Electronic cigarettes, devices that allow their users to inhale a vaporized flavored nicotine based e-liquid rather than the smoke from combustible tobacco, have increased in popularity in the US and all around the globe, with an estimated 2.5 million vapers in the United States alone. Moreover, even though they are usually considered to be safer than their tobacco counterparts, ecigarettes still contain nicotine and some additional substances that still lack long term studies over their adverse effects.

ecig light upThe recently proposed FDA regulations would restrict the sale of newly designed tobacco products to people under the legal age, and also would require the Administration’s review before new devices are released on the market. They would also require health warnings on their packages and some discussions about limits to marketing and flavorings of these products are still ongoing.

One of the biggest concerns involving e-cigarettes is whether their use increases or decreases the overall use of nicotine and tobacco. There is slight evidence from the Center of Disease Control and Prevention that children and adolescents are using electronic cigarettes and that some of them had never used other tobacco products before trying ecigs. Regarding this matter and the negative effects nicotine has on children, the Food and Drug Administration’s proposed ban on the sale of ecigs to underage persons seems to be justified. However, whether the sales to adults should also be restricted remains still unclear. It is unknown but far likely that adults who had not previously smoked are beginning to use e-cigarettes but some recent surveys and studies come to show that this is not the case.

When referring to e-cigarettes as a smoking cessation product, a handful of studies and clinical trials have failed to come to a similar conclusion on whether the use of these devices by those already addicted results in higher rates of kicking the habit. Although some have found that electronic cigarettes are effective in helping smokers to quit, others have shown continued use of both e-cigarettes and tobacco, thus suggesting a failure in the smoking cessation attempt. However, we can’t ignore the thousands of online testimonials from users that have given up on smoking completely after coming across e-cigarette type devices.

One of the reasons behind the lack of conclusive evidence is that nicotine absorption varies among different devices, and may even vary among users of the same device for those types that allow users to refill the e-liquid themselves. Moreover, although it is clear that the used method and nicotine concentration plays a crucial role on the effects of these devices, this fact is not often considered carefully in clinical trials.

Another example is a chemical found in most e-liquid and called ‘propylene glycol’, a common constituent of many foods that, although safe to eat, whether it is safe to be inhaled is still unknown. This calls for further research on the effects of all of the chemicals found in electronic cigarettes and their long-term effects on vapers, as well as on those exposed second-hand vapor.