Skip to main content
SpringerLink
Log in

E-Cigarettes: Tobacco Policy and Regulation

  • Tobacco (K Garrison, Section Editor)
  • Published:
Current Addiction Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

The purpose of this review is to describe current trends in e-cigarette use, provide an overview of the potential health risks and benefits, and discuss tobacco policy and regulatory considerations.

Recent Findings

E-cigarette use is popular among youth and adults, despite limited evidence about the long-term risks or benefits. Internationally, there is wide variability in how e-cigarettes are classified, which has also led to large differences in regulations on these products. Regulatory policies that strike a balance between the potential benefit of these devices for adult smokers who are trying to quit smoking with reducing the appeal and addictive potential for youth are critically needed.

Summary

Continued research on the health effects and consequences of e-cigarette use will be essential to inform e-cigarette product standards and tobacco regulatory policies as scientific research strives to keep pace with the ever-changing landscape of e-cigarette technology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Zhu S-H, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, et al. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control. 2014;23(suppl 3):iii3–9.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Huang J, Duan Z, Kwok J, Binns S, Vera LE, Kim Y, et al. Vaping versus JUULing: how the extraordinary growth and marketing of JUUL transformed the US retail e-cigarette market. Tob Control. 2018;28(2):146-151.

  3. Willett JG, Bennett M, Hair EC, Xiao H, Greenberg MS, Harvey E, et al. Recognition, use and perceptions of JUUL among youth and young adults. Tob Control. 2019;28(1):115-116. https://doi.org/10.1136/tobaccocontrol-2018-054273.

  4. • Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the field: use of electronic cigarettes and any tobacco product among middle and high school students - United States, 2011–2018. MMWR Morb Mortal Wkly Rep. 2018;67:1276–7. https://doi.org/10.15585/mmwr.mm6745a5. Recent 2018 national rates and trends in e-cigarette use among U.S. youth.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Electronic cigarette market by product type, flavor, and distribution channel - global opportunity analysis and industry forecast, 2017-2023. In: Research and markets 2018. https://www.researchandmarkets.com/research/pjkd84/global_electronic?w=5.

  6. Morean ME, Kong G, Camenga DR, Cavallo DA, Krishnan-Sarin S. High school students’ use of electronic cigarettes to vaporize cannabis. Pediatrics. 2015;136:611–6. https://doi.org/10.1542/peds.2015-1727.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Breitbarth AK, Morgan J, Jones AL. E-cigarettes-an unintended illicit drug delivery system. Drug Alcohol Depend. 2018;192:98–111.

    Article  CAS  PubMed  Google Scholar 

  8. • Hsu G, Sun JY, Zhu S-H. Evolution of electronic cigarette brands from 2013–2014 to 2016–2017: analysis of brand websites. J Med Internet Res. 8: 2018;20(3):e80. Reviews trends in e-cigarette devices, flavors, point-of-sale, and discusses regulation implications.

  9. Ambrose BK, Rostron BL, Johnson SE, Portnoy DB, Apelberg BJ, Kaufman AR, et al. Perceptions of the relative harm of cigarettes and e-cigarettes among U.S. youth. Am J Prev Med. 2014;47(2, Supplement 1):S53–60. https://doi.org/10.1016/j.amepre.2014.04.016.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Patel D, Davis KC, Cox S, Bradfield B, King BA, Shafer P, et al. Reasons for current e-cigarette use among US adults. Prev Med. 2016;93:14–20.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Pepper JK, Ribisl KR, Emery SL, Brewer NT. Reasons for starting and stopping electronic cigarette use. Int J Environ Public Health. 2014;11:10345–61. https://doi.org/10.3390/ijerph111010345.

    Article  Google Scholar 

  12. Tsai J, Walton K, Coleman BN, Sharapova SR, Johnson SE, Kennedy SM, et al. Reasons for electronic cigarette use among middle and high school students—National Youth Tobacco Survey, United States, 2016. MMWR. 2018;67(6):196–200.

    PubMed  Google Scholar 

  13. Ambrose BK, Day HR, Rostron B, Conway KP, Borek N, Hyland A, et al. Flavored tobacco product use among US youth aged 12-17 years, 2013-2014. JAMA. 2015;314(17):1871–3.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Pepper JK, Brewer NT. Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review. Tob Control. 2014;23:375–84. https://doi.org/10.1136/tobaccocontrol-2013-051122.

