Electronic cigarettes (also known as e-cigarettes or personal vaporizers) are an alternative to tobacco cigarettes. They are battery-operated devices that create an inhalable, water-based mist instead of smoke. The rechargeable battery powers a heating element called an “atomizer.” The element uses low heat to turn liquid in the cartridge, which contains propylene glycol, glycerin, food flavoring and nicotine, into a fog-like mist. There are many models of e-cigarettes available. Some look like traditional cigarettes, others look similar to a pen and some even look like small flashlights. Some have LED lights, some have built-in liquid reservoirs, others have combined atomizer cartridges, some are tubular and some are even rectangular boxes. They come in all shapes and sizes and have different features for former smokers who wish to distance themselves from anything resembling a traditional cigarette or want a longer battery life and/or better performance.

While anything containing nicotine cannot be called 100% safe, evidence from numerous studies strongly suggests that they are magnitudes safer than tobacco cigarettes. Harm reduction experts can point to research supporting that switching from cigarettes to a smokefree product will reduce health risks to less than 1% of smoking traditional cigarettes – nearly the same as non-smokers. For tobacco harm reduction health professionals, it is misleading and irresponsible for public health officials to tell smokers that smokeless products, such as e-cigarettes, are “not a safe alternative to smoking” simply because they are “only” 99% safer and not 100% safe.

No. This myth was created by a 2009 FDA press statement regarding electronic cigarettes. The FDA tested 18 cartridges from 2 companies. Of those 18 cartridges, 1 tested positive for a non-toxic amount of diethylene glycol (approximately 1%). While diethylene glycol is occasionally used in anti-freeze, the chemical is not a standard ingredient in e-cigarette liquid and it has not been found in any other samples tested to date. The base liquid for e-cigarette liquid is usually propylene glycol. Propylene glycol is considered GRAS (Generally Recognized As Safe) by the FDA and EPA. While it is also sometimes found in anti-freeze, it is actually added to make the anti-freeze less toxic and safer for small children and pets. Propylene glycol is a common ingredient found in many of the foods we eat, cosmetics we use and medications we take. It is also used in the fog machines used in theaters and night clubs.

Though testing by the FDA and other labs have discovered trace amounts of tobacco-specific nitrosamines, which are known to cause cancer with high exposure, the amounts found were extremely low and unlikely to cause cancer. To put it in perspective, an e-cigarette contains nearly the exact same trace levels of nitrosamines as the FDA-approved nicotine patch and about 1,300 times less nitrosamines than a cigarette.

This is the most common question on e-cigarette forums. The best answer to that question is “none” and “it doesn’t matter.” Since those considering e-cigarettes are usually seeking to replace tobacco cigarettes, they are under the assumption that having the most realistic, tobacco-flavored e-cigarette will bring the most satisfaction. The truth of it is that after switching to e-cigarettes for a few weeks, the vast majority of users discover that looks ultimately don’t matter – performance does. And the best performing e-cigarettes don’t necessarily look anything like traditional cigarettes because they require larger batteries. And the most popular flavors with experienced users are often as far from tobacco-tasting as one can get. One problem is that none of the tobacco flavors really taste like burning tobacco – they taste more like fresh tobacco smells and slightly sweet. So, experienced e-cigarette users will tell you that nothing tastes exactly like a burning tobacco cigarette. But, we know you won’t believe us and insist on buying something that looks and tastes like a tobacco cigarette. That’s ok – we’ve all been there!

There is a lot of anecdotal evidence and even some scientific research surveys that strongly indicate that e-cigarettes are an effective alternative to smoking. Surveys show that up to 80% of e-cigarette users quit smoking traditional cigarettes while using e-cigarettes. However, while some users have gradually reduced the nicotine levels down to zero, the majority of e-cigarette users treat the devices as an alternate source of nicotine and not as a nicotine cessation program. So there is not as much scientific evidence yet that show how effective e-cigarettes are when used to treat or cure nicotine addiction. Yet, anecdotal reports by users who have used e-cigarettes as a way to wean from nicotine also indicates they seem to be very effective way to break smoking triggers and dramatically reduce nicotine levels. As with pharmaceutical NRTs, it depends upon the smoker and the strength of his or her addiction and resolve to quit. E-cigarettes also appear to be a much safer option for short-term use in the event of relapse. The good news is, nicotine by itself has very low health risks, so switching to e-cigarettes can be nearly as good as quitting altogether. The most important thing for those who cannot or will not quit nicotine to do is to stop the exposure to the harmful chemicals in cigarette smoke and e-cigarettes can help them do it.