E-cigs; what is the truth?

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Electronic cigarettes, or e-cigs, are all the rage. There are pop-up stores and online stores everywhere you look. Some 5-10% of adults now smoke e-cigs worldwide, and the numbers continue to grow. So what’s it all about and is it safe?

E-cigs heat a liquid that usually (but not always) contains nicotine, to produce a vapour that is inhaled. The first prototype was patented in 1965 although the modern design was introduced in 2003. There are now some 500 brands of e-cig with new designs being introduced constantly.

E-cigs are used to help smokers quit and or as an alternative to smoking. They are also sometimes used to inhale cannabis (this habit is more commonly called vaping). Some users purely enjoy the vapour and have created a hobby of “cloud chasing”.

E-cigs do produce harmful substances but are generally considered to be much less damaging than regular cigarettes. Some authorities consider the health risks to be negligible or insignificant but this view is controversial. E-cigs do not produce tar, carbon, ash or carbon monoxide (normal cigarettes do). Most of the toxic substances found in cigarette smoke are absent from e-cig vapour, or present at concentrations less than 1% of those found in cigarette smoke.

Because e-cigs are relatively new, the long term effects are not really known, although it seems likely that they will be less harmful than regular smoking. Safety in children and during pregnancy has not been adequately studied (nor is it likely to be) and so should be viewed with caution (= avoided).

There is debate about the effects of passive smoking (inhalation by non users resulting from proximity to an e-cig user). Some authorities feel it is completely safe but this seems an extreme view at this time and so most public-spaces do prohibit e-cigs even though many households do not object to e-cig use even indoors.

Nicotine is highly addictive (similar to heroin and cocaine) and so are e-cigs. This has created concerns that non-smokers may become nicotine addicts nonetheless, via e-cigs. This seems a very real and reasonable concern, although only a small percentage (less than 10%) of e-cig users are never-smokers. What may be of more concern is that a number of smokers now use e-cigs in addition to smoking, thereby increasing their overall nicotine intake. E-cigs can be recommended to smokers looking to quit, as a form of nicotine replacement (nicotine replacement is known to help quitters). Ideally the quitter should only use e-cigs for a limited period of time (this is not usually the pattern unfortunately).

Leading health authorities see e-cigs as a useful option for those trying to quit smoking and do agree that e-cigs are significantly less harmful than cigarette smoking. There are concerns around children, pregnancy, long term safety, and the very-real possibility that e-cigs add to a smoker’s nicotine intake.

E-cigs may be something of a good-news story on the health front, but we should be clear in saying that e-cigs are not actually “good for you” – it’s just that they are not (nearly) as bad for you as smoking.

About the Author:

Colin was a medical practitioner (GP) from 1988 to 2000. Since then he has worked in the wellness field, designing, developing and delivering various products and services. Out of clinical practice for many years now he no longer practices medicine formally but retains a keen interest in helping people become more-well versions of themselves. He acts as a wellness coach and not as a medical practitioner today. Colin's approach and philosophy is based on empowerment: the notion that people only need a little help to make choices they usually already want to anyway - it's about respect and support rather than instruction or correction. Colin lives at the Vaal Dam with his wife Cathy. He spends time walking mountains, cycling, motorbike riding, kayaking, sailing and always looking for better & better balance.


  1. Sibusiso September 27, 2018 at 2:25 pm - Reply

    True E-cigs are addictive, i once had one because i loved the big smoke cloud they produce. But at the end i was killing myself, i started feeling pains on my chests and weird breathing. That’s when i stopped using E-cigs. Now i’m healthy again. 🙂

  2. Miles September 27, 2018 at 3:24 pm - Reply

    Don’t Smoke!!! You are shortening your life by smoking period.

  3. Esann September 27, 2018 at 10:53 pm - Reply

    The fact remains that e cigs presents as addictive. So in a day and age when healthy living is incentivised and much is understood about the harmful effects of smoking, we are faced with people being offered “alternatives” to a bad habit….and buying into yet another potentially bad habit.

