The following is a summary of “Electronic Nicotine Delivery Systems: An Updated Policy Statement from the American Association for Cancer Research and the American Society of Clinical Oncology” published in the November 2022 issue of Clinical Cancer by Herbst et al.

American Association for Cancer Research (ACR) and American Society of Clinical Oncology (ASCO) updated policy on e-cigarettes. Since the publication of the Surgeon General’s report in 1964, combustible tobacco usage has dropped to record lows, illustrating the usefulness of tried-and-true methods to curb the habit. Electronic nicotine delivery systems (ENDS), most notably e-cigarettes, have shown worrying growth that could stall efforts to reduce tobacco usage. The growing popularity of ENDS among both new and former smokers is a big problem. Preliminary data links ENDS usage to DNA damage and inflammation, important steps in cancer development, even though ENDS produce fewer carcinogens than combustion tobacco. 

In addition, chronic exposure to high doses of nicotine has been linked to an increased risk of addiction, hypertension, impaired brain development, and immune system suppression. Until longitudinal investigations are finished, the extent of long-term health hazards will be unknown. Though ENDS have been promoted as a useful aid in the fight against conventional tobacco smoking, more research is required to determine whether or not they are indeed effective in helping adult smokers finally kick the habit. Epidemiological studies show that between 36% and 54% of ENDS users “dual use” ENDS and combustible cigarettes and that 15% to 42% of adult ENDS users have never used any other tobacco product. 

This policy statement describes recent research developments in the field of ENDS and urges swift action to curb the tobacco industry’s deceptive business practices and safeguard public health. To minimize the use of ENDS among people of all ages who have never smoked tobacco, researchers urge the immediate prohibition of all ENDS products with natural or synthetic nicotine that do not have a tobacco flavor. Concurrently, our organizations place a premium on using evidence-based treatments to encourage smoking cessation and prevent relapse in an effort to lower cancer rates and boost public health. We, therefore, acknowledge the pressing need for study into the connection between ENDS and inequalities resulting from the use of tobacco products.