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How does nicotine affect health, and why are e-cigarettes and e-shishas accompanied by health risks?

No. 56 | 02/12/2015 | by Sel / VV

Nicotine is not harmless. In fact, it is toxic and entails serious health risks – even if it is consumed by delivery devices such as e-cigarettes without the toxic substances contained in tobacco smoke. Nevertheless, nicotine-containing electronic inhalation devices are marketed as a safe alternative to cigarettes to smokers as luxury items and to young people as lifestyle accessories. The German Cancer Research Center (DKFZ) has issued two new publications that present comprehensive facts about nicotine and e-cigarettes.


A new publication by the Cancer Prevention Unit of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) in Heidelberg shows that nicotine is not only physically and mentally addictive but is also suspected to promote atherosclerosis, type 2 diabetes and cancer. Numerous research publications have provided evidence that nicotine causes cancer, boosts its progression and adversely affects the outcomes of chemotherapy and radiotherapy treatments. Nicotine can have serious, long-term and harmful effects on the course of a pregnancy and the health of an unborn child. Nicotine consumed during pregnancy is associated with sudden infant death and impairs the later development of the brain and lungs.

“Nicotine is anything but a harmless substance, as manufacturers of e-cigarettes tend to make us believe,” says Dr. Verena Viarisio, who is a staff scientist at the DKFZ’s Cancer Prevention Unit and the author of the present fact sheet on nicotine as a health risk. “Nicotine is toxic, addictive and harmful to health in many ways. Young people and pregnant women in particular should neither smoke nor use e-cigarettes.”

The DKFZ has also issued another publication on the health hazards of e-cigarettes and e-shishas in collaboration with the Bavarian State Office for Health and Food Safety. The authors evaluated numerous studies providing evidence that the health hazards from the use of e-cigarettes result from three factors: the mixture of chemicals made up of carrier substances, flavors and nicotine; individual user behavior; and the technology of delivery devices. For example, levels of substances that are carcenogenic or potentially carcenogenic such as formaldehyde and acetaldehyde in the aerosol of an e-cigarette increase with the rising temperature of the vaping device. This temperature, in turn, is determined by the device’s battery voltage and the vaping behavior of the user.

“E-cigarettes and e-shishas do not belong in the hands of children,” says Associate Professor (PD) Dr. Wolfgang Schober, a staff scientist at the Bavarian State Office for Health and Food Safety and the principal author of an overview publication entitled “E-Zigaretten und E-Shishas: Welche Faktoren gefährden die Gesundheit?” (E-cigarettes and e-shishas – what are the factors that may cause health problems?). “We therefore welcome the venture by the Federal Ministry of Family Affairs to ban the sale of e-cigarettes and e-shishas to children and youth. For the safety of adult consumers, we urgently need to introduce minimum technical standards.”

The publications “Gesundheitsrisiko Nikotin” (Nicotine as a health risk) and “E-Zigaretten und E-Shishas: Welche Faktoren gefährden die Gesundheit?” (E-cigarettes and e-shishas – what are the factors that may cause health problems?) are available as pdf files for download at

With more than 3,000 employees, the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is Germany’s largest biomedical research institute. DKFZ scientists identify cancer risk factors, investigate how cancer progresses and develop new cancer prevention strategies. They are also developing new methods to diagnose tumors more precisely and treat cancer patients more successfully. The DKFZ's Cancer Information Service (KID) provides patients, interested citizens and experts with individual answers to questions relating to cancer.

To transfer promising approaches from cancer research to the clinic and thus improve the prognosis of cancer patients, the DKFZ cooperates with excellent research institutions and university hospitals throughout Germany:

  • National Center for Tumor Diseases (NCT, 6 sites)
  • German Cancer Consortium (DKTK, 8 sites)
  • Hopp Children's Cancer Center (KiTZ) Heidelberg
  • Helmholtz Institute for Translational Oncology (HI-TRON Mainz) - A Helmholtz Institute of the DKFZ
  • DKFZ-Hector Cancer Institute at the University Medical Center Mannheim
  • National Cancer Prevention Center (jointly with German Cancer Aid)
The DKFZ is 90 percent financed by the Federal Ministry of Education and Research and 10 percent by the state of Baden-Württemberg. The DKFZ is a member of the Helmholtz Association of German Research Centers.


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