Safety, Quality, and Health Effects of E-Cigarettes

In July 2009, the Food and Drug Administration (FDA) Division of Pharmaceutical Analysis tested the ingredients in a small sample of cartridges from the two leading brands of e-cigarettes. They found that the samples contained detectable levels of known cancer-causing agents and other toxic chemicals, including diethylene glycol (commonly found in antifreeze) in one cartridge and nitrosamines in several cartridges.

The tests also found that there was no consistency in the levels of nicotine between different products with the same label. Some of the products labeled “no nicotine” still contained low levels of nicotine.

Like other forms of nicotine, the e-cigarettes and nicotine containers can be deadly to children or pets, who risk nicotine poisoning from ingesting the liquid nicotine. While most people may simply buy refill bottles from a tobacco retail store or vaping shop, some users refill their own cartridges at home. These refill bottles, as mentioned above, can contain up to 7 grams of nicotine. The fatal dose of nicotine for adults is estimated at 30-60 mg, while for children it is estimated at only 10 mg, or about 4 drops of a maximum strength refill bottle.

Regulation of E-Cigarettes

In 2010, following a lawsuit by e-cigarette manufacturers, federal courts ruled that the FDA could regulate e-cigarettes as tobacco products under the Tobacco Control Act, but not as tobacco cessation aids.

In 2011, the FDA issued a statement announcing they intend to regulate e-cigarettes as tobacco products, as allowed by the courts, which includes marketing restrictions, mandated ingredient listing and pre-market review. However, there are limitations to what the FDA can restrict in regards to e-cigarettes. The FDA has yet to issue regulations specific to e-cigarettes, though they are expected to at any time.

At the state and local level, many governments have chosen to limit and regulate e-cigarettes. Many entities have banned the use of e-cigarettes in areas where smoking is already prohibited, by adding vaping to existing smoke-free laws. Others are banning or limiting the sale of e-cigarettes to minors. Another approach is to regulate who can sell e-cigarettes, by requiring tobacco retailer licensure in order to sell.


While more studies are likely to be conducted on the safety, efficacy, and integrity of e-cigarettes in the months and years to come, most public health professionals agree it is premature to call e-cigarettes a safe alternative to traditional cigarettes. Additionally, the dramatic increase of e-cigarette usage by youth and the ever present marketing of e-cigarettes to all populations have created concern with public health leaders.

"These data show a dramatic rise in usage of e-cigarettes by youth, and this is cause for great concern as we don’t yet understand the long-term effects of these novel tobacco products," said Mitch Zeller, director of FDA’s Center for Tobacco Products. "These findings reinforce why the FDA intends to expand its authority over all tobacco products and establish a comprehensive and appropriate regulatory framework to reduce disease and death from tobacco use."


  • American Cancer Society, Prevention and Early Detection. “Guide to Quitting Smoking,” Revised May 2009.
  • American Legacy Foundation. “Tobacco Fact Sheet: Electronic Cigarettes,” Revised June 2013.
  • Public Health Law and Policy, Technical Assistance Legal Center. “Electronic Cigarettes: How They Are- and Could Be- Regulated,” July 2011.
  • Campaign for Tobacco Free Kids. “FDA and the States Must Regulate E-Cigarettes to Protect Public Health: Our Policy Regarding E-Cigarettes,” July 2013.
  • Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. “Electronic Cigarette Use Among Middle and High School Students — United States, 2011–2012,” Volume 62, Number 35, September 6, 201
Call at 775-328-6160 or 775-328-2454

1 Cancer.gov
2 Oral Health America
3 Campaign for Tobacco Free Kids, Fact sheet - Smokeless Tobacco and Kids. www.tobaccofreekids.org

Last modified on 04/02/2018