Electronic cigarettes: are they safer than tobacco? A first evaluation for a better risk communication

Background Many smokers have reduced the number of cigarettes smoked thanks to the use of electronic cigarette (e-cig) with positive effects on their health. However, currently, it is in progress an unjustified demonization of e-cig because of data lack about its certain health effects on the smokers allowing to the its detractors to raise serious doubts about his salubrity. In addition, some latest studies have demonstrated metals and Volatile Organic Compound (VOC) release by e-cig causing a great heterogeneity concerning e-cig laws worldwide with several and different policies approach. Therefore, aim of our study was to assess the metal content in various typologies of e-cigs liquids and into their extracts, to carry out a risk evaluation of e-cig vs tobacco. Methods Risk evaluation was carried out comparing our results: Vanadium (V), Cromium (Cr), Manganese (Mn), Cobalt (Co), Nickel (Ni), Cuprum (Cu), Molibdeno (Mo), Arsenic (As), Cadmium (Cd), Antimony (Sb), Mercury (Hg), Thallium (Tl), Lead (Pb) obtained by ICP-MS full-scan analysis with data of several authors in liquids and tobacco samples. Results Cr, Mn, Co, Mo, Cu, As, Cd, Sb and Tl concentrations were determined (µg/L) respectively in the ranges of: 0.75-1.68; 1.8-65.8; 0:35-1:13; 4.25-11.5; 0.8-1.68; 6.43-32.0; 0.3-14.3; 0.65-4.65; 0.35-1.15 in liquids. All values in extracts were lower than the calculated Method Detection Limits. Our results were comparable with those indicated by other authors. Conclusions Injury risk to health by tobacco smoke has been already demonstrated by several authors. Even if e-cigs show low doses of VOC (data literature) and metals, they are generally not absolutely risk free, so, we can suggest that e-cig use exposes to a lower risk compared to the traditional tobacco. In fact, e-cig use in smokers reduces exposure to toxic and carcinogenic substances resulting from the tobacco and paper combustion and so it represents a good tool for replacement of tobacco smoke and to contribute in risks prevention related to cigarette smoke. Our first data, in addition to the few data already available, may support a better risk evaluation for a better risk communication that allows a good preventive action on public health of smokers and non-smokers. Main message E-cigs are safer than tobacco so our data on metals in liquid extracts, which are the only data available in recent literature, represent today a great tool for a better risk management.