Are E-Cigarettes a Healthy Alternative to Smoking?

Researchers say smokeless cigarettes pose health risks to individuals trying to quit and lure nonsmokers into nicotine addiction.

November 21, 2013

Even though smoking is at an all-time low in the United States, electronic cigarettes—plastic, battery-powered devices that deliver a smokeless hit of vaporized nicotine to the lungs—are proliferating, with sales surpassing $1 billion dollars this year.

And while it’s clear that inhaling vapor—what users call “vaping”— is safer than smoking, what’s not clear is how safe.

Some research suggests that the device is about as effective as nicotine patches for smoking cessation, but leading public health experts are concerned that e-cigarettes may both facilitate nicotine addiction and pose long-term health risks.

Perpetuating Addiction

“In two well-controlled studies, more than 90 percent of the subjects added e-cigarettes without subtracting regular tobacco cigarettes,” said Dr. Daniel Seidman, director of smoking cessation services at the Columbia University Behavioral Medicine Program. “People may just use them as a way to maintain their nicotine addiction in smoke-free environments.”

Dr. Seidman is also concerned that using e-cigarettes may be far more addictive than other cessation techniques—like nicotine gum—because of  “pulmonary absorption.” Nicotine absorbed through the lungs travels more quickly to the brain.

“That is why smoking ‘crack’ is more addictive than snorting cocaine, which is delivered through the nose,” he said.

Targeting Teens

If e-cigarettes are ineffective for kicking a nicotine habit, they may be very effective for beginning one. Companies are aggressively marketing e-cigarettes—which are unregulated by the FDA—to teenagers. Nothing prevents them from targeting this vulnerable population. According to the Centers for Disease Control, e-cigarette use by American teenagers doubled from 2011–2012; and evidence suggests that the devices may serve as a gateway to smoking cigarettes.

Unknown Health Risks

While vapor is marketed as, and perceived by many to be, “cleaner” than smoke, researchers at the University of California, San Francisco, have found that the chemicals produced by e-cigarettes can cause cancer and birth defects.

For smokers looking for a cessation device similar to the e-cigarette without the health risks, Seidman recommends an FDA-approved form of nicotine replacement therapy called a nicotine inhaler, which one puffs on like an e-cigarette but with little nicotine reaching the lungs.