Tobacco and Nicotine

Page last updated June 11, 2020 by Doug McVay, Editor/Senior Policy Analyst.

26. Health Effects of E-Cigarette Use

"In summary, only a few studies have directly investigated the health effects of exposure to e-cigarette aerosol, but some demonstrate the ability of e-cigarette aerosol exposure to result in biological effects. Long-term biological effects are unknown at this time because e-cigarettes have not been in widespread use long enough for assessment."

Rachel Grana, Neal Benowitz and Stanton A. Glantz, "Contemporary Reviews in Cardiovascular Medicine: E-Cigarettes: A Scientific Review," Circulation (Dallas, TX: American Heart Association, May 13, 2014). 2014;129:1972-1986. doi: 10.1161/CIRCULATIONAHA.114.007667, p. 1978.
http://circ.ahajournals.org/co...
http://circ.ahajournals.org/co...

27. Efficacy of E-Cigarettes in Tobacco Cessation

"In contrast to the assumption that e-cigarettes would function as a better form of NRT [Nicotine Replacement Therapy], population-based studies that reflect real-world e-cigarette use found that e-cigarette use is not associated with successful quitting; all4,79,80,82 had point estimates of the odds of quitting of <1.0. The 1 clinical trial examining the effectiveness of e-cigarettes (both with and without nicotine) compared with the medicinal nicotine patch found that e-cigarettes are no better than the nicotine patch and that all treatments produced very modest quit rates without counseling.86 Taken together, these studies suggest that e-cigarettes are not associated with successful quitting in general population-based samples of smokers."

Rachel Grana, Neal Benowitz and Stanton A. Glantz, "Contemporary Reviews in Cardiovascular Medicine: E-Cigarettes: A Scientific Review," Circulation (Dallas, TX: American Heart Association, May 13, 2014). 2014;129:1972-1986. doi: 10.1161/CIRCULATIONAHA.114.007667, pp. 1980-1981.
http://circ.ahajournals.org/co...
http://circ.ahajournals.org/co...

28. Limitations of Some Research on Health Effects of E-Cigarettes

"National Vaper’s Club, a pro–e cigarette advocacy group, published a 'risk assessment' of e-cigarette and cigarette use that concluded that 'neither vapor from e-liquids or cigarette smoke analytes posed a condition of 'significant risk' of harm to human health via the inhalation route of exposure.'77 The authors failed to detect benzo(a)pyrene in conventional cigarette smoke despite the fact that it is an established carcinogen in cigarette smoke, and their assessment of conventional cigarettes concluded that they did not pose significant risk, both of which point to fatal errors in the data, data analysis, or both. Another report15 funded by the Consumer Advocates for Smoke-free Alternatives Association and published on the Internet used occupational threshold limit values to evaluate the potential risk posed by several toxins in e-cigarettes, concluding that 'there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces.' Threshold limit values are an approach to assessing health effects for occupational chemical exposures that are generally much higher (often orders of magnitude higher) than levels considered acceptable for ambient or population-level exposures. Occupational exposures also do not consider exposure to sensitive subgroups such as people with medical conditions, children, and infants who might be exposed to secondhand e-cigarette emissions, most notably nicotine."

Rachel Grana, Neal Benowitz and Stanton A. Glantz, "Contemporary Reviews in Cardiovascular Medicine: E-Cigarettes: A Scientific Review," Circulation (Dallas, TX: American Heart Association, May 13, 2014). 2014;129:1972-1986. doi: 10.1161/CIRCULATIONAHA.114.007667, p. 1978.
http://circ.ahajournals.org/co...
http://circ.ahajournals.org/co...

29. Second-Hand Exposure From E-Cigarette (Electronic Nicotine Delivery System) Use

"17. In summary, the existing evidence shows that ENDS aerosol is not merely 'water vapour' as is often claimed in the marketing for these products. ENDS use poses serious threats to adolescents and fetuses. In addition, it increases exposure of non-smokers and bystanders to nicotine and a number of toxicants. Nevertheless, the reduced exposure to toxicants of well-regulated ENDS used by established adult smokers as a complete substitution for cigarettes is likely to be less toxic for the smoker than conventional cigarettes or other combusted tobacco products. The amount of risk reduction, however, is presently unknown. The 2014 Surgeon General's Report concluded that non-combustible products such as ENDS are much more likely to provide public health benefits only in an environment where the appeal, accessibility, promotion, and use of cigarettes and other combusted tobacco products are being rapidly reduced.7

Electronic Nicotine Delivery Systems, Report by World Health Organization to 6th Session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control, July 21, 2014, p. 5.
http://apps.who.int/gb/fctc/PD...

30. Cigarette Use Among US Youth, 2014

"• Prevalence of cigarettes is generally higher than for any of the illicit drugs, except for marijuana. About one third (34%) of 12th graders reported having tried cigarettes at some time, and one seventh (14%) smoked in the prior 30 days. Even among 8th graders, about one seventh (14%) reported having tried cigarettes and 4% reported smoking in the prior 30 days. Among 10th graders, 23% reported having tried cigarettes, and 7.2% reported smoking in the prior 30 days. The percentages reporting smoking cigarettes in the prior 30 days are actually lower in all three grades in 2014 than the percentages reporting using marijuana in the prior 30 days: 4.0% for cigarettes versus 6.5% for marijuana in 8th grade; 7.2% versus 16.6% in 10th grade; and 13.6% versus 21.2% in 12th grade. These numbers reflect mostly the considerable decline in cigarette use that has occurred in recent years, though the recent increase in marijuana use has contributed to their standing relative to each other as well. Among 8th, 10th and 12th graders, lifetime prevalence of marijuana use in 2014 was also higher than lifetime prevalence of cigarette use. (Annual prevalence of cigarettes is not assessed.) As noted below, however, daily use in the prior 30 days was higher for cigarettes than for marijuana or alcohol in 8th and 12th grades. For 10th graders marijuana daily use was higher than daily cigarette use (3.4% versus 3.2%)."

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (June 2015). Monitoring the Future national survey results on drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 85.
http://monitoringthefuture.org...

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