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Douglas A. Taranow, DO, FACOS

New York, NY


Posted May 16, 2013 in Health & Lifestyle

Traditional tobacco cigarettes contain over 4,000 chemicals, more than 50 of which are known to cause cancer. As people became aware of the harmful effects of smoking tobacco cigarettes, alternatives to these “cancer sticks” have been highly sought after. Many products, from gums to patches, have been developed to help kick the butt, but, unfortunately, only about 10 percent of people who try to quit smoking cigarettes are successful.

Chinese pharmacist Hon Lik introduced the first tobacco-less electronic cigarette to the market in 2004. After this, many companies all over the world began manufacturing their own electronic cigarettes and developing new technologies to improve quality, and now there are numerous different brands to choose from. Although electronic cigarettes, commonly known as “e-cigarettes” or “e-cigs,” have not been approved by the FDA as smoking cessation devices, many people use them as an alternative way to get their nicotine fix or to help them quit smoking conventional tobacco cigarettes altogether.

What are electronic cigarettes and how do they work?

Electronic cigarettes are devices that use battery power to convert a liquid solution into vapor. This vapor is inhaled the same way that conventional cigarette smoke is inhaled, but e-cig vapor does not contain the thousands of harmful chemicals found in tobacco smoke.

The main liquid in e-cigarettes is usually propylene glycol, which has been approved for use in food by the FDA. Natural and artificial flavors are used to create different aromas and tastes. Liquid cartridges with varying amounts of nicotine are available, or cartridges containing no nicotine at all can be purchased.

There are generally three main parts to an e-cigarette: the battery, the vaporization chamber, and the cartridge with liquid. The battery powers an atomizer in the vaporization chamber, which converts the liquid in the cartridge into vapor for inhalation using heat. Some e-cig companies utilize a cartomizer, which combines the atomizer and cartridge into one piece that connects to the battery, making their e-cig a two-piece product. The cartomizer lasts longer with more puffs per refill and usually costs less than the cartridge for a three-piece electronic cigarette.

Main Brands and Costs

  • SmokeStik®- Celebrities such as Dennis Quaid, Katherine Heigl, and Charlie Sheen have been seen puffing on this brand of e-cigarette that uses a cartomizer rather than an atomizer and cartridge. SmokeStik offers a disposable version of their e-cig at $12.95 for beginners or experienced smokers who don’t want to make an investment before trying it out. Their starter kits range from $39.95 to $99.99 and come with a carrying case, charger, and a variety of flavor cartomizers.
  • V2® Cigs- The V2 Cigs company offers over 10 different flavor choices, with fragrances and tastes based on top tobacco cigarette brand flavors so people can still enjoy their favorite aromas without the harmful effects of the tobacco smoke. V2 offers a wide range of products that can cost anywhere from $24.95 to $159.95.
  • Green Smoke®- Green Smoke e-cigs advertise as having very similar nicotine levels and smoke volume as conventional cigarettes, and they are known for their strong flavors. They offer a trade-in program where you can exchange your current e-cig for a Green Smoke e-cig at no cost. Their single kits range from $59.97 to $129.97, their “Love Birds Kit” with contents for two smokers is $169.97, and their six-pack of disposables is $59.97.
  • blu eCigs®- This company has developed Smart Pack Technology that can be turned on or off, and it lets you know when blu retailers or other blu smokers are within 50 feet of you. This pack also has a battery management system to monitor and charge the spare battery, and it has a mini USB for data management and charging the pack battery. Liquid cartridges are available with and without nicotine. Starter kits offered by blu range from $69.95 to $89.95 and include a pack, two electronic cigarette batteries, a wall and USB charger, and a five-pack of e-cig cartridges in the strength and flavor of your choice. 

