Electronic cigarettes: Should health professionals oppose use by their patients?

Aims: Electronic cigarettes are rapidly becoming
the most popular type of tobacco-free nicotine
product sold in the UK. The aim of this review
was to summarize existing literature on the
potential risks and benefits posed by e-cigarettes.
Methods: A thorough search of relevant
databases was undertaken using the search
terms: electronic cigarette/s, e-cigarette/s,
e-cig/s, electronic nicotine delivery system/s.
Results: Electronic cigarettes contain small
amounts of toxic chemicals including tobacco-
specific nitrosamines, which are known to
be human carcinogens; impurities such as
myosamine, anabasine, and beta-nicotyrine,
which are considered to be harmful to humans;
and diethylene glycol, which can be toxic in
high doses. Mouth and throat irritation are
the most commonly reported side effects in
follow-up studies. However, substitution of
electronic cigarettes in the homes of parents who
currently smoke improves indoor air quality
and should be associated with a fall in the risk
of sudden infant death syndrome, respiratory illness and ear disease.
Conclusion: Electronic
cigarettes need standards that reduce product
variation and licensing as a medicinal product
to provide validated external quality assurance
of ingredients and potential contaminants.
However, based on their risks and benefits to
others, and leaving aside the issues of their use
as an aid to smoking cessation, there may be a
case for their short-term use where patients have
failed to give up smoking using other smoking
cessation techniques to reduce exposure of
others to second hand smoke.