Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies

Continue

Navigation

In the spotlight: e-cigarettes

It’s hard not to notice the recent increase in the popularity of electronic cigarettes. Also known as e-cigarettes or vapourised cigarettes, people are using these small devices more and more to quit, cut down or replace tobacco for good.

But how safe and effective they are still can’t be assured, so should we be using them at all? Here, we explain more about e-cigarettes and take a closer look at the current guidelines and evidence that’s out there.

Smoking
Dr Paul Zollinger-Read

Details

  • What is an e-cigarette? What is an e-cigarette?

    A typical e-cigarette is made up of three main parts: a battery, an atomiser (heating system) and a cartridge containing nicotine. These replaceable cartridges contain nicotine in a liquid called propylene glycol or glycerine and water. The level of nicotine can vary and some cartridges are flavoured. Some look like cigarettes, but more and more are starting not to.

    Over the past few years, e-cigarettes have rocketed in popularity. It’s estimated that around 1.3 million people currently use e-cigarettes in the UK. In 2010, the number of smokers who had tried e-cigarettes was 9 percent. This rose to 35 percent in 2013.

  • Are e-cigarettes safe? Are e-cigarettes safe?

    This is still a grey area that has triggered a lot of debate. This is because there is no evidence on the long-term safety of e-cigarettes as yet. But according to the National Institute of Health and Care Excellence (NICE), there is little evidence to date that suggests e-cigarettes can cause any harm. And especially in comparison to smoking.

    Recent guidelines from NICE support the use of licensed nicotine products, such as nicotine patches, gum and sprays, as a way to cut down, quit or use as a substitute for smoking. E-cigarettes are still under question until more safety research is carried out.

    If you smoke, it’s mainly the burning of a cigarette and inhaling its toxins and carcinogens (cancer causing substances) that causes illness and poor health. Not the nicotine. Nicotine is a drug that causes you to become addicted to smoking. Because of this reason, NICE concludes that it’s safer to use licensed nicotine containing products than to smoke.

    The concern with e-cigarettes, however, is that they are currently unregulated products in the UK. E-cigarettes are thought to be far less harmful than tobacco. But at the moment there is no long-term evidence on their effectiveness, quality and safety. This is why there is often such debate around e-cigarettes.

  • Are there plans to regulate e-cigarettes? Are there plans to regulate e-cigarettes?

    Yes. The Medicines and Healthcare Products Regulatory Agency (MHRA) wants all nicotine containing products regulated in the UK. This will happen when the European Commission’s new Tobacco Products Directive (legislation) comes into effect, which is expected to be in 2016.

    This doesn’t mean that you will no longer be able to buy e-cigarettes, but rather, you’ll benefit from improved safety and quality requirements. There will be new rules on packaging and labelling to make sure that you know exactly what’s in them and any potential hazards of using an e-cigarette.

    And regulation is good news. Because e-cigarettes are evolving so quickly and becoming so popular, their safety and quality is essential. If you look into buying an e-cigarette at the moment, it’s likely that it won’t display its contents, how to use it properly or how to dispose of it safely. One study also found that e-cigarettes frequently leak, which can be a hazard to you, your children and pets. This is because we still don’t know what the long-term effects are of handling nicotine or getting it on your skin. And the contents of the cartridge can be toxic if consumed.

    Until the Tobacco Products Directive comes into effect in 2016, the UK government has said it will work on getting nicotine containing products licensed as medicinal products.

  • Bupa Health Assessments

    Get an overview of your current health and any potential future risks with a Bupa health assessment. Book yours today.

  • What is a safe dose range for an e-cigarette? What is a safe dose range for an e-cigarette?

    Again, the long-term safety and effectiveness of e-cigarettes still hasn’t been looked into thoroughly. But it’s important to know that the maximum threshold of nicotine is 20mg per millilitre. Anything above this, and it shouldn’t be classed as a consumer product. You may be able to buy e-cigarettes at higher dosages but these are only OK if they’re approved as a pharmaceutical product.

    The variation of nicotine content and how the nicotine is delivered from product to product also shows why regulation will be a real benefit.

  • Is the vapour from e-cigarettes safe for non-users to inhale? Is the vapour from e-cigarettes safe for non-users to inhale?

    We can’t say for sure until there is long-term research available on the safety of e-cigarettes. However, if you use an e-cigarette, what you exhale is mostly water vapour and therefore thought to be far less harmful than second-hand smoke from cigarettes.

  • I'm finding it hard to give up smoking. Should I try e-cigarettes? I'm finding it hard to give up smoking. Should I try e-cigarettes?

    Giving up smoking is the best thing you can do for your health. In general, stopping in one step (sometimes called 'abrupt quitting') offers you the best chance of staying smoke free. But if you’re struggling to do this, nicotine products can help you cut down, stop and importantly reduce the harm that smoking can cause. NICE supports licensed nicotine containing products such as gum, sprays and patches, which have been shown to help people quit. There are also smoking cessation services that can offer the support you need to stop smoking for good.

    If you decide to use e-cigarettes, it’s important to be aware that their effectiveness, safety and quality cannot be assured as yet. However, they are likely to be less harmful than cigarettes.

    You can read more and keep up to date with developments on regulating e-cigarettes on the MHRA’s website and the European Commission’s website.

  • Resources Resources

    Further information

    Sources

    • Electronic cigarettes. Action on Smoking and Health (ASH). www.ash.org.uk, published March 2014
    • Tobacco: harm-reduction approaches to smoking. National Institute for Health and Care Excellence (NICE), June 2013. www.nice.org.uk
    • Nicotine containing products. Medicines and Healthcare Products Regulatory Agency. www.mhra.gov.uk, published 31st December 2013
    • E-cigarettes myth buster. European Commission. ec.europa.eu, published 26 February 2014
    • Revision of the Tobacco Products Directive. European Commission. ec.europa.eu, accessed 26 March 2013
    • Trtchounian A, Talbot P. Electronic nicotine delivery systems: is there a need for regulation? Tob Control 2011; 20:47–52. doi:10.1136/tc.2010.037259
    • Smoking cessation services: guidance. National Institute for Health and Care Excellence (NICE), February 2008. www.nice.org.uk
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
    Ask us a question
  • Related information Related information

  • Author information Author information

    Produced by Alice Rossiter, Bupa Health Information Team, April 2014.

    Let us know what you think using our short feedback form
    Ask us a question

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information: verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Image of Andrew Byron

Andrew Byron
Head of health content and clinical engagement




  • Dylan Merkett – Lead Editor – UK Customer
  • Nick Ridgman – Lead Editor – UK Health and Care Services
  • Natalie Heaton – Specialist Editor – User Experience
  • Pippa Coulter – Specialist Editor – Content Library
  • Alice Rossiter – Specialist Editor – Insights
  • Laura Blanks – Specialist Editor – Quality
  • Michelle Harrison – Editorial Assistant

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.

Readable

In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.

Reliable

We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.

Relevant

We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: healthinfo@bupa.com. Or you can write to us:

Health Content Team
Bupa House
15-19 Bloomsbury Way
London
WC1A 2BA

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.