Are electronic cigarettes the safest alternative to tobacco?

The constant health warnings about the dangers of tobacco have caused some smokers to seek out new ways of enjoying smoking

– but without the risks associated with ingesting tobacco smoke and tar.

Electronic cigarettes are the main alternative to tobacco products and are becoming increasingly popular.

Some smokers have turned to using the Middle Eastern shisha pipe. Shisha pipes have also received celebrity endorsement, as well as appearing on the pavement tables of cafes in city centres up and down the UK.

However, shisha and e-cigarettes may seem to offer a similarly safe alternative to smoking tobacco – but recently released research from the University of California San Francisco has raise concerns that shisha may not be any less toxic than smoking tobacco.

It is known that using e-cigarettes in place of tobacco products can reduce the levels of harmful by-products in the smoke and tar produced by tobacco – while at the same time offering a compatible nicotine buzz in the vapour which e-cigs generate instead of smoke.

The shisha is a water-pipe which operates in a similar way to electronic cigarettes by generating vapour which contains nicotine. However, researchers at the University of California San Francisco found alarmingly high levels of toxic by-products in shisha vapour, including carbon monoxide and potentially lethal benzene in waste products of the eight male and five female smokers whose smoking habits they followed for the study.

The popularity of sharing a shisha pipe has rocketed by 210% in the last five years –with the student population especially embracing the communal experience of the shisha water pipe.

With shisha pipes, part of the experience is being seen enjoying “smoking” with friends while having a drink or a meal.

Electronic cigarettes offer an experience more akin to smoking tobacco and the habit of actually handling a cigarette – which is why for smokers who find quitting hard, e-cigarettes can mean the difference between kicking the habit and relapsing back into it.

Many smokers who have turned to shisha pipes may actually be unaware of the dangers – levels of toxic chemicals produced by shisha pipes may actually exceed those in smoke tobacco.

The US researchers found that, whereas tobacco smokers inhale around 0.5L of smoke over 8-12 puffs on a cigarette, shisha users may take as many as 200 puffs on the pipe in a one-hour session and inhale up to 1L of vapour as a result – almost double the amount of toxic chemicals which smokers take in during a smoking session.

The amount of benzene in shisha pipe smokers was also found to be double that of cigarette smokers, say the California researchers. The study participants were examined after smoking 11 cigarettes and compared with a shisha user enjoying three sessions. Benzene has been linked to the virulent blood cancer leukaemia

A researcher who worked on the US study likened shisha smoking to “burning a charcoal brick on top of the tobacco”.

Both shisha and electronic cigarettes are available in fruit flavours, but in the case of shisha pipes, the flavouring may actually mask the risks.

Tobacco researcher Neal Benowitz, who worked on the shisha study, said:
“…most of what you’re smoking is a moist fruit preparation, which is mixed with the tobacco. It smells good and it tastes good.”
The research suggested that most shisha users only enjoy their habit once a week – meaning the as an alternative to daily smoking, more regular sessions might be needed and these would increase the number of harmful chemicals ingested.

The study throws up the possibility that in the future not only will tobacco smokers be turning to electronic cigarettes to help them quit – but shisha smokers who previously did not realise the dangers of their habit will also be seeking an alternative and turning to electronic cigarettes to reduce their intake of toxic chemicals, while still enjoying a fruit-flavoured nicotine buzz with friends.

There is some good news for shisha lovers, however, as nicotine levels are lower than in tobacco cigarettes – but to enjoy nicotine without harmful chemicals in high doses, e-cigarettes may yet turn out to be the only viable alternative to tobacco for smokers.

The portability of electronic cigarettes and the reduced health risk gives e-cigs a tangible advantage over shisha pipes as a smoking alternative.

The World Health Organization has said that smoking one shisha pipe is the equivalent of smoking 100 cigarettes when it comes to health risk – and research chemist Peyton Jacob from the University of California San Francisco has this warning for those who opt for shisha pipes over electronic cigarettes:

“In addition to delivering toxic substances from the charcoal and tobacco, the heat causes chemical reactions which produce toxic volatile organic compounds (VOCs) – and polycyclic aromatic hydrocarbons (PAHs). Some PAHs are highly carcinogenic and can cause lung cancer.”

The shisha study is published in the journal Cancer Epidemiology, Biomarkers & Prevention, published by the American Association for Cancer Research.