E-cigarette studies, research and reports

Throughout this web site I've mentioned a number of studies, presentations, commentary from healt professionals, special reports and various research carried out on e-cigarettes and vaping. 

The following is a summary of all the research mentioned and some additional sources, brief descriptions of the reports and links to the actual study papers and statements.

Please note: I've started to list the research chronologically, so if you haven't visited this page for some time, you may find ecig studies you haven't seen in listings further down the page as I add items as I become aware of them.

Trends In Ecig Use In England (PPT)
A study by researchers from University College London
has found the use of ecigarettes by those who have never smoked is negligible. Evidence also indicates ecigs are not ‘renormalizing’ smoking - and they may be contributing to a reduction in smoking prevalence. Published April 2014.
 
Ecigs Among The Least Harmful Nicotine Delivery Products
A study that sought to estimate the harm level of various forms of nicotine delivery products rated cigarettes as the most harmful (overall weighted score of 100) and ENDS (electronic nicotine delivery systems) were rated among the least harmful. Published in European Addiction Research, April 2014.

"A Moral And Ethical Duty" To Provide Ecigarettes
In an open letter published on The Montreal Gazette; the medical director of the Smoking Cessation Clinic at the Montreal Chest Institute and other health professionals have voiced their support for the authorization of the sale of ecigs in Canada. In his letter, Dr. Gaston Ostiguy mentions states there is a "moral and ethical duty to provide these products to addicted smokers."

Ecig Gateway Effect Claims Deconstructed
A study by Professor Stanton Glantz and Dr Lauren Dutra on teenage smoking and ecig use has been thoroughly debunked by Clive Bates, who called the document "false, misleading and damaging". Mr. Bates was previously director of Action on Smoking and Health (ASH-UK). Published March 2014.

Glycerol Does Not Cause Lipoid Pneumonia
In March 2014, another story started doing the rounds of the media relating to a person who had contracted lipoid pneumonia and glycerol based eliquids were pointed to as the culprit. Dr. Konstantin Farasalinos details why glycerol cannot cause lipoid pneumonia.

Impact Of EU Ban On Higher Nicotine E-cigarettes On Smoking. (PDF)
The EU Tobacco Products Directive (TPD), which will limit nicotine eliquid levels to 20mg/ml, will curb the use of e-cigarettes says a report from London Economics. It estimates the TPD will result in the deaths of an additional 105,000 people a year in Europe. Published February 2014.

Real-World Effectiveness Of E-Cigarettes: A Population Study
This study found e-cigarette users were more likely still to be abstinent than either those who used NRT (Nicotine Replacement Therapies) bought over-the-counter or used no aid at all. Published February 2014 (abstract).

The Effects Of Nicotine On Human Health 
According to the American Council On Science And Health, the relative risk of mortality from lifetime use of various tobacco and nicotine products is comparatively low. "Electronic cigarette vapor appears chemically incapable of causing cancer
as cigarette smoke has done." The report, Nicotine And Health, was published in January 2014.

Contaminants In Ecig Eliquids And Workplace Health Risks (PDF)
A study that reviewed available data on chemistry of ecig aerosols and eliquids found no evidence to suggest vaping produces inhalable exposures to contaminants that justify concerns relating to the health and safety of workplaces. Published January 2014.

A Longitudinal Study Of Ecig Users
A study carried out by has concluded electronic cigarettes may contribute to relapse prevention in former smokers and smoking cessation in current smokers. It also found in dual users who were still smoking at the point of follow-up had decreased their tobacco cigarette consumption by 5.3 cigarettes a day. Published January 2014.

Nicotine Myth Busting
Not a study or formal report as such, but I found this interview with nicotine expert Dr Jacques Le Houezec quite enlightening. Dr. Le Houezec busts a few myths surrounding nicotine and offers some advice on storage and related issues - valuable info for vapers.

Ecigs Do Not Stiffen Arteries (PDF)
Researchers from Onassis Cardiac Surgery Center in Greece have found that while smoking just 2 tobacco cigarettes caused significant stiffening of the aorta, no difference was observed after the use of e-cigarettes by both smokers and vapers. Published December 2013.

The Importance Of Flavours In Eliquids
A study headed by Dr. Konstantinos Farsalinos finds flavours play a major role in the overall experience of dedicated vapers and support the hypothesis that flavoured eliquids are important contributors in reducing or eliminating the smoking of tobacco cigarettes. Published December 2013.

Second Hand Vapor Study (PDF)
A new study (Published in Oxford Journal, December 2013) shows while e-cigarettes are a source of second-hand exposure to nicotine; it's far, far less than that associated with second hand cigarette smoke. Additionally, e-cigarette second-hand vapor did not contain combustion related toxicants tested for. Lead author was Maciej Goniewic from the Roswell Park Cancer Institute in Buffalo, N.Y.