  4. Analise September 28, 2018 at 4:56 am - Reply

    E-cigarettes are not safe or healthy. At least, not in absolute terms. it has been estimated that they carry around 1-2% of the risk of smoking, which is about the same health risk you get from drinking a cup of coffee.
    They are, however, an awful lot safer for you than regular cigarettes. I found it interesting that E-cigarettes are smoke-free and tobacco-free, but not nicotine-free.

    • Dr Colin Burns September 28, 2018 at 8:21 am - Reply

      Thanks Analise. I do feel I must query the comment about coffee. Coffee has many health benefits and it’s really only harmful when drunk in excess (up to about 4 cups a day is considered OK by most experts). I would not compare nicotine and coffee in this way.

      • Analise October 2, 2018 at 6:30 am - Reply

        agree, I’m merely stating that Nicotine has similar qualities as caffeine. Nicotine is found in the tobacco plant. Caffeine is present naturally in tea, coffee, cocoa beans and some herbs.Both nicotine and caffeine are addictive.Nicotine can kill in a lower dose when compared to caffeine. However, it cannot do so at the minor levels found in electronic cigarettes. As with many things, too much of a good thing is bad for you and the same is true for nicotine and caffeine.Most would not think twice before guzzling down a cup of coffee, consuming 3 or 4 cups a day but have a strong fear about electronic cigarettes. In fact, I have come across people that would rather smoke real cigarettes thinking that e cigarettes are worse (because of what they read in the media). Yet, caffeine and nicotine are more similar to each other than they are different.
        If vaping follows the same direction as the coffee culture, perhaps one day you will be sitting in a cafe coffee in one hand, an e cigarette in the other.

  5. Shane Langeveldt September 28, 2018 at 5:55 am - Reply

    although vaping is a good relieve from stress, it is not so addictive. I have been on the e-cigs/vape for more then a year. and find it very easy to stop. vaping is also cheaper overall.

  6. Virgil Prinsloo September 28, 2018 at 6:26 am - Reply

    As stated in the article, the long term effects are unknown at this stage so in my opinion, its pro’s and con’s are subject to peoples preferences and prejudices.

    Personally I find it to be more of a gimmick that the younger generation is buying into and less sociable for the more mature crowd. The cloud of “smoke” it creates resembles that of a giggle twig (cannabis) user and its prevalence is often frowned upon, again… depending on the audience.

    The so-called “positive” associations to e-cigs may encourage minors to use them which could open the door to more devastating experiments amongst the youth.

  7. Siehaam Abrahams September 28, 2018 at 6:35 am - Reply

    I totally agree but should reiterate that with smoking cigarettes you have bad breaths, smelly hands and clothing, the odor is just bad and more dangerous to the passive smoker.

    with e-cigarettes although not good there is non of the above.

  8. nicholas.mack@sanlam.co.za September 28, 2018 at 6:42 am - Reply

    This article is a good read, because I also believe that E-Cigs/Vapes are much less harmful than the alternative smoking measure, and that it has been medically proven yet to be harmful. I started Vaping this year, to help me quit smoking hooka pipe. and it helped. and because vaping is so convenient, I have created a HABIT yet, I continue my daily routine with a puff in between. but when I was smoking hooka, it made me miserable, because I had cravings and very bad habits that kept me from doing the things I really want to do. I vape 0mg Nicotine, and therefore hope I will eventually quit smoking permanantly

  9. nicholas.mack@sanlam.co.za September 28, 2018 at 6:45 am - Reply

    A few corrections from previous comment. …it has NOT been medically proven… I have NOT created a bad habit yet…

  10. Kevin Conradie October 1, 2018 at 6:23 am - Reply

    I see E-sig (vaping) as a healthier option to smoking although not healthy as many would say. I would suggest that shops selling e-sigs and e-sig products should be regulated by forcing them to inform customers of the consequences (nicotine addiction) so that non-smokers who start will be informed. They could be forced to sign a concent form which should be kept on file and could be audited randomly.

