A Comparative Health Risk Assessment of Electronic Cigarettes and Conventional Cigarettes

Abstract

Background: Although some studies have identified hazardous substances in electronic cigarette (EC) liquids and emissions, there is limited information about the health risks of using ECs. Methods: In this study, the U.S. Environmental Protection Agency (EPA) health risk assessment model and findings of a literature review were used to determine and profile hazards. Focus was put on the toxicants reported in the literature on conventional cigarette (CC) smoke that most strongly associated with adverse health effects. To evaluate their health risks, dose-response relationships and standard-use conditions were used to estimate average hazard exposures and to calculate the overall health risks of ECs and CCs, benchmarked against international guideline levels for each hazard. Results: Four hazards (acrolein, diethylene glycol, propylene glycol and cadmium) reported in EC emissions and seven hazards (acetaldehyde, acrolein, formaldehyde, cadmium, CO, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N′-nitrosonornicotine (NNN)) reported in CC emissions had maximum exposure levels higher than the guideline levels. Two hazards (acrolein, propylene glycol) in EC emissions and five hazards (acetaldehyde, acrolein, formaldehyde, cadmium, NNN) in CC emissions had average exposure levels higher than the guideline levels. Conclusions: Based on the conditions of use, ECs should be a safer nicotine-delivery product than CCs.

Discussions between health professionals and smokers about nicotine vaping products: results from the 2016 ITC Four Country Smoking and Vaping Survey

“…A 2016 report by the WHO stated that there is not enough research to quantify the relative risk of NVPs over combustible products , and WHO has previously urged countries to restrict the sale, promotion and use of electronic cigarettes . Additionally, some recent reviews have also demonstrated the inconclusive evidence about the health risks associated with NVPs use . Therefore, our data may be indicating that HPs in England (and in the other countries) may be conflicted about the role of NVPs in smoking cessation due to the opposing positions of various NGO and public health organizations.…”

Comprehensive overview of common e-liquid ingredients and how they can be used to predict an e-liquid’s flavour category

“…Flavours increase product attractiveness among all types of (potential) users, that is, among youth and adults8 and among current smokers, dual users, exclusive vapers, as well as never-users 9. For smokers, switching to e-cigarettes may be beneficial, as e-cigarette use (ie, vaping) is considered less harmful than regular cigarette smoking 10–14. In line with this, the use and marketing of e-liquid flavours that are appealing to smokers may contribute to public health benefits.…”

Considerations and Future Research Directions for E-Cigarette Warnings—Findings from Expert Interviews

“…This study points to challenges and avenues for future research about e-cigarette warnings. E-cigarettes pose the potential for nicotine addiction and accidental exposure, and may also expose users to some chemicals and carcinogens [ 8 , 9 , 10 ]. However, the science on potential e-cigarette health effects is nascent and research thus far suggests that they appear to be much less harmful to individual health than tobacco cigarettes [ 6 , 7 ].…”

“…E-cigarettes are novel products that appear to be much less harmful to individual health than tobacco cigarettes [ 6 , 7 ], but are not completely harmless [ 8 ]. They pose potential for nicotine addiction and accidental exposure, and may also expose users to some chemicals and carcinogens (although much less so than cigarette smoking) [ 8 , 9 , 10 ]. Thus, consideration of warnings for e-cigarettes appears relevant.…”