Smoking Kills, and So Might E-Cigarette Regulation
Gilbert Ross MD, is medical and executive director of the American Council on Science and Health. In this special report on The American, he states "simple common sense would dictate that inhaling the fewer, less harmful ingredients of e-cigarettes as compared to inhaling the thousands of chemicals in the smoke from burnt tobacco, many of which have been shown to be carcinogenic, is highly likely to be healthier." Published November, 2013.

Regulation: When Less Is More (PDF)
Presentation slides from Clive Bates (of the Counterfactual) concerning the dangers of over-regulating ecigarettes. Mr Bates urges positivity about the vast potential about ecigs, to put the (minor) risks in perspective and regulate as though the 1 billion who are predicted to die from tobacco related illnesses in the 21st century matter most. Presented at The E-Cigarette Summit, Royal Society, London in November 2013.

Research on Safety of Electronic Cigarettes (PDF)
Dr. Konstantinos Farsalinos' comprehensive presentation on existing data relating to the safety of ecigarettes. Presented at The E-Cigarette Summit, Royal Society, London in November 2013.

Nicotine Safety in the Context of E-Cigarette Use (PDF)
Contrary to popular belief, the fatal overdose level for nicotine may be far higher than the generally accepted 50 to 60 mg (adult) says Dr. Jacques Le Houezec. This research was presented at the The E-Cigarette Summit, Royal Society, London in November 2013.

A Longitudinal Study Of Electronic Cigarette Users
A study of 477 ecigarette users by researchers from the University of Auckland and University of Geneva has arrived at the conclusion that "E-cigarettes may contribute to relapse prevention in former smokers and smoking cessation in current smokers" Published October 2013.

Ecigs Not A Gateway To Smoking
The study is yet to be published, but according to research presented at the annual meeting of the American Association for Cancer Research (October 2013), the use of ecigarettes by teens does not lead on to smoking tobacco in the vast majority of cases.

E-Liquids Shown To Have Low Cytotoxicity (PDF).
The results of testing of 20 e-liquids has revealed the majority of the vapor samples were found to have no adverse effects on cardiac cells. Even on the several that did have some effect (two of which were tobacco derived), the worst was 3 times less toxic compared to cigarette smoke. Published October 2013 in the International Journal of Environmental Research And Public Health.

Nicotine Levels Selection and Patterns of Electronic Cigarette Use
Another study from Dr. Konstantinos E. Farsalinos that concludes nicotine levels seem to play a crucial role in achieving and maintaining smoking cessation in a group of motivated subjects. The study involved 111 participants who had completely substituted smoking with electronic cigarette use for at least 1 month. Published September 2013

Vaping: coronary circulation and oxygen supply (PDF)
Recent research indicates electronic cigarette use does not affect the oxygenation of the heart. Lead by principle investigator Dr Konstantinos Farsalinos; results of the research were presented at the European Society of Cardiology annual congress in Amsterdam in August, 2013.

Eliquids: No Health Concerns
A study by Professor Igor Burstyn of Drexel University School of Public Health based on a review available data has confirmed chemicals generally found in ecig eliquids pose no health concerns. Published August 2013 (PDF).

MHRA Ecigarette Research
The UK's Medicines and Healthcare Products Regulatory Agency (MHRA) carried out extensive research on ecigarettes, arriving at the conclusion there was little concern that e-cigarettes can harm users by delivering toxic nicotine levels and little evidence of non-smokers taking up electronic cigarettes. The link above takes you to the general page on nicotine containing products and the findings mentioned are contained in 3 documents (all PDF) here, here and here. Published in June 2013.

Efficiency and Safety of an Electronic Cigarette as Tobacco Cigarettes Substitute
In a 12-month trial of ecigarettes to evaluate smoking reduction/abstinence in 300 smokers not intending to quit; complete abstinence from tobacco smoking was documented in 10.7% and 8.7% at week-12 and after a year respectively. For the group receiving the higher dose nicotine cartridges, the tobacco cigarette cessation rate was 13% after a year. The study was published on PLOS One on June 24, 2013.

Evaluation of Electronic Cigarette Use And Liquid Consumption
This 2013 study challenges an EU proposal that would result in eliquids containing more than 4 milligrams of nicotine per milliliter being banned unless approved as medicinal products. The link above will take you to the International Journal of Environmental Research and Public Health abstract. Commentary from one of the study researchers, Dr Konstantinos Farsalinos, can be viewed here.

Cytotoxicity evaluation of ecig vapor extract
A 2013 study designed to evaluate the cytotoxic potential of 21 eliquids compared to the effects of cigarette smoke found ecig vapor is significantly less cytotoxic compared to tobacco. At this stage, the study notes are paid-access only, but comments on the study by Dr. Michael Siegel, can be viewed here. Additional commentary from the study's lead author, Dr Konstantinos Farsalinos, can be accessed here.

Vaping profiles and preferences
1,347 vapers were surveyed in an effort to characterize e-cigarette use, users and effects. Results generally showed respondents found ecigarettes to be satisfying to use; cause few side effects; considered healthier than smoking, resulted in improve cough/breathing and lowered levels of craving. The survey was hosted at the University of East London. Published March 2013.

