Position statement on e-cigarettes by American Thoracic Society

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Experts from the world’s leading lung organizations have released a position statement on electronic cigarettes, focusing on their potential adverse effects on human health and calling on governments to ban or restrict their use until their health impacts are better known.

Produced by the Forum of International Respiratory Societies (FIRS), the position statement will be presented on July 9th, 2014 at a meeting hosted by FIRS and the NCD [Noncommunicable Disease] Alliance, “Shared Drivers, Shared Solutions: NCDs, Lung Health and Sustainable Development.”

The meeting coincides with the United Nations High-Level Review on the Prevention and Control of Noncommunicable Diseases on July 10-11, which will include chronic respiratory illness — including COPD, the third-leading cause of death worldwide–for the first time.

FIRS, established in 2001, is an organization composed of the world’s leading international respiratory societies working together to improve lung health globally, including the American Thoracic Society (ATS), the Asociación Latinoamericana del Thorax (ALAT), the American College of Chest Physicians (ACCP), the Asian Pacific Society of Respirology (APSR), the European Respiratory Society (ERS), the International Union Against Tuberculosis and Lung Disease (The Union), and the Pan African Thoracic Society (PATS). The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

Past ATS President Dean Schraufnagel, MD, is the lead author of the statement and will be presenting it at the meeting. “The gravity of tobacco use on global health and the historical behavior of the tobacco industry that has included deceit about the health effects of tobacco, intentional marketing to children, and manipulating nicotine levels in cigarettes to maintain addiction should prompt us to proceed cautiously,” said Dr. Schraufnagel. “Nicotine is central to lifelong addiction, and these are nicotine delivery devices.”

The position of the Forum of International Respiratory Societies (FIRS) on electronic nicotine delivery devices includes:

• The safety of electronic cigarettes has not been adequately demonstrated.

• The addictive power of nicotine and its untoward effects should not be underestimated.

• The potential benefits of electronic nicotine delivery devices, including harm reduction and as an aid to smoking cessation, have not been well studied.

• Potential benefits to an individual smoker should be weighed against harm to the population of increased social acceptability of smoking and use of nicotine.

• Health and safety claims regarding electronic nicotine delivery devices should be subject to evidentiary review.

• Adverse health effects for third parties exposed to the emissions of electronic cigarettes cannot be excluded.

• Electronic nicotine delivery devices should be restricted or banned, at least until more information about their safety is available.

• If electronic nicotine delivery devices are permitted, they should be regulated as medicines and subject to the same evidentiary review of other medicines.

• If electronic nicotine delivery devices are not regulated as medicines, they should be regulated as tobacco products.

• Research, supported by sources other than the tobacco or electronic cigarette.

• industry, should be carried out to determine the impact of electronic nicotine delivery devices on health in a wide variety of settings.

• The use and population effects of electronic nicotine delivery devices should be monitored.

• All information derived from this research should be conveyed to the public in a clear manner.