Smokers who swap cigarettes for e-cigarettes or NRT have lower carcinogen levels

man smoking electronic cigarette

E-cigarettes and nicotine replacement therapy are less toxic and safer if used instead of conventional cigarettes, according to research published in Annals of Internal Medicine
(online, 6 February 2017).

People who swapped smoking regular cigarettes for e-cigarettes or nicotine replacement therapy (NRT) for at least six months had much lower levels of toxic and cancer-causing substances in their body than people who continued to use conventional cigarettes, the researchers found.

They based their conclusions on an analysis of five groups of smokers — people who used combustible cigarettes only; former smokers who had used only e-cigarettes for more than six months; former smokers who had used only NRT for more than six months; people who were long-term users of both combustible cigarettes and e-cigarettes and people who used combustible cigarettes and NRT. Each group was made up of 36 or 37 smokers; the total number of study participants was 181.

Participants’ urine and saliva samples were analysed for biomarkers of nicotine, tobacco-specific N-nitrosamines (TSNAs), and volatile organic compounds (VOCs).

The researchers found that people who only used e-cigarettes or nicotine replacements had lower levels of TSNAs and VOCs than either those who only smoked combustible cigarettes, those who used both combustible cigarettes and e-cigarettes, or those who used both combustible cigarettes and nicotine replacement. Participants who only used e-cigarettes had lower levels of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) than all the other groups, including the nicotine replacement-only users. Participants who used combustible cigarettes either on their own or in combination with NRT or e-cigarettes all had largely similar levels of TSNA and VOC metabolites.  


[1] Shahab L, Goniewicz ML, Blount BC et al. Nicotine, carcinogen, and toxin exposure in long-term e-cigarette and nicotine replacement therapy users: a cross-sectional study. Annals of Internal Medicine. doi/10.7326/M16-1107

Last updated
The Pharmaceutical Journal, February 2017;():DOI:10.1211/PJ.2017.20202309

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