Do Electronic Cigarettes Actually Work?

There are all sorts of products out on the market made to wean smokers off a dangerous habit—the patch, the lozenge, and the gum, for example. Yet, what about the e-cigarette?

Though it’s marketed as a “safer” alternative to cigarettes, and not necessarily a smoking-cessation device, unlike the other nicotine delivery products, e-cigarettes—battery-operated devices that supposedly work by heating up a liquid nicotine substance which “e-smokers” inhale as vapor—aren’t regulated by the Food and Drug Administration (FDA).

In fact, according to the American Medical Association, on January 14, a federal judge ruled that e-cigarettes should not be subject to FDA regulation because they are merely an alternative to traditional cigarettes, which are readily available. Medical experts counter that, though they may be marketed as alternatives to traditional cigarettes, people are turning to them as a smoking cessation product, which means that greater oversight is critical.

In the midst of this heated debate, however, a researcher from the Institute for Drug and Alcohol Studies at Virginia Commonwealth University decided to put two brands of e-cigarettes to the test, to see just how they stack up against actual cigarettes. His findings, published in the February issue of the journal Tobacco Control, suggest that the e-smokes fail to deliver much nicotine, or help reduce cravings.

The study, led by psychologist Thomas Eissenberg, included 16 smokers. In four different phases of the study, each separated by two days, they were asked to: smoke a cigarette from their preferred brand; “sham smoke” a cigarette—or basically “puff” on it without lighting it; use an Njoy NPRO electronic cigarette filled with a 16mg nicotine cartridge; and use a Crown 7 Hydro e-cigarette filled with a 16mg nicotine cartridge. Both e-cigarettes’ batteries were fully charged for each “smoking” session.

Prior to the trials, smokers were asked to abstain from nicotine for 12 hours. At the beginning of each session, they had catheters inserted into their veins, enabling researchers to take blood samples multiple times—5, 15, 30 and 45 minutes after the first puff—to measure for nicotine content. They found that, as you would expect, actually smoking dramatically increased nicotine content in the blood. Yet, when it came to the e-cigarettes, both brands increased nicotine content only nominally more than sham smoking. What’s more, the products did little to reduce cigarette cravings.

In light of the findings, Eissenberg argues for more thorough testing and regulation of the products, as well as a greater awareness of potential health risks of misuse. As he points out, for example, the refill liquid for e-cigarettes, which is meant to be added by the drop, is sold in bottles containing some 500mg of nicotine, or 10 times the lethal dose. As Eissenberg concludes:

“[T]he results reported here all support the notion that electronic nicotine delivery devices (E- cigarettes) and their nicotine-containing solution should be evaluated, regulated, labeled and packaged in a manner consistent with cartridge content and product effect. At the least, consumers should be aware that, unlike several regulated nicotine products (eg, gum,patch), these putative drug delivery systems do not deliver nicotine effectively after acute administration.”

Eissenberg’s findings add to earlier concerns from the FDA, the World Health Organization, and other health organizations that have questioned the safety of the faux cigarettes and urged potential users to “exercise caution.”

So, what’s the bottom line? If you’re looking for a safer alternative to cigarettes, it’s hard to oversell the health benefits of kicking the habit. And if you’re looking for products to help you quit smoking, it’s best to look elsewhere.

Related Topics: cigarette, e-cigarette, electronic cigarette, quit smoking, smoking, Tobacco, Addiction, Mental Health
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  • watfordjc

    Just wondering if you have looked at any of the comments to the CNN article, since what you have wrote seems to be a verbatim copy of that article.

    Just one problem is that you mention 500mg nicotine being a lethal dose yet don’t cite a single reported incident of fatal nicotine poisoning as a result of electronic cigarettes. Statistics for deaths from nicotine poisoning do not appear to be readily available.

    You also link to an page that suggests that medical intervention for smoking cessation is the best way to succeed, when this study suggests people are more likely to succeed with unassisted cessation: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000216

    You seem to have ignored most of the concerns about the validity of the study and how it was conducted, including the participants not being given guidance on how to use an electronic cigarette.

