New report shows that e-cigarettes can both harm and help the smoking epidemic

Today, the National Academies of Sciences, Engineering and Medicine released a Consensus Study Report on the Public Health Consequence of E-Cigarettes. The report outlines the evidence-based consensus on the health consequences of e-cigarettes by a committee of experts. The committee came to several conclusions about the usage, safety and efficacy of e-cigarettes as cessation devices. We concur with their primary conclusions that e-cigarettes are less toxic than combustible tobacco products, that there is great variability among e-cigarette products and that there is limited evidence that e-cigarettes may be effective aids to promote smoking cessation. The report also found that there is substantial evidence that e-cigarette use increases risk of ever using combustible tobacco cigarettes among youth and young adults.

The report also suggests from the risk side, that due to the variability of various types of e-cigarette devices, there is no way for consumers to determine differences between products and their relative harms. Because of this variability, we are deeply concerned with FDA’s decision to delay fully regulating e-cigarettes until 2022. The sooner the FDA can review each product, the sooner consumers will know which products best deliver nicotine and have the fewest known harmful ingredients. This report is extremely timely given the FDA’s upcoming review of Philip Morris International’s IQOS product. While we can’t draw direct comparisons between e-cigarettes and heat-not-burn products, it does raise the point that electronic nicotine delivery systems (ENDS) are not benign and that less harmful than a cigarette doesn’t mean harmless.

Overall findings from the report suggest that regulation of e-cigarettes is critical for the protection of public health. Without FDA pre-market review of these products, there is no way for a consumer to reliably know what they are getting. It is also important to be very concerned about youth experimentation and uptake of ENDS products, the proliferation of flavors and highly appealing products such as JUUL, a product that now has roughly 50 percent of the e-cigarette market. We must continue efforts to educate youth and young adults who don’t smoke that taking up e-cigarette use poses substantial risks.

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