HealthDay News — Vapor from e-cigarettes may contain up to 15 times higher levels of formaldehyde compared with regular cigarettes according to a letter published in the New England Journal of Medicine.

“The popular ‘tank system’ e-cigarettes allow users to really turn up the heat and deliver high amounts of vapor, or e-cigarette smoke,” explained David Peyton, PhD, of Portland State University in Oregon in a university press release.

“Our research shows that when heated at higher temperatures, e-cigarette juices can vaporize and form large amounts of ‘hidden formaldehyde,’ five to 15 times higher than the amount of formaldehyde in traditional cigarettes.” Users open up the devices, put their own fluid in, and adjust the operating temperature as they like, allowing them to greatly alter the vapor generated by the e-cigarette.

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When used at low voltage, e-cigarettes did not create any formaldehyde-releasing agents, reported the investigators. However, high-voltage use released enough formaldehyde-containing compounds to increase a patient’s lifetime risk of cancer five to 15 times higher than the risk caused by long-term smoking.

The American Vaping Association, an industry group advocating for e-cigarette manufacturers, argued that the study from Petyon and colleagues was flawed because e-cigarette users wouldn’t operate their devices at such high-voltage.

“When the vapor device was used at the realistic setting of 3.7 volts, levels of formaldehyde were similar to the trace levels that are released from an FDA-approved [smoking-cessation] inhaler,” association president Gregory Conley, JD, MBA, told HealthDay.

“However, when the researchers increased the voltage to 5 volts and continued to have their machine take three- to four-second puffs, this caused extreme overheating and the production of formaldehyde.”

This is known “in vapor product science as the ‘dry puff phenomenon,'” noted Conley. “Contrary to the authors’ mistaken belief, these are not settings that real-life vapers actually use, as dry puffs are harsh and unpleasant. In the real world, vapers avoid dry puffs by lowering the length of their puff as they increase voltage.”


  1. Peyton DH et al. N Engl J Med. 2015; doi: 10.1056/NEJMc1413069