HAMS: Harm Reduction for Alcohol

Tobacco Harm Reduction Part Three: Electronic Cigarettes


The evidence that we have so far suggests that electronic cigarettes are probably far safer than tobacco cigarettes and that they have the potential to save the lives of countless smokers who are failed by conventional stop-smoking aids such as the patch or gum, etc.

The American Association of Public Health Physicians estimates that a person who switches from regular cigarettes to electronic cigarettes reduces their risk of tobacco-related death by 99.9%. Isn't it time that these devices were properly studied and promoted as the lifesavers that they are?

Are All Electronic Cigarettes Created Equal?

One of the biggest problems with electronic cigarettes currently is the fact that they are completely unregulated and there is no real quality control. As of this writing only two brands of electronic cigarettes have been adequately tested for safety: Ruyan V8 and NJoy.

Ruyan V8:

The Ruyan electronic cigarette company of Hong Kong commissioned Dr. Murray Laugesen of Health New Zealand Ltd to test their electronic cigarette cartridges for safety. Dr. Laugesen found only tiny traces of carcinogens in the electronic cigarette vapor at levels which were only a tiny fraction of those produced by regular cigarette smoke. Dr. Laugesen concluded that Ruyan V8 electronic between 100 and 1.000 times safer than regular cigarettes (Health New Zealand, 2009). We give a link to Dr. Laugesen's report in its entirety in our reference section.


When the FDA reported trace levels of carcinogens found in Njoy and Smoking Everywhere electronic cigarettes, the NJoy electronic cigarette company commissioned Exponent Health Sciences to do an independent study on the safety of NJoy electronic cigarettes as compared to regular cigarettes. This independent study found fewer carcinogens present in NJoy electronic cigarettes than were found in FDA approved quit smoking devices such as the Nicotrol inhaler. A link to this study in its entirety is given in our reference section.

Smoking Everywhere

Although Smoking Everywhere electronic cigarettes were investigated in the FDA report, Smoking Everywhere has so far failed to commission an independent study to prove their safety. Until such time as they commission such a study we are unable to make any statements about the safety of their products.

Brand summary

If you choose to use ecigarettes for your tobacco harm reduction plan we recommend that you use either the Ruyan V8 or the Njoy, because these have the best documentation of safety. We also very strongly encourage manufacturers of other brands of ecigarettes and cartridges to hire independent consultants to test them for safely so that the consumer will know that they are buying a safe product.

Hazards Associated With Electronic Cigarettes

Dr. Laugesen (Health New Zealand, 2009) recommends the use of sealed unopenable nicotine cartridges. Bottled nicotine or nicotine cartridges which can be opened by children pose a great hazard for accidental nicotine poisoning. 10 mg of nicotine can poison a child and 30-40 mg can poison an adult. Using liquid nicotine for a cheap refill is hazardous and accidental spillage can lead to nicotine poisoning. Tipping an ecigarette up can also lead to drainage of liquid nicotine onto the lips. We recommend that you always buy brands which use sealed refill cartridges to avoid the dangers of spillage and accidental nicotine poisoning.

Electronic Cigarettes Compared to Inhalers, Patch, Gum, etc.

Preliminary studies suggest that smokers are far more successful at switching to electronic cigarettes than to the patch, gum, inhalers, etc. because the ecigarettes mimic actual smoking so well. Studies have shown that it is not merely the chemical which is addictive; the rate of delivery and the delivery system itself also have a major effect on addiction and habit formation (Liu et al 2005, Robinson et al 2000). The biggest difference between electronic cigarettes and regular cigarettes is the lack or carcinogens: it is their similarity to real cigarettes in all other respects which makes them such a successful nicotine replacement device compared to inhalers, gum, etc.


In conclusion we would like to see more research done on the life saving potential of ecigarettes. It is time for Big Pharmacy to put the health of the public before profit and for the FDA to put public health before Puritanism and to research and support this life-saving harm reduction device.


American Association of Public Health Physician

AAPHP Statement re State Regulation of E-cigarettes


American Legacy Foundation 2009,
American-Legacy-Foundation: Electronic cigarette ("e-cigarette") fact sheet.


Bullen C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M. (2010).
Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial.
Tob Control. 19(2), 98-103.


Etter JF. (2010).
Electronic cigarettes: a survey of users.
BMC Public Health. 10(1), 231.



FDA (2009).
FDA: Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted By FDA. US: Food and Drug Administration (FDA), July 2009,


Health New Zealand (2009).

Accessed June 3, 2010

Laugesen M. (2008-10-30).
"Safety Report on the Ruyan e-cigarette Cartridge and Inhaled Aerosol".
Health New Zealand Ltd.


Lindsay J. (2009-07-30).

"Technical Review and Analysis of FDA Report: Evaluation of e-cigarettes".
Exponent Health Sciences.

Liu Y, Roberts DC, Morgan D. (2005).
Sensitization of the reinforcing effects of self-administered cocaine in rats: effects of dose and intravenous injection speed.
Eur J Neurosci. 22(1), 195-200.



The New York Times. (2009).
Cigarettes Without Smoke, or Regulation


Robinson ML, Houtsmuller EJ, Moolchan ET, Pickworth WB. (2000).
Placebo cigarettes in smoking research.
Exp Clin Psychopharmacol. 8(3), 326-32.


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