Are Electronic Nicotine Delivery Systems (ENDS) an effective aid in smoking cessation?: A critical look

Abstract

Objective To evaluate the current status of knowledge on safety and effectiveness of ENDS as an potential aid in smoking cessation and raise awareness of health professionals and tobacco control advocates in this matter. Methods Review of clinical studies, public health agencies reports, smoking cessation guidelines, regulatory policies and best practice in smoking cessation programs in various countries. Results Tobacco industry promotes ENDS as safe and effective aid in smoking cessation. Some clinical observations and trials prove that ENDS can be supportive in quitting smoking and contribute to better quit rates than nicotine replacement therapy. However, there are more and more studies that show that ENDS are not safe and effective in smoking cessation. Critical studies indicate on the risk of ENDS use for nicotine intoxication and acute and chronic diseases, a potential of nicotine addiction among ENDS users, a big proportion of dual (cigarette and ENDS) users among ENDS consumers, sharp increase in ENDS use among teenagers and tobacco experimenters, promotion of tobacco products within ENDS advertising and promotion, lack of guidelines for using ENDS in the process of smoking cessation, lack of ENDS registration as safe and effective aid to cease smoking, contradictory statements of various medical societies on the risks and benefits of ENDS use, bans of ENDS sale and use in leading countries in tobacco control. Conclusions There is still not clear evidence whether ENDS are safe and effective aid in smoking cessation and if they can substitute science and evidence based therapies. Moreover, these products are rather used by tobacco industry or strengthening tobacco market than for ending tobacco epidemic. Therefore, these products should not be broadly used by health professionals in treatment of tobacco dependence and advised not to be used by teenagers, pregnant women, patients with allergy, tobacco experimenters and non-smokers.

Keywords

• ENDS
• smoking cessation
• critical look