    Article  PubMed  Google Scholar 

  15. Wang TW, Gentzke A, Sharapova S, Cullen KA, Ambrose BK, Jamal A. Tobacco product use among middle and high school students—United States, 2011–2017. MMWR. 2018;67(22):629–33.

    PubMed  Google Scholar 

  16. Yoong SL, Stockings E, Chai LK, Tzelepis F, Wiggers J, Oldmeadow C, et al. Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta-analysis of country level data. Aust N Z J Public Health. 2018;42:303–8.

    Article  PubMed  Google Scholar 

  17. Morean ME, Camenga DR, Bold KW, Kong G, Jackson A, Simon P, et al. Querying about the use of specific e-cigarette devices may enhance accurate measurement of e-cigarette prevalence rates among high school students. Nicotine Tob Res. 2018. https://doi.org/10.1093/ntr/nty240.

  18. Barrington-Trimis JL, Gibson LA, Halpern-Felsher B, Harrell MB, Kong G, Krishnan-Sarin S, et al. Type of e-cigarette device used among adolescents and young adults: findings from a pooled analysis of eight studies of 2166 vapers. Nicotine Tob Res. 2017;20(2):271–4.

    Article  PubMed Central  Google Scholar 

  19. Krishnan-Sarin S, Jackson A, Morean M, Kong G, Bold KW, Camenga DR, et al. E-cigarette devices used by high-school youth. Drug Alcohol Depend. 2019;194:395–400.

    Article  PubMed  Google Scholar 

  20. •• USDHHS. E-cigarette use among youth and young adults. A report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services; Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health; 2016. Comprehensive summary of scientific research to date on e-cigarette use trends and health effects in youth and young adults.

    Google Scholar 

  21. Bold KW, Kong G, Cavallo DA, Camenga DR, Krishnan-Sarin S. E-cigarette susceptibility as a predictor of youth initiation of e-cigarettes. Nicotine Tob Res. 2016;20(1):140–4.

    PubMed Central  Google Scholar 

  22. Carey FR, Rogers SM, Cohn EA, Harrell MB, Wilkinson AV, Perry CL. Understanding susceptibility to e-cigarettes: a comprehensive model of risk factors that influence the transition from non-susceptible to susceptible among e-cigarette naïve adolescents. Addict Behav. 2018.

  23. Kwon E, Seo D-C, Lin H-C, Chen Z. Predictors of youth e-cigarette use susceptibility in a US nationally representative sample. Addict Behav. 2018;82:79–85.

    Article  PubMed  Google Scholar 

  24. Garrison KA, O'Malley SS, Gueorguieva R, Krishnan-Sarin S. A fMRI study on the impact of advertising for flavored e-cigarettes on susceptible young adults. Drug Alcohol Depend. 2018;186:233–41.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Johnston LD, Miech RA, O'Malley PM, Bachman JG, Schulenberg JE, Patrick ME. Monitoring the future national survey results on drug use, 1975–2017: overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan; 2018.

    Book  Google Scholar 

  26. Gravely S, Fong GT, Cummings KM, Yan M, Quah AC, Borland R, et al. Awareness, trial, and current use of electronic cigarettes in 10 countries: findings from the ITC project. Int J Environ Res Public Health. 2014;11(11):11691–704.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Farsalinos KE, Poulas K, Voudris V, Le Houezec J. Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries. Addiction. 2016;111(11):2032–40.

    Article  PubMed  Google Scholar 

  28. Hummel K, Hoving C, Nagelhout GE, de Vries H, van den Putte B, Candel MJ, et al. Prevalence and reasons for use of electronic cigarettes among smokers: findings from the International Tobacco Control (ITC) Netherlands Survey. Int J Drug Policy. 2015;26(6):601–8.

    Article  PubMed  Google Scholar 

  29. Yong H-H, Borland R, Balmford J, McNeill A, Hitchman S, Driezen P, et al. Trends in e-cigarette awareness, trial, and use under the different regulatory environments of Australia and the United Kingdom. Nicotine Tob Res. 2014;17(10):1203–11.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Jones L. Vaping - the rise in five charts. BBC News 2018. https://www.bbc.com/news/business-44295336.

