Peter Hajek, Jean-François Etter, Neal Benowitz, Thomas Eissenberg, Hayden McRobbie
Context
- Electronic cigarettes (EC) are devices designed to deliver nicotine without tobacco smoke by heating a solution of nicotine, flavouring, additives and propylene glycol and/or vegetable glycerine.
- During the past few years EC have been gaining popularity, primarily among smokers who want to reduce the risks of smoking 3, 4.
- The reaction by the public health community to this unfolding phenomenon has ranged from enthusiastic support to vigorous opposition.
- Both sides of the debate agree that any policy and regulatory decisions affecting EC should be guided by evidence.
Purpose of the Review
Reviewed available research on the use, content and safety of electronic cigarettes (EC), and on their effects on users, to assess their potential for harm or benefit and to extract evidence that can guide future policy.
Key Messages
- EC aerosol can contain some of the toxicants present in tobacco smoke, but at levels which are much lower. Long-term health effects of EC use are unknown but compared with cigarettes, EC are likely to be much less, if at all, harmful to users or bystanders.
- EC are increasingly popular among smokers, but to date there is no evidence of regular use by never-smokers or by non-smoking children.
- EC enable some users to reduce or quit smoking.
- Allowing EC to compete with cigarettes in the market-place might decrease smoking-related morbidity and mortality.
- Regulating EC as strictly as cigarettes, or even more strictly as some regulators propose, is not warranted on current evidence.
- Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to EC as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use.
References