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Do e-cigarettes kill you? Researchers don’t know.

E-cigarettes come in all shapes and sizes.
E-cigarettes come in all shapes and sizes.
Dondi Tawatao / Getty Images News

The Food and Drug Administration currently doesn't regulate e-cigarettes (short for electronic cigarettes) — but some Congressional Democrats want that to change.

Sen. Dick Durbin (D-IL), Rep. Henry Waxman (D-CA), and other congressional Democrats pressed the agency Monday to restrict e-cigarette sales to teens. They released a report that found e-cigarette makers market the devices in ways that might appeal to youth, by offering candy and fruit flavors and advertising on television and radio.

The report serves as a good reminder that e-cigarettes — first introduced in 2006 — are a relatively new product that we don't know a ton about. The research is still ongoing about what harm they pose, and countries, including the US, are still sorting out how, exactly, e-cigarettes ought to be regulated.

How do e-cigarettes work?


An e-cigarette unscrewed. Oli Scarff / Getty Images News

E-cigarettes are slender electronic devices that imitate conventional smoking by vaporizing liquid nicotine. Using an e-cigarette can give a buzz similar to smoking cigarettes — only the buzz comes through vapor, not highly toxic cigarette smoke.

When a user inhales on the e-cigarette mouthpiece, it powers up the device. The e-cigarette then vaporizes some of the liquid nicotine, which is located in an insertable cartridge. The vaporized nicotine then flows through the device and into the user's mouth. Each hit has about 90 percent of the nicotine from a conventional cigarette puff, according to Popular Science.

What makes e-cigarette vapor different than tobacco smoke?


That vapor is odorless. AFP

E-cigarettes don't contain tobacco. Instead, they vaporize liquid nicotine (with perhaps some flavoring).

Conventional cigarettes, on the other hand, contain tobacco and all the additives tobacco companies add to the substance to make the product taste or feel a certain way.

Another key difference is tobacco is burned and inhaled as pungent smoke, while e-cigarettes just heat up liquid nicotine to turn it into an odorless vapor.

How many people use e-cigarettes?

The Centers for Disease Control and Prevention (CDC) in 2013 found 6.8 percent of youth in grades 6–12 and 6 percent of adults have used e-cigarettes. That represents about 5 million youth and 14.5 million adults.

Those who stuck with the habit now support a big market: Bloomberg Industries projects e-cigarette sales could reach $1.5 billion this year.

So can e-cigarettes kill you?


Can this kill you? Thomas Coex / AFP

We don't really know. One of the major risks of e-cigarettes right now is that we simply don't have a lot of good information about their health effects.

One study from an international group of scientists found e-cigarettes are safer than conventional cigarettes but still toxic. Researchers estimated conventional cigarette smoke contained 9-450 times more toxins than e-cigarette vapor. They also advised more research into the issue.

Another ongoing study indicates e-cigarettes could cause genetic mutations that can lead to cancer. Researchers from UCLA, Boston University, and the University of Texas so far found that certain cells exposed to e-cigarette vapor showed similar genetic changes as cells exposed to conventional cigarette smoke. The changes weren't identical, but researchers said there were striking similarities — enough to raise concerns that e-cigarettes could, at some level, lead to lung cancer.

Are there other potential risks to e-cigarettes?


The dark side of e-cigarettes. Frederic Brown / AFP

Researchers have linked some other risks to nicotine and e-cigarettes, including addiction, developmental issues among youth, and reports to poison centers.

For starters, nicotine is still addictive, as the Mayo Clinic explains. That means using e-cigarettes even a few times could lead to lifelong cravings for the drug.

And nicotine also poses some health concerns. Researchers from the University of California at Irvine found in their review of the research that nicotine alone — the main substance found in e-cigarettes — strains development for fetuses, newborns, children, and teenagers. Adolescents exposed to nicotine in particular showed enhanced vulnerability to impulsivity and mood disorders, among other issues.

The CDC also found the rise of e-cigarettes led to hundreds of phone calls to nationwide poison centers each year related to the product and liquid nicotine. Callers complained about vomiting, nausea, and eye irritation, and more than half the cases involved children five and younger.

Do e-cigarettes help people quit smoking?


This isn't an actual cigarette; it's an e-cigarette. Peter Macdiarmid / Getty Images News

Some research indicates e-cigarettes can help some people quit smoking, but e-cigarettes are far from a cure-all.

One study from Italian researchers followed smokers who originally didn't intend to quit but picked up e-cigarettes for one year. Roughly 8.7 percent quit conventional smoking by the end of the year, while 10.3 percent reduced their conventional smoking in favor of e-cigarettes.

Another study published in The Lancet had similar findings. The analysis found e-cigarettes, with or without nicotine, appeared similarly effective as nicotine patches.

In both studies, however, less than one in 10 of the studied population reportedly quit smoking altogether after taking up e-cigarettes. And, in the Italian study, the quit and reduced-consumption rates fell as people went back to smoking further into the year.

There's also research that indicates e-cigarettes could have the opposite effect: they might push people to start smoking. A study from the University of California in San Francisco found use of e-cigarettes was associated with higher odds of smoking among adolescents, and adolescents who experimented with e-cigarettes were less likely to abstain from picking up conventional smoking. Even worse, adolescents who smoked conventional cigarettes and e-cigarettes also smoked more cigarettes per day than those who only smoked cigarettes.

The problem, as researchers noted, is nicotine is still addictive, even if it comes in an e-cigarette. And, as the Mayo Clinic explains, a nicotine addiction is what drives people to consume tobacco all their lives despite the health problems it causes.

How does the federal government regulate e-cigarettes?


Congress's favorite traffic sign. Drew Angerer / Getty Images News

It basically doesn't, for now. Unlike conventional cigarettes, federal law doesn't prohibit e-cigarette sales to minors, free sample distributions of e-cigarettes, television and radio advertisements for e-cigarettes, and characterizing e-cigarettes with candy and fruit flavors that appeal to children.

The FDA in 2011 promised to regulate e-cigarettes as tobacco products, but an agency spokesperson said its latest proposal ran into a number of complicated, but so far unnamed, issues. The proposed rule was submitted in October to the Office of Management and Budget, and it's currently going through a review period. The spokesperson declined to comment further until the rule is published.

That leaves states, counties, and cities to enact e-cigarette regulations. The American Nonsmokers' Rights Foundation tracks which lower levels of government have acted here.

What's this I hear about e-cigarettes exploding?

E-cigarettes are electronics, so they can explode. Here is one example:

Still, like most electronic malfunctions, it's rare. Most people can use their e-cigarettes without worry of explosions.

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