E-cigarette Studies

Smoking at work, in gastronomy, and publicly accessible rooms has been prohibited for years. There are good reasons for this, even if tobacco consumers grumble. The topic is still present and highly controversial. If you don’t want to give up smoking but want to protect your health and your immediate surroundings, you can use e-cigarettes. But there are various studies, especially from the USA, which also classify the ingredients of e-cigarettes as harmful to health. What’s up? Are the horror reports true, or are e-liquids the healthy alternative to nicotine?

In the following article, the myths are replaced by hard facts with the summarized results of scientific studies. Even strict advocates of non-smoking should be a little more forgiving afterward because there is good news for consumers of e-liquids and the “passive smokers” in their area.

E-cigarettes curb nicotine consumption and smoking behavior

First, if you find quitting smoking difficult, the e-cigarette is a good interim solution. The success rate is much higher than when using nicotine patches, for example. This is the conclusion of a 2019 British study published in The New England Journal of Medicine. Here is the link to the study

Only 0.3% of all e-cigarette users were never smokers before! Most nicotine dropouts use “vaporizers.” (D. Kotz et al, Deutsches Ärzteblatt 2018) Link to the publication in the Ärzteblatt

A long-term study covering 2006 to 2017, i.e., over 11 years, provided startling results for Great Britain. These numbers can certainly also be transferred about other European countries: Up to 70,000 Britons are said to have stopped smoking per year – the e-cigarette represented an exit an interim solution. The SSA (roughly translated: The Society for Studies of addictive behavior) published the results in 2019. Link to the publication

In December 2018, the SSA republished research by Gary Chan, Kylie Morphett et al. Here, the observation is recorded that nicotine consumption has steadily decreased over the last 50 years while the number of people using e-cigarettes is increasing. E-Liquids are trendy all over Europe. Most of them are ex-cigarette smokers. Read here.

Not a “bad role model” for young people

And anyone who previously believed that young people would fall victim to a new hype and therefore start smoking: it is not true. An article in the Deutsches Ärzteblatt 2018 (D. Kotz, D; M. Böckmann; S. Kastaun) shows that e-liquid smokers are recruited for the most part from former nicotine consumers, not from “beginners,” but predominantly from the “dropouts.” Link medical journal

Several scientific publications from different countries also prove this.

2019, Britt Hallinberg et al, Tobacco Control: Young people have by no means increased their smoking habits since vaporizers have been around. Two hundred fifty thousand young people between 13 and 15 were asked in England, Scotland and Wales. Interest in the e-cigarette was minimal. link

In the medical journal The Lancet, scientists from New Zealand postulated in 2020 that adolescents are increasingly trying vaporizers but not using them daily. In the case of non-smokers, the experiment seems to remain the same – only 0.8% are interested in it. There can therefore be no talk of a new risk of addiction or a new, seductive trend. On the contrary, the following development seems to be emerging: Nicotine consumption is gradually decreasing worldwide. Numerous “dropouts” use e-cigarettes permanently or as a temporary solution (Natalie Walker et al). link

At the same time, vaporizers seem to be losing popularity again among young Germans. This resulted from the DEBRA study, published in the Ärzte-Zeitung in May 2019 (D. Kotz).

Tobacco consumption is falling – thanks to tobacco heaters

In the journal Nicotine & Tobacco Research, Italian experts published the results of further observations (Masiero et al 2019): Smokers who are already concerned about the risks of tobacco consumption temporarily use e-cigarettes to help them stop smoking. Stop. Link to article

Experiments with 210 smokers were documented. 70 used vaporizer liquids containing nicotine, 70 used nicotine-free “placebo” e-cigarettes, and another 70 made up the control group. A quarter of the subjects using the vaporizers were smoke-free at the end of three weeks. Only 10% of the nicotine-smoking control group managed to quit cigarettes. All users of the vaporizers reported that they were smoking far less than before at the end of the study.

