures of what they describe as more socially acceptable, "guilt-free" smoking.

The reasoning behind such claims is that e-cigs, which have the look of conventional cigarettes stylishly updated for the techno-age, produce vapor instead of ash or smoke. They also generally deliver lower amounts of nicotine than conventional cigarettes—a feature that may make e-cigarettes useful as an aid to smoking cessation.

Research Urgently Needed

Whether that is so was the focus of a study published in The Lancet, which concluded that e-cigarettes were statistically comparable to nicotine patches in helping smokers quit over a six-month period.

But this was only the first study to compare e-cigarettes to an already established quitting aid. "There is still so much that is unknown about the effectiveness and long-term effects of e-cigarettes" that more research is "urgently needed," cautioned lead researcher Chris Bullen, director of the National Institute for Health Innovation at the University of Auckland in New Zealand.

In that vein, Alexander Prokhorov, a smoking cessation expert at Houston's MD Anderson Cancer Center who was not involved in the study, commented, "I'm glad that there is finally some tangible research starting to appear." But several aspects worry him. "Nicotine is not a neutral substance," and in addition to being highly addictive, "it can be a poisonous substance."

Because e-cigs mimic the look and rituals of conventional cigarette smoking, there is a danger that rather than e-cigs helping you quit, "you may just switch to this product and continue using it," Prokhorov said. And since a smoker's dependence on nicotine remains, there is a risk for a relapse to smoking conventional cigarettes.

Not a Risk-Free Alternative

Still, wouldn't there be some potential benefit to using only electronic cigarettes as an alternative to conventional cigarettes? "There is no question that e-cigarettes deliver less toxins than conventional cigarettes," said Stanton Glantz, director of the University of California, San Francisco's Center for Tobacco Control Research and Education. They may have as little as one-tenth of the toxins inhaled from burning tobacco, he said. (Related: "Cigarettes vs. e-Cigarettes: Which Is Less Environmentally Harmful?")

But that's not the entire story, he emphasized. "Whereas e-cigarettes are less dangerous than regular cigarettes, in an absolute sense they are negative," because they contain a number of toxic chemicals and ultrafine particles in addition to nicotine, and secondhand e-cig vapor could be harmful.

Moreover, he continued, "most people who use e-cigarettes also continue to use regular cigarettes; they are dual users. That means they are probably suffering all the risks from smoking."

There is also a quality control issue for e-cigarettes, both Glantz and Prokhorov agreed. Unlike prescription nicotine patches, no electronic cigarettes have been approved for therapeutic use by the U.S. Food and Drug Administration.

"Further research is needed to assess the potential public health benefits and risks of electronic cigarettes and other novel tobacco products," said FDA spokesperson Jennifer Haliski. (Although the FDA's authority extends only to those e-cigs marketed for therapeutic purpose, with none having gained approval, it has announced its intention to propose broadening regulations to encompass additional categories of tobacco products that would include all electronic cigarettes.)

That's an important point, said Glantz, because the Lancet study's bottom line is that electronic cigarettes "are no worse than nicotine patches, but they are no better either." That leads to the question: "Why would you use something that has not been tested when there is something [with] quality control and [that] has been tested?"

Gateway Cigs for Teens?

Another question, about the average age of electronic cigarette users, brings us to the second study. This one, conducted by the Centers for Disease Control and Prevention, shows that the number of U.S. middle and high school students using e-cigarettes doubled between 2011 and 2012, bringing the number nationwide who had tried e-cigs to 1.78 million.

That statistic is disturbing, said Tim McAfee, director of the CDC's Office on Smoking and Health, because about 90 percent of all smokers begin in their teens. E-cigarettes may be particularly attractive to youngsters because they are sold in a broad array of flavors, including cherry, vanilla, and even bubblegum.