  31. BIS Research. Global e-cigarette and t-vapor market to reach $86.43 billion by 2025, Reports BIS Research. Minnesota: PRNewswire; 2018. https://www.prnewswire.com/news-releases/global-e-cigarette-and-t-vapor-market-to-reach-8643-billion-by-2025-reports-bis-research-675808803.html.

    Google Scholar 

  32. Wang TW, Asman K, Gentzke A, Cullen K, Holder-Hayes E, Reyes-Guzman C, et al. Tobacco product use among adults - United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67:1225–32.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Goniewicz M, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014;23(2):133–9.

    Article  PubMed  Google Scholar 

  34. •• National Academies of Sciences E, and Medicine. Public health consequences of e-cigarettes. Washington, DC: The National Academies Press; 2018. https://doi.org/10.17226/24952. Comprehensive summary of scientific research to date on e-cigarette toxicity and health effects

  35. Chun LF, Moazed F, Calfee CS, Matthay MA, Gotts JE. Pulmonary toxicity of e-cigarettes. Am J Phys Lung Cell Mol Phys. 2017;313(2):L193–206.

    Google Scholar 

  36. Behar RZ, Luo W, McWhirter KJ, Pankow JF, Talbot P. Analytical and toxicological evaluation of flavor chemicals in electronic cigarette refill fluids. Sci Rep. 2018;8(1):8288.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Bengalli R, Ferri E, Labra M, Mantecca P. Lung toxicity of condensed aerosol from e-CIG liquids: influence of the flavor and the in vitro model used. Int J Environ Res Public Health. 2017;14(10):1254.

    Article  CAS  PubMed Central  Google Scholar 

  38. Muthumalage T, Prinz M, Ansah KO, Gerloff J, Sundar IK, Rahman I. Inflammatory and oxidative responses induced by exposure to commonly used e-cigarette flavoring chemicals and flavored e-liquids without nicotine. Front Physiol. 2018;8:1130.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Rowell TR, Reeber SL, Lee SL, Harris RA, Nethery RC, Herring AH, et al. Flavored e-cigarette liquids reduce proliferation and viability in the CALU3 airway epithelial cell line. Am J Phys Lung Cell Mol Phys. 2017;313(1):L52–66.

    Google Scholar 

  40. Kamilari E, Farsalinos K, Poulas K, Kontoyannis CG, Orkoula MG. Detection and quantitative determination of heavy metals in electronic cigarette refill liquids using total reflection X-ray fluorescence spectrometry. Food Chem Toxicol. 2018;116:233–7.

    Article  CAS  PubMed  Google Scholar 

  41. Pankow JF, Kim K, McWhirter KJ, Luo W, Escobedo JO, Strongin RM, et al. Benzene formation in electronic cigarettes. PLoS One. 2017;12(3):e0173055.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Sleiman M, Logue JM, Montesinos VN, Russell ML, Litter MI, Gundel LA, et al. Emissions from electronic cigarettes: key parameters affecting the release of harmful chemicals. Environ Sci Technol. 2016;50(17):9644–51.

    Article  CAS  PubMed  Google Scholar 

  43. Jensen RP, Luo W, Pankow JF, Strongin RM, Peyton DH. Hidden formaldehyde in e-cigarette aerosols. N Engl J Med. 2015;372(4):392–4.

    Article  CAS  PubMed  Google Scholar 

  44. Wang P, Chen W, Liao J, Matsuo T, Ito K, Fowles J, et al. A device-independent evaluation of carbonyl emissions from heated electronic cigarette solvents. PLoS One. 2017;12(1):e0169811.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Valentine GW, Jatlow PI, Coffman M, Nadim H, Gueorguieva R, Sofuoglu M. The effects of alcohol-containing e-cigarettes on young adult smokers. Drug Alcohol Depend. 2016;159:272–6.

    Article  CAS  PubMed  Google Scholar 

  46. Gaur S, Agnihotri R. Health effects of trace metals in electronic cigarette aerosols—a systematic review. Biol Trace Elem Res. 2019;188(2):295-315.

  47. DeVito EE, Krishnan-Sarin S. E-cigarettes: impact of E-liquid components and device characteristics on nicotine exposure. Curr Neuropharmacol. 2018;16(4):438–59.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Kong G, Morean ME, Cavallo DA, Camenga DR, Krishnan-Sarin S. Reasons for electronic cigarette experimentation and discontinuation among adolescents and young adults. Nicotine Tob Res. 2015;17:847–54. https://doi.org/10.1093/ntr/ntu257.

