The problem

Electronic or e-cigarettes are relatively new (introduced in Europe in 2006) compared to conventional tobacco cigarettes. But what are their implications for health? Research is growing on their effects, and reviewing large numbers of studies together can allow deeper insights.

The project

Researchers at the HRB Evidence Centre identified and analysed more than 360 published studies about e-cigarettes and health. This systematic review found that e-cigarettes were linked with acute health issues including poisonings, burns, lung injury and worsening of asthma as well as early signs of damage to blood vessels. An analysis of seven studies showed e-cigarettes are no more effective than approved and regulated nicotine replacement therapies (NRTs) to help people stop smoking, and a separate analysis of 9 studies concluded that e-cigarettes increase the risk of adolescents starting to smoke tobacco cigarettes. 

The outcomes

We now know that:

  • E-cigarettes are no more effective than medically approved and regulated nicotine replacement therapies to help people stop smoking
  • Adolescents who use e-cigarettes are three to five times more likely to start smoking tobacco cigarettes compared to those who never used e-cigarettes
  • E-cigarettes can lead to poisonings, burns, lung injury and asthmatic attacks. Some of the chemicals in e-cigarettes are thought to cause tissue and cell damage and are linked to cancer. The long-term health effects beyond 24 months are not researched.
The research on e-cigarettes produced three publications, which are freely available on the HRB website:
  1. Electronic cigarette use and tobacco cigarette smoking initiation in adolescents: An evidence review
  2. Electronic cigarettes and smoking cessation: An evidence review
  3. Harms and benefits of e-cigarettes and heat-not-burn tobacco products. A literature map

Dr Jean Long, Head of the Evidence Centre at the HRB, says:

“HRB evidence shows that e-cigarettes are no more effective than approved and regulated nicotine replacement therapy to help people stop smoking. They can cause harm to health and our findings also highlight that e-cigarettes have the potential to make adolescents more likely to start smoking tobacco. These factors need to be considered as part of any smoking harm-reduction strategy.”

‘Electronic cigarettes – what are the risks for health?’  is part of a wider collection of success stories across four themes from this year’s annual Health Research in Action. Download the full publication.