What You Need to Know About E-Cigarettes

Get the facts on e-cigarettes today.

As a family physician I have had many patients ask me about e-cigarettes. “Are they safe?” one patient wanted to know. “Do they actually work, doc?” another inquired. I usually begin by answering, “there are things we know about e-cigarettes, but there are things that we don’t know as well…”

E-cigarettes fall into the category of products called ENDS - Electronic Nicotine Delivery Systems. They are typically battery-operated devices that deliver nicotine along with flavorings and other chemicals via vapor. E-cigarettes come in many shapes and sizes and it is reported that there are over 250 brands on the market, though it is likely there are more. E-cigarette devices generally consist of 3 parts: 1) a cartridge which holds the solution of nicotine, flavor, and other chemicals, 2) a heating device (also called a vaporizer), and 3) a source of power, which is usually a battery.

E-cigarettes have become very popular over the years. Per the FDA, in 2014, 12.6% of U.S. adults had tried an e-cigarette and 3.7% used e-cigs daily or on some days. Adults are not the only ones using e-cigarettes either, as there has been an increase in the number of young people using them. According to the U.S. Surgeon General’s report on e-cigarettes, they are the most commonly used tobacco product among youth, having surpassed conventional cigarettes in 2014.

People use e-cigarettes for many different reasons. Some feel that they are safer than conventional cigarettes and others cite the desire to quit smoking and feel that e-cigarettes have helped them reach their goals. But, while this might be the case, e-cigarettes are not necessarily safer. The Surgeon General states that “although e-cigarettes generally emit fewer toxicants than combustible tobacco products, we know that aerosol from e-cigarettes is not harmless.” Furthermore, even though many e-cigarette companies state that their product can help smokers quit, the FDA has not approved e-cigarettes as a safe or effective smoking cessation tool.

As a physician, I am concerned about the potential harm of e-cigarettes. E-cigarette liquid often contains nicotine, flavorings, and other chemicals; reports show that e-cigarette vapor can contain carcinogens and toxic substances such as formaldehyde and acetaldehyde. This is a concern for many reasons; we simply do not know enough about the overall safety and long-term effects of these chemicals to understand their full effect on the body.

I also have concerns about e-cigarettes exploding. Over the years, more and more reports of e-cigarette explosions have been described in the media and a quick internet search for “e-cigarettes exploding” pulls up articles that describe these devices exploding in pockets, purses, and pants, among other places. In a 2014 report, FEMA stated that these incidents are “rare,” but regardless, these explosions often come without warning and are not only dangerous but potentially deadly. Hospitals and burn centers treating patients with e-cigarette injuries have reported 2nd and 3rd degree burns in patients in addition to other potentially catastrophic injuries. One report describes an e-cigarette exploding in the face of a user, knocking out his teeth and leaving a hole in his tongue as a result. While the reasons for these explosions are varied, FEMA states that 80% of explosions occur during charging. Other possible reasons include using non-approved power adapters with e-cigarette devices, not using the device properly, and problems with the lithium battery itself, to name a few.

In past years, e-cigarettes have not been regulated, however in 2016 the Food and Drug Administration finalized a rule that allows the FDA to regulate all tobacco products, including e-cigarettes. With this regulation, ingredients in e-cigarettes will be reported and evaluated, and new tobacco products will undergo a premarket review, with several stipulations in place. The hope is that with regulation, youth access to e-cigarettes will be restricted and the safety of these devices will be further evaluated in greater detail.

As I mentioned earlier, what I often say to my patients regarding e-cigarettes is “there is a lot that we know and a lot we don’t know.’’ As a physician, I want patients to be safe and healthy. I hope that the changes in e-cigarette regulations and the growing body of knowledge that we obtain will help us better understand the risks and benefits of e-cigarettes and related products.


Dr. Jennifer Caudle is a board-certified Family Physician and Assistant Professor at Rowan University School of Osteopathic Medicine. She is a frequent on-air medical contributor to the Dr. Oz Show, Fox News, HLN, CBS Philly News and other national and local networks. She has also written articles for Huffington Post, CNN.com/Opinion, The Daily Beast and others. Her website is www.jennifercaudle.com and she can be reached on Twitter and Instagram @drjencaudle, and on Facebook at Facebook.com/DrJenniferCaudle. 

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