Dangers of the Electronic Cigarette: Sorting Fact from Fiction 

FALSE. The e-cigarette is less dangerous than tobacco because it does not produce carbon monoxide, a highly toxic compound generated by the combustion of a traditional cigarette. It also does not contain the 4,000 harmful or carcinogenic substances found in tobacco.

This is sufficient reason for vaping to be officially recognised today as a harm reduction tool. Tabac Info Service states on its website that "if you completely quit smoking by using an electronic cigarette instead, you reduce the risk of developing serious diseases, such as cancer." This position is shared by the National Academy of Medicine, which states that "it is established that the vaporiser is less dangerous than the cigarette." On the other hand, British Health Authorities have been asserting for several years that "e-cigarettes are at least 95% less harmful than tobacco," based on scientific research.

As a reminder, traditional cigarettes cause the death of over 75,000 people each year in France alone.

FALSE. The composition of an electronic cigarette is not a mystery. First of all, it incorporates a simple vaporisation mechanism: the battery sends energy to a coil, heating the e liquid in the tank and transforming it into vapour. The e liquid itself is composed of several well-known elements.

Firstly, e liquid mainly consists of propylene glycol (PG) and vegetable glycerine (VG). PG has long been used in the food and pharmaceutical industries. It has several interesting properties for vaping. It serves as an excellent carrier for flavours and also enhances the throat hit (the sensation sought by smokers) caused by nicotine. VG, on the other hand, is a non-toxic solvent used in the food, pharmaceutical, and cosmetic industries. Its purpose is to increase the volume of vapour generated.

An e liquid can also contain nicotine, which is the only substance common to both traditional and electronic cigarettes. It is not carcinogenic (see below), but it possesses addictive properties. In the context of vaping, its role is to satisfy the smoker's craving during tobacco cessation.

Finally, an e liquid may contain food-grade flavours, which can be either natural or synthetic. These flavours give taste to the inhaled vapour. There is a wide variety of flavours in the world of electronic cigarettes so that individuals can find the one that suits them.

FALSE. Since 2016, the Tobacco Products Directive, transposed into French law by the Ordinance of May 19, 2016, has established strict regulations for vaping products. It regulates nicotine e-liquids, specifying that the maximum volume cannot exceed 10 ml, and the nicotine content cannot exceed 20 mg/ml. It also requires manufacturers to provide user instructions and various mandatory labelling.

This Directive has also established continuous market surveillance of vaping products. All nicotine e-liquids must be notified six months before being placed on the market. In France, ANSES is responsible for collecting and analysing all this information.

FALSE. The danger of tobacco cigarettes is not directly related to nicotine. As mentioned earlier, substances like carbon monoxide and tar are the ones that contribute to the development of cancer. Nicotine itself is not carcinogenic, which is why it can be found in many nicotine replacement therapies sold in pharmacies (such as patches or gum).

However, nicotine has gained a bad reputation, mainly due to the confusion between addiction and toxicity. While nicotine consumption leads to addiction in smokers, it does not directly cause cancer.

TRUE. E liquids for electronic cigarettes can contain nicotine and therefore can lead to addiction. However, vaping is intended for smokers who are already addicted to nicotine. This is why non-smokers should not use e-cigarettes.

The purpose of nicotine in an e liquid is to alleviate the cravings experienced by smokers during tobacco cessation. Once a smoker successfully quits smoking, they can gradually reduce their nicotine intake to decrease their dependence on it.

FALSE. The vapour from an electronic cigarette does not expose those around you to the inhalation of the 4,000 chemical substances present in tobacco smoke, including irritants, toxic products, and over 50 substances that are known to cause or promote the development of cancer.

Passive vaping is therefore less problematic than passive smoking, which has been proven to be harmful worldwide. According to an official report requested by the Ministry of Health, the elements in the vapour of an e cigarette dissipates by 95% in less than a minute in a room where it is used. The authors of the report state that the half-life of vapour is approximately a hundred times shorter than the half-life of tobacco smoke.

Furthermore, the report states that the components found in e cigarette vapour (propylene glycol, vegetable glycerine, flavours, nicotine, etc.) are present at "levels much lower than the values considered toxic or carcinogenic, even under the most extreme conditions of e cigarette use."

Therefore, they conclude that e cigarette vapour not only has a shorter lifespan than smoke from a traditional cigarette but is also much less toxic.

However, it is still important to protect those around you. We particularly recommend not exposing minors to e cigarette vapour and, whenever possible, avoiding vaping in the presence of non-smokers.

FALSE. Simultaneously using an electronic cigarette and a traditional cigarette does not pose immediate problems. In fact, it can be advised initially to help you get accustomed to vaping while maintaining an optimal nicotine intake.

However, completely quitting smoking should remain a priority in the long term. Even if you decrease your consumption and smoke only a little, you are still exposing yourself to the harmful effects of tobacco. A Norwegian study demonstrated that light smokers (smoking fewer than 4 cigarettes per day) have a mortality rate 50% higher than non-smokers. They are also three times more likely to die from cardiovascular disease than non-smokers.

If you use an electronic cigarette and continue to smoke, even if you have reduced your tobacco consumption, the risk of developing tobacco-related diseases persists. The best thing for your health is to strive to quit smoking completely and permanently.

