There is a marked increase in the development and use of electronic nicotine delivery systems (ENDS) or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as “electrical devices that generate an aerosol from a liquid” and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on: the epidemiology of ECIG use; their ingredients and accompanied health effects; secondhand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact, in vitro and animal studies; and user perspectives.
ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support that ECIGs are an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licensed stop-smoking treatments. So far, there is conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIGs use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Negative health effects cannot, based on the current knowledge, be ruled out.