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Cancer Care | Lungs, Breathing & Allergies | Wellness

New Research: E-Cigs Safer Alternative to Regular Cigarettes

Some evidence says e-cigs may help people quit

Contributor: Raul Seballos, MD

The popularity of electronic cigarettes (e-cigs) has outpaced available scientific data – especially when it comes to answering two questions: Are they safe? Can they help people quit conventional cigarettes?

Now, a new analysis of 81 studies supports e-cigs as a safer alternative to conventional cigarettes, and there is some evidence that e-cigs may even help smokers quit, researchers say.

More people using e-cigs

This review article, published in Addiction, finds more people are using e-cigarettes, particularly those who already smoke conventional cigarettes.

Other research supports this finding. Earlier this year, the Centers for Disease Control and Prevention (CDC) reported that 1 in 5 U.S. cigarette smokers have tried the readily available e-cigs. In addition:

  • E-cig sales have doubled every year since their introduction in 2007
  • The $1.5 billion U.S. e-cig industry tripled its sales in 2013
  • E-cig use also doubled among high school students, from 4.7 percent in 2011 to 10 percent in 2012

Toxicant comparison

Researchers also compared the toxicant levels in both e-liquids and aerosols versus tobacco smoke. They found that e-liquids and aerosols were much lower in toxicants and that their carcinogen content was “negligible.” This is supported by a finding by Roswell Park Cancer Institute researchers. They reviewed 12 e-cig brands and found that toxicant levels were 9 to 450 times lower than in cigarette smoke.

While this may mean e-cigs are less harmful than conventional cigarettes, this does not mean they are carcinogen-free. Notably, some e-cigs emit different amounts of nicotine with each puff, perhaps due to inconsistency or lack of quality control in manufacturing.

Also, despite the finding in this analysis that humectants (such as propylene glycol) seem safe to inhale, repeated inhalation of propylene glycol or vegetable glycerin is known to cause airway irritation. No long-term data is available on the overall effects of e-cigs on the lungs. In particular, the effects in people with respiratory diseases are still unknown.

Can e-cigs help you quit smoking?

In this latest review, the authors recommend clinicians to support smokers who either aren’t able or willing to stop tobacco use and who wish to switch to e-cigs to reduce harm from smoking. Of note, two of the five authors have links to e-cig manufacturers. However, they say clinicians should continue to stress the importance of quitting cigarettes and nicotine altogether.

Other research supports the idea that e-cigarettes can reduce smoking urges and could help motivated smokers to quit. E-cigs have been shown to be as effective as nicotine inhalers in reducing both craving and withdrawals effects. Another study found that e-cigs may be comparable but were no more effective for smoking cessation than nicotine patches or placebo e-cigs after six months.

Whether e-cigs can safely help people quit smoking remains to be seen. Since e-cig manufacturers have not submitted an application to the FDA for their use in smoking cessation, e-cigs are not currently FDA-approved for such use

Lingering concerns

One concern is whether e-cigs may increase nicotine addiction among younger users. Flavored e-cigs have the potential to entice new smokers — especially students in middle school and high school. During 2011–2012, the number of U.S. middle and high school students who experimented and used ecigs doubled, resulting in an estimated 1.78 million students having ever used e-cigarettes as of 2012, according to the CDC.

Recently, the American Medical Association (AMA) requested tighter restrictions on the sale and marketing of e-cigarettes. The AMA’s recommendations include a minimum age of purchase; childproof packaging; restrictions on flavors that appeal to young people, and a ban on unsupported claims that the devices help people quit smoking. Preventing the marketing of e-cigarettes to minors is another priority, the AMA says. 

Tags: cancer, cigarettes, electronic cigarettes, lung cancer, quit smoking, smoking, smoking cessation, stop smoking
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  • http://websitecash.net/ Scott McKirahan

    It should be noted that the study that allegedly showed that e-cigarettes were no more effective than the patch was flawed. First off, the study showed they were 25% more effective but that was dismissed as “insignificant.” Second, the e-cig they used had nearly 50% less nicotine than the patch it was tested against.

    • esreveR Backwards

      all nicotine replacement systems are flawed. If you run out and cannot get them replaced people go back to smoking. Most do nothing to address the symptoms of addiction.

      • OfJamaicensis

        Health is the problem not the habit.

