E-cigarettes: effective cessation tool or new gateway to smoking tobacco?

9 October 2019

Approximately 40 million people use e-cigarettes worldwide, a market that allows tobacco companies to generate significant revenues. (Source: Euromonitor international) Simultaneously, more and more health experts are raising questions about potential risks. 

Whether the use of electronic cigarettes (e-cigarettes) - also known as vaping - helps people quit smoking or whether it incites users to take up cigarette smoking is also an important part of the debate.

E-cigarettes include several types of devices such as battery operated vapes that heat a liquid (also known as e-liquid) into a cloud of aerosol that users breathe in. Most of these liquids include nicotine alongside several other chemicals and flavouring. Other electronic cigarettes such as Heated Tobacco Products (HTPs) use small sticks of tobacco that are heated at a temperature of 250°C instead of being burnt at more than 800°C in traditional, combustible cigarettes.

Dr Sonali Johnson, Head of Knowledge, Advocacy and Policy
Dr Sonali Johnson,
Head of Knowledge,
Advocacy and Policy

Dr Sonali Johnson, Head of Knowledge, Advocacy and Policy at the Union for International Cancer Control (UICC) explains UICC’s position:

Is it safe to use e-cigarettes and vaping devices?

The long-term implications of using vaping devices are not yet known and we also do not know yet whether they can cause cancer. It may take several years or even decades for cancer to develop with combustible cigarettes. If this was the case with e-cigarettes, at least 30 years would be needed to come up with reliable data and clinical evidence that could prove the link. However, available studies have already shown that e-cigarettes produce compounds that can reduce the efficacy of chemotherapy or facilitate the growth of established tumors (Sanner et al, 2015).

We have access to a growing body of evidence that shows a negative health impact of e-cigarettes and other vaping devices. More than 400 reviews are available in the PubMed database alone, a public online resource  maintained by the National Center for Biotechnology Information  at the U.S. National Library of Medicine.  Clinical tests have shown that e-cigarettes can have damaging effects on the respiratory tracks and the heart. Liquid tanks or cartridges were found to be infected with either harmful bacteria or fungus, bacteria can then colonise the lungs for example and trigger infections (Lee et al, 2019).

While vaping might be less risky than traditional smoking, continued efforts to understand the long-term health effects need to be made before establishing the safety of using e-cigarettes.

Should e-cigarettes and vaping devices be banned?

e-cigarette smoker with an "interdiction" sign over it

We are troubled by the recent news which puts the safety of e-cigarettes in doubt. However, it is premature at this stage to make a clear and informed decision on this as health experts are divided over this issue. What we know is that there is some evidence showing e-cigarettes as an effective cessation tool that can help smokers quit smoking cigarettes.  

We also recognise the concerns about reports of an “e-cigarette epidemic” in the USA among adolescents and young people between 11 and 25 years with some experts warning that individuals who vape are more prone to taking up cigarette smoking within six months compared to teenagers who never used such devices. 

Until the quality of this evidence has been fully determined, UICC recommends exercising prudence when it comes to e-cigarettes and vaping. We are taking a careful approach and are in the process of building our knowledge on the topic, drawing on robust and reliable data and analysis.

How is UICC taking this debate forward?

As the leading advocate for the prevention of cancer, tobacco control is central to our mission of reducing the global cancer burden and this includes a well-informed approach to the use of products positioned as alternatives to smoking, such as vaping devices.

UICC has a leading role in countering the dissemination of misinformation by the tobacco industry and e-cigarettes manufacturers. Of concern is that powerful marketing campaigns promoting e-cigarettes are being targeted particularly at youth populations and are reinforced by a current lack of regulation around flavoured products and the absence of advertisement bans.

We want to raise awareness about this heavily layered topic, made all the more complex by encompassing several health and socio-economic domains. UICC is currently gathering information from our members, the global health community and experts and working with members and partners such as McCabe Centre for Law and Cancer, the Framework Convention Alliance, Cancer Research UK, the American Cancer Society  and other organisations active in tobacco control.

Ultimately, UICC is working towards strengthening the tobacco control efforts of our membership network by identifying, gathering and sharing the latest research results on electronic cigarettes and vapes, by understanding and bringing attention to the marketing approaches of the tobacco industry, explaining the impact of policies and regulations and by sharing evidence-based advocacy materials and recommendations.

For more information about Tobacco Control, please contact Mr Yannick Romero, Advocacy Networks Manager at romero@uicc.org.

For more information, we invite you to read the following document:

Last update: 
Wednesday 9 October 2019
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