    Article  PubMed  Google Scholar 

  49. Pepper JK, Lee YO, Watson KA, Kim AE, Nonnemaker JM, Farrelly MC. Risk factors for youth E-cigarette “Vape trick” behavior. J Adolesc Health. 2017;61(5):599–605.

    Article  PubMed  Google Scholar 

  50. Talih S, Balhas Z, Salman R, Karaoghlanian N, Shihadeh A. “Direct dripping”: a high-temperature, high-formaldehyde emission electronic cigarette use method. Nicotine Tob Res. 2015:ntv080.

  51. Krishnan-Sarin S, Morean ME, Kong G, Bold KW, Camenga DR, Cavallo D, et al. “Dripping” among youth using e-cigarettes. Pediatrics. 2017;139(3):e20163224.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Cheng T. Chemical evaluation of electronic cigarettes. Tob Control. 2014;23(suppl 2):ii11–i7.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Morean ME, Kong G, Cavallo DA, Camenga DR, Krishnan-Sarin S. Nicotine concentration of e-cigarettes used by adolescents. Drug Alcohol Depend. 2016;167:224–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Duell AK, Pankow JF, Peyton DH. Free-base nicotine determination in electronic cigarette liquids by 1H NMR spectroscopy. Chem Res Toxicol. 2018;31:431–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Spindle TR, Eissenberg T. Pod mod electronic cigarettes—an emerging threat to public health. JAMA Netw Open. 2018;1(6):e183518-e.

    Article  Google Scholar 

  56. Goniewicz ML, Boykan R, Messina CR, Eliscu A, Tolentino J. High exposure to nicotine among adolescents who use Juul and other vape pod systems (‘pods’). Tob Control. 2018:tobaccocontrol-2018-054565. https://doi.org/10.1136/tobaccocontrol-2018-054565.

  57. • Bhatnagar A. E-cigarettes and cardiovascular disease risk: evaluation of evidence, policy implications, and recommendations. Curr Cardiovasc Risk Rep. 2016;10(7):24. Review of cardiovasular effects of nicotine and e-cigarettes.

    Article  Google Scholar 

  58. Benowitz NL, Fraiman JB. Cardiovascular effects of electronic cigarettes. Nat Rev Cardiol. 2017;14(8):447.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. US Department of Health and Human Services. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General. Rockville: US Department of Health and Human Services; 2010.

    Google Scholar 

  60. Benowitz NL, Burbank AD. Cardiovascular toxicity of nicotine: implications for electronic cigarette use. Trends Cardiovasc Med. 2016;26(6):515–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Franzen KF, Willig J, Cayo Talavera S, Meusel M, Sayk F, Reppel M, et al. E-cigarettes and cigarettes worsen peripheral and central hemodynamics as well as arterial stiffness: a randomized, double-blinded pilot study. Vasc Med. 2018;23(5):419–25.

    Article  PubMed  Google Scholar 

  62. Nocella C, Biondi-Zoccai G, Sciarretta S, Peruzzi M, Pagano F, Loffredo L, et al. Impact of tobacco versus electronic cigarette smoking on platelet function. Am J Cardiol. 2018;122(9):1477–81.

    Article  CAS  PubMed  Google Scholar 

  63. Alzahrani T, Pena I, Temesgen N, Glantz SA. Association between electronic cigarette use and myocardial infarction. Am J Prev Med. 2018;55(4):455–61.

    Article  PubMed  Google Scholar 

  64. Abreu-Villaça Y, Seidler FJ, Tate CA, Slotkin TA. Nicotine is a neurotoxin in the adolescent brain: critical periods, patterns of exposure, regional selectivity, and dose thresholds for macromolecular alterations. Brain Res. 2003;979(1–2):114–28.

    Article  CAS  PubMed  Google Scholar 

  65. Yuan M, Cross SJ, Loughlin SE, Leslie FM. Nicotine and the adolescent brain. J Physiol. 2015;593(16):3397–412.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Dwyer JB, McQuown SC, Leslie FM. The dynamic effects of nicotine on the developing brain. Pharmacol Ther. 2009;122:125–39. https://doi.org/10.1016/j.pharmthera.2009.02.003.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. • Smith RF, McDonald CG, Bergstrom HC, Ehlinger DG, Brielmaier JM. Adolescent nicotine induces persisting changes in development of neural connectivity. Neurosci Biobehav Rev. 2015;55:432–43. Reviews nicotine effects in adolescent brain development.

