Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes.

Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research.

Table of Contents

• Front Matter
• Summary
• Summary Annex Report Conclusions by Level of Evidence
• 1 Introduction
• 2 Committee Approach
• Section I: E-Cigarette Devices, Constituents, and Exposures
• 3 E-Cigarette Devices, Uses, and Exposures
• 4 Nicotine
• 5 Toxicology of E-Cigarette Constituents
• 6 Research Needs: E-Cigarette Devices, Constituents, and Exposures
• Section II: Effects of E-Cigarettes on Health
• 7 Modes of Action
• 8 Dependence and Abuse Liability
• 9 Cardiovascular Disease
• 10 Cancers
• 11 Respiratory Diseases
• 12 Oral Diseases
• 13 Developmental and Reproductive Effects
• 14 Injuries and Poisonings
• 15 Research Needs: Effects of E-Cigarettes on Health
• Section III: Public Health Implications of E-Cigarettes
• 16 Combustible Tobacco Cigarette Smoking Among Youth and Young Adults
• 17 Smoking Cessation Among Adults
• 18 Harm Reduction
• 19 Modeling of E-Cigarette Use
• 20 Research Needs: Public Health Implications of E-Cigarettes
• 21 Concluding Observations
• Appendix A: Questions from the Center for Tobacco Products of the Food and Drug Administration Submitted for the Committee's Consideration
• Appendix B: Search Strategy and Quality Assessment
• Appendix C: Glossary of Terms Related to E-Cigarettes
• Appendix D: Cytotoxicity Tables
• Appendix E: Public Meeting Agenda
• Appendix F: Committee Biosketches