E-cigarettes: methodological and ideological issues and research priorities

Cigarette combustion, rather than either tobacco or nicotine, is the cause of a public health disaster. Fortunately, several new technologies that vaporize nicotine or tobacco, and may make cigarettes obsolete, have recently appeared.

**Note: this is an article, not a study per se.

Published: 16 February 2015

Positive: Yes

Link to publication: http://www.biomedcentral.com/1741-7015/13/32

doi:10.1186/s12916-014-0264-5

Author:

JF Etter


Summary

Abstract

Cigarette combustion, rather than either tobacco or nicotine, is the cause of a public health disaster. Fortunately, several new technologies that vaporize nicotine or tobacco, and may make cigarettes obsolete, have recently appeared. Research priorities include the effects of vaporizers on smoking cessation and initiation, their safety and toxicity, use by non-smokers, dual use of vaporizers and cigarettes, passive vaping, renormalization of smoking, and the development of messages that effectively communicate the continuum of risk for tobacco and nicotine products. A major difficulty is that we are chasing a moving target. New products constantly appear, and research results are often obsolete by the time they are published. Vaporizers do not need to be safe, only safer than cigarettes. However, harm reduction principles are often misunderstood or rejected. In the context of a fierce ideological debate, and major investments by the tobacco industry, it is crucial that independent researchers provide regulators and the public with evidence-based guidance. The methodological and ideological hurdles on this path are discussed in this commentary.


Conclusion

A window of opportunity is now open but will soon close. In the United States, the Food and Drug Administration is developing regulations that will apply to e-cigarettes and vaporizers, and European Union Member States are now transposing the Tobacco Products Directive into national laws. Once these regulations are in place, they will be very difficult to change. However, because harm reduction strategies are often misunderstood or rejected [14], there is a risk that e-cigarettes and vaporizers will be excessively regulated. Regulators must consider the unintended consequences of excessive regulation, and should be held accountable for any such consequences. Given that e-cigarettes and vaporizers are already much safer than combustible cigarettes, any benefit of regulations will be small, whereas the unintended consequences can have a large negative impact. Unfortunately, current proposals for regulation are often worse than the status quo. It is sad that this is happening with the help of some public health professionals, scientists and elected representatives of the people.

Full text: JF Etter Feb2015