Regulating Electronic Cigarettes: Not Tobacco and Not (Yet) Therapy
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LEADING ARTICLE
Regulating Electronic Cigarettes: Not Tobacco and Not (Yet) Therapy Eva Anthopoulou1
Published online: 11 June 2016 Ó Springer International Publishing Switzerland 2016
Abstract Electronic cigarettes are nicotine delivery devices that have rapidly penetrated into the market since their invention in 2003. Their remarkably rapid spread has raised questions concerning their safety and efficacy as smoking cessation aids. However, despite this uncertainty, the number of users is increasing, especially among smokers and ex-smokers who are trying to keep away from tobacco cigarettes. Several chemical studies have been conducted and a safer profile compared with tobacco cigarettes has been recognized. Clinical and population studies have given a first insight into the efficacy of e-cigarettes as smoking cessation aids, supporting their potential. Nonetheless, these preliminary findings cannot lead to reliable conclusions about their long-term safety and efficacy and further research is warranted. The burden of tobacco-related diseases is a major cause of morbidity and mortality worldwide and further measures are needed in order to reduce tobacco harm. At the moment, e-cigarettes are categorized as consumer products in the UK because the Medicines and Healthcare Products Regulatory Agency’s (MHRA’s) recommendation to regulate e-cigarettes as medicines did not get the adequate response; however, very soon e-cigarettes will be regulated under the EU’s Tobacco Product Directive. E-cigarettes are widely used and the preliminary findings on safety and efficacy, in combination with the need for new tobacco harm reduction strategies,
& Eva Anthopoulou [email protected] 1
Pharmaceutical Medicine Group, Faculty of Life Sciences and Medicine, Institute of Pharmaceutical Sciences, King’s College London, Room 3.54 FWB, 150 Stamford Street, London SW1 9NH, UK
suggest that the investigation of e-cigarettes’ potential as a smoking cessation aid is imperative.
Key Points Electronic cigarette use has raised questions regarding their safety and efficacy as smoking cessation aids. Tobacco smoking prevalence is still high and tobacco-related diseases are a major cause of morbidity worldwide. The current electronic cigarette regulatory framework is vestigial. These products are increasing in popularity, and there is need for new tobacco harm reduction strategies and generation of integrated regulatory policies.
1 Introduction Electronic cigarettes, also known as e-cigarettes or electronic nicotine delivery systems (ENDS), are a relatively new class of products within the tobacco market. They are battery-powered devices that vaporize a liquid solution that is inhaled by the user to deliver a dose of nicotine without burning tobacco, and they are widely sold on the internet and in retail shops [1]. In 2003, the Chinese pharmacist Hon Lik, was the first to design the electronic cigarette and the next year the Chinese company ‘‘Ruyan’’ was the first to manufacture and commercialize the e-cigarette in the Chinese
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