        • esreveR Backwards


          • OfJamaicensis


    • Paul

      This is a review of 81 separate studies–which specific one are you referring to?

  • OfJamaicensis

    ” Notably, some e-cigs emit different amounts of nicotine with each puff, perhaps due to inconsistency or lack of quality control in manufacturing.”
    As in smoking the amount of Nicotine varies by puff, depends on how hard you puff. And even if the puffs where exactly the same with different nicotine levels, it’s not really a problem since vapers stop puffing when the have got what they want.
    Do patches give the same Nicotine levels all day long, or do they adjust depending on conditions (heat, cold, wet, dry)?

  • http://www.jackhumphrey.com/ JackHumphrey

    I’ve had not even one cigarette since Dec 29, 2013 because of vaping/ecigs! Vastly safer because: no combustion, no 500+ chemicals – its pretty obvious which would be safer right on the surface of the issue. Glad the studies are finally coming out, but why would anyone need a study to figure out which of the two are safer in the first place? Glycol and nicotine vs. combustion, smoke, and chemicals? I love when studies are done by people with no first-hand knowledge of smoking. Any smoker can tell you the difference right off the bat between the two and it is VAST – people will live longer but quitting smoking and they won’t die sooner because they replaced it with vaping. Painfully Obvious.

    • esreveR Backwards

      Not trying to troll or anything but “Combustion” is the sequence of exothermic chemical reactions between a fuel and an oxidant accompanied by the production of heat and conversion of chemical species.

      • AdamYYZ

        Thanks for pointing that out. I found Jack’s post confusing and indecipherable until you clarified that. :I

  • JDK

    I quit smoking analogs in September 2013. This ego may very well be the best thing that happened to me, as I’ve had a parent and grandparent succumb to Cancer. Neither one of them ever smoked. That alone increased my risk of getting Cancer. Smoking probably tripled it. Since I quit, no more Bronchitis or Pneumonia. And lastly, they are dirt effing cheap!!! If you smoke and desperately want to quit, this may be your way out. Try Mt Baker Vapor for all of your vaping needs!! They are the best as far as pricing and customer service. VAPE ON!!

  • anonymous

    i’m 54, female, i smoked 2 packs a day for 35 yrs, quit completely within 1 week of e-cig & that was 4 yrs ago. i quit coughing almost immediately & believe they saved my life. Nicotine is NOT a carcinogen. someone has changed ALL of what wikepedia says about nicotine, propylene glycol & e-cigs. Initially, the information i read was that a chinese doctor was putting propylene glycol in childrens tents to cure pnuemonia, both bacterial & viral.& also invented the first e-cig. The FDA allowed big tobacco to ADD & keep adding more of the addictive chemicals to keep us hooked. Now, since everyones dropping tobacco for e-cigs, Reynolds just bought Lolliard AND they developed the VUSE e-cig. The FDA is also putting costly regulations that will run out the smaller e-cig companies so that REYNOLDS will still be making their money. Also they released false information & used scare tactics about e-cigs so that big tobacco would remain BIG. I will never buy one thing from a filthy greedy tobacco company, EVER. This is exactly why NO-ONE trusts ANY govt agency. All lying, crooked & greedy & dont act in the peoples best interest.

    • esreveR Backwards

      FDA did not allow anything. FDA up until recently did not have the authority to regulate or control tobacco in any way.

      Anyone can change Wikipedia.

      Big tobacco companies have their hand in almost every aspect of the ecig market from making the components that make ecigs, to the companies that sell ecigs, to the labs and companies that sell the ecig juice.

      • David Hicks

        Big Tobacco has only just recently entered the Ecig market, they did not invent or make popular this brilliant devise. As a Vaper NOTHING I use comes from Big Tobacco and never will, unless the market is given to them by FDA.

        • http://websitecash.net/ Scott McKirahan

          Even if (more realistically, “when”) the market is given to Big Tobacco, you’ll still be able to get everything you use now. You’ll just have to buy it direct from China. All of the local shops will be gone as will the U.S. websites. Plan ahead, and nothing will change. You’ll end up getting stuff cheaper, too. In the end, the only thing that will really change is job loss for local and internet U.S. sellers and all sales taxes states are getting from e-cig sales will be gone. When will people ever learn that more government is always a bad thing? Everything they ever try to do backfires on them!

