30 January 2018

The most definitive report yet on e-cigarettes

Addiction Drugs Respiratory

A new US report, based on more than 800 published studies, has found electronic cigarettes could bring an immediate net benefit to public health by helping smokers kick the tobacco habit.

But that benefit would be wiped out if young people continued to take up nicotine-laden e-cigarettes and went on to smoke conventional cigarettes, the consensus report, compiled by the National Academies of Sciences, Engineering and Medicine, concluded.

“If e-cigarette use by adult smokers leads to long-term abstinence from combustible tobacco cigarettes, the benefit to public health could be considerable,” the report said.

“Without that health benefit for adult smokers, e-cigarette use could cause considerable harm to public health in the short- and long-term, due both to the inherent harms of exposure to e-cigarette toxicants and to the harms related to subsequent combustible tobacco use by those who begin using e-cigarettes in their youth.”

The most comprehensive review to date of research on e-cigarettes found “conclusive evidence” that switching completely from tobacco to e-cigarettes reduced exposure to harmful compounds.

It also showed “substantial evidence” that the switch resulted in reduced short-term adverse outcomes in several organ systems.

There was “no available evidence” of links between e-cigarettes and cancer, respiratory and major cardiovascular disease in humans, it said, noting the short history of usage.

And despite the known hazards of e-cigarette aerosols, the short-term effects were less than those of cigarettes.

While the 600-page report found “substantial evidence” that vaping by young people raised the risk they would try smoking tobacco, it did not establish whether they became habitual smokers.

The US Food and Drug Administration last year revealed plans to encourage the take-up of stop-smoking aids, including e-cigarettes, while reducing the amount of nicotine permitted in conventional cigarettes.

The strategy is to reduce nicotine levels in tobacco products to levels that addicts will not find satisfying, while making alternatives available.

“We still have to provide an opportunity for adults who want to get access to satisfying levels of nicotine,” FDA Commissioner Dr Scott Gottlieb told the Associated Press in January.

The two-pronged FDA plan could prevent 8 million smoking-related deaths, he said.

Philip Morris International, the maker of Marlboro cigarettes, has declared its intention to “design a smoke-free future” by embracing e-cigarettes and non-burning tobacco products.

The company is currently trying to win US government approval for a device that delivers nicotine and tobacco flavour by heating plugs of tobacco, which it says is less hazardous than high-temperature burning of regular cigarettes.

The product, dubbed IQOS, has already been launched in Europe, Canada, Japan, New Zealand and other world markets.

The academies’ report can be downloaded at https://www.nap.edu/download/24952