"We know that this makes these products more appealing to children," he said. "The worry is that it is going to acclimatize kids to the behaviors that are like smoking. Until proven otherwise, we need to assume that this may increase their chances of taking up smoking with burn [conventional] cigarettes." Prokhorov shares that worry.

"My major concern is that this will be a gateway behavior, a potential risk of getting kids hooked on nicotine for life," he said. That's also why Glantz favors greater regulations, including banning the use of flavors (which are prohibited in conventional tobacco cigarettes) as well as prohibiting the sale of e-cigs to minors.

"In the current world, where cigarettes are ubiquitous with a marketing budget of $8 billion a year, we have to be careful and not make it easy" for vulnerable children to start using tobacco, said McAfee, whose budget for the CDC's 2012Tips from Former Smokers campaign was $54 million.

"You go on YouTube and see how e-cigarettes are being glamorized, making smoking look sexy and rebellious," he said, which are the very elements that research has shown will attract kids to smoking. This is why media critics are comparing current e-cig ads to the ubiquitous cigarette ads of the 1950s, he added.

But going back to that era would be a mistake, said Prokhorov. "Psychologically, our society has just started to enjoy a tobacco-free and smoke-free life," he said. "The renaissance of cigarettes in e- or any other form is not a pretty picture."

E-cigs Explained

How it works

The e-cigarettes are some very advanced devices, that's why their functioning may be a little bit unclear. I'll try to explain you step by step how they are made, how should you use it and what makes it different from the analog cigs. The smokeless cigs are devices powered by a battery, in order to turn an aromatic liquid into vapors that contain nicotine, which can be inhaled for satisfying your nicotine need, but all this without any ash, smoke or fire and without any toxic substances released while using them. The fact that there are no burning resulted gases is what makes the e-cigarettes healthier, but vaping also means no tar, and implicitly no bad smell or bad breath.

The first thing you must know about the electronic cigarettes is that they are formed by a cartridge filled with flavored liquid, a component that heats, called atomizer and the battery that powers the whole system. Almost all manufacturers start from this simple scheme, but small customizations is what makes one product better than other ones. As an example, while many still use these 3-pieces cigarettes, some evolved to using only two components, by including the atomizer in the liquid tank. This solution is welcomed mostly because of the leaks that appeared when liquid was transported to the atomizer and the fact that it had to be cleaned almost after every cartridge replacement. By having a compact disposable component, your single job will be to buy enough refills for never to run out of them.

If you think that the price of the e-cigs is too big, you must understand that it also contains a microprocessor that calculates the exact amount of vapors you need and initiates the mechanism according to the pressure you apply while puffing. Another cutting edge component is the pressure sensor, which detects whenever you use it, improving the vaping experience a lot. You may not know, but before using it, you had to press a button each time you used it, consuming much more energy and getting the battery drained in less time. While everything works, you'll see that the e-cigarette has a red LED on the tip, looking exactly like a regular cig and also letting you know that you can start inhaling. Long story short: when the sensor detects you puff, it lets the processor know you're using it and the second one starts the device. The battery offers the necessary energy for all the components, including the atomizer. That's when the diode lightens, showing it started working, and the heating part starts getting hot and turning the flavored nicotine liquid into vapors. In less than a second, vapors will start being produced and you can start enjoying your favorite aroma without all the risks that smoking comes with.

If you think about which type of battery you'll get, you must know that almost all the producers use Li-Ion accumulators that can be recharged, exactly like the one from your phone. The electronic cigarette you'll order, no matter from which company you'll get it, will arrive almost completely assembled, with the battery already charged, and you'll have to only pick a cartridge and put it in the right place, and everything is ready. What you must know is that the liquid used for the vapor cigarettes is completely safe, and it is approved to be used in food.  The substance is called Propylene-Glycol and it is mixed with various flavors and, in some cases, nicotine. Nobody says that the product is 100% healthy, but compared with the tobacco smoking, it is a breath of fresh air.

