Potential Shouldn’t Equal Policy.

August 2015

More research is needed before e-cigs are called cessation tools.

In his New York Times Op-Ed “A Tobacco Tax to Save Lives” on August 18, Mr. Nocera writes, “the e-cigarette has the potential to be the greatest tobacco cessation device ever invented.” The key word here is potential. The key question is whether or not potential should translate into policy.


We don’t think it should. 


There is insufficient evidence to show that e-cigarettes are safer than cigarettes or that they are effective cessation tools, as argued in The Global Health Implications of e-Cigarettes in JAMA on August 18. Earlier this year, the US Preventive Services Task Force issued a draft recommendation on the use of electronic nicotine delivery systems (ENDS), such as e-cigarettes, to help people quit tobacco. They concluded that, due to the lack of well-designed trials, it’s too soon to call e-cigarettes cessation tools.

If the lack of data isn’t enough to cause concern about ENDS for cessation purposes, what about the lack of consistent regulation over the manufacturers of these products? The piece, China’s E-Cigarette Boom Lacks Oversight for Safety, published in the New York Times in December, warns that Chinese manufacturers, responsible for 90% of the world’s e-cigarettes, are operating under little oversight, which could account for dangerous compounds detected in some e-cigarettes.

Between the lean efficacy data and the questionable safety of ENDS, we contend that it’s premature to argue that smokers should move to ENDS over widely available cessation aides like the nicotine patch, gum or prescription medications that are proven effective and covered under most health plans.

Financial incentives, like a lower tax on a product, should be awarded to products proven safe and effective and approved through the government’s regulatory processes. If the e-cigarette companies wish to move the masses to their product and away from regular cigarettes, Mr. Nocera should be encouraging them to conduct the necessary trials required for FDA approval and that could someday open the door to a legitimate tax deferential. 

Read the New York Times piece here.