Are e-cigarettes safe to puff?

As electronic or e-cigarettes grow in popularity, some health advocates want them to be regulated.

E-cigarettes are battery-operated devices that use a liquid-filled cartridge that can contain mint, vanilla or other flavourings. The contents are vaporized into a mist that is breathed into the lungs. Some cartridges also contain nicotine.

Some analysts project that e-cigarettes will outsell regular cigarettes within a decade. (Ashley Smith/Times-News/Associated Press)

Health Canada has not authorized stores to sell nicotine-filled cartridges, but they are available online and at some flea markets.

"To date, no electronic cigarettes with nicotine or health claims have been authorized by Health Canada," a spokesperson for the department said in an email Tuesday.

"As the safety, quality and efficacy of these products remains uncertain, Health Canada continues to advise Canadians not to use electronic cigarettes as they may pose health risks."

Electronic cigarettes are sometimes marketed as an option to help people quit smoking, or as a tobacco replacement.

Analysts think the market for e-cigarettes will surpass $10 billion in the U.S. by 2017 and that e-cigarettes will outsell regular cigarettes within a decade, said David Sweanor, a law professor at the University of Ottawa who works on tobacco and health issues.

"No one's given me a kiss on the cheek for giving them a piece of Nicorette gum, but I have gotten that for giving them an electronic cigarette," Sweanor said.

Sweanor believes in using e-cigarettes as a risk reduction strategy for cigarette smokers. "People smoke for the nicotine, they die from the smoke." 

E-cigarette regulations elsewhere

Last week, the U.K. government announced it plans to treat e-cigarettes as a medicine starting in 2016.

France plans to prohibit use of e-cigarettes in public venues, Reuters said.

EU-wide regulations are due to be introduced in 2016, U.K.'s Medicines and Healthcare Products Regulatory Agency said.

In 2009, the U.S. Food and Drug Administration found traces of carcinogens and a harmful substance used in antifreeze in two brands of e-cigarettes. Shipments from China were blocked until a federal judge indicated the devices should be regulated as tobacco products rather than drugs or medical devices, the New York Times reported.

In March, Australia's government said it was concerned about the use of electronic cigarettes, saying the impact of wide-scale use is not known and the outcome in the community could be harmful.

In Singapore, legislation prohibits "the importation, distribution, sale or offer for sale of any confectionery or other food product or any toy or other article that is designed to resemble a tobacco product."  

It's not nicotine itself that causes most of the harm associated with cigarettes, said Dr. Peter Selby, chief of the addictions division at the Centre for Addiction and Mental Health in Toronto.

"We really don't know whether these are meeting any kinds of standards of safety for people to inhale on them, whether they have nicotine or not," Selby said of e-cigarettes.

For Selby, the main issue is whether e-cigarettes meet manufacturing and regulatory inspection standards for producing products under hygienic conditions, for example, and to ensure they don't explode and cause burns. The potential harm of inhaling nicotine in e-cigarettes also needs to be compared with the risk from regular cigarettes.

"We need a framework to study that and understand it so we can actually tell smokers it is a safer option," Selby said.

"Right now, it looks like we’ve got our head in the sand. If you take the nicotine out of the tobacco and only give people nicotine, the potential harm is likely very, very small."

During National Non-Smoking Week in January, the Canadian Lung Association said it encourages people to quit smoking using scientifically proven methods such as nicotine replacement patches and gums. The group also objects to flavours that appeal to children, fearing e-cigarettes may encourage those under 18 to try tobacco products.

At Esmoker Canada, an e-cigarette store in Toronto, Mario Martinasevic says sales have almost doubled every month. Customer Ashley Harris calls e-cigarettes without nicotine a convenient alternative to cigarettes that she can smoke at the office or at a bar when out with friends without stepping outside.

"I don't want to be inhaling nicotine," said Harris. "I'm finding it fine without it."

Since switching to using e-cigarettes, Harris said food tastes better, she's feeling more physically fit and her teeth are better. She's also saving money.

With files from CBC's Kim Brunhuber