The Claim That E-Cigarettes Are ‘Harmless’ Is Unreliable

In recent years, as people's awareness of smoking control and health has increased, e-cigarettes, which claim to be harmless or even help smokers quit, have become increasingly popular. Major international tobacco companies have also entered the e-cigarette market. According to statistics, global e-cigarette sales reached $3 billion in just 2013. However, the International Union Against Tuberculosis and Lung Disease recently issued a statement saying that the safety of e-cigarettes has not been fully scientifically validated, and regulation remains a blank slate.

So far, there is no systematic safety assessment data for e-cigarettes, either domestically or internationally.

E-cigarettes are electronic products that mimic traditional cigarettes, having the same appearance, smoke, taste, and feel. They are products that allow users to inhale vaporized nicotine and other substances through methods such as atomization.

Merchants have long promoted e-cigarettes as containing no tar, suspended particles, or other harmful components, even marketing them as "quit smoking miracles" and "lung cleansers." However, the safety of e-cigarettes has not been fully scientifically validated. So far, there is no systematic safety assessment data for e-cigarettes, and therefore, it cannot be determined what potential health risks e-cigarettes may pose to users.

Experiments have shown that when people use e-cigarettes, they may inhale various undiscovered toxic compounds in addition to nicotine. Meanwhile, the secondhand smoke produced by e-cigarettes may also pose health risks. E-cigarettes release inhalable liquid fine particles and ultrafine particles, nicotine, and carcinogens into indoor air. Because e-cigarettes do not produce smoke, they can more easily mislead consumers into a false sense of safety and health.

Additionally, a study in the United States found that for teenagers, e-cigarettes are seen as substitutes for traditional cigarettes, which not only do not help them quit smoking but may also lead to nicotine addiction and even encourage them to start smoking. A survey on national youth smoking in the U.S. showed that in 2013, over 260,000 teenagers tried e-cigarettes for the first time, more than three times the number in 2011. Among those who tried e-cigarettes in 2013, 49.3% intended to switch to traditional cigarettes, compared to only 21.5% of those who tried e-cigarettes in 2011. (Zeng Fanyu, Director of the Office of the China Smoking Control Association)

Some e-cigarettes have extremely high nicotine content, which may pose much greater harm than regular cigarettes.

Although e-cigarettes do not contain tar, the nicotine they contain is not harmless; inhaling nicotine alone also poses health risks.

Nicotine itself is not a carcinogen, but it can act as a "tumor initiator." Moreover, there is sufficient evidence to show that exposure to nicotine during pregnancy and adolescence can have long-term adverse effects on brain development.

The U.S. Food and Drug Administration tested the components of 19 e-cigarettes on the market and found that the smoking devices contained carcinogens and other toxic chemicals. They also analyzed the components of two popular e-cigarette brands and found that one sample contained diethylene glycol, which can damage the kidneys in large doses, while other samples contained nitrosamines and other carcinogens.

The French National Consumer Research Institute also pointed out that some e-cigarette products surveyed in their study had extremely high nicotine content, which could even be lethal to an infant. Furthermore, due to the rapid heating speed of e-cigarette devices, a highly toxic molecule called acrolein is also produced during this process.

In 2013, Dr. Elizabeth Porter, director of the Federal Center for Health Education in Germany, found through research and analysis that e-cigarettes contain a large amount of propylene glycol, which can irritate the respiratory tract and lead to acute symptoms. Therefore, she believes that the health risks of e-cigarettes may be greater than those of traditional cigarettes. (Yang Jie, Researcher at the Tobacco Control Office of the Chinese Center for Disease Control and Prevention)

Regulation remains a blank slate; it is recommended that e-cigarettes be strictly controlled as pharmaceuticals.

China is the inventor and major producer of e-cigarettes, with over 90% of the world's e-cigarettes coming from places like Shenzhen, China. However, regulation of e-cigarettes in China remains a blank slate. In China, e-cigarettes are neither classified as pharmaceuticals, nor health products, medical devices, or tobacco, resulting in most e-cigarettes being in a "three no" state, meaning no product standards, no quality regulation, and no safety evaluation.

Internationally, there are significant differences in attitudes and policies towards e-cigarettes among governments. Some countries view them as consumer products, others as drugs, and some as tobacco products. Consequently, policies regarding e-cigarettes vary widely, with some countries supporting them, others banning them, some imposing moderate regulations, and others remaining silent.

In China, the preferred regulatory approach should be to treat e-cigarettes as pharmaceuticals. Since the main component of e-cigarettes is nicotine, which is a highly toxic addictive substance, they should be regulated by the National Medical Products Administration as pharmaceuticals. If e-cigarettes are managed by tobacco departments like traditional cigarettes, it could lead to explosive growth in the e-cigarette market, with dire consequences. It is recommended that national health and drug administrative departments specifically allocate projects, organize professionals, and allocate research funds to scientifically evaluate the safety of e-cigarettes, and then propose scientifically reasonable policies.

If it is not possible to regulate e-cigarettes as pharmaceuticals, in the absence of sufficient research evidence, the following measures should be considered:

1. A complete ban on advertising, promotions, and sponsorship of e-cigarettes.

2. A ban on promoting e-cigarettes as a means to quit smoking.

3. A ban on displaying e-cigarettes in retail stores.

4. A ban on selling e-cigarettes to minors.

5. A ban on using flavor additives that are appealing to children in e-cigarettes and their liquids.

6. Packaging and labeling of e-cigarettes and disposable e-cigarettes should indicate the additives used, nicotine content, and health warning labels.

7. A ban on using e-cigarettes in public places, workplaces, and public transport.

8. Establish consumer safety standards for e-cigarette liquids, ensuring consistency in production processes, and setting upper limits on nicotine content. (Guan Quan, Senior Project Officer at the International Union Against Tuberculosis and Lung Disease)