For almost 20 years, Johannesburg resident Justin Adan smoked more than a pack of cigarettes
a day. Three months ago he started using
an e-cigarette and noticed a difference in his
health and in his pocket. 

Now he smokes a cigarette only now and again, “like
when I forget my vapour in the office and I’m outside
with the smokers, or when I need to recharge it or run out
of juice. But I no longer have a burning desire to smoke.” 

E-cigarettes deliver nicotine in the form of a vapour,
which is inhaled. They are battery-operated and the
vapour comes in a variety of flavours. 

Research by the Royal College of Physicians in the
United Kingdom, which was published in April 2016,
found that e-cigarettes are safer than conventional cigarettes
and are suitable for smokers “who are trying to
reduce harm to themselves or others from smoking, or to
quit completely”. 

E-cigarettes are relatively new and one of the biggest
concerns raised about the safety of using these devices
is the long-term effect. According to the Royal College
study, the health hazard from the long-term use of e-cigarettes
is “unlikely” to be more than the harm caused by
cigarettes. 

But South Africa’s health department argues that this
has not been proved. 

“I realise that the safety is unknown at this time. But
my personal experience is that it’s a lot better than actually
smoking,” says Adan. 

A keen gym-goer, he says his physical improvement
was almost immediate. “I feel better and am able to train
a lot harder now than before.” 

Another upside to vaping, says Adan, is the cost. He
started using e-cigarettes three months ago and spends
about R900 a month on them. He was spending R1500 a
month on cigarettes. 

But that is not why he started. 

“The main reason I switched over is because of my wife.
She hates the smell of cigarettes.” 

For Adan, the e-cigarette has made him feel healthier,
helped him to save money and improved his relationship
with his wife. But what does the research say?

Are e-cigarettes safer than normal cigarettes?  


Tackling nicotine addiction
In 2014 the Cochrane Library, a peer-reviewed healthcare
research platform, published a scientific review of the evidence for and against the use of electronic cigarettes
to either help a smoker quit cigarettes or reduce
tobacco smoking. The review included the two best studies
out of almost 600. The studies involved more than
600 people. 

The findings include: 

  • Almost half the people who try to quit “cold turkey”
    don’t manage to stop smoking for even a week. 
  • Less than 5% of people who try to quit without support
    are tobacco-free for up to a year. 
  • After one year the average quit rate for a widely used
    antidepressant medication, bupropion, marketed as
    Zyban, was between 18% and 30%.
  • After one year the average quit rate for nicotine
    replacement therapy, which includes patches and gum,
    was 15%. 
  • One of the reasons the quit rates remain low is that
    “none adequately addresses the sensory and behavioural
    aspects of smoking that smokers miss when they stop
    smoking”. 
  • Tobacco is primarily addictive because of the ingredient
    nicotine, which activates the reward system in the
    brain. But research has shown that “sensory and behaviour
    cues” such as holding a cigarette and the sensation
    of inhaling smoke “over time become almost as rewarding
    as nicotine”. 
  • Just under 10% of people who use e-cigarettes that
    contain nicotine quit smoking tobacco after a year. 
  • But people who use an e-cigarette are more likely
    “to cut down the amount [of tobacco] they smoked by at
    least half” – a greater reduction than people who use the
    nicotine replacement patch. 
  • Electronic cigarettes with nicotine seem to help
    smokers who are unable to quit altogether reduce the
    amount of harmful tobacco they consume, more so than
    electronic cigarettes that do not contain nicotine, and
    more than nicotine replacement patches. 
  • There was no evidence that “short-term [e-cigarette]
    use is associated with health risk”.

e-cigarettes (smoking)Council Against Smokingsmoking-related diseases