Lung societies advise restriction, ban on e-cigarettes

Experts from the American Thoracic Society and American College of Chest Physicians have joined international organizations in a position statement on electronic cigarettes, focusing on their potential adverse effects and urging governments to ban or restrict their use.

“The gravity of tobacco use on global health and the historical behavior of the tobacco industry that has included deceit about the health effects of tobacco, intentional marketing to children, and manipulating nicotine levels in cigarettes to maintain addiction should prompt us to proceed cautiously,” Dean Schraufnagel, MD, professor of medicine and pathology at the University of Chicago and past president of the ATS, said in the release. “Nicotine is central to lifelong addiction, and these are nicotine delivery devices.”

Dean Schraufnagel

The position statement was presented July 9 at a meeting in New York City called “Shared Drivers, Shared Solutions: NCDs, Lung Health and Sustainable Development” which coincided with the United Nations High-Level Review on the Prevention and Control of Noncommunicable Diseases.

The position of Forum of International Respiratory Societies on electronic nicotine delivery devices includes:

The safety of electronic cigarettes has not been adequately demonstrated.
The addictive influence of nicotine and its effects should not be underestimated.
The potential benefits of electronic nicotine delivery devices, including harm reduction and as an aid to smoking cessation, have not been well-studied.
Potential benefits to an individual smoker should be weighed against harm to the population of increased social acceptability of smoking and use of nicotine.
Health and safety claims regarding electronic nicotine delivery devices should be subject to evidentiary review.
Adverse health effects for third parties exposed to the emissions of electronic cigarettes cannot be excluded.
Electronic nicotine delivery devices should be restricted or banned, at least until more information about their safety is available.
If electronic nicotine delivery devices are permitted, they should be regulated as medicines and subject to the same evidentiary review of other medicines.
If electronic nicotine delivery devices are not regulated as medicines, they should be regulated as tobacco products.
Research, supported by sources other than the tobacco or electronic cigarette industry, should be carried out to determine the impact of electronic nicotine delivery devices on health in a wide variety of settings.
The use and population effects of electronic nicotine delivery devices should be monitored.
All information derived from this research should be conveyed to the public in a clear manner.

The Forum of International Respiratory Societies, established in 2001, is an organization composed of leading international respiratory societies working together to improve lung health globally, including the Asociación Latinoamericana del Thorax, the Asian Pacific Society of Respirology, the European Respiratory Society, the International Union Against Tuberculosis and Lung Disease and the Pan African Thoracic Society. The goal of the Forum of International Respiratory Societies is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.