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E-cigarettes: How harmful are they?

Published on Apr 25, 2014 5:42 PM

E-cigarettes are not just soaring in popularity in Singapore, but also in the rest of the world.

Under the Singapore Tobacco Act, the devices cannot be distributed, sold or imported. In the United States, the Food and Drug Administration (FDA) on Thursday proposed a set of rules to regulate e-cigarettes.

Calls for strict rules have become louder, following data from a new Centers for Disease Control study showing the number of calls to poison centres involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014.

These are alarming numbers. Equally distressing is that worldwide sales of e-cigarettes are expected to top US$10 billion (S$12.59 billion) by 2017, according to Wells Fargo, and will exceed those of traditional cigarettes by 2047, said Bloomberg Industries.

Various e-cigarette products for sale are seen at the Henley Vaporium in New York City in this file photo taken on Dec 18, 2013. E-cigarettes are not just soaring in popularity in Singapore, but also in the rest of the world. -- FILE PHOTO: REUTERS

Exactly how dangerous are e-cigarettes to health?

Inadequate studies
Supporters say there is no tobacco in e-cigarettes, so how can they be bad for health? Compared to normal cigarettes, e-cigarettes are definitely an alternative to tobacco. But studies on the side effects of inhaling pure liquid nicotine are inadequate to date, and therefore, unknown, warn health experts.

Nicotine levels
The caution then leads to the next point: Since the jury is still out on the effects of liquid nicotine inhalation, there is an equal chance of it being as harmful as it is safe, and if it is the former, the level of nicotine in an e-cigarette then becomes an issue, especially since users are able to choose cartridges filled with different quantities.

Also, liquid nicotine is just another form of nicotine, and it has long been acknowledged that nicotine is highly addictive.

Quality control
And even if nicotine inhalation is eventually proven safe, there is still the question of quality control. Health experts say that some manufacturers may not list all the chemical ingredients used in e-cigarettes.

Second-hand vapour
As with traditional cigarettes, there is second-hand smoke, or rather, vapour. Proponents protest that it is only water vapour and therefore innocuous - even as some users have complained of vomiting, nausea and eye irritation, from liquid nicotine ingestion - while opponents assert that there can be no certainty until conclusive research is done.

Gateway to tobacco use
Probably the greatest safety concern regarding e-cigarettes is not the physical harm to the user but to youths. In the US, e-cigarettes are marketed to children and teens in fruit and candy flavours - think chocolate, cherry and cotton candy - raising the worry among public health advocates that after e-cigarettes, which may glamourise smoking, come traditional cigarettes.

In March this year, the journal of the American Medical Association, published a study, concluding: "Use of e-cigarettes was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents."

With so much unknown surrounding them, e-cigarettes are like the wild, wild west. Perhaps then, the decision to pick up an e-cigarette should be based on what you don't know, instead of what you know.