Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit
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Aims: We reviewed available research on the use, content and safety of electronic cigarettes ( EC ), and on their effects on users, to assess their potential for harm or benefit and to extract evidence that can guide future policy. Methods: Studies were identified by systematic database searches and screening references to F ebruary 2014. Results: EC aerosol can contain some of the toxicants present in tobacco smoke, but at levels which are much lower. Long‐term health effects of EC use are unknown but compared with cigarettes, EC are likely to be much less, if at all, harmful to users or bystanders. EC are increasingly popular among smokers, but to date there is no evidence of regular use by never‐smokers or by non‐smoking children. EC enable some users to reduce or quit smoking. Conclusions: Allowing EC to compete with cigarettes in the market‐place might decrease smoking‐related morbidity and mortality. Regulating EC as strictly as cigarettes, or even more strictly as some regulators propose, is not warranted on current evidence. Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to EC as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use.
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Vaping does not involve tobacco combustion, which is the primary source of harm from smoking cigarettes.
“Vaping has the advantage that it does not involve tobacco combustion, which is the primary source of harm from smoking cigarettes [7, 17].”
From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [7]
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Hajek, P., Przulj, D., Pesola, F., Griffiths, C., Walton, R., McRobbie, H., Coleman, T., Lewis, S., Whitemore, R., Clark, M., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-01808-0 · Cited by 85 · see citing works
Self-citationPrevalence of major risk factors and use of screening tests for cancer in the United States
Fedewa, S. A., Sauer, A. G., Siegel, R. L., & Jemal, A. (2015) · Cancer Epidemiology, Biomarkers & Prevention · doi:10.1158/1055-9965.epi-15-0134 · Cited by 77 · see citing works
Hajek, P., Phillips-Waller, A., Przulj, D., Pesola, F., Smith, K. M., Bisal, N., Li, J., Parrott, S., Sasieni, P., Dawkins, L., et al. (2019) · Health Technology Assessment · doi:10.3310/hta23430 · Cited by 72 · see citing works
Self-citationAddiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping
Frie, J. A., Nolan, C. J., Murray, J. E., & Khokhar, J. Y. (2022) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntab231 · Cited by 53 · see citing works
Vaping during pregnancy: a systematic review of health outcomes.
Ussher, M., Fleming, J., & Brose, L. (2024) · BMC pregnancy and childbirth · doi:10.1186/s12884-024-06633-6 · Cited by 27 · see citing works
“Vaping involves heating liquid which typically contains flavourings, propylene glycol and vegetable glycerine [7], and results in the formation of carcinogens and toxicants, including nitrosamines, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and heavy metals, which…”
Background
- Authors
- Hajek, P., Etter, J., Benowitz, N., Eissenberg, T., & McRobbie, H.
- Affiliations
- UK Centre for Tobacco and Alcohol Studies Wolfson Institute of Preventive Medicine Queen Mary University of London London UK
- University of Geneva (CH)
- University of California, San Francisco (US)
- Virginia Commonwealth University (US)
- Queen Mary University of London (GB)
- Corresponding author
- McRobbie, Hayden
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2014-07-31
- Volume
- 109
- Issue
- 11
- Pages
- 1801-1810
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC4487785
- OpenAlex
- W2121853742
- Semantic Scholar
- cbaed68727c2a9fd4c69fa3fed2a0789c8c9d4c5
- Cited by
- 546
- References
- 100
- Citations by year
- 2026: 13 · 2025: 19 · 2024: 20 · 2023: 26 · 2022: 29 · 2021: 34 · 2020: 48 · 2019: 53 · 2018: 60 · 2017: 59 · 2016: 66 · 2015: 98 · 2014: 19 · 2012: 1
- FWCI
- 9.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-sa)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- National Institutes of Health
- Medical Research Council (MR/K023195/1)
- Economic and Social Research Council (ES/G007489/1)
- National Institute on Drug Abuse (R01-DA 02277, R01DA002277, P50DA036105)
- National Cancer Institute (P50CA180890)
- Center for Tobacco Products (P50DA036105, P50CA180890)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Inhalation and Respiratory Drug Delivery
- Keywords
- electronic cigarettes, e-cigarette aerosol, harm reduction, smoking cessation, never smokers, children, e-cigarette regulation, health policy, nicotine use
- MeSH terms
- Smoking Prevention, Humans, Nicotine, Safety, Risk Assessment, Electronic Nicotine Delivery Systems
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