A new study published in the prestigious New England Journal of Medicine casts doubts over the safety of some uses of e-Cigarettes, including those that do not contain nicotine. 

Vaping has become increasingly popular as an alternative to smoking and in some cases as an (unlicenced) alternative to patches, gum or lozenges in attempt to quit smoking. 

To date, there has been a mixed response from the medical profession as the products have been touted as safe alternatives to tobacco without any quality safety studies being performed.  Over the last few years, there has been a small body of evidence developing but results are so far inconclusive.  There is some evidence that these products may be comparable to other nicotine replacement therapies as an aid to smoking cessation, though the studies are small in scale and of poor quality (cochrane review of e-cigarettes)

There have been concerns raised about addiction, unsafe use and increased youth use of nicotine products with several studies suggesting this is a growing problem.

e-cigarettes generally suspend a flavour or nicotine in propylene glycol which is then vapourised by a small battery-powered heating coil.   The volume of vapour per puff can be varied by changing the power output of the device (usually by fitting a variable voltage battery) but concern has been raised that the higher temperatures needed for a deeper draw might convert the propylene glycol into formaldehyde.

Formaldehyde is a high-level carcinogen and is a significant contributor to the cancer risk of smoking cigarettes. 

A study published in January 2015 in the prestigous New England Journal of Medicine showed that at low voltages (3.3V) there was no formaldehyde produced but at higher voltage (5V) formaldehyde was produced in levels far in excess of those produced from standard cigarette smoking.  For regular users averaging 120 puffs (about 2 cartridges) per day, this could equate to the equivalent formaldehyde exposure of between 60 and 100 standard taylor-made cigarettes per day.

The take-home messsage from this is that there is a risk of cancer from e-cigarettes when they are used at higher voltages.  The study methodology was robust and there is good science underpinning the findings.

If you choose to use an e-cigarette, we strongly recommend that you do not use them at over 3.3V and that you do not use high-power/low resistance coils as these may have the same effect.

It is also worth noting that the nicotine containing products are just as addictive as standard cigarettes and that to date there is no good evidence to support claims that e-cigarettes are safe.

Credits:

e-cigarette/vaping: TBEC Review