Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review

Abstract

Electronic cigarettes are a recent development in tobacco harm reduction. They are marketed as less harmful alternatives to smoking. Awareness and use of these devices has grown exponentially in recent years, with millions of people currently using them. This systematic review appraises existing laboratory and clinical research on the potential risks from electronic cigarette use, compared with the well-established devastating effects of smoking tobacco cigarettes. Currently available evidence indicates that electronic cigarettes are by far a less harmful alternative to smoking and significant health benefits are expected in smokers who switch from tobacco to electronic cigarettes. Research will help make electronic cigarettes more effective as smoking substitutes and will better define and further reduce residual risks from use to as low as possible, by establishing appropriate quality control and standards.

“Skittles & Red Bull is my favourite flavour”: E-cigarettes, smoking, vaping and the changing landscape of nicotine consumption amongst British teenagers – implications for the normalisation debate

“…These include their appeal to young people; the risk of increased nicotine dependence; their potential to act as a 'stepping stone' or 'gateway' to traditional cigarettes and other substances; 1 their use in enclosed public places; the possible risks to bystanders from second hand inhalation; and the lack of manufacturing and retail regulation. For UK public health policy makers, professionals and the press this debate has polarised around the relative merits of e-cigarettes as a low harm means to smoking reduction or cessation (Cahill et al, 2013;McNeill A et al, 2015;Nutt et al, 2014;PHE, 2015;RCP, 2007), contrasted with the potential risks associated with their use, as a gateway to tobacco and through the 'renormalisation' of smoking more generally (BBC News, 2014;Davies, 2014;Farsalinos and Polosa, 2014).…”

E-Cigarettes Use Behavior and Experience of Adults: Qualitative Research Findings to Inform E-Cigarette Use Measure Development

“…The public's fastpaced adoption of these new products is occurring without users or scientists having adequate knowledge or full understanding of the characteristics, long-term health impacts, and implications of e-cigarette use, which are critical to inform future tobacco control regulations. [1][2][3][4][5][6] Such regulations need to be carefully targeted for different subpopulations at risk. Among US high school students the estimated prevalence of e-cigarette use in last 30 days was 13.4% in 2014, surpassing all other types of tobacco or nicotine products.…”

The rise of e‐cigarettes: implications for health promotion

“…In the US and United Kingdom (UK), between 2010 and 2012 the use of ECs doubled from 3.3% to 6.2% (US) and 2.7% to 6.7% (UK), 9 while the percentage of Australians who had tried ECs increased from 2% in 2010 to 16.8% in 2013. 10 The National Drug Strategy Household Survey (2013) 3 showed that almost 1 in 7 smokers aged 14 or older have used ECs in the last 12 months, with those aged 18-24 more likely users (27%) than older smokers aged 60-69 (7.2%).…”