The Benefits

  • Healthier than Traditional Cigarettes– Because there is no tobacco used in electronic cigarettes, the thousands of carcinogens found in traditional cigarette smoke are not put into your body when you inhale the vapor. This eliminates the chances of lung cancer, periodontal disease, as well as a multitude of other cancers and diseases that are caused by smoking traditional cigarettes. E-cigs also eradicate tar buildup in the lungs, mouth, and airway from smoking. The tar resin that builds up can break down healthy tissue over time and is highly poisonous. Many people have also reported that their “smoker’s cough” has been relieved after switching to e-cigs. The heat produced to convert the liquid to vapor is much lower than the temperature for combustion used in smoking tobacco, so if undisclosed chemicals (see “Quality Control” in The Negatives section) are present in the e-cig liquid, lower amounts will be released into the vapor and inhaled compared to traditional cigarettes. While mimicking the act of smoking a tobacco cigarette, e-cig users can still enjoy “smoking” without so many of the negative consequences and feel less guilty.
  • Less Regulations of Use- Since e-cigs do not produce ash or an offensive odor that can affect the people around you, they are not subject to smoking laws and are generally legal to use in non-smoking areas. Because no flame is used to vaporize, e-cigarettes are cool to the touch and are not controlled by fire codes.
  • More Youthful Appearance- Electronic cigarettes do not contain the thousands of chemicals in the tobacco plant or those added by cigarette manufacturers, which can contribute to premature aging of the skin. When these chemicals are released into the environment they dry out the natural oils in your skin as the smoke touches your face, and this can cause wrinkles and a grayish skin color to develop. In addition, the heat that cigarette smoking exposes you to and squinting your eyes to avoid getting smoke in them can also contribute to wrinkles. Further, some research suggests that smoking increases the production of an enzyme that breaks down collagen in skin. E-cigs eliminate these wrinkle-causing factors.
  • Price- Although the initial cost of the e-cig device may be expensive compared to traditional cigarettes, the cartridges or cartomizers are the only parts that need to be replaced once all of the liquid has been vaporized. Depending on the brand of e-cigs, cartridges may last about as long as a pack of 20 tobacco cigarettes and sell for anywhere from $2 to $10. Consumers can purchase less expensive bottles of e-liquid to refill the cartridges themselves, making them cheaper than a regular pack of cigarettes. Replacement cartomizers also cost less than the equivalent amount of traditional cigarettes. Smoking regular cigarettes can increase the price you pay for dry cleaning and dental cleaning, and it can also lower the resale value on vehicles and homes stained from tobacco smoke, while e-cigarettes do not leave smoke stains. In addition, switching to e-cigs can also prevent illnesses and reduce the cost of other health-related expenses from smoking traditional cigarettes.
  • Low Nicotine and Nicotine-Free Options- Liquid cartridges are available with variable amounts of nicotine that can be controlled by the e-cig user. Many companies also offer cartridges and cartomizers with no nicotine at all for users who simply want to enjoy the taste of the vapor. Although most electronic cigarettes do contain nicotine, this chemical is believed by some to help improve conditions such as Alzheimer’s Disease and Tourette’s Syndrome. 

The Negatives

  • Nicotine Affects Health and Appearance- Although there is no tobacco in electronic cigarettes, many of the liquids used for vaporization contain nicotine. Nicotine is a chemical known to have numerous adverse health effects, such as causing birth defects and other reproductive harm, accelerating the development of hardened arteries by increasing the level of “bad” LDL cholesterol in your body, and making many smokers hyperglycemic by blocking the release of insulin. In addition, nicotine narrows the blood vessels in the skin and restricts blood flow. This decreases the amount of oxygen and nutrients delivered to the skin, which can lead to premature wrinkles. Nicotine is also a major cause of yellow teeth, which can make a person appear older than their age.
  • Quality Control- Health experts worry that manufacturers may not make public all of the chemical ingredients contained in their liquid cartridges. A small study conducted by the FDA in 2009 revealed that some cancer-causing compounds that are found in tobacco were also found in some e-cigarettes, as well as other toxic chemicals. These products have not been submitted to the FDA for approval or evaluation; therefore, the actual levels of nicotine in these products and whether they contain other harmful chemicals are not known.
  • Unknown Effects- Since electronic cigarettes are a relatively new development, there has not been enough time to conduct adequate studies of them. Both the short- and long-term health effects of exposure to pure nicotine vapor are unknown, and it may take more than a decade to determine the long-term effects. 


When it comes to smoking, obviously the healthiest choice would be to quit altogether. Unfortunately, this is a daunting task to some because nicotine can be highly addictive. Cigarette smokers who desire a healthier alternative can switch to electronic cigarettes and experience less detrimental effects on their health, but there are still negative consequences that accompany e-cigs.

For those who have quit smoking, but still want to smoke occasionally, e-cigs may be a viable option. Former smokers should beware of how addictive nicotine is and test out an e-cigarette first to determine if it is right for them before making a major purchase.