    Article  CAS  PubMed  Google Scholar 

  68. Sargent JD, Gabrielli J, Budney A, Soneji S, Wills TA. Adolescent smoking experimentation as a predictor of daily cigarette smoking. Drug Alcohol Depend. 2017;175:55–9.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Hines JZ, Fiala SC, Hedberg K. Electronic cigarettes as an introductory tobacco product among eighth and 11th grade tobacco users—Oregon, 2015. MMWR Morb Mortal Wkly Rep. 2017;66(23):604–6.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Krishnan-Sarin S, Morean ME, Camenga DR, Cavallo DA, Kong G. E-cigarette use among high school and middle school adolescents in Connecticut. Nicotine Tob Res. 2015;17:810–8. https://doi.org/10.1093/ntr/ntu243.

    Article  PubMed  Google Scholar 

  71. Case KR, Mantey DS, Creamer MR, Harrell MB, Kelder SH, Perry CL. E-cigarette-specific symptoms of nicotine dependence among Texas adolescents. Addict Behav. 2018;84:57–61.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Morean ME, Krishnan-Sarin S, O’Malley SS. Assessing nicotine dependence in adolescent e-cigarette users: the 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Nicotine Dependence Item Bank for electronic cigarettes. Drug Alcohol Depend. 2018;188:60–3.

    Article  CAS  PubMed  Google Scholar 

  73. • Soneji S, Barrington-Trimis JL, Wills TA, Leventhal AM, Unger JB, Gibson LA, et al. Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: a systematic review and meta-analysis. JAMA Pediatr. 2017;171(8):788–97. Meta-analysis summarizing e-cigarette use as a significant predictor of future cigarette smoking among youth.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Audrain-McGovern J, Stone MD, Barrington-Trimis J, Unger JB, Leventhal AM. Adolescent E-cigarette, hookah, and conventional cigarette use and subsequent marijuana use. Pediatrics. 2018;142(3):e20173616.

    Article  PubMed  PubMed Central  Google Scholar 

  75. DiFranza JR, Savageau JA, Fletcher K, O’Loughlin J, Pbert L, Ockene JK, et al. Symptoms of tobacco dependence after brief intermittent use: the development and assessment of nicotine dependence in youth–2 study. Arch Pediatr Adolesc Med. 2007;161(7):704–10.

    Article  PubMed  Google Scholar 

  76. McCabe SE, Veliz P, McCabe VV, Boyd CJ. Smoking behaviors and intentions among current e-cigarette users, cigarette smokers, and dual users: a national survey of US high school seniors. Prev Med. 2017;99:228–35.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Park J-Y, Seo D-C, Lin H-C. E-cigarette use and intention to initiate or quit smoking among US youths. Am J Public Health. 2016;106(4):672–8.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Miech R, Patrick ME, O'Malley PM, Johnston LD. E-cigarette use as a predictor of cigarette smoking: results from a 1-year follow-up of a national sample of 12th grade students. Tob Control. 2017:tobaccocontrol-2016-053291.

  79. Barrington-Trimis JL, Urman R, Berhane K, Unger JB, Cruz TB, Pentz MA, et al. E-cigarettes and future cigarette use. Pediatrics. 2016;138(1):e20160379.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Leventhal AM, Strong DR, Kirkpatrick MG, Unger JB, Sussman S, Riggs NR, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700–7. https://doi.org/10.1001/jama.2015.8950.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Bold KW, Kong G, Camenga DR, Simon P, Cavallo DA, Morean ME, et al. Trajectories of e-cigarette and conventional cigarette use among youth. Pediatrics. 2018;141(1):e20171832.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Wills TA, Knight R, Sargent JD, Gibbons FX, Pagano I, Williams RJ. Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii. Tob Control. 2017;26(1):34-39.

