Electronic cigarette (e-cigarettes, also known as Electronic Nicotine Delivery Systems or ENDS) use has grown rapidly within a few years and this rapid expansion of their use took public health professionals in tobacco control by surprise. The products are regulated to different extents in different jurisdictions and new products and forms are being manufactured constantly and added to the markets. Unlike other new tobacco-derived products that had limited sustained interest in them, e-cigarettes have become a major product used globally. E-cigarette use and acceptability vary by country making it a global health issue in terms of assessing the evidence and reaching consensus about harms versus benefits. The recent outbreak of lethal respiratory distress illnesses that are associated with e-cigarette use gained worldwide attention about serious risks these products may cause. There are major concerns and restrictions regarding e-cigarette use in many countries, largely because of the unknown consequences of epidemic nicotine use by youth; conversely, e-cigarettes are seen as part of the solution to reducing the harm from cigarette smoking in some jurisdictions. The WHO’s report on the tobacco epidemic released in July 2019 concluded that e-cigarettes are not recommended for smoking cessation and the harm to health must be better evaluated, but that the evidence regarding their role in nicotine addiction among young people is convincing. This policy brief provides an overview and assessment of possible policy approaches to address this major public health issue. Although the United States is a rich source of data this should not imply that this policy brief is focused on the United States, nor is this brief meant to be a review article that covers every aspect of this phenomenon, especially given the uncertainty and rapidly changing situation with regard to harms or potential benefits attributable to e-cigarettes.

INEP PUBLICATIONS:
A Policy Brief: Electronic Cigarettes and Public Health adopted (2020), endorsement period closed, now seeking publication. Lead authors Wael Al-Delaimy (former Chair; Expert Advisor) and Fiona Sim (RSPH). The INEP-approved document is in the Members Only page