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Eur Arch Otorhinolaryngol. 2019 Jan;276(1):17-25. doi: 10.1007/s00405-018-5185-z. Epub 2018 Nov 3.

Are electronic cigarettes a healthier alternative to conventional tobacco smoking?

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Wissenschaftliches Institut für angewandte HNO-Heilkunde (WIAHNO, Scientific Institute of Applied ENT Medicine) of the Deutscher Berufsverband der HNO-Ärzte e. V. (German Professional Association of ENT Surgeons), Maienbeeck 1, 24576, Bad Bramstedt, Germany.
Schleswig-Holstein University Hospital, Lübeck Campus, ENT Clinic, Lübeck, Germany.


Electronic cigarettes (EC) with and without nicotine are used by more and more consumers within the last decade. The long-term risks of vapor inhalation are unknown. This study should describe the state of the art of knowledge with respect to the following four items: (1) ingredients of the vapor and their potential risks, the influence of EC on smoking of combustible tobacco to (2) adults and (3) the youth, and (4) the side effects of passive vaping. The vapor of EC contains, in comparison to tobacco smoke, less harmful substances, qualitatively and quantitatively. But, due to failing standardization of EC, this comparison is difficult. Adults are often using both, EC and combustible cigarettes dually. In addition, EC were used for supporting smoke-quitting. Unfortunately, consuming EC with and without nicotine due later to a higher risk of conventional tobacco smoking for the user. In general, the effects of passive vaporing are unknown. Although the vapor of EC is less harmful than tobacco smoke, EC are not hazard-free lifestyle products. Technical standardization should be desirable. Adult smoker's benefit using EC is given by completely change to EC only. The rates of success using EC for smoke quitting are not well evaluated. Children and their parents should be informed on the risks of EC use as a precursor of combustible smoking mandatorily. Internet selling EC to any non-adult should be forbidden by law. EC ought not to be allowed to weaken non-smoker's rights, and third persons should be protected by the potential hazards of EC vaporing.


Electronic nicotine delivery systems; Gateway hypothesis; Head and neck cancer; Ingredients; Review; Risks; Smoking; Smoking cessation; e-Cigarette

[Indexed for MEDLINE]

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