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June 14, 2016

In June, the British Medical Journal published a study that examined the “effectiveness and safety of electronic cigarettes at 24 months.” The study aimed to measure the “sustained abstinence from tobacco cigarettes and/or e-cigarettes over 24 months.” The study found a nearly 40 percent disparity between those smokers who used e-cigarettes to help quit smoking and those who tried to quit without e-cigarettes or other smoking cessation aids.


Of the 229 e-cigarette respondents in the survey, 61 percent reported remaining “abstinent from tobacco,” while only 23.1 percent of the 480 tobacco smokers reported abstinence. The report provides strong evidence in favor of the view e-cigarettes and vaporized nicotine products (VNPs) can be effective tobacco-harm-reduction products. According to the authors, “[The study,] to date, is the only study to directly compare smokers of tobacco cigarettes only with users of e-cigarettes only.”

The authors of the study concluded “e-cigarette use alone might support tobacco quitters remaining abstinent from smoking.” The study also points out dual usage – using traditional tobacco cigarettes as well as e-cigarettes – “does not improve the likelihood of quitting tobacco … but may be helpful to reduce tobacco consumption.”


Other studies have provided evidence to the value of e-cigarettes as a tool to help smokers quit using tobacco.  In 2015, Public Health England published a study that found e-cigarettes and VNPs are “95 percent less harmful than cigarettes and should be promoted as a tobacco-cessation method.”


The Tobacco Advisory Group of the Royal College of Physicians published Nicotine without Smoke: Tobacco Harm Reduction in April 2016. The report found e-cigarettes helped to produce “a relatively high quit rate” for tobacco cigarette smokers, and it found, “The long-term health risks associated with smoking ... are unlikely to exceed 5% of those associated with smoked tobacco products.”


The report’s authors say the VNP products have not “attracted significant use among adult never-smokers” and that “promotion of the use of non-tobacco nicotine, including e-cigarettes … as a substitute for smoking … is therefore likely to generate significant health gains in the [United Kingdom].”


Despite this study and other similar studies showing the benefits of e-cigarettes, the Food and Drug Administration (FDA) recently ordered e-cigarettes and VNPs to be classified and regulated as though they are tobacco products. The new ruling, which takes effect in August, requires any e-cigarette or VNP product that was introduced to the market after 2007 to apply for a “premarket tobacco application.”


The process is expected to be costly and could—as Jeff Stier, a senior fellow at the National Center for Public Policy Research, says—limit health benefits by “the very need to have new products that are less harmful be held to a higher standard, than … the cigarette,” which Stier says “doesn’t make sense from a public health perspective.


FDA should reconsider its position to burden the e-cigarette industry with unnecessary and costly regulations. Instead, it should acknowledge the wealth of evidence showing the benefits of these products and find ways to promote them as an effective tobacco-harm-reduction strategy.

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute.

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