February 06, 2017
3 min read
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E-cigarettes proven safer than traditional cigarettes

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Researchers observed lower levels of selected carcinogens and toxins among former smokers who only used nicotine replacement therapies or e-cigarettes long-term compared to people who had used combustible cigarettes long-term, according to recent findings.

Perspective from Frank Leone, MD, MS

“Although longitudinal cohort studies and randomized, controlled trials will provide the best data to answer questions about the safety and efficacy of e-cigarettes for smoking cessation, these designs are time- and resource-intensive,” Lion Shahab, PhD, from the department of epidemiology and public health at University College London, and colleagues wrote. “In the absence of long-term data, a more pragmatic approach is to compare smokers and former smokers with or without concurrent e-cigarette use in real-life settings.”

To examine the potential risk of long-term e-cigarette use, researchers designed a cross-sectional study in London, England to compare exposure to nicotine, tobacco-related carcinogens and toxins among smokers of combustible cigarettes, e-cigarettes and nicotine replacement therapy (NRT). They divided 181 participants into five groups: combustible cigarette-only users, former smokers who since quitting have used only e-cigarettes or only NRT long-term (6 months or longer) and long-term dual combustible cigarette/e-cigarette or combustible cigarette/NRT users. Shahab and colleagues analyzed participants’ urine and saliva for biomarkers of nicotine, tobacco-specific N-nitrosamines and volatile organic compounds.

The results showed significantly lower metabolite levels for tobacco-specific N-nitrosamines and volatile organic compounds in e-cigarette only and NRT-only users compared with combustible cigarette-only, dual combustible cigarette/e-cigarette or dual combustible cigarette/NRT users. The investigators observed lower levels of the metabolite 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol in e-cigarette-only users compared with all other groups. Among combustible cigarette-only, dual combustible cigarette/NRT and dual combustible cigarette/e-cigarette users, they observed similar levels of tobacco-specific N-nitrosamines and volatile organic compound metabolites.

“Long-term NRT-only or e-cigarette–only use among former smokers is associated with substantially reduced levels of selected carcinogens and toxins compared with combustible cigarette smoking; however, concurrent use of NRTs or e-cigarettes with combustible cigarettes does not seem to offer this benefit,” Shahab and colleagues wrote. “Nicotine delivery of e-cigarettes and NRTs, although variable, is roughly similar to combustible cigarettes, but smaller meaningful differences may exist.” by Savannah Demko


Disclosure: Shahab reports receiving grants from Cancer Research UK and Pfizer, and personal fees from Atlantis Health Care. Please see the full study for a list of all other author’s relevant financial disclosures.