  83. Adkison SE, O'Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong H-H, et al. Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med. 2013;44(3):207–15.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Brose LS, Hitchman SC, Brown J, West R, McNeill A. Is the use of electronic cigarettes while smoking associated with smoking cessation attempts, cessation and reduced cigarette consumption? A survey with a 1-year follow-up. Addiction. 2015;110(7):1160–8.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Zhu S-H, Zhuang Y-L, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys. BMJ. 2017;358:j3262. https://doi.org/10.1136/bmj.j3262.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Johnson L, Ma Y, Fisher SL, Ramsey AT, Chen L-S, Hartz SM, et al. E-cigarette usage is associated with increased past-12-month quit attempts and successful smoking cessation in two US population–based surveys. Nicotine Tob Res. 86: 2018:1-8. https://doi.org/10.1093/ntr/nty211

  87. Kulik MC, Lisha NE, Glantz SA. E-cigarettes associated with depressed smoking cessation: a cross-sectional study of 28 European Union countries. Am J Prev Med. 2018;54(4):603–9.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Rigotti NA, Chang Y, Tindle HA, Kalkhoran SM, Levy DE, Regan S, et al. Association of E-cigarette use with smoking cessation among smokers who plan to quit after a hospitalization: a prospective study. Ann Intern Med. 2018;168(9):613–20.

    Article  PubMed  Google Scholar 

  89. Kalkhoran S, Glantz SA. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir Med. 2016;4:116–28.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Weaver SR, Huang J, Pechacek TF, Heath JW, Ashley DL, Eriksen MP. Are electronic nicotine delivery systems helping cigarette smokers quit? Evidence from a prospective cohort study of US adult smokers, 2015–2016. PLoS One. 2018;13(7):e0198047.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. • Hartmann-Boyce J, McRobbie H, Bullen C, Begh R, Stead LF, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Libr. 2016;(9). https://doi.org/10.1002/14651858.CD010216.pub3. Meta-analysis indicating there is some evidence that nicotine containing e-cigarettes are more effective than placebo (no-nicotine) e-cigarettes for smoking cessation, although the quality of the evidence is low given the limited number of randomized controlled trials.

  92. Malas M, van der Tempel J, Schwartz R, Minichiello A, Lightfoot C, Noormohamed A, et al. Electronic cigarettes for smoking cessation: a systematic review. Nicotine Tob Res. 2016;18(10):1926–36.

    Article  PubMed  Google Scholar 

  93. • Yong H-H, Hitchman SC, Cummings KM, Borland R, Gravely SM, McNeill A, et al. Does the regulatory environment for e-cigarettes influence the effectiveness of e-cigarettes for smoking cessation?: Longitudinal findings from the ITC Four Country Survey. Nicotine Tob Res. 2017;19(11):1268–76. Examines the influence of regulatory environment on real-world effectiveness of e-cigarettes across multiple countries.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Caponnetto P, Campagna D, Cibella F, Morjaria J, Caruso M, Russo C, et al. EffiCiency and safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One. 2013;8(6):e66317.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J et al. Electronic cigarettes for smoking cessation: a randomised controlled trial, in press. Published online. Lancet. 2013;382(9905):16-22.

  96. Halpern SD, Harhay MO, Saulsgiver K, Brophy C, Troxel AB, Volpp KG. A pragmatic trial of e-cigarettes, incentives, and drugs for smoking cessation. N Engl J Med. 2018;378:2302-2310 .

  97. • Hajek P, Phillips-Waller A, Przulj D, Pesola F, Myers Smith K, Bisal N, et al. A randomized trial of e-cigarettes versus nicotine-replacement therapy. N Engl J Med. 2019;380(7):629-637.

  98. Coleman B, Rostron B, Johnson SE, Persoskie A, Pearson J, Stanton C, et al. Transitions in electronic cigarette use among adults in the Population Assessment of Tobacco and Health (PATH) study, waves 1 and 2 (2013–2015). Tob Control. 2018:tobaccocontrol-2017-054174.

  99. Inoue-Choi M, Liao LM, Reyes-Guzman C, Hartge P, Caporaso N, Freedman ND. Association of long-term, low-intensity smoking with all-cause and cause-specific mortality in the National Institutes of Health–AARP diet and health study. JAMA Intern Med. 2017;177(1):87–95.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Pope CA, Burnett RT, Krewski D, Jerrett M, Shi Y, Calle EE, et al. Cardiovascular mortality and exposure to airborne fine particulate matter and cigarette smoke shape of the exposure-response relationship. Circulation. 2009;120(11):941–8.

    Article  CAS  PubMed  Google Scholar 

  101. Wills TA, Pagano I, Williams RJ, Tam EK. E-cigarette use and respiratory disorder in an adult sample. Drug Alcohol Depend. 2019;194:363–70.

    Article  PubMed  Google Scholar 

  102. Huang L-L, Kowitt SD, Sutfin EL, Patel T, Ranney LM, Goldstein AO. Electronic cigarette use among high school students and its association with cigarette use and smoking cessation, North Carolina Youth Tobacco Surveys, 2011 and 2013. Prev Chronic Dis. 2016;13:E103.

  103. Gmel G, Baggio S, Mohler-Kuo M, Daeppen J-B, Studer J. E-cigarette use in young Swiss men: is vaping an effective way of reducing or quitting smoking? Swiss Med Wkly. 2015;146:w14271-w.

    Google Scholar 

  104. Goniewicz ML, Leigh NJ, Gawron M, Nadolska J, Balwicki L, McGuire C, et al. Dual use of electronic and tobacco cigarettes among adolescents: a cross-sectional study in Poland. Int J Public Health. 2016;61(2):189–97.

    Article  PubMed  Google Scholar 

  105. USDHHS. The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. p. 17.

    Google Scholar 

  106. Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville: U.S. Department of Health and Human Services. Public Health Service; 2008.

    Google Scholar 

  107. • Kennedy RD, Awopegba A, De León E, Cohen JE. Global approaches to regulating electronic cigarettes. Tob Control. 2017;26(4):440–5. Describes e-cigarette product classifications and summarizes global e-cigarette regulatory policies.

    Article  PubMed  Google Scholar 

  108. •• Institute for Global Tobacco Control. Country laws regulating e-cigarettes: a policy scan. Baltimore: Johns Hopkins Bloomberg School of Public Health; 2018. http://globaltobaccocontrol.org/e-cigarette/country-laws-regulating-e-cigarettes. Summarizes global e-cigarette regulatory policies by country.

    Google Scholar 

  109. • World Health Organization. Electronic Nicotine Delivery Systems. WHO Framework Convention on Tobacco Control. 2014. http://apps.who.int/gb/fctc/pdf/cop6/fctc_cop6_10-en.pdf. Provides detailed policy suggestions for countries to regulate e-cigarettes.

  110. Family Smoking Prevention and Tobacco Control, PUBLIC LAW 111–31 (2009).

  111. • Food and Drug Administration. Deeming tobacco products to be subject to the federal food, drug, and cosmetic act, as amended by the family smoking prevention and tobacco control act; restrictions on the sale and distribution of tobacco products and required warning statements for tobacco products. Final rule. Fed Regist. 2016;81(90):28973. U.S. FDA plan to regulate e-cigarettes as a tobacco product.

  112. FDA. Statement from FDA Commissioner Scott Gottlieb, MD, on proposed new steps to protect youth by preventing access to flavored tobacco products and banning menthol in cigarettes: U.S. Food & Drug Administration; 2018.

  113. Nielsen HB. Tobacco “all channel” data through August 12, 2017. Charlotte: Wells Fargo Securities, LLC; 2017.

    Google Scholar 

  114. Kong G, Morean ME, Cavallo D, Camenga DR, Krishnan-Sarin S. Sources of electronic cigarette acquisition among adolescents in Connecticut. Tob Regul Sci. 2017;3(1):10–6.

    Article  PubMed  PubMed Central  Google Scholar 

  115. US FDA. FDA launches new campaign: “the real cost” youth e-cigarette prevention campaign. 2018. https://www.fda.gov/TobaccoProducts/PublicHealthEducation/PublicEducationCampaigns/TheRealCostCampaign/ucm620783.htm.

Download references

Funding

Research reported in this publication was supported by grant number P50DA036151, U54DA036151 from the NIDA and FDA Center for Tobacco Products (CTP), and R01CA207229 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

Author information

Authors and Affiliations

  1. Yale University School of Medicine, 34 Park Street CMHC, New Haven, CT, 06519, USA

    Krysten W. Bold & Suchitra Krishnan-Sarin

Authors
  1. Krysten W. Bold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suchitra Krishnan-Sarin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Krysten W. Bold.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Tobacco

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bold, K.W., Krishnan-Sarin, S. E-Cigarettes: Tobacco Policy and Regulation. Curr Addict Rep 6, 75–85 (2019). https://doi.org/10.1007/s40429-019-00243-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40429-019-00243-5

Keywords

Search

Navigation