According to Cancer Research UK, "For a smoker, the health hazards of continuing to smoke greatly outweigh any potential risks of using nicotine replacement therapy".[40]

A recent Greek study found that e-cigarettes are no threat to the heart. Dr. Konstantinos Farsalinos of the Onassis Cardiac Surgery Center in Athens told the annual meeting of the European Society of Cardiology that "Electronic cigarettes are not a healthy habit but they are a safer alternative to tobacco cigarettes. ... Considering the extreme hazards associated with cigarette smoking, currently available data suggest that electronic cigarettes are far less harmful and substituting tobacco with electronic cigarettes may be beneficial to health." Farsalinos and his team examined the heart function of 20 young smokers before and after smoking one tobacco cigarette against that of 22 e-cigarette users before and after using the device for seven minutes. While the tobacco smokers suffered significant heart dysfunction, including raised blood pressure and heart rate, those using e-cigarettes had only a slight elevation in blood pressure. The Greek clinical study was the first in the world to look at the cardiac effects of e-cigarettes. Another small study, also in Greece, reported earlier in 2012 the devices had little impact on lung function.[41]

A report from a UK Government advisory unit favoured the adoption of "smokeless nicotine cigarettes" over the traditional "quit or die" approach, believing this would save more lives.[42]

While electronic cigarettes may deliver nicotine to the user in a manner similar to that of a nicotine inhaler, no electronic cigarette has yet been approved as a medicinal nicotine replacement therapy (NRT) product or subjected to the necessary clinical testing for such approval. Doubts have even been raised as to whether electronic cigarettes actually deliver any substantial amount of nicotine.[43]

Research carried out at the University of East London on the effects of using an electronic cigarette to reduce cravings in regular tobacco smokers showed that there was no significant reported difference between smokers who inhaled vapour containing nicotine and those who inhaled a placebo vapour containing no nicotine. The report concluded that although electronic cigarettes can be effective in reducing nicotine-related withdrawal symptoms, the nicotine content does not appear to be of central importance, and other smoking related cues (such as taste or vapour resembling smoke) may account for the reduction in discomfort associated with tobacco abstinence in the short term.[44][45]

Though some manufacturers have marketed electronic cigarettes as an alternative to smoking cigarettes,[46] the World Health Organization has stated they know of no evidence confirming these claims.[47]

In an online survey from November 2009 among 303 smokers, it was found that e-cigarette substitution for tobacco cigarettes resulted in reduced perceived health problems when compared to smoking conventional cigarettes (less cough, improved ability to exercise, improved sense of taste and smell).[48]

Trace amounts of 'volatile organic compounds', namely formaldehyde, as well as traces of ketones, mercury and tetramethylpyrazine, have been found in electronic cigarette vapour, but the quantities are significantly smaller than the quantities found in tobacco smoke and do not pose a significant health risk.[49][50]

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