An Update on e-Cigarettes and Health

By Michael Fergenson, AJN senior editorial coordinator

Photo by Michael Dorausch, via Flickr

Photo by Michael Dorausch, via Flickr

Last May, I wrote a post titled “E-Cigarettes: Positive Smoking Substitute or a New Problem Replacing the Old?” It explored the pros and cons of using e-cigarettes, then a relatively new and little-studied product, to aid in smoking cessation. The FDA has warned that little is known about how effective they are as smoking cessation aids and also warned that there is no way for consumers to know exactly how much nicotine and other potentially harmful chemicals are being inhaled during use. Concerns have also been raised that e-cigarettes could lead to children smoking real cigarettes. So, what have we learned since then?

One study says e-cigarettes are as effective as the patch

One study published in The Lancet, September 2013, recruited 584 smokers in Auckland, New Zealand, who wanted to quit. Half were given e-cigarettes and half got coupons for nicotine patches, and another 73 were given e-cigarettes without nicotine. The study found that smokers using the e-cigarette to help them quit were only slightly more successful than those using a nicotine patch: 7.3% of those using e-cigarettes quit smoking, compared to 5.8% of people using the patch. Either way, only 38 of the 584 quit, which wasn’t enough to enable researchers to say for sure that one approach was better than the other. In light of the small size of this study, more research must be done to see just how effective e-cigarettes are as a smoking cessation aid.

Concerns grow over youth smoking

In September 2013, the CDC published a report about e-cigarette usage among middle and high school students. According to that report, e-cigarette experimentation and recent use doubled for these students in the period from 2011 to 2012, from 3.3% to 6.8%, meaning that around 1.78 million students had used e-cigarettes as of 2012. The report expressed concern that an estimated 160,000 of these students had never used conventional cigarettes—e-cigarette use may lead to nicotine addiction and eventually result in the use of conventional cigarettes or other tobacco products. In addition, nicotine use has the potential to negatively affect adolescent brain development. Because adolescents are susceptible to social and environmental influences to use tobacco products, including e-cigarettes, the CDC says that developing strategies to prevent marketing and sales of e-cigarettes to youth is critical.

More research needed

There is still much we do not know about the safety and long-term efficacy of e-cigarettes. So, before you ask yourself, what is the best vape pen 2017, the FDA still warns that the contents may contain unknown, and potentially harmful, chemicals and more research is needed to see whether they are an effective means of smoking cessation. It is apparent, however, that some strategies and regulations to prevent use among teens may be practical. The European Union and United Kingdom are planning to regulate e-cigarettes as they would a medicine.

It remains to be seen if a balance can be struck between excessive regulation, which may push people back to regular cigarettes, and underregulation, which can lead to unsafe and unknown chemicals being used in e-cigarettes, along with the potential for young people to begin smoking.

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2017-01-04T14:39:34+00:00 October 18th, 2013|Nursing|3 Comments
Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Sam October 18, 2013 at 4:45 pm

    I bought an e cigarette just because i thought they were interesting and ended up quitting my nearly 2 pack a day habit less than a week later. I feel better and can finally BREATHE again! It helps with the hand to mouth habit (i loved having a cigarette while driving) this is something the patch can’t do. less than 2 years later i’m down to 6mg and almost off the nicotine completely. I can’t even be around people smoking cigarettes because it makes me sick to my stomach. so people an create as many biased articles as they like, but i know that they DO work as long as you start on the correct nicotine strength. I now work in a store that sells electronic cigarettes and it makes me so happy when customers come in thanking me for helping them kick the nasty cancer sticks. there are minimal health risks compared to the thousands of chemicals in regular cigarettes! I’m a n example that they do work and get to hear others success stories every day. I WILL fight for my right to vape!

  2. Kelly P. October 18, 2013 at 2:34 pm

    We have had a problem with employees “smoking” these in the nurses station, in the hallways, and in the telemetry room. At first a complaint was made to the manager about the inappropriateness in a hospital. After nothing was done, a complaint was made to HR. The staff were notified that the no-smoking policy encompassed e-cigarettes. They were aware that certain staff members did not like the e-cigarettes, so when the ban came out from HR, they bullied the employees who complained. Now employees smoke them in the break room. They make a point of saying things to the employees who object; comments like “Are you going to tell HR?” It is an uncomfortable predicament for the employees to be in.

  3. Betsy Marville RN October 18, 2013 at 10:58 am

    Thank you for highlighting this new emerging pushback from tobacco companies. It took years of lobbying, research and effort to establish laws that prevent targeting minors, and smoking indoors and on planes. As a former smoker, it was easier to quit when smoking was more and more inconvenient and unaccepted.
    Earlier this year several co-workers began using e-cigarettes in our office. I found out that there are no existing laws banning indoor e-cigarette smoking. When a coworker used one in my own office, I immediately became nauseated and had a sharp headache. I looked up online at the time for information and found “research” by a company that produces e-cigarettes stating that there was essentially no nicotine exhaled and there was no danger to second hand e-smoke. Whether I was reacting to exhaled nicotine or some additive, I can report that something was exhaled that had no good effect on me.
    Three coworkers in individual offices near mine continued to use them causing me to have to abandon my office as I got sicker each exposure. Although I had no legal right to request that they not use them, after speaking to our HR director, a request was made to everyone to use the e-cigarettes only outside. My colleagues are considerate and caring people and were using the e-cigarettes to help quit smoking or to avoid carcinogens of cigarettes. They stopped using them indoors immediately. i know they thought them harmless to all of us. I am concerned that since there is no regulation for indoor use, people less fortunate than I will be forced to inhale potentially harmful, certainly irritating vapors. I will have no right to request others not to use them in public buildings. There are also new TV ads with Jenny McCarthy using e-cigarettes and stating something like, it is time to take back the right to smoke. I grew up int the 60’s and 70’s and can still sing the lyrics of most of the TV cigarette jingles that we all learned while watching G-rated shows. We’ve come a long way baby, let’s not go back there again.

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