(February 2012)

The European Respiratory Society, ERS is opposed to the use of all tobacco and unapproved nicotine delivery products such as cigarettes, chewable tobacco, and emerging products that include electronic cigarettes (e-cigs), snus, dissolvable tobacco and waterpipes.

In response to the successful increase in tobacco-free policies, the tobacco industry has developed these new products, allowing consumers to obtain nicotine without the use of a cigarette.¹ In many cases, these new products are claimed and/or perceived to be 'harm reducing' or safe alternatives to conventional cigarettes; however, there is no reliable science to substantiate this claim.² Rather, available research suggests that these products pose a significant health risk to citizens, placing them at continued high risk for disease and negative health outcomes. ^3,4

There is a growing concern about the potential health risks associated with e-cig usage and exposure. A recent sample of the product was found to contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze.⁵ These concerns can only be adequately addressed by proper evaluation and regulation by the appropriate national and European authorities.

Therefore, based on current information and available research, ERS does not classify e-cigs as a safe alternative to smoking nor does it consider them an approved tobacco cessation tool or suitable for use in places where conventional cigarette smoking is prohibited. ERS recommends following effective smoking cessation treatment guidelines based on clinical evidence which do not advocate the use of such products.

In general, ERS subscribes to the medical principle of primum non nocere and holds that Tobacco users "should not trade one carcinogenic product for another..."⁶

ERS fully endorses the Article 14 guidelines of the WHO Framework Convention on Tobacco Control⁷ and therefore maintains that the best health advice to smokers is to quit smoking.

 

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¹Pederson LL, Nelson DE (2007), Literature review and summary of perceptions, attitudes, beliefs, and marketing of potentially reduced exposure products: communication implications. Nicotine Tob Res. 2007 May; 9(5):525-34.
http://ntr.oxfordjournals.org/content/9/5/525.abstract  (accessed 12 January 2012)

²Report by the Convention Secretariat Conference of the Parties to the WHO Framework Convention on Tobacco Control (2010), "Control and prevention of smokeless tobacco products and electronic cigarettes" (Fourth session Punta del Este, Uruguay, 15–20 November 2010 FCTC/COP/4/12 (http://apps.who.int/gb/fctc/PDF/cop4/FCTC_COP4_12-en.pdf (accessed 12 January 2012)

³US Food and Drug Administration Statement on Cigs(2012),
http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm (accessed 12 January 2012)

⁴Health Canada – Advisory on E-Cigs(2009,)
http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2009/2009_53-eng.php(accessed 12 January 2012)

⁵Utah Tobacco Prevention And Control Program- position on E-Cigs(2010), http://www.tobaccofreeutah.org/pdfs/Ecigarettes.pdf(accessed 12 January 2012)

⁶US Surgeon General (2003), http://www.surgeongeneral.gov/news/testimony/tobacco06032003.htm

⁷Article 14 guidelines of the WHO Framework Convention on Tobacco Control(2010),
http://www.who.int/fctc/Guidelines.pdf (accessed 12 January 2012)