If you haven't bought an e-cig before, you'll probably need to order a starter kit that contains multiple batteries, a variety of cartridge aromas and the charger, specially designed for your new device. From some companies you could also get covers and transportation cases.

Although the whole electronic cigarette thing became extremely popular on the internet, you'll see that many companies decided to open real shops in many cities. A good reason for migrating to the electronic cigs is also the fact that you'll save plenty of money by forgetting about the analogs, but the fact that you'll use an exquisite device, a real gadget should make you happy. Although these cigs are popular, you'll always have something to start a new conversation, talking about the brand you use and how many flavors you can buy.

Compared to other products, I must say that I've seen many sites dedicated to this project that are proud with the fact that they offer lifetime guarantee, being so sure that their mechanism is flawless and everything will help you understand that getting a nicotine kick doesn't mean smoke anymore.

Be Wary of Misleading Headlines on E-Cig News Stories

Are e-cigarettes safe?  Well you might not think so if you base your view on the headline of a story recently published by the 'aboutmyarea' website. The story details the fact that one particular brand of e-cigarette available in the UK (called 'e Health Cigarette') is currently under a European safety recall due to the fact that its battery charger may pose a danger. Unfortunately, the headline accompanying the story was misleading, as it read: "Could Your Electronic Cigarette Send Your House Up In Smoke?". Another news wire also reported on the same story with the equally daft headline "Alert over electric cigarette hazard". 

Now we don't mean to get on our soapbox here, but it needs to be stated that headlines are important, in so much as plenty of readers tend to form their entire opinion about a topic simply by reading those headlines. Many readers never even go as far as reading the body of the article itself. The headlines about this story have done a great disservice to electronic cigarettes, by wrongly implying the e-cig device itself could start a fire. In reality, when a quality e-cigarette is used in accordance with the instructions and with the supplied batteries, there is almost no fire risk at all.

In this particular case, the problem is not with the e-cigarette, but with the faulty charger being supplied with it by this manufacturer. According to the safety recall, this defective charger could pose a danger of arching, overheating or electric shock. In theory, if this charger overheated it could potentially start a fire. Trading Standards in Yorkshire is encouraging users of this brand to heed the recall after a market stall in East Riding was found selling them.

E-Cigarette Safety

In terms of fire hazard, we'd like to set the record straight here, by stating that quality electronic cigarettes are extremely safe. The devices themselves use only low-voltage batteries which pose no risk of fire under normal circumstances. As with any battery-operated device, they could explode if overheated, but the danger of that is no greater than with your laptop, MP3 player or smart phone.

In addition, the fact that electronic cigarettes do not produce any burning embers or ash makes them inherently safer than tobacco cigarettes. How many stories have we read over the years of house fires being caused by careless cigarette smoking? With electronic cigarettes we have not heard of any such stories because they don't exist. You could fall asleep in your bed with your electronic cigarette in your hand (as many of us probably often do) and no harm will be done.

The fire safety issue is but one reason why smokers should consider giving electronic cigarettes a try. But if you need any further motivation, just consider the following:

• e-cigs are far cheaper than the equivalent amount of tobacco
• e-cigs do not leave behind the foul odours of cigarette smoke
• e-cigs can be used virtually anywhere
• e-cigs don't produce any dangerous second hand smoke
• e-cigs don't contain the thousands of chemicals found in tobacco smoke, only nicotine

E-Cigs: Is It Safe to Vape?

Hello. I am Dr. Sandra Fryhofer. Welcome to Medicine Matters. The topic is electronic cigarettes: Is vaping safer than smoking? There's a new study in the journal Tobacco Control. Here is why it matters.

Electronic cigarettes -- e-cigs -- look like cigarettes in size and shape, but they are nonflammable, so you don't smoke them. Instead, you "vape" them, and vaping seems to be catching on. The Centers for Disease Control and Prevention (CDC) says their use is growing rapidly. Already about 1 in 5 cigarette smokers in the United States have tried them, and they are available everywhere -- in retail outlets, on the Internet -- but experts disagree on whether vaping is safe.

