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Following a high-profile Royal College of Physicians’ report encouraging smokers to consider e-cigarettes as a less harmful alternative, we asked Dr Andy McEwen, executive director of the National Centre for Smoking Cessation and Training, to answer some of the most commonly asked questions about the devices.

1. Are e-cigarettes safer than smoking?

Dr McEwen: Yes. Experts think that e-cigarettes are, based on what we know so far, much safer than cigarettes. Smoking is associated with a number of very serious health risks to both the smoker and to others around them. So switching from tobacco to e-cigarettes substantially reduces a major health risk.

2. Is nicotine dangerous?

Dr McEwen: Nicotine doesn’t cause smoking-related diseases, such as cancers and heart disease, but it is addictive. However, there’s a common misconception that you can overdose on nicotine using e-cigarettes. But you are in no danger of poisoning yourself, nor have there been any cases of overdose from inhaling the nicotine-containing fluid that an e-cigarette vaporises, known as e-liquid. So you can use your e-cigarette as often as you need to help manage nicotine withdrawal and urges to smoke.

Much the same as with Nicotine Replacement Therapy, if you do have more nicotine than you’re used to, then you might feel a little nauseous or lightheaded, both of which pass quickly. If this happens, just reduce the level of nicotine in the e-liquid that you buy, or use the e-cigarette less.

3. Do e-cigarettes produce harmful chemicals or blow up?

Dr McEwen: Some studies have found chemicals in e-cigarette vapour that are known to cause health problems. But these studies have tended to use artificial conditions, and when good quality e-cigarettes are used normally (e.g. not overheated), there are far fewer harmful chemicals present in the vapour than in tobacco smoke. If the e-liquid is being overheated it tends to produce an acrid, unpleasant taste – you’ll know if this happens.

As with any rechargeable device, such as mobile phones and laptops, it’s important to charge e-cigarettes with the right charger, and don’t leave it unattended while charging. Ensure that you buy from reputable suppliers and avoid generic charging equipment. There have been reported cases of e-cigarettes causing fires, but far fewer than the number caused by cigarettes, which are the most common cause of lethal house fires.

4. Is it OK to smoke and vape at the same time?

Dr McEwen: There’s no evidence that smoking cigarettes and vaping at the same time is any worse than just smoking tobacco. But the greatest health benefits are seen when people stop smoking tobacco completely, so quitting smoking should be the goal.

Some people manage to switch completely to vaping quickly, while others take a little time. You may have to try a number of different e-cigarettes and e-liquids before you find one that helps you to stop smoking completely, but this is quite normal.

5. Can I use an e-cigarette in the Stop Smoking Services?

Dr McEwen: Yes. If you choose to use an e-cigarette, Stop Smoking Services can still support you in your quit attempt – and these services the most effective way to quit. Their trained stop smoking practitioners provide behavioural support, advice on what might be the best way for you to stop and access to approved stop smoking medications.

6. Which e-cigarette should I start with?

Dr McEwen: This is very much a personal choice. The refillable tank system e-cigarettes might take a bit of getting used to, but they allow you to use more flavours, and generally deliver more nicotine than e-cigarettes that look like tobacco cigarettes. Users tend to say these types are more satisfying. Specialist e-cigarette retailers can give you advice, and you can also chat to other e-cigarette users on a range of internet forums.

How much nicotine you need will depend upon how much nicotine you’re used to getting from your cigarettes. And, of course, how much nicotine you get from your e-liquid will depend upon the type of e-cigarette that you use and how you use it. As a rough guide, most 20-a-day smokers find that 18mg/ml (1.8 per cent) nicotine is sufficient, so you could start with this and see how you get on.

7. How should I use my e-cigarette to help me to stop smoking?

Dr McEwen: Using an e-cigarette is different from smoking a cigarette. It usually involves taking slower and longer puffs over a longer period of time. This is because e-cigarettes heat a coil in a liquid (think of a kettle). You may find you need to take a few puffs on an e-cigarette at times when you wouldn’t have smoked, but this is nothing to worry about, and the way you use your e-cigarette will develop over time. It’s not like a cigarette, which you smoke from start to finish. With an e-cigarette you can use it once or twice, and then put it away. If you find you’ve got it in your mouth all the time, you might need to use a stronger e-liquid. 

If you get a bit of a cough when you use your e-cigarette, this isn’t unusual and it might help to switch from an e-liquid with a high proportion of propylene glycol to one with more vegetable glycol, which can be more soothing.