The group was smokers who were self-motivated to quit nicotine addiction. But there may be similarly good results with the vaporizers, for example, if there is a strong need to quit smoking for medical reasons.

What’s in the liquids – and how “healthy” are they?

The assumption often arises that e-liquids for vaporizers are more harmful to health than nicotine and that their ingredients are dubious. On closer inspection, this assumption turns out to be incorrect. E-Liquids are not entirely free of potentially harmful substances. However, compared to tobacco that is smoked, the measured levels for such substances are extraordinarily low, and, what’s more, they are chemically volatile, which means they vanish into the air almost immediately as soon as the “vaporizer” exhales.

In the lab, tobacco smoke and e-cigarette vapor were tested for their effect on cultured human lung cells. What happened to the cells was observed over many hours.

The cells “treated” with e-liquid vapor behaved and divided normally, suffered no damage, and divided on schedule, and few of these cells died. This was dependent on the amount of vapor they were exposed to.

However, under the influence of tobacco smoke, cell movements and cell division stopped completely after a few hours. Ultimately, all cells in the area affected by the smoke died.

In 2016, David J. Nutt and colleagues from Imperial College London published a risk assessment of e-liquids in The Lancet. They are 95% less harmful than tobacco smoke. Link to article

The following studies came to very similar conclusions:

In 2014, Prof. Peter C. Bartsch was concerned with the acute toxicity (toxicity) of e-cigarette smoke on lung cells: In the short term, the cell cultures remained healthy and largely functional – in stark contrast to the effects of tobacco smoke. However, some functional limitations were observed at high concentrations. PDF link.

In the same year, Professor Dartsch examined the long-term effects of e-liquids on lung cell cultures: Depending on the brand and composition, his research reports were able to give the all-clear here, too: the cell cultures remained active and healthy. In ComparisonComparison, tobacco smoke gradually killed the cell cultures completely. Link to PDF

Cell mutations lead to tumor cells and, thus, cancer. The extent to which e-cigarette vapor has a mutagenic effect was also checked in 2015 by Professor Dartsch: He used a special test (Ames test) that uses standardized methods to check whether and which DNA changes could be triggered by which substances. In the case of tobacco smoke, it can be assumed that longer use and larger amounts greatly increase the risk of pathological cell changes. This was not the case with the e-liquids, regardless of the dose. Link to PDF

Passive smokers – still at the mercy?

In Nicotine and Tobacco Research 2019, experts from Lithuania, Switzerland, the Netherlands, and France participated in a study on the constituents of e-cigarette smoke (Dainius Martuzevicius et al). The particles released into the air when vaporizers are used are highly “volatile,” meaning chemically unstable, and they vaporize within ten to fifteen seconds of being emitted from the device. In ComparisonComparison, the air from tobacco smoke is heavily and permanently polluted: the emitted particles are stable and are inevitably inhaled by other people in the room.

Every passive smoker knows the unpleasant feeling when the airways seem to narrow under the influence of tobacco smoke. This phenomenon is largely absent when someone with an evaporator sits across from you.

A study from 2012 already shows that the proportion of formaldehyde in evaporator smoke corresponds to that of normal breathing air and is, therefore, of no relevance to health. (Indoor Air 2013, T. Schripp et al; Department Material Analysis and Indoor Chemistry, Fraunhofer Wilhelm‐Klauditz‐Institut ). Here the link

Passive smoking is demonstrably unhealthy and, in many cases, can have the same consequences as smokers themselves have to fear.

The good news for anyone whose partner, friend, or colleague is switching to e-cigarettes: Everything the other person breathes in is ultimately the smoker’s breath and not the result of a combustion process at the end of a cigarette! Correspondingly fewer unwanted pollutants get into the air we breathe.

This is proven, for example, by a study from the USA by McAuley, TR, Hopke PK, Zhao J, et al. ComparisonComparison of the effects of e-cigarette vapor and cigarette smoke on indoor air quality. Inhal Toxicol 2012. Link to study

Here, too, the list of relevant research work could be extended.

