The default classification of e-cigarettes as tobacco products rather than medicines has meant there has been no real obligation on the part of manufacturers to submit to or participate in extensive clinical trials of their products. This is changing. Not because of any voluntary philanthropy on the part of big business, but, rather, because of the incredible popularity of e-cigarettes. And because tobacco kills nearly six million people each year.


Independent research (studies and trials not funded by the e-cigarette or tobacco companies) is starting to take a closer look at every aspect of electronic “nicotine delivery technologies” – from the chemicals contained in the solvent and the compounds formed during the atomisation process, to how much nicotine is delivered with each puff or if the exhaled vapor contains any second-hand risks, and (after safety, this is the big one) whether or not e-cigarettes actually help people quit smoking.


There are two central themes in the discussion around what this research could tell us.
The first, obviously, is the same question we have all been asking from the start: are e-cigarettes safe?
The second is more complex: are they safer than tobacco cigarettes?
For now, even though there is no clear-cut evidence of the former and there are no large scale, long-term studies that conclusively prove the latter, the language of recent medical and scientific publications seems increasingly sympathetic towards the use of e-cigarettes as an alternative to tobacco smoking. When it comes to health, first prize, of course, is for people to give up smoking completely. Abstinence equals “do no harm”. But, faced with the prospect of one billion smokers (that is how many people the WHO says are tobacco smokers, right now), many of whom either can’t or won’t quit, there is growing support for an approach that counsels: “do less harm”, a model that emphasises reduced exposure to toxins rather than reduced consumption of nicotine.