Whether or not that is actually occurring, however, is simply unclear.

But Theodore Wagener, PhD, of the University of Oklahoma Health Sciences Center in Oklahoma City, says potential harms from e-cigarettes tend to be “overstated relative to the potential benefits,” noting that the risk of accidental poisoning “is no different from many household devices and chemicals available in supermarkets.” E-cigarettes might also represent a public health good, reducing secondary smoke exposures for nonsmokers, Wagener argues.


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It’s really just too soon to know, Brawley says, because too little research has been done.  

“Truth be told, we need to study e-cigarettes more,” American Cancer Society chief medical officer, Dr. Otis Brawley, tells The Advisor Blog. “I’m not a fan, but I’m certainly not willing to say they should be taken off the market because they are harmful.” 

Marketing spin and fearfulness have dominated the debate thus far, Dr. Brawley says.

“I see both e-cigarette advocates and manufactures making claims that are not scientifically proven, although they have not been disproven, either,” he says. “And I see some tobacco-control advocates, too, exaggerate in the opposite direction, definitely exaggerating or overstating the harms associated with e-cigarettes — claiming harms we really don’t have evidence for. There have been suggestions in the press from tobacco control advocates that e-cigarettes deliver carcinogens and cause biologic harm. That’s an overstatement. We don’t know that to be true. On the other hand, I’ve heard advocates claim e-cigarettes can be used as an effective way to withdraw from cigarettes. I don’t know that to be true, either.”

Indeed, although most e-cigarette users report using the devices to quit smoking, the median duration of e-cigarette use among former smokers appears to be nearly identical to that of simple tobacco abstinence: 100 days. A 2011 study published in the American Journal of Preventive Medicine reported that at 6 months since cigarette smoking cessation, 31% of e-cigarette users had not started smoking cigarettes again (95% CI: 24.8%-37.2%), although e-cigarettes did appear to help reduce the number of cigarettes smoked.

“The anti-e-cigarette crowd has one point that I see merit in: e-cigarettes might be a threat to antismoking laws,” Brawley says. “And there’s probably some kid who will see somebody using an e-cigarette and will decide to try cigarettes. The image of people using e-cigarettes is not good for tobacco cessation. That’s one legitimate concern. But on health concerns, I’m on the fence.”


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