        • Guest

          You do know that Big Tobacco has their hands in every aspect of the ecig/vape market? Everything from factories that makes the ecig/vape parts to the liquid you put in them…

          • OfJamaicensis

            No I did not know that because it’s not true.

          • esreveR Backwards

            Then you don’t know as much as you think you know about e-cigs.. The info is publicly available, go look.. It would be stupid of ANY company with the reach and power as Big Tobacco to NOT get into a market that a wide variety of their customers is moving to and quitting their main product. Companies that don’t change with the times go out of business >.<

        • esreveR Backwards

          umm, sorry but Big Tobacco entered the ecig/vape market years ago. They open up parent companies but if you trace those companies you find big tobacco at the end.

  • esreveR Backwards

    On a side note. I challenge anyone that has quit smoking cigs but still smokes a ecig weeks, months, years after to not use it at all for one full month. If you can do that, then you have *truly* beaten the addiction.

    • OfJamaicensis

      As a Vaper of nearly one year what you suggest does not seem as a remote alternative. While smoking, no way.

      • OfJamaicensis

        Is addiction the problem, should it not be Health?

        • May Leach

          Health and addiction are in the same family addiction is a diease

          • David Hicks

            Vaping an Ecig is more a Habit than addiction. Why do millions of people spend 5 to 10 dollars per day on Starbucks. Is that a habit, an addiction or lifestyle behaviour. Whichever, I dont see a problem with drinking coffee.

          • jl

            I smoked for almost 40 yrs. It took about 6 months to completely quit cigs but thanks to vaping I have quit cigs completely and feel so much better. I sstarted w/24 mg of nicotine and I am down to 6mg. Next stop—0mg. Great for quitting cigs.

          • esreveR Backwards

            Congrats in your path to completely quitting. Once you get down to 0mg will you quit the vape too?

      • esreveR Backwards

        What doe snot seem like an alternative? Completely quitting smoking by putting down the vape that allowed you to quit cigs?

        • OfJamaicensis

          Giving up Nicotine does not seem remote while vaping, while it was unthinkable while smoking.

    • David Hicks

      Why are you obsessed with addiction. If I use Nicotine and you use caffeine, whats the big deal.

      • May Leach

        I smoked 19 years I was am addicted to nicotine. I can go without coffee for months and months I could not have gone a full day with out smoking. I do not agree caffeine and nicotine are the same. For me at least. Tbere are some who never smoked but can not go a day without caffeine

        • David Hicks

          Point is, if Nicotine and or coffee is delivered in a clean safe way what is the problem. I could argue Ecig vapor has less dangerous chemicals etc than a cup of Starbucks coffee. Coffee is dangerous, “we just dont know whats in it”, and being marketed to kids, LOL.

          • Bret

            All this isn’t about nicotine or caffeine or addiction…its about money! and how much of it the tobacco companies can stuff into their pockets .Its all in the bottom line

          • esreveR Backwards

            Yea, that too…

          • OfJamaicensis

            as well as Big Pharma and the Gov. adding to the bottom line.

    • http://websitecash.net/ Scott McKirahan

      What makes you think that anyone needs to conform to what your “ideal” is of how to live one’s life? Live, and let live. Stop feeling so insecure that you can only feel good about yourself if everyone else is the same as you. It’s people like you that create the huge divides there are in society and, ultimately, wars!

      • esreveR Backwards

        LOL! Thanks for attempted to label me as to try to explain away my actions. Who said anything about making anyone conform? I made a challenge. Nothing other then that….

  • OfJamaicensis

    “e-cigs may increase nicotine addiction among younger users”

    The real world evidence so far does not support this worry.

    Ash London April 2014
    “Use of electronic cigarettes in Great Britain”

    Best quote -
    “Summary of findings
    • An estimated 2.1 million adults in Great Britain currently use electronic cigarettes.
    • About one third of users are ex-smokers and two-thirds are current smokers.
    • The main reason given by current smokers for using the products is to reduce the
    amount they smoke while ex-smokers report using electronic cigarettes to help them stop smoking.
    • Regular use of electronic cigarettes amongst children and young people is rare and is confined almost entirely to those who currently or have previously smoked.

  • Jon Krueger

    Other literature reviews find differently. What the science is telling us: the vast majority of e-cigarette use is dual use; little of it ends up in quitting smoking; use of -e-cigarettes does not increase quitting smoking; in fact e-cigarette use decreases quitting smoking.


