Understanding Harm in Electronically Vaporized Nicotine Products

There are a large number of legislative and public-health efforts surrounding electronic vaporizers of nicotine-containing liquids. Some positive, some negative. Likewise, a large number of studies are either underway or have been conducted. Some positive, some negative.

But at the base of the questions comes a single question: how do we quantify the potential harm?

For this we turn to what we can call risk profiles. We’ll start with an unrelated subject: knives.

There’s an anecdote that says roughly that the duller the knife, the less safe it is. How can that be? Well, we can imagine all the potential knifes, from blunt to dull to barely sharp to razor. The duller end of the spectrum tends to require more cutting force, which leads to a greater potential for that force to become misdirected or wild. A sharper knife also tends to command more attention to handling, more respect.

And so on. So we look at so-called e-cigarettes.

One study purports to find minute levels (but not levels that raise concern compared to current occupational guidelines) of certain metals. The methodology of this study may have other issues, but take it as granted for the moment that for the tested devices these metals are present in minute levels. This is an increase in the risk of these particular devices.

But we want a baseline risk profile. A baseline gives us the ability to ascertain the ideal level of risk for any actual use. It gives us something to compare actual risk against. While we can compare risk to the control, or to the cigarette, comparing to a meaningful baseline gives us a better gauge of how much risk we are adding in a more complex scenario, rather than relative to control or to cigarettes.

What’s safest, according to what we know? A dripping atomizer made of a well-machined, clean, single, high-purity/surgical-grade metal. A coil made of clean resistance wire and with a silica wick. Juice made with only propylene glycol, vegetable glycerin, and nicotine (no flavoring). A device that heats the coil only enough to vaporize the liquid.

This would be something close to the baseline. It is a conservative set-up. You remove as many extra parts as possible. No filler, no cotton, no non-resistance wire, no solder joining non-resistance to resistance wire, no rubber o-rings, etc. You still need an insulator to separate the positive and negative posts, but that can be ceramic, and contact with the vaporization chamber and juice can be minimized.

With a baseline setup, the risk seems to come down to three substances in very low levels. Formaldehyde, acetaldehyde, and acrolein may be present at low levels. The less heat, the less chance of them being present and the lower levels they will be found at. Acrolein will be entirely absent unless excessive heat is being produced (280°C) in vegetable glycerin.

In all likelihood the risk of the baseline is significantly lower than the average North American diet. But that’s the baseline. The more complex the setup (adding a plastic tank (glass maintains the low risk), cotton wick (that’s organic and capable of burning in contact with a coil if dry), rubber (o-rings and insulators), solder, and flavorings) all add potential increases to the baseline harm.

The baseline has very minimal harm potential. Low enough that adding it to your normal life should not increase risk significantly. That’s what the data says today, anyway. And compared to the levels of volatile organic compounds in actual cigarettes (which do contain a significant risk, but not an absolute risk like being shot point-blank as the risk is often portrayed in the media), it is low enough risk that wasting time on public-use bans and other inanities miss the point.

Even the more complex vaping scenarios still stay well below the risk of traditional cigarettes and many other daily risks.

The Food and Drug Administration should be proposing their regulations for electronically vaporized nicotine products in the near future.