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The E-cigarette is an electronic smoking device designed to give smokers a dose of nicotine with a "smoking experience" but without flame, second-hand smoke, ashes, butts, tar, or tobacco-related carcinogens. But are they as safe as advertised?

The electronic or E-cigarette is a nebulizer device that looks like a cigarette and feels like a cigarette that creates an aerosol mist that the user can inhale like cigarette smoke. Although the idea of using heated air as a tobacco smoke replacement was explored in the 1960's, the modern E-cigarette is the invention of Chinese pharmacist named Hon Lik, who released an ultrsound device in the shape of a cigarette as the first commercially available E-cigarette in 2000.

E-cigarettes use high-frequency ultrasound to make a fine mist of a solution of water, propylene glycol, and varying amounts of nicotine.

Vibrating the liquid releases the mist, which is inhaled by the E-cigarette user. Most users of E-cigarettes prefer to get their hit of nicotine as they use the device, but some users of E-cigarettes prefer no nicotine at all and other users prefer to use a solution that provides even more nicotine than the typical cigarette.

The E-cigarette aerosol contains none of the carcinogenic toxins found in actual tobacco smoke, and there's no risk of second-hand smoke affecting people nearby.

But most countries prohibit advertising E-cigarettes as a means of smoking cessation, and the use of E-cigarettes may have some surprising side effects. Here are three essential facts about E-cigarettes users need to know.

1. E-cigarettes are seen as a "gateway drug" to smoking hookahs.

As odd as it may sound, one of the reasons advertising of E-cigarettes is restricted in some countries is that public health authorities were concerned that use of the device could lead to habitual use of other alternatives to conventional tobacco use, such as the hookah or hookah steam stones.

2. The more often you smoke, the less likely you are to have tried E-cigarettes.

Researchers at Mississippi State University in the USA reported in 2012 that 25% of people who smoked cigarettes every day had tried cigarette alternatives (E-cigarettes, snus, "chew,"  hookah pipes, hookah stones, and dissolvable tobacco products), but 39% of people who smoke occasionally had tried them. About 7% of people who have never smoked any conventional cigarettes have tried an alternative nicotine delivery device such as an E-cigarette.

3. If you're trying to quit, E-cigarettes may be what you need to replace the feel of holding a cigarette.

Researchers at the Centro per la Prevenzione e Cura del Tabagismo - CPCT at the Università di Catania in Italy note that only 3 to 5% of people who break the habit of smoking are still cigarette-free six months later. They documented three cases in which the most difficult issue was not nicotine replacement but the habit of holding a cigarette, and using E-cigarettes made it possible to stop smoking regular cigarettes for good. Nicotine patches, they found, do not address the need for the ritual of smoking a cigarette.

Continue reading after recommendations

  • Farsalinos KE, Romagna G. Chronic idiopathic neutrophilia in a smoker, relieved after smoking cessation with the use of electronic cigarette: a case report. Clin Med Insights Case Rep. 2013.6:15-21. doi: 10.4137/CCRep.S11175. Epub 2013 Jan 24.
  • Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, Prokopowicz A, Jablonska-Czapla M, Rosik-Dulewska C, Havel C, Jacob P 3rd, Benowitz N. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2013 Mar 6. [Epub ahead of print]
  • Photo courtesy of christopher cornelius by Flickr: