Columbia: As increasing numbers of Americans take up vaping, a public health debate has raged over the relative risks and merits of e-cigarettes. Do they help people quit tobacco or rather serve as a gateway to other addictions, and are there other dangers to using the devices?
Arriving with a “breaking news” alert on the New York Times, a new report
by from the National Academies of Sciences, Engineering, and Medicine
aims to clear the air on e-cigarettes, offering the most comprehensive
health assessment of the devices to date.
Mailman School environmental health scientist Ana Navas-Acien,
one of the report’s expert authors, says producing it was a challenge,
as the devices are still relatively new—both as an emerging technology
and area of research.
“These products are
evolving very rapidly,” she says. “Over the last few years, there has
been a proliferation of different kinds of e-cigarettes, as well as
differences in how they are being used.”
course of several months in 2017, the expert committee met in
Washington, DC, and Woods Hole, Massachusetts, weighing evidence from
more than 800 research papers and hearing from representatives from
industry, and with retailers and users—a perspective which helped them
appreciate the diversity of device designs and how some can be
The Food and Drug
Administration, which commissioned the report, has regulated
e-cigarettes since 2016 under the broad category of “tobacco products”
and calls them “electronic nicotine delivery systems.” The committee,
instead, chose the term “e-cigarettes,” reflecting the fact that some
use the devices for flavored “e-juices” free of nicotine.
valued committee member, Navas-Acien contributed expertise in two areas
newly relevant to e-cigarettes. She is an authority on the link between
exposure to metals—a potential risk with the heated coils used in the
devices—and risk for diabetes and heart disease as well as in measuring
exposure to secondhand smoke.
In the report, the
committee concluded there is strong evidence that e-cigarette aerosol
contains metals. Depending on the device, these might include nickel, a
carcinogen; lead, a neurotoxicant; and others. (An upcoming paper by the
Mailman researcher explores the topic in greater detail.) On the whole,
however, the report states that e-cigarette users and those breathing
secondhand vapors are exposed to fewer toxic chemicals than with regular
On the big question of the connection
between e-cigarettes and tobacco use, the report details evidence that
teenagers and young adults who use e-cigarettes are at increased risk
for trying cigarettes. Overall, though, fewer young people are smoking.
As for adults, the report finds e-cigarettes can help them break a
“You need a device that is sufficiently
satisfying for those who want to quit,” says Navas-Acien, “but at the
same time, one that doesn’t increase the risk of long-term addiction.”
federal law bans minors from purchasing e-cigarettes. Many states and
localities also ban the use of e-cigarettes wherever smoking is banned.
Armed with the new report, the FDA will consider whether further
regulation is needed. For instance, they might look at ways to reduce
the chance of devices exploding and causing burns—another risk
highlighted by the committee.
the report is far from the final word on e-cigarettes. Since the devices
are so new, their long-term risks are unknown. Says Navas-Acien, “There
is a lot of high-quality science we still have to do.”