Experts Say E-Cigarettes May Be Less Harmful, but Set Two Conditions

A group of 24 nicotine-dependence researchers has given doctors a carefully qualified message about e-cigarettes: for adult smokers who cannot or do not want to quit, switching completely may be considerably less harmful than continuing to smoke.

The recommendations, published in the Journal of the American Medical Association, review existing evidence on the harms of smoking and offer guidance for conversations between doctors and smokers. The researchers say some toxin levels can be about 90 percent lower when vaping than when smoking. They also stress that avoiding nicotine entirely remains the best option.

The experts attach two important conditions to their conclusion. First, e-cigarettes are not harmless. They can maintain nicotine addiction, and their long-term health effects remain insufficiently understood because there are far fewer long-term studies than for conventional cigarettes. Second, the potential benefit applies to a complete switch, not to using e-cigarettes alongside traditional cigarettes.

The researchers explain that conventional cigarettes cause much of their harm through the combustion of tobacco, which releases large quantities of toxic and carcinogenic substances. E-cigarettes heat a liquid containing, among other ingredients, nicotine and produce an aerosol instead of burning tobacco. This lowers exposure to many toxins, but it does not mean cancer risk falls by the same proportion. Nicotine primarily causes addiction and is not the main cause of most smoking-related cancers and diseases.

The experts also say nicotine e-cigarettes may help people quit conventional cigarettes more effectively than nicotine-replacement therapies such as patches, gum and lozenges. A recent Cochrane review found that roughly eight to 10 out of every 100 people using nicotine e-cigarettes to quit remained abstinent for at least six months. The researchers suggest vaping may work better for some smokers because its use and nicotine delivery resemble a cigarette.