8. Will e-cigarettes be cheaper for me than smoking?

Dr McEwen: Yes, and you’ll notice savings very quickly compared with buying cigarettes. A starter kit for the tank-style devices can range from £20-70. You’ll then only need to replace the atomiser (heating coil or ‘head’) occasionally for a couple of pounds and, more regularly, buy your e-liquid, which can start at £3.00 for 10 ml. How often you need to change the atomiser will depend on how you use the device, but typically it’ll be around every two weeks or when you get a ‘burnt’ taste or low vapour production.

9. Can I use e-cigarettes in places where I can’t smoke?

Dr McEwen: There are no laws preventing or restricting where you can use e-cigarettes. Some places, such as some sports stadiums and most airports, do not allow vaping while others do. If there are no signs indicating this then you should always ask. But it helps to be respectful when using e-cigarettes around others, especially non-smokers.

10. Is second-hand vapour from e-cigarettes dangerous? How can I protect my children?

Dr McEwen: Unlike second-hand smoke from cigarettes – which is known to cause cancer – there’s no evidence that second-hand e-cigarette vapour is dangerous to others. Some studies have found traces of toxic chemicals in second-hand vapour, but at such low levels that they’re not harmful to those around you. E-cigarettes aren’t recommended for use by non-smokers and children.

In order to prevent accidental poisoning, for example by young children drinking e-liquids, you should store your e-cigarettes and liquids away safely, just as you would with household cleaning products and medicines.

The National Centre for Smoking Cessation and Training trains stop smoking practitioners to deliver effective support to people wanting to move away from tobacco. They’ve developed a briefing to support local Stop Smoking Services to incorporate e-cigarettes into their everyday practice.

Comments

Palash Patra September 16, 2016

if we add something in cigar which present of fire react with nicotine and separate C,N,H. Can we do this?

Julie Moseley September 7, 2016

Rob, I have asthma and it is triggered by PG , amonst various other common chemicals . And yes, PG is in my asthma inhaler. It is increasibngly widely used by the pharmaceutical industry, much to my consternation. I am not at all conceerned that somebody might vape a PG, containing e cig in my vicinity, I am however ver y worried that the paranoia-induced over-regulation of e cigs might limit the available choices to the poibnt that the Pg -free alternatives go from hard-to -find to nonexistent. Alison, I hope this also helps to answer your query? I might add that nobody has yet sought to ban or restrict the use of chlorine bleach as a cleaning agent in public places including hospitals! The fumes from this cause me far worse problems than PG vapour does . Please, people, do a me a favour , and try to identify the real issues before smothering me in concern for my wellbeing. I don’t mean you two. You do seem to be making an effort , but you don’t seem to have twigged that this focus on the possible evils of vaping is founded on prejudice , not reality. if p[eople put a fraction of such concern into what is in household chemicals and whether it is reasonable to inflict the fumes on all and sundry , then my life might become substantially easier. Why not worry about the latter? ?Because vaping is evil, and cleaning the floor isn’t evil, no more logic to it than that.

Alison Bishop August 31, 2016

Just wonder if the vapour would affect people with breathing problems?

Steve July 31, 2016

A billion lives will soon rip the carpet from beneath the ney sayers feet. Every negative ‘scientific’ study on ecigs has been debunked spectacularly. Whereas the positive ones just have the bandwagon brigade wagging their fingers with no evidence to back their nonsense up.

I also had to chuckle at someone using asthma as the reason they couldn’t breath around ecig vapour. Doesn’t ejuice contain PG? Conincidently, so do asthma inhalers…

Hayles July 21, 2016

I find that using an e tank makes you cough up oil so I choose the e cig type as you are not inhaling all that oil!
And I use a brand where the liquid has been tested and is made in the UK.

Dikudi July 12, 2016

Totally Agree with you that e-cig are the safe option as compared to traditional smoking. Switch to e-cig by shopping for best E-cig starter kits available at -dikudi.com

ocelot July 5, 2016

Cool

Fiwe Pawns July 2, 2016

E-cigarettes are in fact perfectly safe, I myself have been vaping for over 2 years after being a smoker for over 20 years, my health has improved immensely, I no longer get wheezy, I no longer wake up with a dry mouth or coughing, my taste has improved dramatically, I am enjoying food a hell of a lot more now than I did in 20 years of smoking, my children no longer complain of the smell or of the smoke.

pramod June 20, 2016

Is there any side effect or smell for use of ecig liquid

paul ecig liquid June 20, 2016

well define step by step, I love it. It looks great, fits great and vapes even better.

