Promise vs perils of electronic cigarettes
Electronic cigarettes (e-cigarettes) are battery powered heating devices that contain nicotine, propylene glycol and flavors, which generate a vapor that is inhaled to mimic the experience of smoking. These are considered to be potentially less harmful than tobacco smoke and are used to aid smoking cessation.
However, the availability of such devices to never-smokers as well as current smokers, is controversial, and has led to much debate between clinicians and public health officials. Several clinicians have voiced their concerns regarding safety, re-normalization of smoking and impact on long term public health. Research in this field is growing, but findings at this stage are considered to be preliminary. Additionally, much of the current research can suffer from methodological issues, significant conflicts of interest and inconsistent results. However, researchers are hard at work to address these issues and it should only be a matter of time before influential long-term results will be obtained.
In the meantime, the World Health Organization (WHO) is implementing regulations to restrict e-cigarette advertising and to end e-cigarette use indoors in public and work places. Although it is recognized that e-cigarettes may be harmful, a large group of scientists and clinicians who are specialists in nicotine science and public health policies have signed a statement asking the WHO to consider classification of e-cigarettes under different standards as regular cigarettes. These specialists argue that e-cigarettes are tobacco harm reduction products and are more likely to help people quit smoking compared with other conventional methods, and thus play a significant role in reducing non-communicable diseases and associated deaths.
This special article collection in BMC Medicine addresses the debates around e-cigarettes and includes carefully selected critiques from invited experts on a spectrum of topics from research agendas, health policies and regulation, to psychiatric and public health outcomes.