Are e-cigarettes effective as a smoking cessation aid? This is a controversial question. Some studies claim the devices help smokers quit, while others suggest e-cigarettes may encourage tobacco smoking and may even be a gateway to illicit drug use. A new study adds to the debate, suggesting that e-cigarettes are much less addictive than conventional cigarettes.

A woman smoking an e-cigaretteShare on Pinterest
From a survey of former smokers who now use e-cigarettes, researchers found that e-cigarettes are much less addictive than conventional cigarettes.

The research team – including Jonathan Foulds, professor of public health sciences and psychiatry at the College of Medicine at Pennsylvania State University – publish their findings in the journal Nicotine & Tobacco Research.

The use of e-cigarettes (electronic cigarettes) has increased dramatically in recent years, and their popularity continues to grow. A 2013 study from the Centers for Disease Control and Prevention (CDC) found that among American middle and high school students alone, e-cigarette use doubled between 2011 and 2012.

There are now more than 400 brands of e-cigarettes on the market. Most of these contain nicotine, propylene, glycol, glycerine and flavorings, which are delivered to the user through inhaled vapor. But Prof. Foulds and colleagues note that it remains unclear as to how e-cigarette use influences nicotine dependence.

To find out, the team created a 158-item online survey that was targeted toward 3,609 former cigarette smokers who now use e-cigarettes.

As part of the survey, participants completed the 10-item Penn state Cigarette Dependence Index and the 10-item Penn State Electronic Cigarette Dependence Index, which included questions designed to assess participants’ previous dependence on conventional cigarettes and current dependence on e-cigarettes.

Overall, participants reported having much lower dependence on e-cigarettes than on conventional cigarettes, although the researchers note that those who used an e-cigarette liquid with a higher nicotine concentration and those who had used e-cigarettes for longer periods had higher dependence on the devices.

“However,” Prof. Foulds adds, “people with all the characteristics of a more dependent e-cigarette user still had a lower e-cigarette dependence score than their cigarette dependence score. We think this is because they’re getting less nicotine from the e-cigarettes than they were getting from cigarettes.”

The researchers point out that the long-term health effects of e-cigarette use is unknown, but they say their study shows the devices may have benefits. Prof. Foulds adds:

We don’t have long-term health data of e-cigarette use yet, but any common sense analysis says that e-cigarettes are much less toxic. And our paper shows that they appear to be much less addictive, as well. So in both measures they seem to have advantages when you’re concerned about health.”

The team notes, however, that although may users of e-cigarettes are using the devices in an attempt to quit smoking, they have not been regulated by the Food and Drug Administration (FDA) for this purpose.

What is more, they stress that it is possible the devices may pose long-term health risks, as not enough is known about their safety.

“This is a new class of products that’s not yet regulated,” says Prof. Foulds. “It has the potential to do good and help a lot of people quit, but it also has the potential to do harm. Continuing to smoke and use e-cigarettes may not reduce health risks. Kids who have never smoked might begin nicotine addiction with e-cigarettes. There’s a need for a better understanding of these products.”

Increasingly, researchers are investigating the safety of e-cigarettes. In September, Medical News Today reported on a study claiming that secondhand smoke from e-cigarettes contains higher levels of toxic metals than secondhand smoke from conventional cigarettes.

Another study, published in The New England Journal of Medicine, suggests that the nicotine in e-cigarettes activates a gene in the brain linked to reward response, meaning the devices may be a gateway to addiction, illicit drug use and conventional smoking.