Public Health Consequences of E-Cigarettes
The evidence about harm reduction suggests that across a range of studies and outcomes, e-cigarettes pose less risk to an individual than combustible tobacco cigarettes
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National Academies of Sciences, Engineering, and Medicines
Shahab, L., Goniewicz, M.L., Blount, B.C., et al
Goniewicz, M.L., Knysak, J., Gawron, M., et al
Eisenberg, M.J, Hébert-Losier, A., Windle, S.B., et al.
Stephens, W.E.
George, J., Hussain, M., Vadiveloo, T., et al
Hartmann-Boyce, J., McRobbie, H., Lindson, N., et al
WHO study group on tobacco product regulation
Jackson, S.E., Kotz, D., West, R., and Brown, J.
Beard, E., West, R., Michie, S., and Brown, J.
Gomajee, R., El-Khoury, F., Goldberg, M., et al
Gaiha, S. M., Lempert, L. K., McKelvey, K., Halpern-Felsher, B.
University of Waterloo
Ruoyan, S., Mendez, D., Warner, K.E.
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Nicotine, carcinogen, and toxin exposure in longterm e-cigarette and nicotine replacement therapy users
People who swapped smoking regular cigarettes for vaping products, or nicotine replacement therapy for at least six months had much lower levels of toxic and cancer-causing substances in their body than people who continued to use conventional cigarettes
Levels of selected carcinogens and toxicants in vapour from electronic cigarettes
Levels of selected toxic compounds found in the vapour of an e-cigarette were 9-450 times lower than in tobacco smoke.
Effect of e-Cigarettes Plus Counseling vs Counseling Alone on Smoking Cessation: A Randomized Clinical Trial
In Canada, a recent randomized clinical trial enrolling adults motivated to quit smoking demonstrated that nicotine e-cigarettes plus counseling, as compared with counseling alone, significantly increased point prevalence abstinence at 12 weeks.
Comparing the cancer potencies of emissions from vapourized nicotine products including e-cigarettes with those of tobacco smoke
A study by Stephens (2018) showed that e-cigarette emissions have much less carcinogenic potency (˂1%) than tobacco smoke.
Cardiovascular effects of switching from tobacco cigarettes to electronic cigarettes
A prospective, randomized controlled trial demonstrated significant improvement in vascular health of tobacco cigarette smokers within 1 month of switching from tobacco cigarettes to electronic cigarettes.
Electronic cigarettes for smoking cessation
Cochrane Library Systematic Review of the published literature on the use of vaping products for smoking cessation demonstrated with moderate-certainty evidence that electronic cigarettes with nicotine increase quit rates compared to electronic cigarettes without nicotine and compared to NRT.
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Clinical pharmacology of nicotine in electronic nicotine delivery systems
A WHO study group in 2017 concluded that meta-analysis of the few existing clinical trials at the time, showed that “electronic nicotine delivery system” (ENDS) use increased the likelihood of quitting smoking by a factor of two when compared with placebo.
Moderators of real-world effectiveness of smoking cessation aids: a population study
A robust study on 18,929 adults in the UK demonstrated the use of vapour products was as effective in the real world as using the medicine varenicline and three times more effective than prescription NRT in helping smokers to quit.
Association of prevalence of electronic cigarette use with smoking cessation and cigarette consumption in England: a time series analysis between 2006 and 2017
A large cross-sectional study in the UK found e-cigarette use is associated with more quitting success than NRT-use or no aid. It was noted the findings on cessation “contradict claims that e-cigarettes, as used by smokers in the population, undermine smoking cessation”, and are consistent with previous time series analyses in England and the US.
Association between electronic cigarette use and smoking reduction in France
The longitudinal study in France demonstrated regular electronic cigarette use was associated with a 67% higher likelihood of smoking cessation versus those who did not use vaping products.
E-cigarette devices, brands, and flavors attract youth: Informing FDA’s policies and priorities to close critical gaps
The FDA’s approach to controlling specific e-cigarette devices and flavors has failed to prevent teens and young adults from vaping, according to a Stanford Medicine study. Instead, young people are migrating to widely available flavored vaping products, including new products that circumvent FDA policies.
Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors
‘Our findings raise the possibility that banning some flavoured vaping products may dissuade some adult smokers from vaping, with the possibility that they would return to smoking cigarettes, which are clearly much more harmful than vaping products, given that we know that at least half of regular smokers die of a smoking-caused disease,’ said ITC research assistant professor Shannon Gravely, who was lead author of the study.
Is Adolescent E-Cigarette Use Associated with Subsequent Smoking? A New Look
A recent study published in Nicotine and Tobacco Research suggests that while “Prospective studies have consistently reported a strong association between e-cigarette use and subsequent cigarette smoking…many failed to adjust for important risk factors.”