TRUE. Frequent vaping can eventually lead to a sensation of dry mouth or even throat irritation. It is important in such cases to stay well hydrated. A high nicotine concentration can also cause headaches, nausea, or dizziness. In such cases, it is advisable to lower the nicotine level.

Furthermore, it is possible for an electronic cigarette to cause coughing fits. Again, a high nicotine level can be the cause. However, in the majority of cases, the e cigarette is simply making you feel the damage caused by tobacco to your mucous membranes. The sooner you quit smoking, the sooner this irritation will diminish.

FALSE. Although no serious study has definitively proven that the electronic cigarette does not cause weight gain, its principle functioning helps limit weight gain, typically associated with quitting smoking. Smokers who do not use any nicotine substitutes tend to compensate for their cravings with food. It is an instinctive reflex that also occupies their hands.

By quitting smoking through vaping, not only is the craving satisfied by the nicotine in the e liquid, but the "smoking gesture" is also preserved. Therefore, the body does not need to seek another form of compensation.

Of course, claiming that the electronic cigarette causes weight gain is as false as claiming that it helps with weight loss. In either case, it largely depends on the behavioural habits of the smoker. If you use an e-cigarette as a means of quitting smoking, it is possible that you may experience weight gain, but it will not be directly related to the electronic cigarette.

FALSE. While traditional cigarettes can yellow teeth, the same does not apply to vaping. E-cigarettes do not contain tar, which is the main cause of unsightly stains from tobacco.

In an interview published by Vap'You, a dentist explains that for a vaper, "tooth yellowing, which is a natural and inevitable phenomenon, will slow down and return to normal, just like a non-smoker." He also states that if a new patient comes to the dental office, they would not be able to detect that they vape, unlike a smoker”.

TRUE. It is possible for the electronic cigarette to cause a contact allergy if you are allergic to certain metals (such as nickel, for example). The solution in this case is simply to avoid models that contain those metals, as indicated on the product sheet.

Some components of e liquid can also be problematic, starting with the flavourings. People with food allergies should be cautious with the recipes of their e liquids and avoid those that replicate the taste of foods they are usually unable to consume.

Lastly, it is possible to be allergic to propylene glycol (PG). This type of allergy is very rare (less than 1% of the population is estimated to be affected) and should not be confused with PG intolerance, which is more common among vapers. PG intolerance manifests as milder symptoms (persistent cough, sore throat), which can actually be similar to those experienced when the nicotine level is too high. In such cases, the best solution is to opt for e liquids with a higher vegetable glycerine (VG) content. For those who are allergic, they should consider e-liquids that are 100% VG or based on veggie glycerol or vegetol.

TRUE. Smoking tobacco during pregnancy exposes the woman to various risks such as ectopic pregnancy, miscarriage, and premature delivery. However, in France, one in three women continues to smoke during this period, which is a sad record in Europe.

The question then arises regarding the use of electronic cigarettes. If quitting smoking is difficult, e-cigarettes can be considered a lesser evil. That's why Tabac Info Service does not formally discourage it but advises discussing it with a competent healthcare professional beforehand.

However, there is no evidence demonstrating the safety of electronic cigarettes on the foetus. Therefore, if possible, it is better for pregnant or breastfeeding women to avoid vaping, especially if the e liquid used contains nicotine.

To avoid this issue altogether, we recommend quitting smoking using an electronic cigarette before getting pregnant and gradually reducing nicotine intake. This way, you have a better chance of being completely smoke-free when the time comes!

TRUE. The electronic cigarette should not be used by non-smokers for several reasons. Firstly, e liquids for e cigarettes can contain nicotine, a substance that creates physiological addiction. Additionally, non-smokers may become accustomed to the gesture or taste of their e liquid and develop a psychological addiction. Lastly, the long-term effects of e-cigarettes are still controversial, and there is a potential health risk for non-smokers.

While e-cigarettes are an interesting tool for smokers in terms of risk reduction, they can have the opposite effect on non-smokers. They may develop an addiction they did not previously have and are more likely to transition from e-cigarettes to tobacco cigarettes. The rule remains: if you do not smoke, do not vape.

In France, according to a study by INPES, the proportion of non-smokers among vapers is very low, with 98% of vapers being current smokers (83%) or former smokers (15%).

FALSE. The electronic cigarette is not a medication, and no e cigarette has been granted marketing authorisation as a medicinal product. Currently, no manufacturer has submitted an application in that direction.

This is why e cigarettes cannot be prescribed by healthcare professionals as a substitute for tobacco or as an aid to quit smoking. They are also not sold in pharmacies because they are not on the list of goods that pharmacists can sell.

Therefore, the electronic cigarette is currently considered a consumer product.

FALSE. The batteries of electronic cigarettes do not present a higher risk of explosion than those of smartphones or laptops. Explosions are extremely rare and almost always linked to improper use.

The reason for these (extremely rare) explosions is also well-known to all battery manufacturers. It is called "thermal runaway," a chain reaction caused by very high heat, a violent impact, or a short circuit. The result is a very impressive and potentially dangerous "venting" of gases.

It is worth noting that in the world of electronic cigarettes, it is primarily the rechargeable batteries (large removable cells powering certain kits) that can pose a risk. However, there are very simple precautions to protect against such incidents.