Are E-Cigarettes Really Healthier Than Cigarettes?

Medically Reviewed

It’s been over a decade since smoking was banned in bars, restaurants and clubs in my native New York; my current home state of Virginia followed suit some years later. So it came as a surprise when I looked down a bar to see a man puffing away on what appeared to be a cigarette. However, when he exhaled the “smoke,” it disappeared instantly into the air. It was an e-cigarette, the newest alternative to smoking.

E-cigarettes are an alternative option to consuming regular cigarettes. A user “inhales,” which triggers a heating element in the plastic cigarette that immediately turns water into vapor. Water vapor is then released in a puff, powered by a small battery. The puff of vapor contains nicotine, which is then inhaled by the smokers. Flavorings can also be added to make the inhalation more enjoyable, according to manufacturers. Differing from normal cigarettes, there is no combustion, and thus, no smoke. The batteries can be recharged, and an e-cigarette can be used a number of times before nicotine refills are needed.

Defenders of e-cigarettes rely on two key arguments.

First, e-cigarettes do not produce the amount of second-hand smoke as cigarettes. Though not completely harmless – a study in Nicotine and Tobacco Research found that second-hand inhalers were still exposed to nicotine – those people around puffers are not exposed to the dangerous chemicals and toxins often associated with second-hand smoke.

Some also argue that e-cigarettes can be effective at helping people quit smoking, as smokers can more safely reduce their nicotine intake, fulfilling cravings without taking in as many dangerous substances. In fact, an American Journal of Preventive Medicine study found that e-cigarettes are being widely used by those trying to quit smoking.

Others remain skeptical, concerned that the multiple-use e-cigarette that produces no smell or apparent smoke could be used as a gateway for teens into tobacco use. A report from the Centers for Disease Control and Prevention found that use of e-cigarettes doubled among middle and high school students between 2011 and 2012. A 2012 study from the University of Athens found that electronic cigarettes still do damage to the lungs, raising airway resistance in those taking drags.

Despite the FDA reporting that “e-cigarettes have not been fully studied,” leaving many questions about safety, e-cigarettes are growing in popularity. Despite so many outstanding questions, there is little regulation of e-cigarettes. In an editorial for, Harold P. Wimmer, President and CEO of the American Lung Association, said we are currently living in the Wild West – a “lawless frontier where (the makers of electronic cigarettes) can say or do whatever they want, no matter the consequences.”

While the debate rages about the health consequences of e-cigarettes, some municipalities are looking to get out in front of the movement and take a stand against their use. New York City has recently banned the use of e-cigarettes indoors, for example. North Dakota, New Jersey and Utah prohibit the use of e-cigarettes in smoke-free zones; nine states have rules prohibiting their use in other smoke-free areas, including school zones or state workplaces. Currently, a proposal to regulate e-cigarettes is under review at the White House Office of Management and Budget.

This movement towards regulating e-cigarettes may bother some people, though the legislators feel they are doing their parts to keep Americans safe until the FDA can act. However, until e-cigarettes can be proven to be dangerous to society, the debate will likely continue.


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Centers for Disease Control and Prevention. (September 6, 2013). “Notes from the field: electronic cigarette use among middle and high school students – United States, 2011-2012.” Morbidity and Mortality Weekly Report. Retrieved from

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Reuters. (January 3, 2014). “Secondhand vapor from e-cigarettes contains nicotine but not other toxins: study.” New York Daily News. Retrieved from

Rojas, M., Izzo, M. (December 30, 2013). “Healthy or harmful? Smoking out the truth about e-cigarettes.” Daily Record. Retrieved from

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