Can Electronic Cigarettes Cause Cancer? The science behind ersatz smoking

Illustration by Slug Signorino

In a staff report on your site about whether nonsmoking actors use fake cigarettes when playing a part, the writer said there’s no such thing as noncarcinogenic smoke, implying smoke is the primary danger. What about the new electronic cigarettes—since they’re smokeless, are they noncarcinogenic? —Amit Anand

Well, that’s the theory. Browsing online, we find claims like this: “[Our] premier lineup of smokeless electronic cigarettes utilizes innovative technology to provide a smoking experience without the dangers, hassle and even expense of traditional cigarettes.” Here one recalls the miracle drug diacetylmorphine, introduced in 1898 as a nonaddictive alternative to morphine by Bayer. Diacetylmorphine is better known by its trade name, Heroin. You see how well that worked out.

Like traditional smokes, electronic cigarettes, or e-cigarettes, are a nicotine delivery device. The difference is that whereas the paper-and-weed variety involves burning tobacco and inhaling the smoke, e-cigarettes merely heat nicotine to produce vapor, and you breathe that—hence the term “vaping.”

An e-cigarette consists of a mouthpiece, battery, some electronics, a filament-type heater, and disposable cartridge containing nicotine, propylene glycol, glycerin, and flavorings. When the electronics detect that the smoker has taken a drag, they switch on the heating element, warming air that’s pulled through the cartridge and vaporizing some of the nicotine mix for easy inhaling. Many e-cigarettes are designed to mimic the tobacco kind, often with a colored LED tip that glows.

These things clearly have their advantages. The absence of combustion means no combustion byproducts—including tars, carbon monoxide, and other noxious chemicals—and also no risk of fires and burns. Those in the user’s vicinity don’t choke on tobacco smoke, although if you sit too close you can still get a snootful of secondhand vapor.

Relatively little research has been done on e-cigarettes since their appearance on the market roughly six years ago. However, while it would be foolish to say they’re harmless, studies so far suggest they’re orders of magnitude safer than conventional cigarettes.

In investigating e-cigs, the FDA has focused on two types of chemicals: tobacco-specific nitrosamines (TSNAs), which are carcinogenic, and diethylene glycol (DEG), a plain old poison. E-cigarettes were found to provide a 500- to 1400-fold reduction in TSNAs compared to traditional cigarettes, and DEG was found in only one cartridge tested. Of 16 studies reviewed in 2010, none found more than trace amounts of the carcinogens typical of tobacco smoke in either the nicotine solution or the vapor thereof. Nonetheless, since there’s no minimum safe level of a carcinogen, the FDA still warns against e-cigarettes.

Though you’re not sucking in smoke with e-cigs, you are inhaling vapor. One study reported that vaping for just five minutes made breathing more difficult. The propylene glycol in the nicotine solution can cause respiratory inflammation and increase asthma risk.

A test of 35 nicotine refills in various flavors found several were toxic to human cells. Another study found that because of contamination by the heating filament, some vapor contained tiny particles of silica and metals such as tin, nickel, and chromium. Nine of 11 elements found in e-cigarette vapor were at an equal or higher concentration than that found in conventional cigarette smoke, with what fell implications no one knows.

But e-cigarettes can help reduce or eliminate smoking, even among those not trying to quit. Researchers in Italy furnished a group of volunteer smokers with e-cigarettes, excluding anyone who was consciously trying to stop smoking and providing no encouragement to do so. Despite this, 22 of 27 participants had reduced their consumption of conventional cigarettes by at least 50 percent after six months, and nine had quit altogether.

Other studies have found that despite delivering minimal nicotine, e-cigarettes satisfy regular smokers and significantly reduce the craving to smoke. Compared to things like nicotine patches, e-cigarettes may make it easier to stop smoking because they preserve the rituals of the cigarette. E-cigarette users we’ve talked to unanimously report the product is a passable substitute for the real thing, though some say they still smoke an occasional cigarette when under peer pressure.

Overall, the evidence to date strongly suggests e-cigarettes beat smoking, which kills 443,000 Americans annually and is notoriously hard to stop doing—among people who try to quit on their own, 80 percent relapse within a month. Long-term research on health impacts is needed, and no doubt breaking the nicotine habit altogether is preferable to vaping. But e-cigarettes look like a good plan B.

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Our Readers Say

I would recommend vegetable glycerin liquid over propylene glycol.
Well written article that gives an unbiased opinion of e-cigarettes. I have not smoked in over 20 years and I vape, primarily to taste the eliquid as I make them to ensure the flavor is what I am trying to achieve and because I like the taste. I can't tell the difference in my lungs from vaping and know people who have quit cigarette smoking using the electronic cigarette and it was easier for them to quit using the e-cig. Most eliquid contains a percentage between propylene glycol and vegetable glycerin and if you are sensitive to propylene glycol, then you can purchase straight vegetable glycerin eliquids.
Thank you once again for the straight dope on a confusing topic!
I went to vapor in February this year and have not smoked since. I bought different electric cigs and I didn't like them due to them not lasting long. I googled and found the above website and called and talked to William and he was so helpful. I buy all my vapor needs from the above website. He makes all his own eliquid and does use vegetable and glycerine eliquids. I believe the liquid in this article comes from China. His prices are very fair and you can not beat the service. I just wish the batteries lasted longer before the die..not recharge but die. So far I have gotten about three months from each but they are not expensive compared to a carton of real cigs. Good luck on quitting. I don't miss cigarettes at all. It is fun tasting all the different flavors he has.
Thanks for a fair and balanced article. The long term effects of vaping are still to be determined, but it is becoming clear that they are a much safer and effective alternative to tobacco cigarettes.

