Intended for healthcare professionals

Rapid response to:


Children are three times as likely to try e-cigarettes as tobacco products, study finds

BMJ 2014; 349 doi: (Published 05 December 2014) Cite this as: BMJ 2014;349:g7508

Rapid Response:

In the year 2004 the first e-cigarettes, a Chinese invention, came from the Ruyan company as a pathway to the reduction of tobacco smoking or tobacco harm reduction (THR); e-cigarettes were marketed as less harmful alternatives to smoking.[1] E-cigarettes have become a fashion statement among young tobacco users & their use has spread to nearly all corners of the globe. The use of e-cigarettes by teenagers has resulted in the criticism of e-cigarettes worldwide, & e- cigarettes are the subject of a public health debate.

E-cigarettes have 10 times carcinogens such as formaldehyde and acetaldehyde in vapour (Research from Japan). Ultrafine particles are similar to traditional cigarettes, and cytotoxic metals in vapour produced by heating elements have been identified in e-cigarettes.[2,3] Flavourings, such as diacetyl, & other chemicals,are known to cause serious lung disease. Nicotine is a potent poison & harmful for passive smokers.[4] The most common side effects from e-cigarette use are sore throat, dry cough, and headache due to inhalation of PG/VG and/or nicotine. There is health risks to users, non-users and bystanders.[5]


1. Backgrounder on WHO report on regulation of e-cigarettes and similar products. Geneva: World Health Organization (WHO), 26 Aug 2014.

2. Zhang Y, Sumner W, Chen DR. In vitro particle size distributions in electronic and conventional cigarette aerosols suggest comparable deposition patterns. Nicotine Tob Res 2013;15:501–8.

3. Williams M, Villarreal A, Bozhilov K, et al. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS ONE2013;8:e57987.

4. Diethelm PA, Rielle JC, McKee M. The whole truth and nothing but the truth? The research that Philip Morris did not want you to see. Lancet 2005;366: 86–92.

5. Bullen C, Howe C, Laugesen M, et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013;382:1629–37.

Competing interests: No competing interests

08 December 2014
Dr.Rajiv Kumar
Associate Professor, Deptt. of Pharmacology
Dr.Jagjit Singh, Assistant Professor & co author.
Government Medical College & Hospital, Chandigarh 160030. INDIA
House No- 1156 B, Sector 32 B, Chandigarh , 160030. INDIA.