Verdict on E-Cigs Still Out

Electronic cigarette use helped some cut back regular cigarettes but health risks unknown

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Quitting smoking can be extremely difficult. There may be a slight possibility that an electronic cigarette could help smokers wean off the habit, but long-term risks are still unknown.

In a recent, industry-funded clinical trial, researchers tested the use of electronic cigarettes on a group of smokers over the course of a year.

The results found that electronic cigarette use helped a few people cut back on regular cigarettes or quit altogether.

The researchers suggested further studies look into the long-term health risks from smoking electronic cigarettes, which are currently unregulated in the US.

"Ask your doctor to help you quit smoking."

Pasquale Caponnetto, PhD, from the University of Catania in Italy, worked with a team of fellow scientists to test the use of electronic cigarettes, or e-cigarettes.

E-cigarettes are battery-operated devices, the size of a small pen, designed to vaporize a liquid solution of vegetable glycerin and nicotine and/or aromatic flavors, which come inside a replaceable cartridge. Vegetable glycerin is a non-toxic ingredient in foods, medications and soap. 

When a person puffs on the e-cigarette, in the same fashion they would a traditional cigarette, the battery-operated heating element inside vaporizes the liquid in the cartridge generating a mist to inhale.

According to the study authors, smokers across the globe have been trying electronic cigarettes to help cut back on smoking, relieve symptoms of tobacco withdrawal or quit smoking altogether.

Very little scientific data on the health risks of using e-cigarettes exists.

For this clinical trial, the researchers recruited 300 otherwise healthy, smoking adults in Italy, who had no intention of quitting, to use e-cigarettes for 12 months.

The smokers were split into three groups, each containing 100 people.

Members of Group A were given an e-cigarette and 7.2-mg nicotine cartridges for 12 weeks. Members of Group B were given an e-cigarette and 7.2-mg nicotine cartridges for six weeks, followed by 5.4-mg nicotine cartridges for another six weeks. Members of Group C were given e-cigarettes with nicotine-free cartridges for 12 weeks.

Over the course of 12 months, the participants made nine visits to the trial site to report how much they had been smoking and give a breath sample to measure carbon monoxide levels in their blood.

Carbon monoxide is a toxic by-product of smoking, which can be measured with a machine that detects carbon monoxide parts per million (ppm) in a person's breath.

At the start of the study, the participants smoked an average of 19 cigarettes, nearly one whole pack, per day.

After 12 weeks, 25 percent of participants had dropped out of the study. By 12 months, 39 percent of the participants had dropped out.

Overall, after 12 months, 10 percent of Group A had reduced their cigarette smoking and 13 percent had quit. Among those in Group B, 9 percent had reduced their cigarette smoking and 9 percent had quit. And 12 percent of Group C had reduced their cigarette smoking and 4 percent had quit.

The study authors noted that reports of shortness of breath fell across the board from 20 percent at the start of the study to 4 percent after 12 months.

No increase in smoking-related side effects were found over the course of the trial.

The authors concluded that the use of e-cigarettes helped promote reducing or quitting smoking regular cigarettes with no added side effects. The authors suggested further investigations into the long-term safety of e-cigarette use.

In the US, there are no regulations on the amount of nicotine concentration or other chemicals allowed in an e-cigarette cartridge or serum.

This study was published in June in PLOS ONE.

Arbi Group Sri provided e-cigarette kits and cartridges for this experiment. Study co-author Riccardo Polosa has received lecture fees, consulting fees or research funding from Pfizer, GlaxoSmithKline and Arbi Group Sri.

Lega Italiana AntiFumo provided grant support for the study and the University of Catania provided funding for co-authors Pasquale Caponnetto and Riccardo Polosa.

Review Date: 
June 27, 2013
Last Updated:
September 6, 2013