Studies Show E-Cig Vapor is MUCH Safer than Cigarette Smoke & The Value of Tobacco Harm Reduction

As most members of our vape community are well aware of, vaping (E-cigarettes) has emerged as an amazing tool to address the overwhelming harm to public health caused by tobacco smoking by offering smokers a far less harmful means of receiving nicotine. For several decades public health policies were dedicated to smoking cessation as the only real means to reduce tobacco-related disease. Unfortunately, it became clear that a proportion of smokers remain unable or unwilling to quit. That fact helped encourage the concept of tobacco harm reduction become recognized. Tobacco harm reduction is a strategy with the aim of lowering the health risks associated with tobacco use. This could potentially be achieved through reducing cigarette consumption by making available alternative and less harmful sources of nicotine. With the rising popularity of e-cigarettes, the concept of tobacco harm reduction has started to become a global reality.

Tobacco Smoke VS Vapor

Following an in-depth review of the evidence provided by several scientific studies, Public Health England reported that e-cigarettes were likely to be 95% less harmful than conventional cigarettes and concluded that the health hazard caused by vaping “is likely to be extremely low and certainly much lower than smoking”. This view was further upheld by the Royal College of Physicians which indicated it is likely to be substantially less harmful than conventional cigarettes, "My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health," reported Professor Peter Hajek of Queen Mary University.


Prolonged exposure to combusted tobacco smoke is the main cause in the development of cardiovascular disease, chronic obstructive pulmonary disease and cancer according to the US Department of Health and Human Services 2010 Surgeon General’s report. Cigarette smoke is a complex aerosol, comprising more than 6000 identified constituents distributed in the particulate, vapor and gas phases. Exposure to both phases and the retention of smoke particles contributes to smoking-related injury and disease. Lung injury after cigarette smoking is particle related. It has been noted that the e-cigarette aerosol, in contrast, comprises soluble liquid droplets and minimal vapor phase components. Numerous studies have shown that the e-cigarette nicotine pharmacokinetic (PK) profile more closely resembles that of a cigarette over other pharmaceutical nicotine-replacement therapy (NRT) products, allowing vaping to have a much greater potential to serve as successful cigarette substitutes.  Vaping delivers nicotine sufficiently to be considered as a perfect potential tobacco harm reduction by mimicking real cigarette smoke, and as the following study shows that compared to the dangers of actual cigarette smoke vapor does not have the same risks.


Figure 1. Borgwaldt RM20S smoking machine.

Using a robust in vitro method, this study assessed the cytotoxic response and cell damage of e-cigarette aerosols that can be effectively compared with conventional cigarette smoke.  An exposure system, comprising a smoking machine, traditionally used for in vitro tobacco smoke exposure assessments, was adapted for use with e-cigarette vapor to expose human lung epithelial cells. Analysis methods were employed to detect/distinguish aerosol dilutions from a reference Kentucky cigarette and two commercially available e-cigarettes. Vape aerosol induced 97%, 94% and 70% less cytotoxicity than standard tobacco cigarette smoke. Test doses where cigarette smoke and e-cigarette aerosol cytotoxicity were observed are comparable with calculated daily doses in consumers. The evidence from this study supports the view that vaping causes far less damage to cell systems when compared to smoking.

According to further research published in Annals of Internal Medicine, Cancer Research UK-funded scientists found that people who swapped inhaling the smoke from regular cigarettes for e-cigarette nicotine vapor for at least six months, had much lower levels of toxic and cancer causing substances in their body than people who continued to use conventional cigarettes.

"This study adds to growing evidence that e-cigarettes are a much safer alternative to tobacco, and suggests the long term effects of these products will be minimal." said Alison Cox of Cancer Research UK


As vaping is a relatively new phenomenon, there are still limited amounts of unbiased scientific data on the longer-term health effects of their use. That is why every one of these studies is so important, as knowledge is the key to win the war on vaping. Understanding and communicating the benefits of nicotine replacements, such as vaping, is an important step towards reducing the number of tobacco-related deaths. The public deserves accurate information on the health risks of vaping vs cigarettes. From the best evidence to date, e-cigarettes are much less dangerous than cigarettes.



References & Citations

Public Health England. (2015). E-cigarettes: an evidence update: a report commissioned by Public Health England. Available from:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/457102/Ecigarettes_an_evidence_update_A_report_commissioned_by_Public_Health_England_FINAL.pdfRoyal College of Physicians. (2016). Nicotine without smoke: Tobacco harm reduction. Available from: https://www.rcplondon.ac.uk/news/promote-e-cigarettes-widely-substitute-smoking-says-new-rcp-reportInt J Environ Res Public Health. (2014) Characteristics, perceived side effects and benefits of electronic cigarette use: a worldwide survey of more than 19,000 consumers. Available from:https://www.ncbi.nlm.nih.gov/pubmed/24758891


European Commission. (2015). Special Eurobarometer 429: attitudes of Europeans towards tobacco and electronic cigarettes. Brussels: European Commission, 2015. Available from:http://ec.europa.eu/public_opinion/archives/ebs/ebs_429_en.pdfWHO SOP. (2016). Standard operating procedure for intense smoking regime of cigarettes. Available from:
www.who.int/iris/bitstream/10665/75261/1/9789241503891_eng.pdf


Adamson JAzzopardi DErrington G, et al. (2011). Assessment of an in vitro whole cigarette smoke exposure system: the Borgwaldt RM20S 8-syringe smoking machine. Available from:
https://www.ncbi.nlm.nih.gov/pubmed/21867559

Figure 1. Borgwaldt RM20S smoking machine. (i) Cigarette smoke generator. (ii) Original four-syringe system. (iii) Four-syringe extension. (iv) Air-flow controller. (v) Cell culture media maintained at 37 °C. (vi) British American Tobacco’s exposure chamber housed at 37 °C, attached to the smoke diluter and culture media

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