E-cigarettes are less harmful than regular cigarettes, but they are not harmless, according to a report by the National Academy of Sciences, Engineering & Medicine (NAS), Public Health Consequences of E-Cigarettes. The report acknowledges continuing concerns with the harms associated with e-cigarettes, particularly as they relate to youth, finding an association between the use of e-cigarettes by youth and the eventual use of combustible tobacco cigarettes.

What is not yet known: the long-term risks of continued e-cigarette use over many years.

These findings are similar to those in a recent comprehensive review conducted by a team of experts at ACS (“Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine"). In stark contrast to cigarettes and other combustible tobacco products, e-cigarettes do not burn tobacco, a process that yields an estimated 7,000 chemicals, including more than 50 carcinogens. While nicotine is highly addictive, and children and pregnant women should avoid any exposure to nicotine due to its deleterious impact on brain development and fetal health, it is the smoke from combustible tobacco products, not nicotine, that injures and kills millions of users each year worldwide.

The report correctly finds that the net public health impact of e-cigarettes depends on several factors, including youth initiation and adult cessation of combustible tobacco use, as well as e-cigarettes’ toxicity. The report determines that, “If e-cigarette use by adult smokers leads to long-term abstinence from combustible tobacco cigarettes, the benefit to public health could be considerable. Without that health benefit for adult smokers, e-cigarette use could cause considerable harm to public health in the short- and long-term due both to the inherent harms of exposure to e-cigarette toxicants and to the harms related to subsequent combustible tobacco use by those who begin using e-cigarettes in their youth.”

The NAS report comes at a time that the Food and Drug Administration (FDA) is promoting a new, comprehensive approach to address the continuum of risk among different tobacco products, including e-cigarettes, while pursuing the potential reduction of nicotine in combustible tobacco products to less or non-addictive levels.

The American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society, says it will continue to advocate for the FDA to use its full authority over all tobacco products, including e-cigarettes, in order to save lives and end tobacco-related death and disease in our lifetime.