  • kingjack2002

    I will be honest here. I am very much into the e-cigarette industry, and I am all for them. Why would you call the name of your article… Do electronic Cigarettes work? So… do Regular Cigarettes Work? They are simply an alternative to smoking. http://www.electroniccigarettesource.com – there is a lot of information here. I am obviously no doctor, but some people are just addicted to the habit of putting something in their mouth… like a habit. I’m not saying that e cigs are a quit smoking product, but they have helped me cut back. Of course e-cigs work. You get to satisfy your nicotine cravings and the oral fixation of smoking… without using regular cigs. So ya they work. BUT they will never get a pack a day smoker to Quit.

  • treecevapes

    Yes, electronic cigarettes really do work as a viable alternative to smoking, as is evident by the hundreds of thousands of former smokers in the U.S. who are currently using them to replace smoking.

    The American Association of Public Health Physicians has stated that the risk associated with electronic cigarettes is likely much less than 1% of the risks posed by combustible cigarettes.

    You can add to that list of experts the American Counsel on Science and Health, Action on Smoking and Healh–U.K., Health New Zealand (founded by Dr. Murray Laugesen), Dr. Michael Siegel (Boston University of Public Health), Bill Godshall (Executive Director, Smokefree Pennsylvania), Dr. Dean Edell (radio talk show host), Drs. Carl Phillips and Brad Rodu (tobaccoharmreduction.org), and Dr. David Baron (Chief of Staff, UCLA), among others.

    As you can see, it would have been a simple thing to find a different perspective on, for example, the FDA propagandized analysis released last year. In its press release, the FDA stated it had found carcinogens in some of the 18 cartridges it tested. Unfortunately, what it didn’t state is that the levels of those carcinogens are about the same as those found in the patch. That’s *detectable.* As in, hardly there.

    The folks raging against the e-cigarette tend to be more than a bit on the anti-smoking zealot side of things and adhere to an all-or-nothing, quit-or-die mentality. Since 440,000 deaths in the United States will be attributed to smoking-related illnesses this year alone, that mentality is obviously about as effective as FDA-approved smoking cessation methods, which is to say: so ineffective that one wonders how they get away with it.

    The biggest problem with Dr. Eissenberg’s study (aside from the sensationalist sound bites used by the media) is that his subjects had never vaped (used an e-cigarette) before, and there’s a learning curve involved that entails taking more than 10 puffs. Vaping and smoking require a different technique.

    The real bottom line? The writer didn’t do enough research to provide accurate information and, as a result, may have turned smokers away from trying an e-cigarette–the one and only thing that has ever worked for so many former smokers.

  • billster23

    This is totally biased…we have done a small pilot study to show how effective the electronic cigarette can be for people to get off tobacco smoking…www.smokestik.com has the report on the front page…if you call that study that was done scientific ….then the study done by smokestik is probably worth a Noble Prize…

  • ezmoose

    I can only speak from my own experience. I smoked two packs of cigarettes per day for 40+ years. Over two months ago, I tried an E Cigarette and haven’t smoked a single cigarette since. E Cigarettes satisfy my nicotine cravings absent the 4000 chemicals associated with smoking. I never tried any of the smoking cessation devices as frankly I am not interested in quitting nicotine. I don’t drink or use illegal drugs, I eat healthy, exercise regularly, and I am not overweight. The only indulgences I allow myself are nicotine (now without smoking) and caffeine. I doubt either of these poses significant health risks. People use E Cigarettes for a number of reasons; however, in my case, they are just a safer alternative to smoking and that works for me.

  • http://madmerv.wordpress.com madmerv

    I smell Tobacco lobbying in this article. Anyway, we don’t know how much damage it is doing, but it only has like 18 chemicals in it which is very minute compared to the 4000 chemicals in cigarettes — nicotine and coffee are bad for you (caffeine can cause psychosis and has long term damage with repeated use) and nicotine acts like glue on arterial plaques, damages the heart and arteries by stressing them through release of vasopressin (the chemical responsible for arteries “beating” via constriction alternative to the heart beat). I think it is easy to stop smoking cigarettes on a regular basis using this as a placebo, and I think you can wean yourself more effectively using it, but we do not know entirely what the health effects are. I suspect that it does a similar type of damage, but in a drastically reduced way.

  • http://madmerv.wordpress.com madmerv

    Nicotine is one of the world’s strongest poisons. I think the bottles should come with a warning label like “Warning: keep out of reach of children!” … if you drank a bottle or three of nicotine e-juice, I bet you would go into convulsions, vomit and possibly die. That’s why Johnson’s Creek smoke juice gives you a syringe and a pair of neoprene gloves with the starter kit.