  11. Ben Beneke October 1, 2018 at 6:51 am - Reply

    Ecigs are a breakthrough into people who smoke and and want a healthier option to quit smoking and in general prolong their life as it contains no harmful chemicals where as cigarettes contains 4700 harmful chemicals. yes we can argue the fact that E cigs contain nicotine which is addictive but its not harmful , like caffeine in coffee it can be addictive but not harmful. 3 years ago i could not breath well i used to smell like ashtray , my daughter who was 5 at the time was begging me to quit as she was worried about my health, i bit the bullet and started vaping and threw away the cigarettes, i can now breath normal and have a active life again going to gym and playing with my kids, vaping saved my life.

    • Dr Colin Burns October 1, 2018 at 6:58 am - Reply

      Thanks Ben. This is a great turnaround for you. Well done indeed. I agree that vaping can be life changing and even life saving for a smoker. It seems that the concerns are more around non smokers taking up vaping and ending up dependent on nicotine, which I do not think is 100% harmless either. Better than smoking does not equal 100% harmless.

  12. benjamin October 1, 2018 at 7:22 am - Reply

    All I can said guys and girl vaping or smoking it gone kill you later in life or will make you sick. Why not stop and save that money for the years you smoking see how you spent on smoking. Stop that habit for you own well. I now I see my Dad suffer to breath on his hospital bed and die in 3 months. .

  13. Felicity Herbst October 1, 2018 at 7:26 am - Reply

    Well yes they might be healthier in some aspects however I do think they pose their own set of health implications, these E-Cigs use oils which end up going into your lungs, so imagine what a build up of oils and moisture created by the E-Cigs will do to your lungs in the long run. This is just looking at one aspect, I am sure that there are numerous potential problems they are not taking into account.

    Yes we all have our vices… but I think this is just another unhealthy option … not a healthy option for smoking as some think.

  14. Manoshe Molatudi October 1, 2018 at 8:04 am - Reply

    No matter what name you can think off, smoking is a health hazard. The best habit is to quit. If you cannot quit, then it should be something that does not produce smoke like i.e.Vicks which you only inhale the smell of it without any visible smoke.

    warm regards,

    Manoshe Molatudi

  15. Julian Ewert October 1, 2018 at 9:51 am - Reply

    I’m a firm supporter of cold-turkey as a method to quit smoking cigarettes. It was not easy but it worked for me. The 1st month was the most difficult (days felt like weeks) but then it became easier and after 3 months almost all cravings had disappeared.

    In my experience, people that try nicotine replacement therapy or vaping as a means to wean-off of cigarettes tend to relapse. This makes sense to me because nicotine is an addictive substance and so, as long as you are introducing nicotine into your body, you are reinforcing the addiction.

    • Dr Colin Burns October 1, 2018 at 1:34 pm - Reply

      Thanks Julian. Cold-turkey can work and has worked for many people. That said, the evidence is pretty clear: aids, including nicotine replacement, medication, group-support, do help and they do improve success rates. They do not, according to good research, increase the relapse rate. Quitting is tough. Certain aids can help. But it is a personal thing. By the way, huge congrats on your own quitting success. You have saved your own life quite possibly, and you have improved your life for sure.

  16. Robyn Charles October 2, 2018 at 11:05 am - Reply

    Regardless if e-cigarettes is healthy than cigarettes, it still efforts your health. Yes, it has a great smell depending on what flavor you choose. I’d rather take care of my health than pollute and poison my body. Its also an expensive habit to have, while cigarettes are much cheaper.

  17. Isabel B October 2, 2018 at 2:20 pm - Reply

    Is it wise to replace a habit with a new one that mirrors the former? As per some school of thoughts e-cigs are not harmful while others believe it is. What we know as a fact is that smokers replace one addiction with another. Not sure if it the best way to go…

  18. Dr Colin Burns October 3, 2018 at 8:39 am - Reply

    I’d just like to offer a comment here. I sense that quite a few opinions are a bit “hard” towards smokers trying to quit. Quitting is extremely tough. Not impossible but tough nonetheless. Cold-turkey quitting is the toughest way to quit. Nicotine replacement can and does help many quitters. these are facts, proven by good research. I think we should all try to be supportive and understanding, more than critical or judgmental. For example, if e-cigs really help I think we should encourage smokers to try them maybe, or at least support them if they do make such a choice.

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