The Link Between E-Cigarettes and Lung Disease

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Electronic cigarettes, also known as e-cigarettes or vapor cigarettes, have been available in the United States since 2006. Initially marketed as a less harmful way for smokers to get a nicotine “fix,” they were even touted as a tobacco-free product that would help smokers kick the habit. While research is still ongoing, evidence suggests that while e-cigarettes are not as dangerous to an individual’s overall health as traditional smoking, they do contain chemicals that pose potential health risks.

What are e-cigarettes?

E-cigarettes are battery-operated devices that look like traditional cigarettes. Instead of burning tobacco, they contain cartridges filled with nicotine, flavorings and other substances. When the e-cigarette is used, the liquid chemicals are turned into a vapor that is inhaled by the smoker.

So, are e-cigarettes as dangerous as conventional cigarettes?

No. When comparing the two side by side, e-cigarettes are definitely the lesser of two evils. That said, they still present some serious health risks to users.

In traditional cigarettes, tar and other chemicals that are inhaled as part of the tobacco smoke can cause cancer and emphysema. Also, secondhand smoke poses a real threat to people in close proximity to the smoker, especially children. By contrast, the aerosol from e-cigarettes is significantly lower in toxins than conventional cigarettes, although some toxins could be detected in studies.

What’s in the vapor?

Liquid cartridges used in e-cigarettes contain nicotine extracted from tobacco and mixed with a base (usually propylene glycol). They may also include flavorings, colorings and other chemicals.

A recent study published in the journal Environmental Health Perspectives specifically examined the chemical flavorings in leading e-cig brands, and found that more than half contain diacetyl, a chemical associated with severe lung disease.

For this study, researchers at Harvard University chose 51 types of flavored e-cigarettes that seemed most appealing to young people, including a variety of fruit, candy and cocktail flavors. By analyzing the air stream of each e-cigarette, they found three potentially harmful flavoring chemicals: diacetyl, pentanedione, and acetoin. Diacetyl is the most dangerous of the three, since it has been linked to severe respiratory diseases such as bronchiolitis obliterans. This irreversible lung disease is more commonly known as “popcorn lung,” due to a high incidence in former workers at microwave popcorn plants.

Do e-cigarettes help people quit smoking?

No. The FDA's Center for Drug Evaluation and Research has not found that e-cigarettes are a safe or effective method for smoking cessation. Some folks choose e-cigs in a sincere attempt to cut back on their smoking. In fact, research suggests that instead of quitting, many e-cigarette users will vape in addition to smoking conventional cigarettes. Another recent study found that smoking e-cigarettes may actually make it harder for smokers to quit; and a previous study from 2013 found that they impede lung function with short-term use the same way normal cigarettes do.

Quitting smoking is always a smart goal, but e-cigarettes are not a smart way to do it.  There are many effective smoking cessation strategies and your health insurance provider may help pay for treatment. If you want to quit smoking, talk to your doctor about proven, effective methods to help you kick the habit—and keep your lungs healthy. 

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 6
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