Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine (original) (raw)
Related papers
Electronic nicotine delivery systems (ENDS): the beginning of the end or the end of the beginning?
The European respiratory journal, 2014
ERSpublications ERS is opposed to the use of unregulated electronic nicotine delivery systems http://ow.ly/z2pfV 5 million people in the world die of active smoking and more than 600 000 nonsmokers die from exposure to passive smoke annually [1]. Smoking is recognised as one of the major preventable causes of death. It significantly increases the chances of developing a respiratory disorder and over half of respiratory diseaserelated deaths are due to smoking [2,3]. One of the key points in the fight against the tobacco epidemic is to encourage as many smokers as possible to quit [4]. The emergence of electronic nicotine delivery systems (ENDS), or electronic (e)-cigarettes, presents complex considerations in this context. E-cigarettes have been subject to regulatory, legal and evidentiary gaps, and they have been met with contrasting reaction from public health experts, clinicians, scientists and governments [5-10]. Some focus strongly on the benefits of these products based on the available evidence while others highlight the risks, also based on the evidence. In certain assessments, they are the beginning of the end for tobacco use, while in others, they herald a new public health threat [11-14]. Benefits It is argued that e-cigarettes and other novel nicotine devices could provide an effective alternative to conventional cigarettes. The case for the potential benefit is that e-cigarettes could lead to a significant decrease in the prevalence of smoking, prevent many deaths and episodes of serious illness, and help to reduce health inequalities that tobacco smoking currently exacerbates [15]. Moreover, e-cigarettes do not involve the combustion of tobacco, and hence are less likely to pose a direct hazard to the user. If used instead of cigarettes, they could possibly lower risks of tobacco related morbidity and mortality [16]. Risks Adverse health effects, their potential to promote continued addictive nicotine use and renormalisation of smoking are the principal risks of e-cigarettes [17, 18]. While short-term health effects have been shown, and appear not as great as the impact of tobacco, the adverse health effects on the long term are not yet known [19-22]. E-cigarettes could undermine prevention and cessation of tobacco. As they become increasingly widely available and are widely marketed, particularly to the young, they could become the main gateway both to tobacco smoking and nicotine dependence [23]. Strong regulatory framework, independent research and transparency At the international level, the World Health Organization (WHO) has looked into options for the regulation of e-cigarettes and the conference of the parties to the WHO Framework Convention on Tobacco
American Journal of Preventive Medicine
Methods: A rapid review of the literature was performed through June 2017 to identify efficacy, patient-oriented harms, and the impact on population health. Results: On an individual level, limited evidence suggests that ENDS may be effective at reducing cigarette use among adult smokers intending to quit. There is insufficient evidence addressing potential long-term harms of ENDS, and limited evidence is available about short-term harms of ENDS and the impact of secondhand exposure. Although ENDS appear safer than combustible cigarettes, they are not without risk. Among youth there is no known benefit and significant concern for harm. On a population level, there may be significant harms associated with ENDS, particularly among youth nonsmokers. The long-term balance of potential benefits versus harms from the individual and population perspectives are unclear. Conclusions: The American College of Preventive Medicine developed practice recommendations that include encouraging screening for ENDS use, strategies to prevent the initiation of ENDS use in nonsmokers, particularly in youth, adoption of a harm reduction model for smokers intending to quit in those who refuse or fail to quit with evidence-based smoking-cessation methods, recommendations on policy and regulatory strategies to decrease public use of ENDS and regulation of their components, and future research needs.
Electronic nicotine delivery systems: a research agenda
2011
Electronic nicotine delivery systems (ENDS, also called electronic cigarettes or e-cigarettes) are marketed to deliver nicotine and sometimes other substances by inhalation. Some tobacco smokers report that they used ENDS as a smoking cessation aid. Whether sold as tobacco products or drug delivery devices, these products need to be regulated, and thus far, across countries and states, there has been a wide range of regulatory responses ranging from no regulation to complete bans. The empirical basis for these regulatory decisions is uncertain, and more research on ENDS must be conducted in order to ensure that the decisions of regulators, health care providers and consumers are based on science. However, there is a dearth of scientific research on these products, including safety, abuse liability and efficacy for smoking cessation. The authors, who cover a broad range of scientific expertise, from basic science to public health, suggest research priorities for non-clinical, clinical and public health studies. They conclude that the first priority is to characterize the safety profile of these products, including in long-term users. If these products are demonstrated to be safe, their efficacy as smoking cessation aids should then be tested in appropriately designed trials. Until these studies are conducted, continued marketing constitutes an uncontrolled experiment and the primary outcome measure, poorly assessed, is user health. Potentially, this research effort, contributing to the safety and efficacy of new smoking cessation devices and to the withdrawal of dangerous products, could save many lives.
