Electronic Nicotine Delivery Systems: An Updated Policy Statement from the American Association for Cancer Research and the American Society of Clinical Oncology

Roy S. Herbst, Dorothy Hatsukami, Dana Acton, Meredith Giuliani, Allyn Moushey, Jonathan Phillips, Shimere Sherwood, Benjamin A. Toll, Kasisomayajula Viswanath, Nicholas J.H. Warren, Graham W. Warren, Anthony J. Alberg

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Combustible tobacco use has reached historic lows, demonstrating the importance of proven strategies to reduce smoking since publication of the 1964 Surgeon General’s report. In contrast, the use of electronic nicotine delivery systems (ENDS), specifically e-cigarettes, has grown to alarming rates and threatens to hinder progress against tobacco use. A major concern is ENDS use by youth and adults who never previously used tobacco. While ENDS emit fewer carcinogens than combustible tobacco, preliminary evidence links ENDS use to DNA damage and inflammation, key steps in cancer development. Furthermore, high levels of nicotine can also increase addiction, raise blood pressure, interfere with brain development, and suppress the immune system. The magnitude of long-term health risks will remain unknown until longitudinal studies are completed. ENDS have been billed as a promising tool for combustible tobacco cessation, but further evidence is needed to assess their potential efficacy for adults who smoke. Of concern, epidemiological studies estimate that approximately 15% to 42% of adults who use ENDS have never used another tobacco product, and another 36% to 54% “dual use” both ENDS and combustible tobacco. This policy statement details advances in science related to ENDS and calls for urgent action to end predatory practices of the tobacco industry and protect public health. Importantly, we call for an immediate ban on all non-tobacco-flavored ENDS products that contain natural or synthetic nicotine to reduce ENDS use by youth and adults who never previously used tobacco. Concurrently, evidence-based treatments to promote smoking cessation and prevent smoking relapse to reduce cancer incidence and improve public health remain top priorities for our organizations. We also recognize there is an urgent need for research to understand the relationship between ENDS and tobacco-related disparities.

Original languageEnglish (US)
Pages (from-to)4861-4870
Number of pages10
JournalClinical Cancer Research
Volume28
Issue number22
DOIs
StatePublished - Nov 15 2022

Bibliographical note

Funding Information:
R.S. Herbst reports personal fees from Cybrexa Therapeutics, personal fees from eFFECTOR Therapeutics, Inc., personal fees from Eli Lilly and Company, personal fees from EMD Serono, personal fees from Genentech, personal fees from Gilead, personal fees from Janssen, personal fees from Merck and Company, personal fees from Mirati Therapeutics, personal fees from NextCure, personal fees from Novartis, personal fees from Ocean Biomedical, Inc, personal fees from Oncocyte Corp, personal fees from Oncternal Therapeutics, personal fees from Pfizer, personal fees from Regeneron Pharmaceuticals, personal fees from Revelar Biotherapeutics, Inc, personal fees from Ribbon Therapeutics, Inc, personal fees from Roche, personal fees from Sanofi, personal fees from Xencor, Inc, other support from American Association for cancer Research, other support from International Association for Cancer

Publisher Copyright:
©2022 American Association for Cancer Research and American Society of Clinical Oncology.

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