UPDATED: E-Cigarettes Versus Regular Cigarettes: Chemicals and Health Risks

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The author’s mother abandoned her e-cigarette (shown above) after discovering it was manufactured in China. Copyright image by Elizabeth Klusinske, all rights reserved.

By now you’ve likely seen someone using an e-cigarette, or “vaping,” as it’s called. Some e-cigarettes look similar to regular cigarettes, while others look like something a cyborg would puff on.

Vaping is growing in popularity, as it’s seen – and promoted – as a healthier alternative to smoking, but we know relatively little about the long-term effects of this habit, and there are disturbing reports about the safety of e-cigarettes manufactured in China.

What are the risks of ‘vaping’ and how do they compare to the health effects from smoking regular cigarettes?

How E-Cigarettes Work

E-cigarettes are powered by rechargeable lithium batteries. They have a heating coil, which heats a liquid mixture of chemicals (such as glycerin or propylene glycol) and nicotine and flavorings to the boiling point, creating a vapor for the user to inhale. An LED light at the tip of the e-cigarette is triggered to simulate the flame at the end of a regular cigarette.

Although e-cigarettes deliver nicotine that is just as addictive as the nicotine in regular cigarettes, they differ from regular cigarettes in that no actual combustion takes place.

Combustion: Where There’s Smoke There’s Fire, and Where There’s Fire, There are Carcinogens

Whether it’s adding a log to a fire, firing up a combustion engine, or smoking a cigarette, the process of combustion chemically alters a substance, resulting in the release of pollutants into the environment (or your lungs).

While it’s true that many cigarette manufacturers add extra chemicals to their product for the sake of making them extra addictive or supposedly “tasty,” many of the problematic compounds in the smoke come simply from the burning of tobacco. This is why even smoking “additive-free” brands such as American Spirit, or cloves – or marijuana for that matter – is also damaging, and puts you at heightened cancer risk (as does having an old, heavily-polluting wood stove or fireplace in your home).

The lack of combustion in e-cigarettes gives them an advantage right out of the gate, since they don’t produce actual smoke.

How Safe are E-Cigarettes?

So, one might expect that this means that e-cigarettes are perfectly safe, especially given some of the claims put forward by the industry. Unfortunately, it’s not such a rosy or straightforward picture, and as with any relatively new product, the regulations have yet to catch up with the usage and the science.

The FDA has received complaints of difficulty breathing, headache, cough, dizziness, sore throat, nose bleeds, cardiovascular problems, and allergic reactions from people vaping, or exposed to second-hand e-cigarette vapor.

Nicotine is in all e-cigarettes. This addictive substance may damage arteries over time and can be life-threatening for people with heart problems.

Propylene glycol (PG) is in almost all e-cigarettes. It is a humidifying agent that is rated as Generally Recognized As Safe (GRAS) by the FDA. However, the FDA has considered propylene glycol for uses in medicine, cosmetics, and theater fog – not how it is currently used in e-cigarettes. Heating and directly inhaling the substance, repeatedly over time, is a very different use.

Here are some fun facts about propylene glycol (PG):

  • Inhaling aerosolized PG habitually can cause problems with the central nervous system, personality and behavioral changes, reduce spleen function, and contribute to eye and respiratory infections.
  • When heated to a high enough temperature, PG converts to a carcinogen – propylene oxide.

Other ingredients in e-cigarettes can vary, such as flavorings added intentionally or chemicals introduced unintentionally.

Based on research, here’s what we do know is in the vapor of many e-cigarettes produced by top-shelf manufacturers:

  • Nitric oxide: People vaping e-cigarettes exhale nitric oxide at approximately the same rate as people smoking regular cigarettes. This is a health concern since nitric oxides increase the risk of heart attack and can reduce lung function.
  • Heavy metals: Heavy metals such nickel, cadmium and lead are present in both first-hand and second-hand vapor in some e-cigarettes, but in concentrations a magnitude lower than in regular cigarettes.
  • Volatile organic compounds: First-hand and second-hand vapor have also been found to contain carcinogenic VOCs like acetaldehyde, formaldehyde, and toluene in concentrations a magnitude lower than in regular cigarettes. However, newer models of e-cigarettes allow for the voltage to be adjusted. Cranking up the voltage produces higher temperatures, which delivers a higher dose of nicotine, but this also generates more formaldehyde* (see update below).
  • Carboxyls (another type of VOC): Most e-cigarettes contain at least trace amounts of the solvents used to dissolve nicotine and flavorings. The solvents in their original state are potent lung irritants, and heating them can create carcinogenic VOCs known as carboxyls. The more flavorings are added, the higher the potential for volatile organic compounds in the vapor upon heating.