  • My2Ctsandmore

    that a tobacco-free nicotine-delivering product is safer than a product that
    delivers nicotine with thousands of tobacco smoke constituents is a fact of
    basic science, and anyone who challenges such a notion would probably benefit
    from a remedial course in basic sciences.”
    Prof M Siegel

  • My2Ctsandmore

    Quitting nicotine is as bad an idea as quitting coffee or s e x.

  • MJS

    I can’t believe a medical institute would help normalize an addictive
    substance. Nicotine is the most addictive drug known, even more addictive than
    cocaine or heroin.

    E-cigarettes Contain carcinogens and other hazardous
    chemicals, including diethylene glycol, which is found in antifreeze. Studies are now showing there are chemicals
    emitted in inhaling the vapor and those particles are larger than those in
    cigarette smoke. Reports of accidental poisonings, notably among children, are soaring.
    There has been a surge in calls to poison control centers. Nationwide, the
    number of cases linked to e-liquids jumped to 1,351 in 2013, a 300 percent
    increase from 2012. E-cig companies are
    targeting this addictive product to youth as made obvious by the
    advertising. Youth use of e-cigs has
    more than doubled. Plus, why would a doctor
    promote an unregulated product, most of which are made in China (you really don’t
    know what you are getting). Is the
    Tobacco / e-cigarette industry funding this article? I guess the medical community needs to be
    more educated on this topic.

    • http://websitecash.net/ Scott McKirahan

      Wow, you must have gotten your disinformation straight from Shill Academy! E-Cigarettes DO NOT contain diethylene glycol. Some e-liquid contains propylene glycol, which IS found in antifreeze, toothpaste and dozens of other FDA approved products. Both the FDA and EPA have recognized propylene glycol as generally safe for human consumption. This argument about something being in antifreeze is juvenile, at best. Water is in antifreeze, too. Are you suggesting it also be banned? Exactly one carcinogen has been found in e-cigarettes at miniscule levels compared to real cigarettes. You likely ingest more carcinogens than that with your daily meals.

      While it is true that calls to poison centers are up (as is general use of e-cigs), there has never been a case of a serious poisoning or death attributed to e-liquid. Common household products result in hundreds more calls to poison control centers than e-cigarettes do. As is so often the case in a society that accepts no blame for its own actions, you need to look at the parents here, not the products!

      There are ZERO studies that show that youth have started using e-cigarettes who did not already smoke tobacco ones. They have switched to them as a healthier alternative. Are you suggesting that they should return to real cigarettes?

      There is not a single advertisement that “targets” youth. They target current smokers who are looking to rid themselves of a harmful habit in favor of one that reduces harm. Please name a commercial that is specifically targeting children! It’s a moot point, either way. In more than 80% of the states, you cannot buy e-cigarettes unless you are at least 18. The FDA’s current deeming regulations forbid the sale to minors on a national level.

      Although I agree that the health industry needs to do a better job of educating themselves on the BENEFITS of e-cigarettes, I suggest you do a little bit of self-education, as well, and stop spouting the same old lies that have been completely discredited. You are embarrassing yourself!

      • esreveR Backwards

        Part 1: http://www.fda.gov/newsevents/publichealthfocus/ucm173146.htm “Specifically, DPA’s analysis of the electronic cigarette cartridges from the two leading brands revealed the following: Diethylene glycol was detected in one cartridge at approximately 1%. Diethylene glycol, an ingredient used in antifreeze, is toxic to humans.”

        So it does happen. I can pull reports from other countries that come to the same conclusion if you think the FDA is biased. If one cartridge has it, others will have it too. So I do concede to you that the levels are low, but does happen..

        Both the FDA and EPA have recognized propylene glycol as generally safe for human consumption. Consumption not inhalation applying to a heat souce that causes vaporization by the Boiling method. ;)
        While it is true that calls to poison centers are up.. Well there have been poisoning to children serious enough to cause parents to take their kids to the hospital.

        This article is not about how dangerious common household products are. (thats getting into the there are other things harmful in your house, one more is ok argument.

        The product is what is “dangerous”. Labeling should be better seen that warns people of the *possible* danger of the product. How’s this the parents fault? For what, smoking in the 1st place?
        There are ZERO studies that show that youth have started using e-cigarettes who did not already smoke tobacco ones.

