Perspectives for Clinicians on Regulation of Electronic Cigarettes
Authors: Olivia A. Wackowski, Cristine D. Delnevo, Michael B. Steinberg
Journal: Annals of Internal Medicine (2016)

Ideas and Opinions1 November 2016Perspectives for Clinicians on Regulation of Electronic CigarettesOlivia A. Wackowski, PhD, MPH, Cristine D. Delnevo, PhD, MPH, and Michael B. Steinberg, MD, MPHOlivia A. Wackowski, PhD, MPHFrom Rutgers School of Public Health, Piscataway, and Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.Search for more papers by this author, Cristine D. Delnevo, PhD, MPHFrom Rutgers School of Public Health, Piscataway, and Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.Search for more papers by this author, and Michael B. Steinberg, MD, MPHFrom Rutgers School of Public Health, Piscataway, and Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1345 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Since their launch in the United States in 2007, electronic cigarettes (e-cigarettes) have generated much debate, which recent events continue to fuel. In April 2016, the Royal College of Physicians (RCP) reaffirmed its position that e-cigarettes should be promoted as harm-reducing substitutes for combustible tobacco. By May, the U.S. Food and Drug Administration (FDA) deemed e-cigarettes to be under its regulatory authority. We briefly review the major RCP and FDA points and practical issues for clinicians to consider.The RCP's Position on E-CigarettesThe RCP report (1) is based on expert opinion, current evidence, and harm-reduction principles. It acknowledges that, ...References1. Royal College of Physicians. Nicotine without smoke: tobacco harm reduction. 28 April 2016. Accessed at www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0 on 3 June 2016. Google Scholar2. Singh T, Arrazola RA, Corey CG, Husten CG, Neff LJ, Homa DM, et al. Tobacco use among middle and high school students—United States, 2011-2015. MMWR Morb Mortal Wkly Rep. 2016;65:361-7. [PMID: 27077789] doi:10.15585/mmwr.mm6514a1 CrossrefMedlineGoogle Scholar3. Food and Drug Administration, HHS. 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;81:28973-9106. [PMID: 27192730] MedlineGoogle Scholar4. Barrington-Trimis JL, Urman R, Berhane K, Unger JB, Cruz TB, Pentz MA, et al. E-cigarettes and future cigarette use. Pediatrics. 2016;138. [PMID: 27296866] doi:10.1542/peds.2016-0379 CrossrefMedlineGoogle Scholar5. Niaura RS, Glynn TJ, Abrams DB. Youth experimentation with e-cigarettes: another interpretation of the data. JAMA. 2014;312:641-2. [PMID: 25117133] doi:10.1001/jama.2014.6894 CrossrefMedlineGoogle Scholar6. Goniewicz ML, 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;23:133-9. [PMID: 23467656] doi:10.1136/tobaccocontrol-2012-050859 CrossrefMedlineGoogle Scholar7. Delnevo CD, Giovenco DP, Steinberg MB, Villanti AC, Pearson JL, Niaura RS, et al. Patterns of electronic cigarette use among adults in the United States. Nicotine Tob Res. 2016;18:715-9. [PMID: 26525063] doi:10.1093/ntr/ntv237 CrossrefMedlineGoogle Scholar8. McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. 2014:CD010216. [PMID: 25515689] doi:10.1002/14651858.CD010216.pub2 CrossrefMedlineGoogle Scholar9. Steinberg MB, Zimmermann MH, Delnevo CD, Lewis MJ, Shukla P, Coups EJ, et al. E-cigarette versus nicotine inhaler: comparing the perceptions and experiences of inhaled nicotine devices. J Gen Intern Med. 2014;29:1444-50. [PMID: 24830741] doi:10.1007/s11606-014-2889-7 CrossrefMedlineGoogle Scholar10. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: 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; 2014. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Rutgers School of Public Health, Piscataway, and Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.Disclaimer: The opinions expressed in this article are those of the authors and should not be construed to reflect those of the funding agencies.Financial Support: All authors have received funding from the National Cancer Institute under project R01CA190444. Dr. Wackowski has also received relevant funding from the FDA Center for Tobacco Products under K01CA189301.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1345.Corresponding Author: Michael B. Steinberg, MD, MPH, Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 2300, New Brunswick, NJ 08903; e-mail, michael.[email protected]edu.Current Author Addresses: Drs. Wackowski and Delnevo: Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854.Dr. Steinberg: Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 2300, New Brunswick, NJ 08903.Author Contributions: Conception and design: M.B. Steinberg.Analysis and interpretation of the data: C.D. Delnevo.Drafting of the article: O.A. Wackowski, C.D. Delnevo, M.B. Steinberg.Critical revision of the article for important intellectual content: O.A. Wackowski, M.B. Steinberg.Final approval of the article: O.A. Wackowski, C.D. Delnevo, M.B. Steinberg.Administrative, technical, or logistic support: C.D. Delnevo.This article was published at www.annals.org on 30 August 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byE-Cigarette Use Without a History of Combustible Cigarette Smoking Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016Mohammadhassan Mirbolouk, MD, Paniz Charkhchi, MD, Olusola A. Orimoloye, MBBS, MPH, S.M. Iftekhar Uddin, MBBS, MSPH, Sina Kianoush, MD, MPH, Rana Jaber, PhD, Aruni Bhatnagar, PhD, Emelia J. Benjamin, MD, ScM, Michael E. Hall, MD, MSc, Andrew P. DeFilippis, MD, MSc, Wasim Maziak, MD, PhD, Khurram Nasir, MD, MPH, and Michael J. Blaha, MD, MPHPrevalence and Distribution of E-Cigarette Use Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016Mohammadhassan Mirbolouk, MD, Paniz Charkhchi, MD, Sina Kianoush, MD, MPH, S.M. Iftekhar Uddin, MBBS, MSPH, Olusola A. Orimoloye, MBBS, MPH, Rana Jaber, PhD, Aruni Bhatnagar, PhD, Emelia J. Benjamin, MD, ScM, Michael E. Hall, MD, MSc, Andrew P. DeFilippis, MD, MSc, Wasim Maziak, MD, PhD, Khurram Nasir, MD MPH, and Michael J. Blaha, MD, MPH 1 November 2016Volume 165, Issue 9Page: 665-666KeywordsDisclosureElectronic cigarettesFood and Drug AdministrationHealth careHealth economicsHealth information technologyNicotineNicotine replacement therapyObservational studiesPrevention, policy, and public health ePublished: 30 August 2016 Issue Published: 1 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...