Public Health Consequences of E-Cigarettes

Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes.


Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research.

Table of Contents


Front Matter
Summary
Summary Annex Report Conclusions by Level of Evidence
1 Introduction
2 Committee Approach
Section I: E-Cigarette Devices, Constituents, and Exposures
3 E-Cigarette Devices, Uses, and Exposures
4 Nicotine
5 Toxicology of E-Cigarette Constituents
6 Research Needs: E-Cigarette Devices, Constituents, and Exposures
Section II: Effects of E-Cigarettes on Health
7 Modes of Action
8 Dependence and Abuse Liability
9 Cardiovascular Disease
10 Cancers
11 Respiratory Diseases
12 Oral Diseases
13 Developmental and Reproductive Effects
14 Injuries and Poisonings
15 Research Needs: Effects of E-Cigarettes on Health
Section III: Public Health Implications of E-Cigarettes
16 Combustible Tobacco Cigarette Smoking Among Youth and Young Adults
17 Smoking Cessation Among Adults
18 Harm Reduction
19 Modeling of E-Cigarette Use
20 Research Needs: Public Health Implications of E-Cigarettes
21 Concluding Observations
Appendix A: Questions from the Center for Tobacco Products of the Food and Drug Administration Submitted for the Committee's Consideration
Appendix B: Search Strategy and Quality Assessment
Appendix C: Glossary of Terms Related to E-Cigarettes
Appendix D: Cytotoxicity Tables
Appendix E: Public Meeting Agenda
Appendix F: Committee Biosketches