BMJ Open, 2015
Introduction: E-cigarettes or electronic nicotine delivery systems (ENDS) have recently attracted considerable attention. Among some individuals there is strong debate and a polarisation of views about the public health benefits versus harms of ENDS. With little regulation, the ENDS market is evolving, and new products are introduced and marketed constantly. Rapid developments in manufacturing, marketing and consumer domains related to ENDS will warrant frequent re-evaluation, based on the state of the evolving science. The purpose of this article is to describe a protocol for an ongoing comprehensive review of the published scientific literature on ENDS. Methods and analysis: We will undertake a systematic review of published empirical research literature on ENDS using the National Library of Medicine's PubMed electronic database to search for relevant articles. Data from included studies will be extracted into a standardised form, tables with study details and key outcomes for each article will be created, and studies will be synthesised qualitatively. Ethics and dissemination: This review synthesises published literature and presents no primary data. Therefore, no ethical approval is required for this study. Subsequent papers will provide greater detail on results, within select categories, that represent gaps in the literature base.
Electronic nicotine delivery systems: is there a need for regulation?
Tobacco Control, 2011
need for regulation? Electronic nicotine delivery systems: is there a http://tobaccocontrol.bmj.com/content/20/1/47.full.html Updated information and services can be found at: These include: References http://tobaccocontrol.bmj.com/content/20/1/47.full.html#ref-list-1 Collections Topic (47 articles) Press releases Articles on similar topics can be found in the following collections Notes http://group.bmj.com/group/rights-licensing/permissions To request permissions go to: http://journals.bmj.com/cgi/reprintform
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2016
This study evaluates the reasons for use and acceptance of Electronic Nicotine Delivery Systems (ENDS) among current and former cigarette smokers to assess if ENDS may become a satisfying alternative to cigarettes. Data are from a national probability sample of 5717 US adults, surveyed June-November 2014. The survey contained questions on awareness, usage, and reasons for use of traditional and novel tobacco products. The analytic sample was current and former smokers who ever used ENDS (n = 729) and was divided into four mutually exclusive categories. Among the 585 current smokers, 337 were no longer using ENDS ("E-Cig Rejecters"), and 248 were continuing to use both ENDS and cigarettes ("E-Cig Dual Users"). Among 144 former cigarette smokers, 101 were non-recent users of ENDS ("Quit All Products"), and 43 were continuing to use ENDS exclusively ("Switchers"). Former smokers (the "Switchers") report finding ENDS a satisfying alterna...
International Journal of Contemporary Medical Research [IJCMR], 2019
Introduction: Electronic nicotine delivery systems (ENDS) are used to smoke or 'vape', a flavoured solution containing nicotine, an addictive chemical found in cigarettes and tobacco products. Contrary to popular belief that they are useful as smoking cessation tools, current data does not support this theory. In fact, they cause various deleterious effects in body including death. Their use has seen exponential rise amongst youth. We conducted a study in northern India to assess its prevalent use and awareness amongst youth. Material and methods: A questionnaire with various questions related to ENDS was circulated amongst higher secondary schools and university students to ascertain their use and awareness amongst students regarding its usage pattern and health effects. After receiving first 200 confirmed responses of use, the data was analysed. Results: First 200 confirmed users were obtained after 764 responses. 82% were exposed to ENDS at an age of 15-20 years. 38% said vaping was 'COOL' and 32% started it because of nice flavours. 28% believed that ENDS are safe and 47% were either not sure or not aware. 41% were now more open to the idea of regular smoking. Conclusion: Nicotine is one of the most addictive drug and exposure of youth to ENDS predisposes them to nicotine at an early age. Understanding of the potential harmful effects of ENDS is not fully comprehended by them predisposing them to addiction. Therefore, the ban on ENDS by the government is justified.