E-cigarette Benefits and Risks

How are e-cigarettes used?

Current evidence suggests that e-cigarettes are 95% safer than tobacco. The research done so far suggests that they are at least as effective as nicotine patches or gum in helping people stop smoking. One study suggests that daily use of a tank device is the best option for most people.

E-cigarettes are not intended to be used alongside ordinary cigarettes but are intended to replace them. They are best used as part of a stop smoking programme. Free face-to-face support can be obtained from local NHS advisers.

Clinical Editor's comments (October 2017)
Dr Hayley Willacy read a study recently that predicted the numbers of years of life that might be saved if current smokers switched to e-cigarettes - see Further reading below. Up to 6.6 million premature deaths could be prevented over a ten-year period in the USA if smokers switched to e-cigarettes. As a result, the average 15 year old switching to e-cigarettes would increase their life expectancy by 0.5 years. These results raise questions about whether the time has come to make the sale of traditional cigarettes illegal. Until recently even if politicians had wanted to force a sales ban, nothing could match the efficiency of cigarettes for giving the nicotine hit. This meant a sales ban would never work.

Who uses e-cigarettes?

A recent survey found that about 2.8 million adults in Great Britain use e-cigarettes. 1.3 million of these have completely stopped smoking. When they were first launched, there was a concern that young people who had never smoked would experiment with e-cigarettes and then move on to smoking tobacco. This does not seem to have happened. Among the under-18s, whilst experimentation with e-cigarettes is fairly common, regular use is rare. Most people who use e-cigarettes have previously smoked tobacco.

What are the risks of e-cigarettes?

E-cigarettes are not risk-free although it can't be repeated often enough that they are much less risky than cigarettes. As well as nicotine, they contain potentially harmful chemicals but at much lower levels than those found in cigarettes.

The short-term risks of e-cigarettes are therefore minimal compared to cigarettes so if you are currently a smoker you would do well to start using them instead. If you have never been a smoker, it is pointless to take on the risk of using them, however small.

Current advice from the NHS is that, along with other forms of nicotine replacement, e-cigarettes are much less risky in pregnancy than smoking tobacco.

Unlike passive smoking, there is no evidence that the vapour produced by e-cigarettes is dangerous to bystanders.

Because they are relatively new on the market, the long-term safety of e-cigarettes is not yet known. They are being monitored but information will need to be gathered over several years before any conclusions can be reached.

Are e-cigarettes regulated?

Since May 2016, e-cigarettes have come under the regulations of the Tobacco and Related Products Regulations 2016. These ensure that the e-cigarettes you buy will have been assessed for quality and consistency and that sufficient information about them is made available to the public. The size of tanks and refills is now also restricted to ensure that people do not use excessive amounts of nicotine.

Since October 2015 it has become illegal for retailers in England and Wales to sell e-cigarettes to people under the age of 18 years or to adults buying them on behalf of people under the age of 18 years.

Are e-cigarettes available on prescription?

Unlike other forms of nicotine replacement, e-cigarettes are not yet available on prescription. This is because although they are regulated by the Government, none of the products is yet registered with the Medicines and Healthcare products Regulatory Agency (MHRA). Registration with the MHRA for any pharmaceutical product is a long and expensive process and none of the manufacturers has yet considered it worthwhile to go down this route. However, there is talk that the Government may make it easier for e-cigarettes to be registered in the future. If this ever happens, you'll hear about it in the media.

What do I do if I think I have had a side-effect to e-cigarettes?

As mentioned above, e-cigarettes are low-risk in the short term but they are relatively new products which are still being monitored. The manufacturers and the Government rely on reports from members of the public about any safety concerns. This is known as post-marketing surveillance.

Since 20th May 2016 the MHRA has collected safety concerns about e-cigarettes and their refill containers through its Yellow Card Scheme.

You can do this online at the following web address: www.mhra.gov.uk/yellowcard.

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Dr Laurence Knott
Peer Reviewer:
Dr John Cox
Document ID:
29456 (v1)
Last Checked:
15 July 2017
Next Review:
14 July 2020

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.