While less harmful than cigarettes, e-cigarettes pose several risks

While e-cigarettes are less harmful than cigarettes, a lot remains unknown about the potential health risks of the products. But this much is clear: the products cannot be viewed as safe. That’s one of the main conclusions of an up-to-date review of e-cigarette science by the European Public Health Association, a network of public health associations in Europe.

Here are some highlights from the association’s assessment of the current state of e-cigarette research.

While e-cigarettes don’t produce tar, they still contain nicotine, formaldehyde and other harmful substances.

“E-cigarettes do not produce the tar produced by traditional cigarettes that is the main cause of lung cancer,” the report states. “However, they do produce formaldehyde, a known carcinogen at levels above recommended levels. In addition, nicotine acts in ways that may encourage spread of established tumors and reduce the effects of cancer chemotherapy. Overall, however, the risk of cancer is unknown, though likely to be lower.”

Using both e-cigarettes and cigarettes — a common use pattern — is riskier than using either product by itself.

“While the vapor from e-cigarettes does not contain some of the harmful substances in traditional cigarettes, it does contain different harmful substances not found in traditional cigarettes, so the health effects of using both can be expected to be greater than either alone.”

Among all age groups, e-cigarettes are most commonly used by those who also use other tobacco products, according to the Truth Initiative® e-cigarette fact sheet. A smoker who switches completely to e-cigarettes from combustible cigarettes will substantially reduce exposure to toxic chemicals and health risks.

Studies have linked e-cigarette use to lung disease and cardiovascular complications.

“E-cigarette use has been tied to lung disease, with a growing body of research…reporting adverse effects of e-cig vapor, potentially linked to flavorings not found in traditional cigarettes that have been tested.”

The report continues, “E-cigarette use adversely affects the cardiovascular system, with a number of studies linking them to impaired functioning of blood vessels.”

E-cigarettes can help some smokers quit, but they can also impair quit attempts.

“E-cigarettes are promoted in some countries as a tool to quit conventional smoking. However, a recent meta-analysis of 27 studies reports that smokers (the whole population, including heavy smokers and all other smokers) who use e-cigarettes are about one-third less likely to quit smoking, compared to smokers who do not use e-cigarettes. These findings are consistent with a study using survey data from all 28 European Union member states, which also found that e-cigarette use was associated with reduced quitting,” according to the report.

E-cigarette use among young people increases the likelihood of smoking cigarettes.

The resource cites a 2018 report from the National Academies of Science, Engineering, and Medicine which found that, “For youth and young adults, there is substantial evidence that e-cigarette use increases the risk of ever using combustible tobacco cigarettes. For e-cigarette users who have also ever used combustible tobacco cigarettes, there is moderate evidence that e-cigarette use increases the frequency and intensity of subsequent combustible tobacco cigarette smoking.”

The report adds that the tobacco industry is promoting electronic products, including e-cigarettes and “heat-not-burn” devices like iQOS, as ways to decrease the smoking rate, but these companies also continue to heavily market cigarettes.

For more information on e-cigarettes, read “E-cigarettes: facts, stats and regulations.”