Electronic Cigarettes and the State of Science

Blog Post created by dr_hays on May 4, 2016

Electronic cigarettes seem to have taken the world by storm.  There are now nearly 500 electronic cigarette products and over 7000 electronic cigarette solutions (“e-juice”) available on the internet (1).  The rapid growth of electronic cigarettes has taken the clinical and scientific world by surprise.  We still have not become accustomed to how rapidly new technologies can spread in his age of social media and entrepreneurship.  The gap between manufacturers and users of electronic cigarettes, and scientists who would like to study electronic cigarettes has created a big problem.  The problem is that we do not have reliable data to tell us whether electronic cigarettes are safe and if they might be helpful for people who want to stop smoking.



There is no doubt electronic cigarettes produce far fewer harmful chemicals than tobacco smoke (2).  This means that smokers who switch from regular cigarettes to electronic cigarettes ought to have less risk of developing tobacco caused diseases.  But in today’s world most of the people using electronic cigarettes also smoke traditional combustible cigarettes so they may not be doing themselves any favors.  Public health scientists are also worried electronic cigarettes may entice young people to start smoking.  There are small bits of evidence that this in fact is happening (3).  Science tends to move slowly while the internet and social media tends to propel new trends at lightning speed.  How will we ever catch up?


There are a lot of scientists who are very interested in studying electronic cigarettes to help people stop smoking and whether or not widespread use of electronic cigarettes would be an overall benefit for public health.  There are over 100 planned and ongoing scientific studies focused on electronic cigarettes.  If you have an interest in knowing more about this research on electronic cigarettes you can check out the website “clinicaltrial.gov” for a brief description of each study (4).



But for today, we will have to be satisfied with incomplete information.  I still advise my patients who want to quit smoking to use what we know works.  That includes both behavioral (changing what I think and do) and medication treatment.  If someone is determined to quit smoking using electronic cigarettes, it is probably worth a try.  The key is to have a goal to completely quit tobacco and ultimately to stop using electronic cigarettes too.  If that goal cannot be reached using electronic cigarettes than using proven quit methods is the best approach.  It will take a few years, but I am confident that the science will eventually catch up and we will understand how best to use electronic cigarettes to eliminate the harm caused by tobacco.






1.       Zhu, Shu-Hong; Sun, Jessica Y; Bonnevie, Erika et al. (2014) Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control 23 Suppl 3:iii3-9




2.       Hajek, P., et al., Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 2014. 109(11): p. 1801-1810.




3.       Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence. JAMA. 2015;314(7):700-707. doi:10.1001/jama.2015.8950.




4.       https://clinicaltrials.gov/ct2/home