E-cigarettes: an aid in smoking cessation, or a new health hazard?

Resource Notes:

Conclusions: E-cigarettes are one of the most controversial issues in public health today. There is little doubt that they are less harmful than smoking, but there is disagreement on the level of risk reduction. However, there is agreement that they are not absolutely harmless. Epidemiological evidence of long-term health effects is unavailable for now, and it will take years to generate final conclusions about the clinical effects of switching from tobacco to e-cigarette use. However, it is reasonable to communicate to smokers the relative risks of smoking and e-cigarette use based on current knowledge, keeping in mind that the ideal pathway is to quit without using any alternative products. While population studies suggest that smokers can successfully quit smoking with the help of e-cigarettes, randomized controlled trials and cohort studies have failed to show substantial effects. This is, at least in part, due to both methodological problems in studies and the complexity and dynamic evolution of the e-cigarette market, as well as the time-consuming research methods. While there is clear evidence that e-cigarettes are not attracting adult never-smokers, there is considerable experimentation among adolescents, including never-smokers. Recent evidence shows a trend for reduction of experimentation among youth while regular use appears to be largely confined to smokers, and smoking prevalence is continuously declining. More research is needed to evaluate the complex interactions between smoking and e-cigarette use in adolescents and the impact of e-cigarettes on adolescent smoking prevalence, and to examine whether e-cigarettes are a source of harm or harm reduction in this population. It appears that e-cigarettes will remain a controversial topic and heated debate will continue for many more years.