Warning to Consumers

FDA Analysis Finds Toxins, Carcinogens in Electronic Cigarettes

By David Mitchell
7/28/2009

The idea that electronic cigarettes offer tobacco users a safer alternative than, say, a pack of Marlboros recently seems to have gone up in smoke.

FDA handout warning of e-cigarette hazards

The FDA issued a warning about the so-called e-cigarettes on July 22, advising consumers about health risks associated with the products, which are battery-operated devices designed to look like and be used in the same manner as regular cigarettes. The devices turn nicotine and other chemicals into a vapor that is inhaled by the user. Manufacturers have touted the smokeless products as safer than conventional cigarettes.

However, after analyzing samples of e-cigarettes and components from two leading brands, the Division of Pharmaceutical Analysis in the FDA's Center for Drug Evaluation and Research said the samples showed detectable levels of known carcinogens and toxic chemicals.

The FDA raised a number of specific issues with the products.

Tobacco-specific nitrosamines, which are carcinogens, were detected in half of the samples tested.
The tobacco-specific impurities anabasine, myosmine and beta-nicotyrine were detected in a majority of the samples.
The vast majority of cartridges labeled as containing no nicotine did, in fact, contain low levels of nicotine.
On testing three different cartridges with the same label, each cartridge emitted a different amount of nicotine.

Furthermore, FDA officials said the test results "suggested that quality-control processes used to manufacture these products are inconsistent or nonexistent." For example, diethylene glycol, a toxic ingredient used in antifreeze, was detected in one cartridge.

"Electronic cigarettes are made overseas, mainly in China, and have not previously been tested for safety," said FP Tom Houston, M.D., of Dublin, Ohio. Houston is director of OhioHealth's Nicotine Dependence Program and clinical professor in the family medicine department at Ohio State University, Columbus.

"As we now see, they may contain more than just nicotine and flavorings," said Houston of the FDA's announcement. "It is also a concern that their novelty, the attractive flavoring, and marketing through the Internet may attract youth to the products."

E-cigarettes are sold without legal age restrictions and do not contain health warnings comparable to those found on FDA-approved nicotine replacement products or conventional cigarettes.

Houston, who is chairman of the AAFP Tobacco Cessation Advisory Committee, said electronic cigarettes aren't a safe substitute for conventional cigarettes and should not be used as a smoking cessation aid. He said people who want to stop smoking have proven methods available to them, such as

seeking help from their family physician or other health care professional;
pursuing tobacco cessation counseling through telephone Quitline services ([800] QUIT-NOW) or programs offered at many hospitals, health departments and voluntary health agencies;
via Internet-based services such as QuitNet; and
using FDA-approved medications known to increase the effectiveness of attempts to quit.

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