Balancing Consideration of the Risks and Benefits of E-Cigarettes

David J.K. Balfour, Neal L. Benowitz, Suzanne M. Colby, Dorothy K. Hatsukami, Harry A. Lando, Scott J. Leischow, Caryn Lerman, Robin J. Mermelstein, Raymond Niaura, Kenneth A. Perkins, Ovide F. Pomerleau, Nancy A. Rigotti, Gary E. Swan, Kenneth E. Warner, Robert West

Research output: Contribution to journalArticlepeer-review

64 Scopus citations


The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes' risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public - including most smokers - now consider e-cigarette use as dangerous as or more dangerous than smoking. By contrast, the National Academies of Science, Engineering, and Medicine concluded that e-cigarette use is likely far less hazardous than smoking. Policies intended to reduce adolescent vaping may also reduce adult smokers' use of e-cigarettes in quit attempts. Because evidence indicates that e-cigarette use can increase the odds of quitting smoking, many scientists, including this essay's authors, encourage the health community, media, and policymakers to more carefully weigh vaping's potential to reduce adult smoking-attributable mortality. We review the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youths with the potential benefits of increasing adult smoking cessation.

Original languageEnglish (US)
Pages (from-to)1661-1672
Number of pages12
JournalAmerican journal of public health
Issue number9
StatePublished - Sep 2021

Bibliographical note

Funding Information:
The paper was presented by K. E. Warner at the E-Cigarette Summit: Science, Regulation & Public Health, USA Virtual Summit, May 25, 2021. The authors are former presidents of the Society for Research on Nicotine and Tobacco (SRNT), the world's leading professional organization dedicated to the subject. They are listed in alphabetical order. All 26 of the then-past presidents were invited to participate as co-authors of this article. (A 27th past president was the active president at the time of preparation of the article.) We were unable to reach one of them. Three were not included because of institutional commitments that they felt might be interpreted as conflicts of interest. The remaining 7 declined to co-author.

Publisher Copyright:
© 2021 American Public Health Association Inc.. All rights reserved.


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