There has been a lot of hyperbole and controversy surrounding electronic cigarettes. Particularly in the media, one can’t help but get confused by the mixed messages put forth.  Some say e-cigarettes are the greatest thing to happen to public health since germ theory, while on the other extreme some so-called experts claim e-cigarettes are somehow worse than the real thing.

None of the media coverage seems to try and answer the most basic question:  Are e-cigarettes bad for you?

As much as I’d just like to answer “no” and then move on to writing about something else, that’s about as unhelpful as politician’s knee jerk e-cigarette bans. The issue is a little more nuanced than that.

The problem with being able to make such a blanket statement is one of absolutes. It surrounds the word “safe.” Many opponents of e-cigarettes object to the device because nobody can say if ecigs are safe in absolute terms. That is a logical trap. What in this world can really be considered absolutely safe?

More to the point, how do you actually determine if anything is completely safe?  It’s damn near impossible to know everything all at once.  No, the thing we need to look at here is how does it stack up to that which e-cigarettes replace?

It’s kind of a given that traditional cigarettes are beyond bad for you. Smoking will kill about half the people who use the product as designed long-term.  There are several contributing factors to the deadliness of smoking, particularly the carcinogens, tar and particulate matter in the smoke.  Much of this is produced by the actual combustion process.

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e-Cigarettes, on the other hand, heat liquid into a vapor without combustion. Therefore, there is no particulate matter.  In addition, there are only a small handful of ingredients in the e-liquid itself as compared to thousands in old-fashioned cigarettes.

While many of the ingredients in cigarettes are known to cause health problems, e-liquid ingredients consist of elements that have not shown to cause harm.  Propylene glycol (and/or vegetable glycerin) is the primary ingredient in e-liquid, both are generally regarded as safe. PG has been studied since the 1940’s with no major findings of harm.

Nicotine, the primary active ingredient has a bit of a bad reputation. There has been some evidence to show nicotine can exacerbate some cardiovascular problems and may lead to developmental issues in children.  Nicotine often gets the brunt of the blame for the addictiveness of cigarettes.

Those assumptions seem logical, but some recent studies have found that nicotine may not be as addictive as once thought. The reason cigarettes are so addictive is because other chemicals interact with the body to increase how rapidly the body metabolizes nicotine along with something called MAOIs which help cigarettes trigger the brain’s pleasure center.

The final ingredient in e-cigarette liquid is flavoring.  Flavoring all comes from standard flavor extracts used for cooking, so they’re perfectly fit for consumption.  Interestingly, this might be one of the problem areas with e-cigarette harm such that it is.  While the flavors have been tested for ingestion, they really haven’t been tested for inhalation.

One study looked at the effect of e-cigarette vapor on cardiac cells. It found that most of the tested vapor did not harm cells except for a handful of samples. The researchers concluded that the difference must be related to flavors.

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Don’t panic yet, as they also pointed out that even with the slightly higher level of cardiac cell damage, it was still less damaging than cigarette smoke.  By several orders of magnitude.

And there, interestingly is the answer to the original question.

Are e-cigarettes bad for you? It might not be possible to answer that question in absolute terms. Just like the standard of absolute safety demanded by prohibitionist is unrealistic.

What is known is that e-cigarettes are much less harmful that cigarettes. What’s also known for sure is traditional cigarettes kill people. So trading the certainty of harm for the small chance of significantly less harm is probably a very good idea.

That is the standard to which e-cigarettes or any other type of harm reduction product should be held.

This article is part of a series of articles designed to explore the basic questions of e-cigarettes.  For more, see the eCig 101 archives.