Ted June 17, 2016

Stephanie re:diacetyl. Cigarettes contain hundreds of time more diacetyl than any ecig does. Yet smokers don’t get popcorn lung. This is believed to be due to diacetyl only being dangerous in its solid/powder form (the form that popcorn workers were exposed to), not when vaporized like in an ecig or regular cig. Even so, many liquids contain no diacetyl, since many suppliers voluntarily removed it to be on the safe side.

Mr Peter Blatchford June 10, 2016

I’ve bought my sister an Ecigs starter kit she was a heavy smoker and quite recently nearly died on life support for nine weeks she has chronic lung condition.

Stephanie June 9, 2016

Has any one heard of a condition called pop corn lung from a chemical in e cigarettes. The chemical is called Diacatyl. I as a parent of teenagers worry as there are a large number of children smoking e cigarettes who have not smoked ordinary cigarettes. I have been informed that this chemical can damage the inning of the lungs and is irreversible . Should schools be informing young people about this if it is fact so they can make an informed choice.

Rob June 9, 2016

Regarding no.10 – second hand vapour can be dangerous, however only to a small minority of people that are allergic to propylene glycol (PG). This is why one should be mindful of vaping around others.

tomasz. June 8, 2016

Tam Bee: sorry you don’t like facts.

Peter June 8, 2016

I found tis article informative.As my wife has COPD we were concerned about the effects of “Second Hand” smoke.this has dispelled those worries Many thanks CRUK

ann June 8, 2016

i had lung cancer and my 5 years will be up nov 24th this year i smoke e cig 2.4 strenth and it hasnt done me any harm except the goverment want to lower the strenth on these which i think its none of his buisiness

Tam Bee June 8, 2016

Get a grip, CRUK!.
“there’s no evidence that second-hand e-cigarette vapour is dangerous to others.”
For years, the tobacco industry consistently lied through its front teeth, assuring everyone that there was no evidence of tobacco use and ‘second-hand smoking’ being harmful. My children and I have as little desire to inhale sevond-hand vapour/smoke than the vapers/smokers would desire to inhale my flatulence. If these obnoxious nicotine substitutes are the best you can do to help smokers beat their addiction, then you really aren’t making much progress, are you?

susan burls June 7, 2016

i must admit that being a laryngetomy if my son or grandson vape around me that it tends to cause problems with my breathing and also have a bit of blood there because it irretates

Chris Morgan June 7, 2016

It took 50 years + to draw a conclusion as to the fact that smoking cigarettes causes cancer from epidemiological data yet the perceived opinion is E-cigarettes are better than normal cigarettes so it’s ok where is the data as to long term affects and as a non smoker who could go into a pub etc without any smoke or vapour the rise of vaping will now mean that won’t be the case the science on this is very limited and the conclusions made at best wishful thinking in my opinion given that there is clearly no epedimiological data as yet and the multiple toxins found interact in complex ways that cannot at this juncture possibly be scientifically proven as far as long term exposure is concerned.
The danger is that rather than simply getting people off smoking the blind acceptance of vaping will have long term consequences that nobody can foresee at this point.

Babs June 7, 2016

It’s a scientific based report so hardly disgusting. We are eating and drinking chemicals everyday of our lives. We know that cigarette smoking is one of the most dangerous things we can do. I’m surprised the license for manufacturing them hasn’t been revoked before now! Oh and and learn to spell the word is ‘weak’ not ‘week’ that’s the days of the week as in Monday etc.

CathyB June 7, 2016

I disagree with Number 10! I have been affected by e-cigarettes (in a non smoking wooden bird hide) by an obnoxious user, who thought it was so hilarious that I could not breathe. I had recently recovered from multiple blood clots in both lungs and had trouble breathing at the best of times, however, she decided it would be fun to make me suffer and find is so amusing. Not the only time I have been affected, in a pub, man puffing huge clouds out, it made our party of 6 suffer, one has asthma also.

Laila Iskander June 7, 2016

Disgusting report, how long will we wait and how much harm will be caused before saying it is dangerous to health, why do we have to put up with week and selfish people’s dirty habits ?

Brian Harrison June 7, 2016

Extremely helpful, THANK YOU.