    I have been using it for a few weeks and I’ve had a very small amount of regular cigarettes since I switched. This is the second time I tried to switch, btw, as I regressed during my previous attempt. However, I feel more confident now that I can move forward with my quitting plan. One of the best things about e-cigs is that they disrupt your normal nicotine intake so dramatically (due to varying doses, the ability to make your own non-nicotine juice, etc), that if you can make it a few days you can probably get away from nicotine altogether. I probably use less nicotine now than when I was smoking a pack a day — additionally, I am certain my lungs are in better shape since I cough maybe 2-3 times lightly per day now instead of 50-100 times which is what happens when I smoke real cigarettes (btw I was smoking those super slims which are about 1/2 to 1/3rd the size of a standard 100mm cig).

    I have noticed, though, that PG irritates the mucus membranes which probably means its doing damage that might contribute to cellular/DNA damage (aka cancer and precancer). I make my own from glycerine-only. It is a much nicer experience. I was able to mix Gotu Kola and other extracts of herbs to basically replace nicotine use with aromatherapy. *Be careful what herbs you use for custom mixes, as some of them are also carcinogenic!*

  • http://madmerv.wordpress.com madmerv

    Maybe this writer could write a similar article called “Do cars really move around?” or “Does the Web really serve content?” or “Do congressmen actually love their wives more than their mistresses?”

  • ezmoose

    Nicotine and caffeine may present some health risks (as do Big Macs, Alcohol, Driving, etc.); however, the pleasure outweighs the risks for me. Besides, I’m too old to die young! lol

  • http://cecorettes.wordpress.com cecorettes

    Incredible,yet another so called study on the effectiveness of electronic cigarettes!!!
    Is it not time that all the current positive research is put together and published as a docket on the alternative safer and healthier way of smoking.
    Clinical trials in New Zealand, South Africa and the USA have found Ecigs such as Cecorettes, Njoy etc to be 95% safer than traditional cigarettes.These trials also show Cecorettes and other Ecigs to be far more successful in reducing ones normal cigarette intake than patches and nicotine gum.Why these products are used by the NHS and other Health departments is beyond belief!! considering that the NRT products, patches and gum only have a one in five success rate,while in the clinical trials ecigs had about 80% or more success rate,and are not even marketed as cessation products,they are sold as alternatives.
    Wake up Dr Thomas Eissenberg,read the full medical reports, and do a real test with all products tested and compaired fairly.

  • http://cecorettes.wordpress.com cecorettes

    Oh !,I forgot to mention Dr Eissenberg,I would be more than happy to send you a full Cecorette starter kit free of charge,for you or a friend to actually use.No doubt you are probably a non smoker,but I am sure that one of your Doctor friends smokes,so let he or she try it out,and find like me, that by using it over just a single week, you do get the nicotine hit without all the poisons and that you can go without a real cigarette for hours whilst using the cecorette as an alternative.

  • amynjoy

    Ben Thomas, Ph.D., a well-respected consultant with 35 years experience in toxicology, pathology, and risk mitigation was interviewed for this article, but unfortunately was not quoted. His points provide valuable factual information and insights on the study�s rather significant design and control flaws:

    - We know there is nicotine in the vapor that is consumed by NJOY customers. This was determined by separate tests by both NJOY and FDA. That being the case, it is highly improbable that there wouldnt be a marked presence of nicotine in the plasma, contrary to the results of the VCU study.

    - A possible reason that could explain the discrepancy between the NJOY and FDA studies, and the VCU study, is that there was no control that we can see for ensuring an equal volume of smoke/vapor was being consumed per puff and without controls for equal consumption the results have to be drawn into question.

    - Relative to the assessment of craving satisfaction, it is impressive how well NJOY did in one instance showing no statistical difference in its craving satisfaction ability compared to a combustible cigarette considering the lack of controls for puff volume.

