This is sadly fatalistic argument from smokers, but thankfully for e-cig advocates, it’s once which is actually well-addressed by research. As we covered earlier in the series – nicotine is not the bad guy people would have you believe. It’s a mild stimulant, just like caffeine, and only has negative connotations because combustible tobacco cigarettes contain around 70 carcinogens amongst the 7,000-plus chemicals you’ll find.
That’s why e-cigs are a revolution in harm reduction, because the dangerous components of cigarettes are almost entirely absent, leaving the nicotine in its pure and relatively innocuous state. This is only the start of your solid rebuttal to this argument, though, because there is now substantial reason to believe that e-cigs don’t carry a significant cancer risk at all.
The first thing to address is the shockingly widespread mistruth that nicotine is the cancer-causing component of cigarettes. Although it’s the main chemical from the smoker’s point of view (since that’s all they want in the first place), it’s the other stuff in cigarettes you have to worry about. Explain that pure nicotine inhalation has been studied in rats (over the course of two years), and the nicotine-consuming rats didn’t develop tumors any more often than those breathing ordinary air. Since several FDA-approved products like patches and gums rely on doses of nicotine, this is the result you might expect, nicotine replacement therapy (NRT) products wouldn't have received approval otherwise.
“But,” your tobacco-smoker friend may counter, “what about all of the other carcinogens they've found in e-cigarettes?” These include things like tobacco-specific nitrosamines, formaldehyde and acrolein, all of which were covered in a recent review of the existing evidence on the levels of various chemicals in e-cig vapor. The paper compared the reported levels of the various carcinogens (as well as heavy metal particles) with their accepted safe exposure limits, finding that all of the potentially dangerous components were only found in much lower concentrations (ordinarily less than one percent of the limit for safe exposure).
For questions about nitrosamines specifically, it’s also extremely useful to point out that they are found in similar quantities in FDA-approved NRT products, a testament to their safety at these levels. As we covered earlier in the series, the FDA analysis which convinced the media that e-cigs contain diethylene glycol was fundamentally flawed, and the results were presented in what can only be referred to as a purposefully misleading fashion.
With all this information, it should be easy to convince the smoker that e-cigs are not going to give you cancer. Whilst it may be a little troubling that there are any carcinogens in e-cigs at all, they don’t act like biological “switches” – it isn't “you ingest a carcinogen, therefore you develop cancer” – they are heavily dose-dependent. With cigarettes, you’re exposed to bucket-loads of carcinogens, each one making a harmful genetic mutation and hence cancer more likely.
That’s why the safe exposure limits exist – because a tiny quantity of carcinogens isn't a cause for concern. E-cigarettes are designed to reduce harm, and their meager risks must be placed into the context of cigarettes, which kill around half of all smokers. Answer with certainty: if you switch to e-cigarettes, your chances of developing cancer will decrease dramatically.