Are electronic cigarettes actually safe for you?

Cancer surgeon Dr Pankaj Chaturvedi who is also one of the nation’s most vocal anti-tobacco campaigners tells us why electronic cigarettes are very hazardous. 

Electronic cigarettes are being increasingly used by youngsters as a safer alternative to regular tobacco cigarettes (though they were recently banned in Maharashtra and Punjan). It’s available in malls and online stores and was even endorsed by Bollywood star Sonam Kapoor as a safe alternative to regular cigarettes. The marketing campaign to promote e-cigarettes is slick and clever and is targeting the youth of metros and this is bound to have huge health repercussions. We’ve still not recognised the threat e-cigarettes pose and haven’t realised that it is going to become a big public health issue. Here are some things you didn’t know about electronic cigarettes: 

What is an e-cigarettes? 

An e-cigarette is nicotine containing electrical device that mimics the act of tobacco smoking by producing hot vapour and often the flavour of smoke. The device uses heat to vaporise a glycerine-based liquid solution. The device is primarily meant to deliver pure nicotine and sold as an alternative to cigarettes. Nicotine comes under category of ‘drugs’ and need to be marketed appropriately.

How harmful is nicotine?

Tobacco has got two major harmful ingredients – cancer causing chemicals (nitrosamines, hydrocarbons etc) and nicotine. Nicotine is a highly addictive and noxious substance. Even a small dosage of nicotine has been found to be fatal for life. It is a cardiac stimulant, causes severe psychological disturbances and shown to have cancer causing effect in animals. Because of these serious side-effects, Food Safety Standard Act of India 2006 section 2.3.4 prohibits addition of nicotine to any food substance.

Where is the evidence that nicotine replacement is beneficial?

Researchers believed that offering purified nicotine, after removing cancer causing chemicals, will be a safer alternative to ‘whole’ tobacco. However, several well-conducted studies have proved that the philosophy of ‘nicotine replacement therapy’ has not made any dramatic impact. A recent randomised trial showed addition of Nicotine replacement therapy to smoking pregnant women did not improve cessation. To be precise, currently there is no affordable and effective drug to help smokers quit.

What is the difference between e-cigarettes and nicotine replacement therapy?

Nicotine replacement therapy (NRT) is offered under medical supervision for a defined period at defined point of attempted quitting. However, usage of e-cigarettes completely lacks any medical supervision and is freely available to unsuspecting patrons mainly youth! This lack of trade restriction makes e-cigs major public health hazard that is worse than tobacco.

What is the status of e-cigs in other parts of world?

Since 2008, the US FDA has been stopping shipments of e-cigarettes from entering the country and Canada fully banned the devices in March 2009. The US FDA issued a warning on 22nd July 2009 not to use electronic cigarettes.

What are the analysis results of e-cigs by USFDA?

USFDA has tested two of the devices: the Smoking Everywhere and Njoy products and found them harmful. At a news conference, FDA analyst Benjamin Westenberger described testing 19 cartridges from the two e-cigarettes at the FDA’s St. Louis facility. Among the findings:

• All but one cartridge marked as having no nicotine actually contained the addictive substance.
• Cartridges marked as having low, medium, or high amounts of nicotine actually had varying amounts of nicotine.
• One of the cartridges contained a toxic antifreeze ingredient, di-ethylene glycol.
• The devices emitted tobacco-specific nitrosamines which are human carcinogens.
• The devices emitted tobacco-specific impurities suspected of being harmful to humans.

How are e-cigs advertised and marketed?

E-cigarette makers and distributors argue that e-cigs are safer than cigarettes. Some have presented anecdotal never-proven case studies to claim that their products have helped people quit smoking. However, no well-conducted study has ever proven that e-cigs help people quit or they are safe. The synthetic nicotine in the e-cigs is clearly a harmful substance and sale of such products need to be strictly regulated.

Are there any nicotine-free e-cigs?

Though there are nicotine-free versions available, hardly any one buys it. E-cigarettes and similar products are sold online and in scores of mall kiosks across India. Non-Nicotine E-cigs have a clear potential to entice new smokers with their fruit and candy flavours.

The views expressed  are Dr Chaturvedi’s, theHealthSite doesn’t necessarily endorse those views. 

Dr Chaturvedi is a Professor and Head Neck Surgeon at Tata Memorial Hospital, a tertiary cancer centre under Department of Atomic Energy, Government of India. He is the co author of the Text Book of Head Neck Surgery, Editor of the International Journal of Head Neck Surgery and published more than 100 papers in peer reviewed journals. He is an accomplished researcher and received Robert Maxwell Byers Award from the American Head Neck Society in 2010. He has been invited as visiting faculty in 22 institutions in 16 countries. He is very active in the field of tobacco control and founded the popular ‘Voice of Tobacco Victims” campaign that played pivotal role in nationwide ban on Gutka. For his contribution in public health, he has received Outstanding Young Indian Award, WHO Director General Award and Judy Wilkenfield award. He was also nominated as the Global Cancer Ambassador by American Cancer Society. He was among the 5 civil society representatives who spoke on tobacco control in special summit of United Nations in 2011.