    - Further, it is important to note that craving satisfaction data is not empirical; it is based on opinion. And to that end, the study was not done blind (so the study participants were aware of which products they were consuming), which means if the participant wasn�t predisposed to trying an electronic cigarette on a self-selected basis (and therefore was happy using combustible cigarettes), their opinions on how well NJOY satisfied their craving by comparison is likely biased in favor of combustible cigarettes.�

    Also, considering reading this as well (http://www.new.njoy.com/customers-say-noy-electronic-cigarettes-satisfying)

  • http://noisytechblog.wordpress.com noisytechblog

    I think 50% of it for me is the action of smoking..the physical action of smoking and the other half was the actual nicotine. I quit after 5 years of smoking and my mother in law after 30 years with e-cigarettes.

    To answer the safety question…common logic suggest they are MUCH MUCH safer than traditional cigarettes. 4000 chemicals vs a few and no tar, smoke or carcinogens. There hasnt been many studies done yet so most companies dont make health claims due to FDA regulations. THey are also much cheaper in the long run vs treaditional cigarettes.

    I tried a few different brands before I found one that I like with the ProSmoke electronic cigarette. Their site is http://www.ProSmokeStore.com. Not spam, just offering you a choice since I had to buya few brands before I found one that tastes great and produced the same amount of vapor or more than a real cigarette. No reason to switch if it doesnt feel the same right?!!?

    They also dont charge you every month for refills like other companies, you buy them as you need.

    Good luck!

  • http://rwoodin.wordpress.com rwoodin

    I have to wonder why there are so many articles about electronic cigarettes like this one popping up all over.

    I smoked tobacco cigs for 37 years and was definately suffering from their effects.

    I was aware, but did not care one way or another about e-cigarettes. I had tried to quit smoking many times using all the available aids – zyban, chantrix, gum, patches. I had lost both of my parents to smoking related deaths and had resigned myself to probably dying from the effects of my habit.

    Then I tried to sell my house and had trouble doing so because of the smoke smell.

    I decided to try e-cigarettes to be able to smoke in the house and not create any odor.

    I never planned on actually quitting cigarettes. No one was more amazed then myself when I found that e-cigarettes were a perfectly adequate substitute for cigarettes – for a heavy smoker such as myself. Some of the ‘Mall’ brands of e-cigarettes that are sold in the kiosk’s might not be to much like a real cigarette. But a little research and experimentation with the many products available online quickly showed me that there are e-cigarettes that taste and act so much like regular cigarettes you can barely tell the difference!

    I decided to try and just smoke e-cigarettes and again, to my amazement found that it was VERY EASY to switch from a 37 year deadly tobacco habit to electronic cigarettes.

    I do not know for a fact that e-cigarettes are ‘healthier’ than regular cigarettes.

    I do know for a fact that my lungs and breathing, which was always labored and congested, cleared up completely.

    My sense of smell returned.

    I’m not getting sick with respiratory and sinus infections any more.

    Most importantly, I feel that my death sentence has been lifted from me. In my opinion, and my opinion alone, I feel that I’m in no where near the danger of developing a fatal condition as I was when I was smoking cigarettes.

    And I never planned on any of this. Thirty Seven years smoking up tp 2 packs of cigarettes a day.

    How dare you keep spewing out the same tired, one sided, narrow minded, biased, poorly researched and extremely limited point of view articles such as this.

    There are literally tens of millions of people just like myself that would gladly give up cigarettes for an acceptable alternative.

    Instead of trying to take an open minded view towards a technology that has the potential to save millions upon millions of lives, the goverment, the FDA and antismoking crusaders have all banded together in an attempt to outlaw electronic cigarettes. And what will be offered to help smokers reduce the harm caused by their tobacco habits? Well, tobacco of course! The FDA has no plans to stop the sale of regular tobacco cigarettes, which are highly taxed and very profitable to the goverment, tobacco and pharmaceutical industries . Tobacco companies will package and sell their product, the goverment will allow it while putting their official stamp of approval on every pack of cigarettes sold and the pharmaceutical companies will continue to churn out very expensive, low succes rate ‘smoking cessation’ products. It’s the gravy train don’t you know?

    It has been quite an education in POLITICS for me this past 6 months as I have learned, from actual in depth research and study, about the many different aspects of this issue.

    Ralph Woodin

  • http://ecigo.wordpress.com ecigo

    From my personal experience e-cigs have been pretty much the only thing that has kept me off the ‘real’ tobacco cigarettes, so for me they have been a god-send.