Previous data from the US Food and Drug Administration (FDA) revealed that one of the ingredients in e-cigarette vapor is polyethylene glycol, the chemical used for theatrical smoke. It is also an FDA-approved food additive commonly found in deodorants, moisturizers, and toothpaste. But that is not the only chemical found in e-cigs. The FDA says that analyses of at least 2 brands of e-cigs revealed detectible levels of known carcinogens and toxic chemicals, such as diethylene glycol, an ingredient in antifreeze, as well as small amounts of tobacco-specific nitrosamines.

The new study in Tobacco Control analyzed vapors from a dozen brands and also found some toxic substances, but at levels 9 to 450 times lower than in regular cigarette smoke, implying that vaping may be safer than smoking. Still, the impact of e-cigs on long-term health needs further study.

The CDC also says it is not clear whether e-cigs help people quit smoking. Many e-cigs also deliver nicotine, so the gadget still keeps some people addicted. It is not clear whether e-cigs will help smokers decrease or increase their use of traditional cigarettes.

There is also concern that electronic cigarettes could entice young people to try them, who would then get hooked on the nicotine. More research is needed. For now, trier and buyer beware.

For Medicine Matters, I am Dr. Sandra Fryhofer.

E-cigarettes to be regulated as medicines

Wednesday June 12 2013

Electronic cigarettes are to be licensed and regulated as an aid to quit smoking from 2016, it has been announced.

E-cigarettes – battery-operated devices that mimic cigarettes – are to be classed as 'medicines', which means they will face stringent checks by medicine regulator the MHRA and doctors will be able to prescribe them to smokers to help them cut down or quit.

This move has been widely welcomed by medical experts and officials, as tighter regulation will ensure the products are safe and effective.

Until this happens, e-cigarettes are only covered by general product safety legislation, meaning they can legally be promoted and sold to children, and we cannot be sure of their ingredients or how much nicotine they contain. The MHRA will not ban the products entirely during this interim period, but will encourage e-cigarette manufacturers to apply for a medicine licence.

 

Are e-cigarettes safe? 

We don't really know until they have been thoroughly assessed and monitored in a large population over time. However, compared with regular cigarettes, they are certainly the lesser of two evils.

First, e-cigarettes don't contain any tobacco – only nicotine, which is highly addictive but much less dangerous. For this reason, smoking e-cigarettes (known as 'vaping') is generally regarded a safer alternative to smoking for those unable or unwilling to stop using nicotine.

Also, while the US Food and Drug Administration (FDA) found the liquid and vapour to contain traces of toxins (PDF, 237kb), including cancer-causing chemicals nitrosamines and formaldehyde, the level of these toxins is about one thousandth of that in cigarette smoke.

We cannot be certain that these traces of toxins are harmless, but tests on animals and a small study of 40 smokers are reassuring, providing some evidence that e-cigarettes are well tolerated and only associated with mild adverse effects (slight mouth or throat irritation, a dry cough).

Public health charity Action on Smoking and Health (ASH) is cautiously optimistic, concluding in its January 2013 briefing (PDF, 447kb) that 'there is little evidence of harmful effects from repeated exposure to propylene glycol, the chemical in which nicotine is suspended.'

Others are more wary. Some health professionals do not recommend them because they believe the potential for harm is significant. It is worth bearing in mind that nicotine is not altogether harmless – for example, it has been linked to anxiety – and research suggests nicotine plays a direct role in the development of blood vessel disease.

E-cigarettes are banned by other countries and by some UK schools concerned about their influence on adolescents (see 'What are the other concerns?'). 

 

What do e-cigarettes contain, and how do they work?

Most e-cigarettes contain a battery, an atomiser and a replaceable cartridge. The cartridge contains nicotine in a solution of either propylene glycol or glycerine and water, and sometimes also flavourings.

