E-Cigarettes and Health

Smokeless nicotine comes under scrutiny.

You may never have heard of it—but it’s the newest drug in town. It’s called an electronic cigarette, or “e-cigarette.” Electronic cigarettes use batteries to convert liquid nicotine into a fine, heated mist that is absorbed by the lungs. No smoke, but plenty of what makes cigarettes go, if you don’t account for taste—or ashtrays and smoke rings.

In an attempt to work around the world’s growing ban on cigarette smoking in public places, a Hong Kong-based company developed the first e-cigarette in 2004. Since then, other companies have done the same, claiming that e-cigarettes are much healthier than regular smokes.

Last month, that claim was vigorously disputed by the World Health Organization (WHO). In fact, WHO said electronic cigarettes can be deadly. Stressing that the device had not been adequately tested, Douglas Bettcher, the director of WHO’s Tobacco Free Initiative, told the Associated Press that “there’s no experience in pharmacology yet of nicotine replacement therapies which actually inhale nicotine in the lungs.” Replacement therapies such as skin patches and gum have undergone thorough clinical testing, Bettcher said. For these reasons, “the World Health Organization does not consider the electronic cigarette to be a legitimate nicotine replacement therapy.”

The anti-smoking group Action on Smoking and Health (ASH) doesn’t think much of e-cigarettes, either. In the U.K. Times Online, ASH director Deborah Arnott said that “at the moment we don’t know enough about this product. Quality control in China is not the highest, and our advice is it’s best to use nicotine products like gums and patches. The electronic cigarettes fall into a regulatory gap and they haven’t been chemically tested.”

So far, electronic cigarettes are being actively marketed in China, Great Britain, Canada, Brazil, Israel, Sweden, and other countries. The cartridges containing the liquid nicotine are available in several flavors, and battery life is estimated at one to three days for most units. The e-cigarette web site www.e-cig.org offers a list of “best places to use your electronic cigarette,” such as airplanes, in church, at the mall, in a restaurant, bar or hospital, or “at your kid’s school recital.”

According to China View News , a “changeable filter contains a liquid with nicotine and propylene glycol. When the user inhales as he would when smoking, air flow is detected by a sensor and a micro-processor activates an atomizer which injects tiny droplets of the liquid into the flowing air, producing a vapour.”

The unit, which looks like a long cigarette, is powered by a rechargeable battery. Propylene glycol is a commercial product sold as a low-toxicity version of antifreeze, among other applications.

E-cigarettes are readily available for purchase online, and at least one American firm has announced plans to market versions of e-cigarettes domestically. However, none of the manufacturers to date seems to be working through the existing regulatory framework, which in most countries calls for toxicity analyses and clinical studies. Jason Cropper, managing director of the Electronic Cigarettes Company, told BBC News that e-cigarettes “are certainly healthier than smoking cigarettes. Tests have been done on mice in the lab and they have shown they are not harmful.” However, Cropper said, no human trials had been undertaken because they are too expensive.

The World Health Organization became involved in the matter after several e-cigarette manufacturers began using the World Health Organization’s logo on advertisements and product inserts. “It’s 100 percent false to affirm this is a therapy for smokers to quit,” Bettcher said. “There are a number of chemical additives in the product that could be very toxic.”

Meanwhile, The Ruyan e-cigarette, a joint effort by Ruyan Holdings Ltd. of Hong Kong and Ruyan America, Inc., won Most Innovative Product of 2008 at the Tobacco Plus Expo in Las Vegas last May.

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