        *ahem* http://ntr.oxfordjournals.org/content/early/2014/08/18/ntr.ntu166.abstract – “Intentions to smoke cigarettes among never-smoking U.S. middle and high school electronic cigarette users, National Youth Tobacco Survey, 2011-2013″
        There is not a single advertisement that “targets” youth.

        *ahem* http://www.jsonline.com/blogs/news/236391541.html – “Group cries foul over billboard depicting Santa smoking an e-cigarette”

        *ahem* Do a google image search under “youth targeted e cig ad”

        The FDA’s current deeming regulations forbid the sale to minors on a national level. -Actually that just changed recently. Up till a few months ago you ANYONE could buy a vape…
        You are embarrassing yourself! – Umm considering the information I have shown above I think this points out just how little most everyone knows about ecigs…

    • OfJamaicensis

      “Nicotine is the most addictive drug known”
      “Study finds nicotine safe, helps in Alzheimer’s, Parkinson’s”

      Tampa Bay Times

      Best quote – Dr. Paul Newhouse, the director of Vanderbilt University’s Center for Cognitive Medicine.
      “”It seems very safe even in nonsmokers,” he said. “In our studies we find it actually reduces blood pressure chronically. And there were no addiction or withdrawal problems, and nobody started smoking cigarettes. The risk of addiction to nicotine alone is virtually nil.””

  • OfJamaicensis

    Read ASH UK below – 700,000 exclusive vapers, 1.4 million dual users. That’s in about 5 years.
    Reason for E-Cig use –
    “The main reason given by current smokers for using the products is to reduce the amount they smoke while ex-smokers report using electronic cigarettes to help them stop smoking”
    NHS smoking services are proud that 150,000 people gave up smoking with their help, over 10 years. Compare that to 700,000 over 3 to 5 years. Wonderful.

  • Terence Nolan

    Smoked for 50+ years consuming around 1 pack per day and
    suffered the results of said addiction. Too many to list. Over years tried
    patches, gum, hypnosis, cold turkey, counseling, prescribed nasty drugs, 2
    weeks of self imposed isolation in the woods, religious commitment, nothing helped. I know I am a nicotine addict
    who likes to blow smoke. That’s it in a nutshell. I’ve seen and heard of
    e-cigs, thought they were bull. Friend came by smoking one – said he hasn’t
    felt the urge for cigs for 6 months. Tried one at a e-cig store and immediately
    found that the level of nicotine satisfied me along with the motion and
    mechanics of blowing smoke from my penny whistle, as I call it. I have never
    looked back over 5 months I’ve used an e-cig. Stopped hacking, coughing almost
    immediately. Family ecstatic. Absolutely viable nicotine addict alternative.
    American tobacco companies got to be taking a hit, along with drug companies
    making all the assorted stop smoking doohickies. Vaping works for this nicotine
    junkie. From about 600 additives in a manufactured cigarette(per Wikipedia) I’m
    down to 4, PG, VG, nicotine liquid, and a flavoring. No wonder I feel better.
    Totally agree that e-cigs be kept from under 18 crowd. No use starting a yet
    undetermined deleterious addiction because of e-cig having less dangerous
    additives than cigarettes. I wish I never toked the first butt over 50 years ago – I wouldn’t be writing
    this blurb now. Happy vaping and BETTER health to all you FORMER tobacco
    product dyed-in-the-wool junkies

    • esreveR Backwards

      Glad your getting healthier. There are more then 4 additives my friend. Happy smoking :)

      • Terence Nolan

        Thanks for the reply. While studying at length the properties of PG, VG, nicotine base and the flavoring, I am no expert in what they do actually contain. All I can say is from a physical difference, of course most notably the absence of hacking, coughing, better diet and taste, etc., I am impressed. It is enough for this ancient mariner. Maybe vaping will prove dangerous to some extent, but from what I have gleaned from so many reports, a nicotine addict like myself is way better off with this metal flute than the obvious complications of continuing with Marlboros. I’m not championing ecigs, just their viability to an addict- me and people in the same monkey-on- my-back boat.

