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E-cigarettes: an evidence update <br /> <br />80 <br />Summary of findings <br />Two recent worldwide media headlines asserted that EC use is dangerous. These were <br />based on misinterpreted research findings. A high level of formaldehyde was found <br />when e-liquid was over-heated to levels unpalatable to EC users, but there is no <br />indication that EC users are exposed to dangerous levels of aldehydes; stressed mice <br />poisoned with very high levels of nicotine twice daily for two weeks were more likely to <br />lose weight and die when exposed to bacteria and viruses, but th is has no relevance for <br />human EC users. The ongoing negative media campaigns are a plausible explanation <br />for the change in the perception of EC safety (see Chapter 8). <br /> <br />None of the studies reviewed above alter the conclusion of Professor Britton’s 2014 <br />review for PHE. While vaping may not be 100% safe, most of the chemicals causing <br />smoking-related disease are absent and the chemicals that are present pose limited <br />danger. It had previously been estimated that EC are around 95% safer than smoking <br />[10, 146]. This appears to remain a reasonable estimate. <br /> <br />Policy implications <br />o There is a need to publicise the current best estimate that using EC is around 95% <br />safer than smoking. <br /> <br />o Encouraging smokers who cannot or do not want to stop smoking to switch to EC <br />could be adopted as one of the key strategies to reduce smoking related disease <br />and death. <br />Other health and safety concerns <br />