Electronic cigarettes have grown in popularity in the UK over the past couple of years. Many of our patients in Walsall have asked us about whether they should use electronic cigarettes as a safer alternative to 'normal' cigarettes, so here is the advice that we give in response to this question.

Frankly, no-one knows if electronic cigarettes are safe, despite the sales pitch that manufacturers and sellers put out.

An electronic cigarette is a device that heats a cartridge that contains nicotine which gives off (hopefully) a nicotine vapour that does not contain smoke (and therefore doesn’t contain carbon monoxide). The cartridges contain either a hard nicotine gel or a solution of nicotine in water. The main problem with these devices is that they aren’t tested like medicines to establish their safety. All medicines in the UK have to be approved by the Medicines and Healthcare products Regulatory Agency  (the MHRA). The only regulations that electronic cigarettes comply with are EU guidance on packaging and logos, not safety. The MHRA is very concerned about the safety of these products, and is conducting an investigation.

Authorities in other countries are also concerned about these products. In the New England Journal of Medicine, researchers argue that a comprehensive approach to regulating these products is needed to protect the public's health.

Testing of these nicotine cartridges reveals poor quality control, variability in nicotine content among brands, and deviations between what the label claims and what the cartridge contains. The devices also often break down rather a lot.

These devices do not reliably deliver nicotine, and have not been properly evaluated in scientific studies the way the US Food and Drug Administration requires of other drugs and devices used for stopping smoking. Smokers attempting to use electronic cigarettes as quitting aids will most likely find them ineffective due to the variable nicotine content and unpredictable delivery.

Manufacturers sell cartridges with a range of up to 20 milligrams of nicotine. However, refill kits allow consumers to fill used cartridges with replacement solutions at much higher doses.

Many brands contain propylene glycol. The safety of inhaling propylene glycol over an extended period of time has not been studied in humans, which is of great concern, as we do not know what effect it has on us.

So we can’t say if it is safe to use electronic cigarettes. In addition to this, our patients who have tried them report spending more on nicotine cartridges than tobacco, which is another concern.

What we do know is that nicotine replacement products (patches, gum, lozenges, QuickMist spray) have a long safety record and have helped millions of people to stop smoking successfully.

If you are concerned about using an electronic cigarette, or would like to talk about stopping smoking, please call Quit Now on 0800 622 6183.