What is Nicotine?
Nicotine is an addictive substance, and almost all e-cigarettes contain nicotine. Even some products that claim not to have any nicotine in them may still contain it. For instance, initial FDA lab tests conducted in 2009 found that cartridges labeled as nicotine-free had traceable levels of nicotine. A 2014 study found little consistency in the amount of nicotine delivered by e-cigarettes of the same brand and strength.1 Similarly, another 2014 study found that the amount of nicotine in e-liquid refills is often substantially different from the amount listed on the package. Experienced users learn how to use e-cigarettes in a way that increases their exposure to nicotine. Newer e-cigarette devices, especially "tank" styles, with higher voltage also deliver a greater concentration of nicotine. This matters because the more nicotine used, the greater the potential for addiction.
Nicotine is not safe. The U.S. Surgeon General has found exposure to nicotine during pregnancy harms the developing fetus, and causes lasting consequences for the developing brain and lung function in newborns. Nicotine exposure also affects maternal and fetal health during pregnancy, and can result in low birth weights, preterm delivery and stillbirth.
Nicotine also has a negative impact on adolescent brain development. Human brain development continues far longer than was previously realized, and nicotine use during adolescence and young adulthood has been associated with lasting cognitive and behavioral impairments, including effects on working memory and attention.
Is Vaping Safer than Smoking Cigarettes/Tobacco?
In short, YES! Though we are uncertain as to how safe they are, we are fairly sure that they are safer than smoking cigarettes. Part of our certainty derives from knowing how harmful regular smoking is. Almost anything is certain to be safer.
Almost anything else that is not acutely toxic (and we know the e-cigs are not) will be safer. Even if e-cigs are about ten times as harmful as smokeless tobacco, that still makes them about 1/10th as harmful as smoking. Smoking is just that bad.
First of all, there is no burning of any plant matter so all those combustion related carcinogens are no longer present. Of course, in most cases, nicotine is still present but, as we've written elsewhere, nicotine is one of the more benign elements in tobacco. All that remains is some uncertainty about the effects of propylene glycol with long term regular use.
However, though there is little danger in smoking e-cigarettes, there are some safety issues involved if people are using refillable versions and handling liquid nicotine. In the liquid form, nicotine is quite dangerous and any spills onto skin should be immediately washed off and certainly it should never be ingested.