  • Arthur Gomez

    I believe we keep asking the wrong questions, instead of asking if its healthy for us? or if Vaping is dangerous to our health? We should ask how can we make Vape better and healthier if its not already?? Lets face it Vape is here to stay and its a new technology that seems to work 4 people such as myself to quit cigarettes. Instead of the FDA trying to find the bad of vaping and ways to regulate it they should say Wow! what a great technology this is? People R actually quitting Tobacco, lets find ways to make this new technology healthy like vaping vitamins etc. The FDA works for Big Tobacco and gets a profit out of them for keeping cigarettes legal! I mean how is it that cigarettes that have claimed the lives of many through cancer have been legal, when marijuana that helps to cure cancer is illegal. My point is this, is Vaping 100% safe? no it isn’t, Is it safer than cigarettes? You bet!! But lets find out whats wrong with Vape and Lets make it better and Healthier, we are smoking liquid, heck if healthy medicine can be put into pill forms why not make it into Vape liquid form, flu shots are now in inhalers why not put it in a Vape although that would taste gross. I’m just thinking out of the box here people.. Vaping Is a new technology for the next millennium, lets keep it going in the right direction in terms of better healthier studies with Vape unlike cigarettes companies who just keep adding more nicotine to their Ultra Lights.

  • Kevin Reed

    I smoked 2.5 packs a day for 35 years. I tried every known way to quit for 20 of those years. the longest I ever quit was 2 weeks right after my Dr. told me I had COPD and would be on O2 in 10 years if I did not stop smoking. She suggested using the patch and inhaler together. Like I said I lasted 2 weeks and was thinking this is working because I had smoked only 3 cigs in that time. Then a very stressful thing happened and I was right back to 2.5 PAD. Sept 2011 I saw ENDS for the 1st time and within 2 weeks had smoked my last stinky. My Dr has lowered my BP meds and tells smokers to try this. When I was a smoker I would climb 1 flight of stairs and would be completely out of breath. My coworkers and boss would make me sit down. Now almost 3 years later as a vapor I climb 2 flights of stairs and breath normally, I run around with my grandchildren now where I couldn’t run after them to save there lives when I was a smoker. Please don’t put me back outside with the smokers. I don’t wanna breath 2nd hand smoke any more and am so sorry that I inflicted that on others for so long. Thank you,

    • esreveR Backwards

      Congrats on smoking “healthier”. Your still breathing out 2nd hand smoke that others breath in….

      • Kevin Reed

        Sorry but no I’m not. There is nothing burning hence No smoke. 1st 2nd or 3rd hand

        • esreveR Backwards

          Definition of smoke = a visible suspension of carbon or other particles in air, typically one emitted from a burning substance. *Typically, not always…
          Vaporization of an element or compound is a phase transition from the liquid phase to vapor There are two types of vaporization: evaporation and boiling. (Vapes use the boiling technique.)

          So there ya go. The heating element in your vape causes the vape juice to vaporize by boiling method. Those particles are then pulled into the lungs and exhailed as…dun dun dunnnnnnnn Smoke.

          Please tell me with all the evidence that is out there on this subject that you don’t believe all you are blowing out is “harmless water vapor” cause that has all be been proven false.

          • Kevin Reed

            Then by your reasoning the vapour that comes off a boiling pot of water, a cloud in the sky, the breath that comes out of your mouth on a cold morning is and I quote “…dun dun dunnnnnnnn Smoke. “…..Now if you wanna have a grown up conversation about this I will happily oblige you. for every study you post saying its harmful I can post one that say it’s not. But having said that I will say this, Me exhaling the vapour from my ends while may be proven unhealthy at some time in the future if I don’t exhale what is probably just as safe as breathing in in any large city, then I will smoke and exhale what we know is bad and inhale what I know was killing me smoke. To be sure you understand what I am saying. I will not vape in your space if it truly bothers you but I can almost guarantee you would not know I did it if I wanted to hide it. This is based on 3 years of vaping and not smoking and felling 10000% more healthy. I climb 2 flight of stairs now and breath normally. I got winded playing with my grandchildren last weekend. 4 years ago when I smoked 50 – 60 cigs a day I could do neither..

          • esreveR Backwards

            Not my reasoning, the definition of smoke, and your finally catching on..
            Did not post any study saying harmful or not harmful (tho tis funny how all the major health facilities around the world all agree ecigs are harmful.)
            I’d notice.
            never said anything about adverse health, only that you were still smoking.

          • Kevin Reed

            Then as are you when you walk outside on a cold winters day or any other time you see your breath

          • esreveR Backwards

            Duh, atleast the air I breath out is harmless water vapor.