Focus: Electronic cigarettes – curse or blessing?

Electronic cigarettes (e-cigarettes) imitate smoking by technical means without actually burning tobacco. They are battery-powered electronic devices designed to inhale vaporised liquids. These “e-liquids” are based on a solution of propylene glycol and/or glycerine, which is mixed with concentrated flavours and, optionally, with a variable amount of nicotine.

E-cigarettes were first introduced at the start of the millennium and have made inroads into the traditional tobacco smoking market at an exponential rate in recent years. The devices are mainly sold over the internet, but are also available over the counter in tobacco stores, pharmacies and supermarkets.

While the e-cigarette business is growing rapidly, knowledge about the potential health effects is lagging behind. E-cigarettes and similar devices such as e-shishas or e-pipes are commonly marketed as healthier alternatives to conventional tobacco smoking. However, the long-term effects of inhaling e-cigarette vapour are not yet fully understood. Furthermore, it is not yet clear how e-cigarettes will affect the smoking behaviour of the public: Will the dominant trend be for conventional smokers to switch to e-cigarettes, thus generally improving public health? Or will non-smokers start using e-cigarettes, with potentially adverse effects on public health?

Regulation is also lagging behind. After several years of almost completely unregulated rapid growth, the e-cigarette business will likely face more stringent regulation in the coming years, as regulators and law makers in many major markets review their positions . This can also be expected to affect the public’s perception of e-cigarettes and the associated risks.

Given the high degree of uncertainty regarding health effects, consumer perception and regulation, a cautionary approach towards e-cigarettes seems justified. All related developments should be closely monitored and regularly reviewed to ensure that the underlying risk exposure is adequately assessed.