Ecigarette toxicants study
Levels of selected carcinogens and toxicants in vapour from electronic cigarettes have been found to be 9 to 450 times less than tobacco cigarettes in 12 brands studied; leading the researchers to conclude "substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants". The study was first published online on March 6, 2013.

Ecigs - therapeutic medical device.. or not?
An in-depth look at the politics behind the push for e-cigarette regulation and the case for electronic cigarettes  being neither a tobacco product or a medical device; therefore not requiring such controls.

Impact of ecigarettes on schizophrenic smokers
Researchers from the CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research center in Italy determined the use of ecigs decreased tobacco cigarette consumption in schizophrenia sufferers who were smokers - and without significant side effects. Published January 2013.

Electronic cigarettes: achieving a balanced perspective
This 2012 paper argues that while more research is needed on the cost–benefit of ecigs and appropriate regulation, the harms so far have been overstated relative to the potential benefits. The paper mentions a study that found of more than 2000 former smokers in this survey, 96% reported that the e-cigarette helped them to stop smoking.

ASH UK Ecigarette Briefing
Given there is little real-world evidence of e-cigarettes causing harm to date; particularly when compared to smoking, UK anti-tobacco group ASH believes if properly regulated, ecigarettes should be made available as part of a harm reduction approach to tobacco. The briefing contains various statistics related to vaping and points out between 2009 - 2011, Google searches using the terms ‘electronic cigarette’ increased
by fifty fold in the UK. The briefing is in PDF format.

E-cigarette Vapor And Cigarette Smoke Comparison
High nicotine e-liquids were vaporized in a series of experiments and the emissions compared to tobacco smoke. The study results indicate "no apparent risk to human health from e-cigarette emissions based on the compounds analyzed".

Is Passive Vaping A Reality?
This study sought to identify and quantify the chemicals released on a closed environment from the use of e-cigarettes - the findings? There's little to be concerned about with regard safety. This research again confirms the type and quantity of
chemicals released are by far less harmful to human health compared to regular
tobacco cigarettes. In fact, it "could be more unhealthy to breath air in big cities compared to staying in the same room with someone who is vaping."

Indoor Vapor Air Quality Study
Data at Clarkson University’s Center for Air Resources and reviewed by an independent toxicologist indicates electronic cigarettes produce very small exposures to byproducts relative to tobacco cigarettes. The study has been peer reviewed and will appear the Journal of Inhalation Toxicology. 

E-cigarettes: harmless inhaled or exhaled 
Report from Health New Zealand stating e-cigarette vapors do not contain substances known to cause death in the quantities found.

Society for Research on Nicotine and Tobacco (PDF)
This research acknowledges that no drug is safe, but the emissions associated with the e-cigarette brand tested appear to be "several magnitudes safer" than tobacco smoke emissions.

Electronic Cigarettes As a Smoking-Cessation Tool
The findings of this study indicate "e-cigarettes may hold promise as a smoking-cessation method" and that further research should be carried out.

Electronic Cigarettes Do Not Damage The Heart
Electronic cigarettes appear to have no acute adverse effects on cardiac function according to research by cardiologist Dr Konstantinos Farsalinos.  He says based on currently available data, ecigs are safer and substituting tobacco with electronic cigarettes could in fact be beneficial to health.

Principles to Guide AAPHP Tobacco Policy
The American Association of Public Health Physicians recommends electronic cigarettes as a safer smoke-free tobacco/nicotine product.

Athens University Ecig Study Challenged
Dr. Michael Siegel questions a University of Athens study claiming e-cigarettes can cause lung damage. 

Propylene Glycol Safe
Monkeys and rats were exposed continuously to high concentrations of propylene glycol, a common component of eliquids for periods of 12 to 18 months. Results of the research state "air containing these vapors in amounts up to the saturation point is completely harmless". 

Effect of ecigs on smoking reduction and cessation
A study showing the use of ecigarettes substantially decreased cigarette consumption without causing significant side effects in smokers who had no intention to quit. Published in 2011 (PDF).

Tobacco harm reduction as a human right
Approximately one-quarter of all lifelong smokers will die in middle age (between 35 and 69) as a result of smoking and the authors of this 2006 paper (PDF) urge tobacco harm reduction being viewed as a human right.

Tobacco cigarette addiction - it's not just the nicotine
Nicotine is the major neuroactive compound of tobacco, but according to this 2005 paper; on its own it has weak reinforcing (addictive) properties. It appears other compounds found in tobacco smoke when combined with nicotine  produce the intense reinforcing properties of cigarette smoking that lead to addiction."

Long-term effects of inhaled nicotine
An experiment where rats breathed in a chamber with nicotine at a concentration twice found in heavy smokers for 20 hours a day, 5 days a week over a 2 year period found no harmful effect of nicotine when given in its pure form by inhalation. Published in 1996.

Keep checking back as I'll be adding to this page as new e-cigarette research and studies become available.

 

 

 

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