Public Health Consequences of E-Cigarettes : A Systematic Review of Biomedical Literature

This report is a comprehensive and systematic review of the literature that evaluates the evidence about e-cigarettes and health. It highlighting gaps that are a priority for future research, and makes recommendations to improve the quality of this research.

The report is by the National Academies of Science, Engineering and Medicine.

A few excerpts from the report

   “Because e-cigarettes have only been on the U.S. market for a relatively brief time— rst imported in 2006, most have entered the market much more recently—it is dif cult to scienti cally compare their health effects to those of combustible tobacco cigarettes, whose health effects were not fully apreciated until after decades of use. However, in contrast to long-term effects, research on short-term health effects of e-cigarettes is now available.

The committee evaluated the current state of knowl- edge on outcomes including dependence and abuse liability, cardiovascular diseases, cancers, respiratory diseases, oral diseases, reproductive and developmen- tal effects, and injuries and poisonings.

Overall, the evidence reviewed by the commit- tee suggests that e-cigarettes are not without biological effects in humans. For instance, use of e-cigarettes results in dependence on the devices, though with apparently less risk and severity than that of combustible tobacco cigarettes. Yet the implications for long-term effects on morbidity and mortality are not yet clear.”

…

CONCLUSION

Although e-cigarettes are not without risk, compared to combustible tobacco cigarettes they contain fewer toxicants; can deliver nicotine in a similar manner; show signi cantly less biological activity in most, but not all, in vitro, animal, and human systems; and might be useful as a cessation aid in smokers who use e-ciga- rettes exclusively. However, young people who begin with e-cigarettes are more likely to transition to com- bustible cigarette use and become smokers who are at risk to suffer the known health burdens of combustible tobacco cigarettes. The net public health outcome of e-cigarette use depends on the balance between pos- itive and negative consequences.

More and better research is needed to help clarify whether e-cigarettes will prove to reduce harm—or induce harm—at the individual and the population levels. The approach taken by the committee to eval- uate the health effects of e-cigarettes in this report is anticipated to provide a generalizable template for future evaluations of the evidence.

Full text of the report may be found here