WHO report on e-cigarettes could be a case of smoke without fire

Analysis: Some research done on risks and benefits of e-cigarettes, but more needed

E-cigarettes: There is no evidence to suggest that nicotine is carcinogenic, but it is addictive

E-cigarettes: There is no evidence to suggest that nicotine is carcinogenic, but it is addictive


The publication of a World Health Organisation (WHO) report into e-cigarettes – labelled electronic nicotine delivery systems (Ends) – is an important statement about their risks and benefits.

E-cigarettes do not contain tobacco; they contain a cartridge filled with nicotine dissolved in water. Add in a battery and a heating element to turn the liquid into nicotine-laced vapour and the “vaper” (as the consumer of e-cigarettes is known) gets a nicotine “hit” with each puff.

Proponents point to the absence of the cancer-causing toxins found in cigarette smoke.

Little research has been carried out into the long-term health effects of e-cigarettes. There is no evidence to suggest that nicotine is carcinogenic, but it is addictive. And in very high doses it is toxic, producing measurable effects on the cardiovascular and metabolic systems.

Yesterday’s report acknowledges that the level of toxins, nicotine and particles emitted from an e-cigarette is lower than from a conventional cigarette. But it says “it is not clear if these lower levels in exhaled aerosol translate into lower exposure”.

It concludes that “since the reasonable expectation of bystanders is not a diminished risk in comparison to exposure to second-hand smoke, but no risk increase from any product in the air they breathe, Ends users should be legally requested not to use Ends indoors”.

Aid to quitting

What about the potential for e-cigarettes as a method for quitting tobacco?

A study published in The Lancet showed that some six months after starting to use e-cigarettes, a little over 7 per cent of traditional smokers had stopped smoking tobacco. This compares favourably with results from nicotine patches.

However, the WHO says “the evidence for the effectiveness of Ends as a method of quitting tobacco smoking is limited and does not allow conclusions to be reached”.

It notes that no e-cigarette product has yet been evaluated as a smoking cessation aid by any government agency.

There is concern among public health advocates that those switching from smoking to vaping will merely swap one addiction for another.

Despite some of the report’s sensible-sounding conclusions, it must be acknowledged that there is a dearth of solid scientific evidence upon which to make sound recommendations.

It is a case of some research done, but more needed to do.

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