Electronic Cigarettes: Myths, Facts, and What You Need to Know

It's not breaking news that cigarette smoking is bad for your health. Cigarette smoke contains thousands of chemicals, including 70 carcinogens — substances that cause cancer and damage the airways. As a result, smoking is the leading cause of preventable death. Worldwide, tobacco use causes more than 7 million deaths annually.

But what if people could still get a nicotine fix without lighting a cigarette? Since electronic cigarettes or e-cigarettes hit the market in 2003, they've rapidly grown in popularity. Some people use them to help them quit smoking, while others use them as an alternative to traditional cigarettes.

Although these options are becoming increasingly popular alternatives to traditional cigarettes, are they safe? And are they a good way to quit smoking? In this article, we'll look at the myths and facts about electronic cigarettes and explore what you need to know before considering a switch.

What are e-cigarettes?

E-cigarettes are battery-operated devices that turn the chemical nicotine — which is highly addictive — into a vapor you inhale. They come in many shapes and sizes. Some look like traditional cigarettes, while others look like pens, USB flash drives, or novelty items.

These devices are also known by various other names, including e-cigs, vape pens, vapes, and electronic nicotine delivery systems (ENDS).

E-cigarettes work by heating a liquid — which can contain nicotine, flavorings, and other chemicals — to create an aerosolable vapor. This liquid is usually called e-juice, e-liquid, or vape juice.

When you turn on an e-cigarette, the battery heats a coil, which turns the liquid into a vapor. You then inhale the vapor, which delivers the nicotine and other substances to your lungs.

In many countries, e-cigarettes are largely unregulated, and there are no manufacturing or safety standards.

Do many people use e-cigarettes?

Yes, e-cigarettes are becoming increasingly popular, particularly among younger people. For example, the United States Surgeon General found that between 2011 and 2015, e-cigarette use amongst high school students increased by an incredible 900%. Although more recent figures show these figures are decreasing, the rate is still alarmingly high, with around 1 in 5 high school students using e-cigarettes.

Are e-cigarettes safe?

No. They may be less harmful in some ways than regular cigarettes but are not entirely safe or harmless.

Many believe e-cigarettes are a safer alternative to traditional cigarettes because they don't contain tobacco or produce tar and carbon monoxide. However, the liquid used for vaping contains multiple chemicals that can cause immediate and chronic health problems.

E-cigarette products usually contain nicotine, which is particularly dangerous for younger people as it impacts brain development, creates memory issues, and increases depression.

The short-term consequences of using e-cigarettes can include:

  • Breathing difficulties
  • Wheezing
  • Coughing
  • Chest pain
  • Dry throat and mouth
  • Asthma
  • Headaches
  • Sinus infections
  • Nosebleeds
  • Nausea

Long-term consequences may include:

  • Increased risk of coronary heart disease, heart attack, and stroke
  • Oral inflammation and significant gum disease
  • Increased risk of seizures

Research from 2019 also associated e-cigarette use with a rare lung disease called hard-metal pneumoconiosis, a condition caused by inhaling toxic metals.

Additionally, people who vape are significantly more likely to begin smoking traditional cigarettes.

Is exposure to e-cigarette vapor harmful to others?

E-cigarette vapor could potentially be harmful to people exposed to the aerosol second-hand. Although manufacturers may suggest that e-cigarettes emit only harmless water vapor, this is not the case. The vapor contains nicotine, ultrafine particles, and low levels of carcinogenic toxins.

Ultrafine particles can exacerbate respiratory issues like asthma and constrict arteries, leading to heart problems. Additionally, at least 10 of the chemicals in vape liquid are carcinogens and reproductive toxins.

The chemicals also include propylene glycol, which causes eye, throat, and airway irritation short term and, in the long term, can cause asthma.

Because of the health risks to bystanders, the World Health Organization (WHO) recommends that e-cigarettes and other devices are not used indoors, particularly in smoke-free environments.

How much nicotine is in an e-cigarette?

Because there are no regulations or standards for e-cigarettes and vaping liquids, the nicotine levels are highly variable, and some may reach or exceed levels in regular cigarettes.

Even when vaping products have labels detailing nicotine levels, they are often unreliable. Unfortunately, mislabeling is a common issue.

Besides the nicotine content, it's important to consider the delivery method. Some e-cigarettes deliver nicotine as effectively as regular cigarettes, while others use nicotine salts which lower the pH of vaping liquids. This allows the device to deliver higher concentrations of nicotine with less irritation.

E-cigarette users are often unaware that the products contain nicotine and can cause addiction. As a result, some young adults show signs of significant dependence, including the inability to concentrate at school, needing to use an e-cigarette as soon as they wake, or waking up in the night with cravings.

Are e-cigarettes a good way to quit smoking?

E-cigarettes are not a scientifically proven smoking cessation aid, although manufacturers may promote them as such.

Although e-cigarettes don't burn tobacco, they still contain toxins at unregulated levels, and experts don't yet know the long-term consequences of inhaling this vapor.

Switching from regular cigarettes to e-cigarettes is not optimal for your health. Plus, there's a risk that you could end up smoking both, which is substantially worse. People who vape and smoke often have worse symptoms than those who only smoke traditional cigarettes. One potential reason is that cigarette toxins enter the tissues more easily because e-cigarette vapor irritates and inflames the airways.

Generally, it's best to quit all forms of smoking, and there are various safe and proven ways to do so. An evidence-based approach includes:

  • Attending behavioral counseling
  • Taking medications like varenicline that block the enjoyable effects of nicotine in the brain
  • Using nicotine replacement therapy, such as chewing gum, inhalers, or patches
  • Making a plan to cope with triggers, like social events or drinking alcohol

If you think it's time to stop smoking for good, talk to your doctor or other qualified healthcare professional for support and to help you find the best strategy for quitting.