Executive Summary: U.S. National Academies of Sciences, Engineering, and Medicine report on the health consequences of e-cigarettes

On Jan. 23, the National Academies of Sciences, Engineering, and Medicine’s Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems released a report titled, Public Health Consequences of E-Cigarettes, which was commissioned by the U.S. Food and Drug Administration. The report is the result of a comprehensive literature review of 800 scientific articles on the subject. This included a review of both short- and long-term studies on how electronic cigarettes affect users, vulnerable populations and third parties, in the form of second- and third-hand vapour.

Overall, the report concluded that “current evidence points to e-cigarettes being less harmful than combustible tobacco cigarettes.” According to the committee, “compared with combustible tobacco cigarettes, e-cigarettes contain fewer toxicants; can deliver nicotine in a manner similar to combustible tobacco cigarettes; show significantly less biological activity in a number of in vitro, animal, and human systems; and might be useful as a cessation aid in smokers who use e-cigarettes exclusively.” It found that completely switching from tobacco to e-cigarettes “reduces users’ exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes” and reduces “short-term adverse health outcomes in several organ systems.”

In terms of second-hand vapour, the committee found that vaping indoors may “expose non-users to nicotine,” but that this exposure was “at lower levels compared with exposure to secondhand tobacco smoke” and “exposure to toxic tobacco-specific combustion products is substantially reduced from e-cigarettes.”

Other significant findings of the report include:

  • there is evidence that e-cigarettes are less addictive than cigarettes;
  • there is some evidence to suggest that switching to e-cigarettes could improve the lung function of smokers who suffer from asthma and the committee concluded that the use “of e-cigarettes instead of combustible tobacco cigarettes by those with existing respiratory disease might be less harmful”;
  • there is some evidence suggesting that e-cigarettes can effectively be used as a smoking cessation tool, especially when they contain nicotine and are used frequently;
  • despite the evidence that e-cigarettes are less harmful than tobacco cigarettes, “the proportion of U.S. adults who consider them to be as harmful as combustible tobacco cigarettes has increased over time.”

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