    However I would agree with noisytechblog in that it is well worth checking out numerous brands to find the flavor, strength and design that’ll best suit you… there are quite a few listed here: http://www.electroniccigaretteadvisor.com/reviews.html for those of you that wish to find out more. Personally I enjoy the blu brand, but it really is all down to personal taste. Shop around and you’re more likely to get a good fit…

  • http://purevapor.wordpress.com purevapor

    This just goes to show you how much wealth and influence the tobacco companies have. From our government to our Doctors we trust to give us honest information about products and they still continue to lie to us.
    As an ex 22 year smoker I can personally tell you that E-Cigarettes have changed my life. I have been without a cigarette for 2 months now and no desire to go back to them. I can also tell you that if the electronic cigarette didn’t deliver the nicotine this wouldn’t have been a viable alternative for me as I am a huge addict. Instead of smoking the 4000 chemicals in cigarettes now I smoke the e-cigarette. Tobacco along with drugs and alcohol are all big money makers for our economy that is why they are trying to cover this up.
    Without 450,000 people kicking the bucket each year the drug companies, hospitals, and all services connected with them wouldn’t make the money they do. That is why this country is in the dire straits that it is. It is all a big scheme to keep Americans smoking and all of the pharmaceutical companies richer. Who do you think pushed the FDA to move on electronic cigarettes in their feeble attempt to shut down the importation of electronic cigarettes? Our country is so corrupt it’s unbelievable.
    There is no doubt in my mind on the success that electronic cigarettes will have in helping people stop smoking. The problem that the FDA and everyone else is that it’s a loophole and at this time they cannot find a basis which to get their greedy paws on the industry to tax and regulate it.
    Let’s see an honest and factual article based on science and from a group that isn’t in bed with the tobacco and pharmaceutical companies. This article is non-sense.

  • http://cecorettes.wordpress.com cecorettes

    I could not agree more that electronic cecorettes will eventually be used as a quit smoking aid,they are proving to be far more succesful than common NRT products like nicorette gum and patches.The problem is that the giant tobacco companies and phamaceutical companies want the e-cig to be banned.These major players are trying everything in their power to halt the developement of electronic cigarettes.
    We at Cecorettes international plan to raise millions of dollars by private investment,to carry out all the neccessary government testing and clinical research in order to move ahead and make the cecorette electronic cigarette available all over the world,with the eventual support of all the cynics and sceptics currently opposed to the developement and acceptance of e-cigs as a true smoking alternative.
    for further information on cecorettes research,visit
    Http://www.cecorettesinternational.com.
    Any interested investors should contact Tony@cecorettes.com

  • http://cecorettes.wordpress.com cecorettes

    Further to our recent comment on this blog,anyone wishing to contact Cecorettes can do so at http://www.cecorettesinternational.com

  • http://themediterraneanmama.com reverena

    Yes, they absolutely do work! They have helped me quit, and I truly loved smoking. I enjoyed smoking. Now, I have time with my kids, I feel comfortable and relaxed, I barely need to use the E-cig and I haven’t gained any weight from quitting! If you read my story, http://www.bestelectriccigarette.wordpress.com , you will see, that they not only work, they actually work quite well.

  • http://rwoodin3.wordpress.com rwoodin3

    Yes, they work extremely well. I quit a 37 year long tobacco habit by switching to e-cigarettes on 10/16/2009. I was simply amazed that I actually stopped smoking tobacco, I never thought I would be able to do that. I only wish these were available for my parents who were both smokers and succumbed to smoking related illnesses. There are no words to describe how much I appreciate finding Electronic Cigarettes. And to see the government, pharmacuetical co’s, big tobacco and all who will benefit from the status quo (lethal tobacco legal with no serious product competition) in a concerted effort to ban e-cigarettes – which is very likley to succeed. It just makes me sick to see such a real opportunity lost to the greed and ignorance of all the various parts of ‘The Anti-Smoking Movement’. The ONLY results of an electronic cigarette ban will be more tobacco smoking related illness, death and, and of course continued profits for big tobacco and big pharma to crank out ineffective ‘nicotine replacement products’ and then channel some of those products back to funding ‘The Anti-Smoking Movement’. What a racket!

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  • davidbieber80

    The study, led by psychologist Thomas Eissenberg, included 16 smokers. In four different phases of the study, each separated by two days, they were asked to: smoke a cigarette from their preferred brand; “sham smoke” a cigarette—or basically “puff” on it without lighting it. jump higher

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