Smokers should be confident that vaping with e-cigarettes is much less harmful to the lungs than smoking cigarettes, according to a new review of the relevant science. A new article published in the Expert Review of Respiratory Medicine journal contends that there is growing evidence showing that electronic cigarette (EC) emission aerosols are relatively safe compared to tobacco smoke. 

"For smokers who want to do something about their health, our review shows that switching to vaping is a very good option if they don't want to or can't quit completely.  No-one can prove that e-cigarettes are one hundred percent safe, but all the science points to vaping being very much safer than smoking," said Dr. Polosa.

Polosa added: "We agree with Public Health England and the Royal College of Physicians of London that it is reasonable to proceed on the basis that vaping is at least 95% less risky than smoking, and probably even less risky than that."

The findings indicate that the lack of clear and accurate reporting of experimental studies has resulted in confusion about the respiratory health risks of ECs.

"The millions of deaths resulting from cigarette smoking illustrate an ongoing, immediate and preventable tragedy that should be fully factored into a rational risk-benefit analysis," said Dr. Polosa. "In our view, there is a growing body of evidence that suggests substituting ECs for cigarettes is an effective method of curbing the use of tobacco cigarettes. Unfortunately, consumer understanding of the relative risks is distorted and in the past few years fewer adult smokers have perceived e-cigarettes as less harmful than tobacco cigarettes. These misperceptions have real consequences and require corrections." 

The article by Polosa et al. is the first attempt to correct most of these misperceptions and to provide authoritative reference when communicating to the public how to improve personal and public health of smokers. Former smokers currently using ECs and smokers intending to use ECs as a substitute for smoking have the right to know the factual information about the potential risks and benefits of these products. Improvement in risk communication can promote more switching among smokers who do not want or cannot quit and eventually reduce or prevent some of the respiratory deaths and disease caused by tobacco smoking.

The authors of the review also found that smokers who substituted cigarettes with ECs experienced improvements in smoking symptoms (cough, phlegm) and exhibited lower levels of exhaled carbon monoxide. These results were even more beneficial for smokers who completely replaced cigarettes with ECs.

For smokers with diseases such as asthma and chronic obstructive pulmonary disease (COPD), EC use may have a beneficial effect on symptoms, though additional data is needed to determine the complete effect ECs may have on lung function.

Dr. Donald Tashkin, pulmonologist and professor at the David Geffen School of Medicine at the University of California, explains: "Yielding accurate findings for determining the respiratory health risks and benefits of e-cigarette use requires substantial improvement of current research designs. Obviously, only large, long-range prospective studies of vapers who have never smoked can provide definitive data to demonstrate any potential impacts regular use of vaping products may have on long term health."

Dr. Polosa concludes: "Challenging uninformative or even misleading research due to problem with methodology and interpretation of these studies is not enough. It is urgent to address common mistakes and to develop robust and realistic methodological recommendations in order to adequately assess the impact of EC use on human health under normal condition of use. The adoption of standardised methods can enable better tobacco harm reduction science."