Conclusion: All contemporaries of smokers who switch to vaporizers can sigh relief.

The ingredients in detail

Over 200 studies exist on the ingredients of e-liquid! The following list does not claim to be complete. In addition, since the introduction of vaporizers, manufacturers have been striving to keep improving their products. It has already been described that the potential for addiction decreases with the help of the tobacco heater and that even cell damage, such as that caused by tobacco smoke, could not be observed.

nicotine

Nicotine is found in tobacco. But the North American natives, for example, who used and smoked tobacco for ritual purposes, neither developed addictive behavior nor did they damage their health.

That’s right; some pollutants are produced when tobacco is burned.

But in small doses, nicotine alone can, for example, promote concentration and stimulate brain activity. It is sometimes used today as a therapeutic agent for diseases such as Alzheimer’s. There are also studies on this, including one from the USA (Dr. Amir H. Rezvani, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, 2001). Link to the study.

Since nicotine in e-cigarettes is vaporized rather than burned, far fewer pollutants are released. The nicotine itself is only toxic in high doses – and if it is vaporized instead of burned, it has no cell-damaging effect.

This article lists several studies dealing with pathological cell changes caused by vaporizing and inhaling e-liquids. In all cases, impairments remained far below those caused by tobacco smoke or could not be observed at all.

The New Zealand scientist Dr. Laugesen has presented several papers on e-cigarettes and their effects compared to tobacco smoking. This can be read in German. The main concern here is the risk of cancer, which can be almost negligible when vaporizing nicotine. Read here.

propylene glycol

This substance has been well-researched and used in many ways. It is contained in food, medicines, and all kinds of cosmetics. When inhaled in a vaporized form, it does not affect cells or organic functions. This was proven as early as 1947, as evidenced by a study (O.H. Robertson, Department of Medicine, University of Chicago, USA, ASPET) Link.

glycerin

Glycerin is a non-hazardous substance – even when applied and inhaled at higher temperatures.

A US study was presented in 1982 (Yolanda S. Stein, Michael Jerry Antal Jr., Maitland Jones jr., Princeton University, USA). link.

actual pollutants

Are there any harmful substances in e-liquids, or are they created during vaporization?

As early as 2012, a team of Polish, US-American, and British researchers proved that e-liquids have between nine and 450 times fewer harmful substances or toxic components than tobacco smoke. (Maciej Lukasz Goniewicz et al, 2012, Tobacco Control). link here

Another documentation by Murray Laugesen Health New Zealand Ltd Christchurch from 2008 shows that the manufacturers of e-liquids are constantly working on their mixtures and have this checked by scientists. Link to documentation as PDF

Urine tests were performed by Dr. Stephen S. Hecht of the Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA, in 2014. Pollutants in the urine of smokers and liquid vaporizers were measured and compared. The toxic profile of e-cigarette users performed significantly better than that of smokers. To publish the study.

More observations

The respiratory organs of vaporizer users were undamaged and healthy in a long-term study (Riccardo Polosa, University of Catania, Italy, 2015) compared to regular tobacco smokers. Link

A major problem for heavy smokers is the damage that tobacco smoke causes to the cilia in the airways: the ciliary cells change. Cilia are the extensions of these ciliary cells. They are mobile, like small tentacles or hair. They transport mucus and liquids as needed through a kind of flickering movement or a flickering current. Cilia and the layer of mucus they move also protect against the penetration of pathogens, for example.

Heavy smokers feel this: They catch a cold more easily because bacteria and viruses can get into the bronchial tubes almost effortlessly via the cilia that are no longer working. Those who use e-cigarettes, on the other hand, do not have to fear this damage. This is proven by a comparative study from 2015 (Peter C. Bartsch, Bartsch Scientific – Institute for Cell Biological Investigations, Schongau, Germany). Link to the study as a PDF

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