Article Update

This article was originally published on December 29th and attracted criticism from vaping enthusiasts. One commenter thought that the article was misleading, saying:

Higher voltages do not lead to higher temperatures as e-cigarettes are used in the real world. Modern devices designed for higher voltages have more efficient wicking capabilities and more airflow. This is old information and the study you are referencing on this has been under much criticism, up to and including published letters from concerned scientists requesting it be retracted due to its poor methodology and the ensuing headline chaos it caused.

Not wanting to spread information that is out-of-date or inaccurate, I looked into the newest research on the topic of the relationship between e-cigarette voltages and formaldehyde output.

The latest research, Effect of variable power levels on the yield of total aerosol mass and formation of aldehydes in e-cigarette aerosols by Gillman, et. al., made several key points:

  • Malfunctioning e-cigarettes give off much higher amounts of aldehydes than properly functioning ones.
  • The concentrations of aldehydes in properly functioning e-cigarettes are lower than in regular e-cigarettes.
  • A malfunctioning e-cigarette releases greater amounts of aldehydes than a regular cigarette.
  • Increasing voltage does increase aldehyde concentrations in e-cigarettes, especially in properly functioning devices.

A malfunctioning e-cigarette without enough e-liquid can cause the coil to overheat, increasing the temperature of the mixture, rather than the rate of aerosolization – which means more aldehyde form. However, since the temperature of the e-liquid is already higher than optimal, further increasing it with extra voltage does not produce as large of leaps in aldehyde formation in malfunctioning e-cigarettes as take place in properly functioning ones!

More research needs to be done into whether people vaping notice malfunctioning e-cigarettes, as these produce the highest output of pollutants, and there are plenty of malfunctioning e-cigarettes “out in the real world.” In the case of a malfunctioning e-cigarette, it’s not entirely clear whether the person using it would be able to detect the noxious fumes and know to abandon the product. In the case of someone new to vaping, it’s entirely possible that they may assume this is normal behavior for an e-cigarette, having never used a properly-functioning one before.

ecig safety

All e-cigarettes are not created equally – if you decide that ‘vaping’ is a healthy choice, be sure to research the manufacturer before making a purchase.

E-Cigarette Production in China

The section above covered the best-case scenario for vaping – e-cigarettes produced by top-shelf manufacturers. Unfortunately, about 90 percent of all e-cigarettes worldwide are produced by a factory called Skorite Electronics in Shenzhen, China. These e-cigarettes are not top-shelf by any stretch of the imagination.

Shoddy manufacturing can lead to contamination during the production process, parts melting in contact with the heating coil during use, and even exploding lithium batteries. A key difference between regular cigarettes and e-cigarettes is that e-cigarettes contain metallic and plastic parts. As a result, when the manufacturing process goes wrong, you can actually get higher levels of certain harmful chemicals than you would from regular cigarettes, and some additional chemicals that aren’t in regular cigarettes.

Alarming discoveries in Chinese e-cigarette vapor include:

  • Twenty-six different elements: Some of these elements were metal particles small enough to penetrate deep into the lungs.
  • Nickel and chromium at four times the concentration found in regular cigarette smoke: The nickel and chromium likely came from either the heating element or from metals entering the e-liquid.
  • Tin particles: These may originate from the solder joints of malfunctioning e-cigarettes.
  • Silicon fibers

E-Cigarettes: Research Before You Use

The FDA is just beginning to figure out the details of how to regulate e-cigarettes. In the meantime, it is up to you, the consumer, to do your homework and make sure you are getting an e-cigarette than is not manufactured in China. Otherwise, the health benefits of switching away from regular cigarettes may go up in smoke. That is not to say that even top-shelf e-cigarettes are completely safe – they come with their own set of risks… But, with well-made e-cigarettes, these risks are likely to be less than that of regular cigarettes.

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