When you suck on the device, a sensor detects the air flow and starts a process to heat the liquid inside the cartridge, so it evaporates to form water vapour. Inhaling this vapour delivers a hit of nicotine straight to your lungs.

 

Will they help me quit smoking?

We don't yet know. The evidence so far is promising, but not strong enough to draw any firm conclusions.

A 2011 study and a 2013 surveyfound that e-cigarettes decreased the number of cigarettes consumed by smokers, and the survey also suggested they reduce cigarette cravings – although participants were recruited from websites of e-cigarette manufacturers, so results may not be representative.

It's not certain whether e-cigarettes deliver as much nicotine as forms of nicotine replacement therapy such as patches, so they may not be as effective at curbing nicotine cravings.

However, they do have the advantage of looking and feeling like cigarettes: they satisfy the same hand-to-mouth action, give out a smoke-like vapour, and some even have an LED light that resembles the burning tip of a cigarette. This could be why a 2010 study found that even placebo e-cigarettes (with no nicotine) relieved the desire to smoke within the first 10 minutes of use.

If you want to try a safer alternative to cigarettes but are concerned about the uncertainties surrounding e-cigarettes, you may wish to consider a nicotine inhalator. This licensed quit smoking aid, available on the NHS, consists of just a mouthpiece and a plastic cartridge. It's proven to be safe, but the nicotine vapour only reaches the mouth rather than the lungs, so you don't get the quick hit of nicotine that comes with e-cigarettes (see box below, which compares e-cigarettes with inhalators).

 

E-cigarettes vs nicotine inhalators

 

 

Is there any risk to others from e-cigarette vapour?

It's not clear until more studies are done (see 'Are e-cigarettes safe?'). Research to date has not shown the vapour to be harmful – it largely consists of water.

According to ASH: "Any health risks of secondhand exposure to propylene glycol vapour are likely to be limited to irritation of the throat." To support this, it cites a 1947 study that exposed animals to propylene glycol for 12-18 months at doses 50 to 700 times the level the animal could absorb through inhalation. Compared to animals living in a normal room atmosphere, no irritation was found, and the kidney, liver, spleen and bone marrow were all found to be normal.

 

What are the other concerns? 

Because e-cigarettes can be smoked in public places such as bars, restaurants and public transport, some people feel they may be normalising what has come to be seen as an unacceptable activity.

Also, some argue that e-cigarettes (with their flavourings and clever marketing) are a 'gateway to smoking' for children and teenagers, encouraging them to smoke when they wouldn't otherwise take up the habit.

If they're not a gateway to smoking, they are at least a gateway to nicotine addiction.Cancer Research UK asks whether smokers who may have otherwise successfully conquered their nicotine addiction may be more likely to stay on e-cigarettes (and thus be addicted to nicotine) long term, if they start using them.

However, these are just theories and questions, which need to be properly researched before we can jump to any conclusions, and their potential influence on children will hopefully not be an issue when e-cigarettes are tightly regulated as a medicine.

 

Where do I buy e-cigarettes, and how much do they cost?

E-cigarettes are widely available online and from newsagents, supermarkets and even some pharmacies. They are currently not available on the NHS.

A single disposable e-cigarette costs about £6. A starter kit costs anything from £17 to £90 (many retail at around £35-£45). For this, you typically get a battery, a charger and two or more replaceable cartridges containing nicotine. When the cartridges run out, a four-pack of refills will cost you £10-£17. In all, they areestimated to be 20% cheaper than cigarettes (this may be an underestimate).

 

How long do they last?

E-cigarette manufacturers say that a refill cartridge is equivalent to anything from seven to 25 regular cigarettes, depending on its nicotine content – but these may be overestimates, and its duration obviously depends on how heavily you use the device. The battery is said to last between two and five hours.

 

This page was updated on June 12 2013.

Analysis by NHS Choices. Follow Behind the Headlines on Twitter.