Electronic cigarettes are becoming more widely used by people to either help them quit smoking, or reduce the number of cigarettes they smoke each day, researchers from the Roswell Park Cancer Institute, Buffalo, New York, reported in the American Journal of Preventive Medicine.

Electronic cigarettes are also known as e-cigarettes or ENDS (electronic nicotine delivery systems).

E-cigarettes started off in China in 2003, and rapidly spread around the world in popularity, mainly through the internet, and more recently through shops as well. While they are similar in appearance to tobacco cigarettes, the user consumes fewer toxins in the form of vapor.

Even though e-cigarettes are known to be much less harmful for health than tobacco smoking products, nobody knows what their long-term health and addiction consequences might be. Electronic nicotine delivery systems have various levels of nicotine.

There is some concern e-cigarettes may appeal to non-smokers, cause addiction, and possibly become an indirect route to tobacco cigarettes. Even so, most people agree that if e-cigarettes are much less harmful than traditional cigarettes, it seems illogical to ban e-cigarettes (especially as tobacco products are legal).

Electronic cigarettes are banned in Australia and Canada.

Investigators in the United Kingdom, the USA, Canada and Australia examined e-cigarette awareness, usage and perceptions among current and ex-smokers.

Lead researcher, Richard J. O’Connor, PhD, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, said:

“We were not aware of any studies to date that examined cross-national patterns of ENDS use. No studies have examined use in markets where ENDS are nominally banned.”

The authors gathered and examined data from the International Tobacco Control (ITC) Four-Country Survey. Nearly 6,000 people responded via telephone or online surveys from July 2010 to the end of June 2011.

The investigators found that:

  • E-cigarette awareness ranged from 73% in the USA to 20% in Australia. E-cigarettes are banned in the Australia and legal in the USA

  • Awareness was greatest among people aged from 18 to 24 years, non-minority populations, and people with higher incomes

  • More than 70% of respondents said that e-cigarettes are less harmful than tobacco cigarettes

  • 16% of respondent had tried e-cigarettes

  • More Americans perceived e-cigarettes as harmful than British people

Current e-cigarette users include people who do not smoke tobacco every day, as well as those who smoke more than a pack a day. Nearly four-fifths of respondents said they used e-cigarettes because they believed them to be less harmful that smoking tobacco cigarettes.

75% said e-cigarettes helped them smoke fewer tobacco cigarettes.

85% said they used e-cigarettes to help them give up smoking.

Nearly three-quarters of respondents said they used e-cigarettes to get their nicotine in places where tobacco smoking was not allowed. This suggests that the products are being used to satisfy nicotine addiction during moments of temporary abstinence.

A high percentage of people in countries where ENDS are banned are aware of the products, suggesting that the internet is promoting the product effectively.

Dr. O’Connor said:

“This study represents a snapshot in time of the use of ENDS from mid-2010 to mid-2011. As the market evolves, awareness, trial, and use of ENDS is likely to increase. Should regulatory authorities approve direct claims about reduced harm, one might expect greater adoption of these products, at least among current cigarette smokers.

If credible evidence can be provided to regulators, through independently researched, well-controlled studies, that ENDS reduces the number of cigarette smokers and does not attract use among nonsmokers, then the net public health effect is likely to be positive.”

Scientists from the University of Athens, Greece, reported that e-cigarettes do harm the lungs.

Electronic cigarettes are long tube-like devices that look like traditional cigarettes, some of them resemble ballpoint pens. Most have replaceable cartridges, while others are throwaway ones.

The device is placed between the lips and is sucked. The sucking action activates a heating element that vaporizes a liquid solution. This vapor is inhaled.

The action is very similar to that used when smoking a traditional tobacco cigarette, making it very easy for smokers and ex-smokers to learn to use.

Hon Lik, a Chinese pharmacist, is widely quoted as being the inventor of the first generation electronic cigarette in 2000. Herbert A. Gilbert, in 1963, patented a device described as “a smokeless non-tobacco cigarette which replaces burning tobacco and paper with heated, moist, flavored air”.

Are e-cigarettes harmful? German researchers are trying to find out.

Written by Christian Nordqvist