E-Cigarettes Are ‘Safer’ Than Traditional Cigarettes: Study


A study published in Annals of Internal Medicine concludes that smoking e-cigarettes, or “vaping,” is safer than smoking traditional cigarettes.

The paper was published just days after a study last week claimed that e-cigarettes may contribute to cardiovascular disease.

Credit: Ecig Click/Flickr, CC BY-SA 2.0

The latest study looked at e-cigarette users, traditional (combustible) cigarette smokers, and nicotine replacement therapy (patch and gum) users.

The researchers, whose work was funded by Cancer Research UK, concluded, “long-term nicotine replacement therapy only, or e-cigarette only use among former smokers is associated with substantially reduced levels of selected carcinogens and toxins compared with combustible cigarette smoking; however, concurrent use of nicotine replacement therapy or e-cigarettes with combustible cigarettes does not seem to offer this benefit.”

More than 180 people participated in the study.

The authors, from King’s College London, University College London, Roswell Park Cancer Institute in Buffalo, N.Y., and the U.S. Centers for Disease Control and Prevention, further concluded, “We found no evidence that e-cigarette only use compared with nicotine replacement therapy-only use is associated with greater levels of carcinogens and toxins. Nicotine delivery of e-cigarettes and nicotine-replacement therapy, although variable, is roughly like combustible cigarettes, but smaller meaningful differences may exist.”

Related: E-Cigarettes May Be Harmful to Your Heart

Last week a study published in JAMA Cardiology reported that chronic e-cigarette users could be putting themselves at risk for cardiovascular disease. The study looked at biomarkers associated with cardiovascular disease in people who smoke combustible cigarettes, such as heart rate variability and oxidative stress. They observed these biomarkers in people who smoke e-cigarettes, too.

The Annals study also looked at biomarkers. In the case of this study, they looked for biomarkers associated with cancer risks known as TSNAs, NNAL and VOCs. “The e-cigarette only users had significantly lower NNAL levels than all other groups,” the authors reported. “Combustible cigarette-only, dual combustible cigarette-nicotine replacement therapy, and dual combustible cigarette-e cigarette users had largely similar levels of TSNA and VOC metabolites.”

Authors Say the Research Has Several Limitations

The authors of the Annals study admit their work has several limitations. “We did not assess indirect exposure and the analysis was limited by the number of biomarkers available and spot sampling, which can only provide a snapshot of exposure. However, given the lack of long-term data, we chose this pragmatic design to quickly evaluate potentially important associations of e-cigarette use with intake of carcinogens and toxins to inform further longitudinal work.”

Many doctors and scientists argue that because “the juice” in e-cigarettes varies widely, there is no way to know for sure what potential carcinogens may be present in which products. Also, because e-cigarettes are relatively new to the market, we won’t know their long-term impact on health for certain for many years.

Related: E-Cigs Could Help People Lose Weight, Despite Other Health Risks

“Although longitudinal cohort studies and randomized controlled trials will provide the best data to answer questions about the safety and efficacy of e-cigarettes for smoking cessation, these designs are time- and resource-intensive,” the authors explain. “In the absence of long-term data, a more pragmatic approach is to compare smoker and former smokers with or without concurrent e-cigarette use in real-life settings.”

Nicoderm patch. Credit: RegBarc/Wikimedia Commons, CC BY-SA 3.0

By comparing biomarkers with a control group of a product already deemed safe – nicotine replacement therapy such as patches and gum – their study demonstrates that e-cigarettes are safer than regular cigarettes, the authors conclude.

But the study last week in JAMA Cardiology isn’t the first to link e-cigarettes with cardiovascular risk. Three years ago, a scientist presented research at the American Association for Cell Biology’s annual meeting and argued that the nicotine in e-cigarettes can cause atherosclerosis, or hardening of the arteries. His research used laboratory animals and human smooth muscle cells.

In an interview with Healthline News, Carl Phillips, scientific director for the Consumer Advocates for Smoke-Free Alternatives Association (CASAA), dismissed the research as “nonsense.”