I really appreciated your analysis of the FDA findings a few years ago. Most of the media attention focused on the harmful components found but completely ignored the fact that they were found in such low levels as to be nearly meaningless. Kudos to you for a fair evaluation.

I started vaping over 4 years ago and stopped a 20 year pack-a-day habit virtually overnight. Sites like the can be a big help to those looking to make the switch.
You might want to re-read the FDA report. There's no evidence that e-cigarettes can cause cancer. That's what trace amounts means. Trace amounts of carcinogens, in other words, amounts that cannot cause cancer in human beings. Before writing this kind of irresponsible nonsense that you're going to attempt to pass off as journalism, it would be nice if you had a basic grasp on the basic terminology. Incidentally, there has not been one reported case of cancer anywhere in the world due to e-cigarettes since 2003, when the products first hit the market. Why do you figure that is?
I commented above and I put the website in the wrong place and it didn't show up. He has the best price and awesome eliquid. He makes it himself and the stuff is great. For those wanting to go to vapor and get the BEST price...and I have shopped online for hours is If you have questions (as I did) call the guy I spoke to Will was so helpful as I knew nothing. Where ever you get your stuff I believe you will not regret going to a safer way of smoking with vapor ecigs. It is totally like much smoke. My mom was just diagnosed with lung cancer so that was my inspiration to quit. I am so glad I did. My smoke shop at the corner has the Chinese thanks! I smoked a lot and so grateful you did this article to reassure me I am ok with Vapor. I feel much better since quitting and I don't smell at all because vapor does not make your clothes or hands is just so cool. No smokers breath to deal with either..whoohoo! Good luck to those that switch!
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The pretense that the E-Cig is 100% Safe is just not right, Your still putting something unnatural to the body in the Body, Safer than Smokeing the real thing true but not !00% Safer... I like this Article ... I smoked Real Cigs for 15 Years .... I started Vaping about 2 months ago .... This is my Second attempt at Vaping .... But when I Started smoking again .... I was Vaping for 1 year .... This time I am working on Weeding myself off the Nicotine .... So for example I Vaped Juices at 36mg of nicotine for 6 weeks , I just recently Switched to 22mg of Nicotine with a Tank of 36 Mg for those Rough times .... I will be getting rid of the 36mg in 2 days than I will be Vaping 22mg for 4 weeks .... Once done I will be switching to 16mg with 1 week of a 22 mg as back up ... than its 2 weeks at 16 mg , than I will switch to a 6mg with a 16 back up for 3 days , than 6mg for 1 week , Than 0mg with 6mg back up for 2 days than 0 mgs for 1 week than I will be removeing the Vaping altogether .... I am also Documenting everything I do How it worked for me than reporting it to my Doctor as well as the FDA If I can ( I have no idea if they accept that or not) I agree with this Article Getting off the Nicotine is and should be the Main Goal!!
Thank you for clearing confusion. I have read many article but I didn't get about effect of e cigarette. But This article clear many confusion.
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With 0% nicotine liquid, vaping is as safe as drinking city tap water or breathing the air. Yes, vaping is putting something abnormal in your body (though I would argue about it being unnatural; you can get it vegetable-based, and flavoring like they use in Jelly Beans), but the quantity of product you are inhaling is very very small. Like fog, a huge cloud of smoke is comprised of a very tiny amount of fluid; if you recondensed the vapor from an ecig puff, you would have a drop so small it wouldn't drown an ant. The sugar from the glycerine is such a small amount, you burn off the calories from the vape just by exhaling it. So yes, there is "bad stuff" in vaping, but in such small amounts that your body can very easily absorb or expel it without it harming you, even over long periods. The nicotine is the only real bad compound in vaping juice, and most places offer 0-nic alternatives.
It's simple - the best option is to NOT SMOKE ANYTHING. Period.
Right - it's safest to stay in your bed eating only organic foods...but that's not realistic. Adults should have the freedom to assess these kinds of risks and choose what is best for them.
"Here one recalls the miracle drug diacetylmorphine, introduced in 1898 as a nonaddictive alternative to morphine by Bayer. Diacetylmorphine is better known by its trade name, Heroin. You see how well that worked out."
The moment I read that, I thought, okay, here we go, another article written by a sarcastic, smoking-counter-culture nazi who has never so much as puffed once in his entire life and equates vaping to smoking on every level while looking down his nose at filthy, 3rd-class smokers as something less than human.
But I was wrong.
I am an ex-smoker and an ex-vaper. I chose to stop vaping because while it seemed to help me stop smoking, in the long run, it didn't really do anything for me.
Yes, I agree that vaping is far better than smoking cigarettes. Perhaps more studies should be done; however, the aim of the anti-smoking culture has been to eliminate cigarette smoking for a few decades now and largely it is succeeding. Let's be satisfied that millions of people have given up cigs. If they want to suck on vapor, why let it bother you if you are a non-smoker?
Thanks for a good article.
I started smoking when I was just 16 years old. I am 66 years old now and last September,5 2013 I smoked my last cigarette. I was at Wal-Mart and a lady was standing in front of my daughter. She told us that she quit smoking with the electronic cigarettes. My daughter said I should try them. I got a e- cig. a week later and haven't smoked a cigarette since. It was so easy to quit. I haven't even wanted a cigarette. The brand I smoke is not expensive.
I have been vaping for over a month now and I have little sight effects I noticed a positive improvement in daily living since using the e cig mainly in breathing I highly recommend a e cig to anyone
Cannabis smoke doesn't cause cancer.

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