While electronic cigarettes debuted in 2003, they are now making an increasingly noticeable impact on the way American consumers handle their nicotine addiction. They are expected to become a $10 billion business by the year 2017 (only 4% of the total cigarette market)! Since the nicotine solution (water, glycerol, propylene glycol, and flavoring) does not contain tobacco, safety regulation is scarce, but marketing techniques present this method as a healthy alternative to tobacco smoking. But just how safe is electronic cigarette smoking? The US FDA has not yet determined the safety of the e-cigarette, but regulation is coming. Keep in mind that nicotine is a vehicle of dependence, making it a clear target for regulation (FDA, 2013a).
In one study performed by Cameron et al., seven e-cigarette nicotine solutions were analyzed for their concentration to see if they matched what their labels had printed on them. For all samples, the amount of nicotine present was equivalent to or lower than what was marked or printed on the manufacturer's concentration range provided. In essence, some companies were giving you less than you paid for. Even at lower levels, these nicotine solutions could be toxic or lethal if taken as otherwise directed. A fatal dose of nicotine is estimated at 30-60 mg in adults and 10 mg in children (Etter et al, 2011, p. 245). For example, if you have a 5 mL vial of 20 mg/mL nicotine solution, you have 100 mg (5 mL x 20 mg/mL) of nicotine, which is a lethal amount. Several reports of unintentional poisoning in children via toxicity (ingestion) can cause side effects such as vomiting, nausea, and tachycardia. Even scarier is that most vials are sold in 5, 10, or 20 mL vials posing a much greater threat to children than these side effects!
In 2009, the FDA published one of the first studies about "e-cigs" noting the carcinogens and toxic chemicals found in them such as diethylene glycol, also found in antifreeze (FDA, 2009). In September of 2010, the FDA issued warning letters to e-cigarette distributors to "get their act together" under the Federal Food, Drug, and Cosmetic Act 4 (FDA, 2010, p. 1). Since then, the e-cigarette industry has been under watch by the FDA and more regulation is anticipated.
While I'm not here to argue one way or the other, I simply wanted to bring light to evidence that hasn't seemed to surface well. I've seen lots of media about how e-cigarettes are the great alternative to bad smoking habits and while I agree, there is always another side of the story to consider. For example: further studies should be conducted to determine changes in gene expression of airway epithelial cells that occur in electronic smokers upon cessation of tobacco smoking. This would help bring light to the effectiveness of electronic cigarettes. More studies on secondhand vapor from e-cigarettes as well as the desire of people to avoid being exposed to the vapor in public places could also be conducted. As you can see, there is much work to be done until electronic cigarettes are able to truly replace tobacco smoking, which is why it is necessary to be so critical now at a moment when the product is most productive.
Sources:
http://onlinelibrary.wiley.com/doi/10.3322/caac.21226/full
http://ons.metapress.com/content/u243m081p2kh22r1/fulltext.pdf?page=1
http://tobaccocontrol.bmj.com/content/23/1/77.short
http://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201311-391FR#.U0Rh1VfYPyU
