AAAR 35th Annual Conference October 17 - October 21, 2016 Oregon Convention Center Portland, Oregon, USA
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Electronic Cigarettes: Evidence, Uncertainty and Policy
JONATHAN SAMET, University of Southern California
Abstract Number: 146 Working Group: Invited by Conference Chair
Abstract Over a five-year span, use of electronic cigarettes (e-cigarettes), which deliver an aerosol generated by a battery-powered vaporizer, has rapidly increased, particularly among adolescents and young adults. Because e-cigarettes can deliver nicotine without the combustion-generated carcinogens and toxins of tobacco smoke, they have been proposed as potentially useful for harm reduction, if substituted for conventional cigarettes. However, the potential for harm reduction needs to be balanced against the potential for e-cigarettes to increase nicotine addiction among adolescents and young adults, to reduce cessation among cigarette smokers, and to “renormalize” use of tobacco products. With the Food and Drug Administration poised to take regulatory authority over e-cigarettes under the Family Smoking Prevention and Tobacco Control Act, the public health impact standard of the Act becomes relevant—that is, what is the overall public health impact of availability of e-cigarettes? This presentation addresses the evidence needed to gauge the public health impact of e-cigarettes and the use of models to estimate the balance between potential harms and benefits. Research to generate the needed evidence is challenged by the highly dynamic pattern of use of tobacco products subsequent to the addition of e-cigarettes to the marketplace. Models must project future scenarios of use that are quite uncertain. Nonetheless, policies are being developed at local, state, and national levels that draw on the limited evidence available and the application of principles of risk management. Research targeted at key uncertainties and careful surveillance are requisite in order to maintain the evidence base needed to minimize public health impact.