Electronic nicotine delivery systems (ENDS): new evidence from the State and Community Tobacco Control Research Initiative: Table 1

Abstract Regulatory authorities have devoted increasing attention and resources to a range of issues surrounding the regulation of novel nicotine and tobacco products. This review highlights the inherent complexity of evaluating prospective policies that pertain to products that heat solutions containing nicotine but not tobacco leaf, sometimes referred to as electronic nicotine delivery systems (ENDS). The U.S. Food and Drug Administration (FDA) is compelled to incorporate a set of public health criteria in their decision-making, collectively referred to as the Population Health Standard. Adherence to this standard is necessary to estimate the impact of prospective ENDS policy decisions on net population harm associated with non-therapeutic nicotine products. For policies that are expected to decrease or increase ENDS use, application of the Population Health Standard requires a comprehensive assessment of the status quo impact of ENDS use on population health. Accordingly, this review first assesses the state of the evidence on the direct harms of ENDS and the indirect effects of ENDS use on smoking, particularly rates of initiation and cessation. After that, the example of flavor restrictions is used to demonstrate the further considerations that are involved in applying the Population Health Standard to a prospective ENDS policy. Implications This narrative review aims to inform regulatory considerations about ends through the prism of the population health standard. More specifically, this review: 1) describes and explains the importance of this approach; 2) provides guidance on evaluating the state of the evidence linking ends to the net population harm associated with non-therapeutic nicotine products; and 3) illustrates how this framework can inform policymaking using the example of flavor restrictions.

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Are strong tobacco control policies associated with bans on the retail sales of electronic nicotine delivery systems?

Tobacco Induced Diseases ◽

10.18332/tid/84007 ◽

2018 ◽

Vol 16 (1) ◽

Author(s):

Alex Liber ◽

Ryan Kennedy

Keyword(s):

Tobacco Control ◽

Delivery Systems ◽

Retail Sales ◽

Control Policies ◽

Electronic Nicotine Delivery Systems ◽

Nicotine Delivery ◽

Tobacco Control Policies

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Electronic nicotine delivery systems - new challenge for tobacco control policy: results from Russian tobacco control policy evaluation study

10.1183/13993003.congress-2018.pa4549 ◽

2018 ◽

Author(s):

Marine Gambaryan ◽

Marina Popovich ◽

Michail Starovoytov ◽

Anna Kalinina ◽

Oxana Drapkina ◽

...

Keyword(s):

Tobacco Control ◽

Policy Evaluation ◽

Control Policy ◽

Evaluation Study ◽

Delivery Systems ◽

Tobacco Control Policy ◽

Electronic Nicotine Delivery Systems ◽

Nicotine Delivery

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The impact of price and tobacco control policies on the demand for electronic nicotine delivery systems

Tobacco Control ◽

10.1136/tobaccocontrol-2013-051515 ◽

2014 ◽

Vol 23 (suppl 3) ◽

pp. iii41-iii47 ◽

Cited By ~ 67

Author(s):

Jidong Huang ◽

John Tauras ◽

Frank J Chaloupka

Keyword(s):

Tobacco Control ◽

Delivery Systems ◽

Control Policies ◽

Electronic Nicotine Delivery Systems ◽

Nicotine Delivery ◽

Tobacco Control Policies ◽

The Impact

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Research support for effective state and community tobacco control programme response to electronic nicotine delivery systems

Tobacco Control ◽

10.1136/tobaccocontrol-2013-051460 ◽

2014 ◽

Vol 23 (suppl 3) ◽

pp. iii54-iii57 ◽

Cited By ~ 11

Author(s):

Carol L Schmitt ◽

Youn Ok Lee ◽

Laurel E Curry ◽

Matthew C Farrelly ◽

Todd Rogers

Keyword(s):

Tobacco Control ◽

Delivery Systems ◽

Control Programme ◽

Research Support ◽

Electronic Nicotine Delivery Systems ◽

Nicotine Delivery

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International expert consensus on electronic nicotine delivery systems and heated tobacco products: a Delphi survey

BMJ Open ◽

10.1136/bmjopen-2020-045724 ◽

2021 ◽

Vol 11 (9) ◽

pp. e045724

Author(s):

Ivan Berlin ◽

Isabelle Jacot-Sadowski ◽

Jean-Paul Humair ◽

Jacques Cornuz

Keyword(s):

Smoking Cessation ◽

Tobacco Control ◽

Delivery Systems ◽

Consumer Products ◽

Delphi Survey ◽

Cross Sectional Survey ◽

Tobacco Products ◽

Electronic Nicotine Delivery Systems ◽

Nicotine Delivery ◽

International Experts

ObjectivesTo provide a consensus from a panel of international experts about electronic nicotine delivery systems (ENDS) and heated tobacco products (HTP).DesignCross-sectional survey.MethodsA Delphi survey was conducted among international experts in tobacco control and smoking cessation. The first part addressed statements or recommendations about ENDS, the second about HTP, both divided into four categories: regulation, sale, use and general issues.SettingExperts from 15 countries.ParticipantsIndividuals with clinical, public health or research expertise in tobacco control and/or smoking cessation.Results268 experts were contacted, 92 (34%) completed the first, 55/92 (60%) the second round. Consensus for ENDS: components of e-liquids, an upper limit of nicotine concentration should be defined; a warning on the lack of evidence in long-term safety and addiction potential should be stated; ENDS should not be regulated as consumer products but either as a new category of nicotine delivery or tobacco products; ENDS should not be sold in general stores but in specialised shops, shops selling tobacco or in pharmacies with restriction on sale to minors; administration of illegal drugs is likely with ENDS. Consensus for HTP: HTP have the same addictive potential as cigarettes; they should be regulated as a tobacco product with similar warning messages as cigarettes; their advertisement should not be allowed. ENDS and HTP use should not be allowed in indoor public places; a specific tax should be implemented for ENDS, taxes on HTP should not be lower than those for cigarettes; use of cigarettes is more likely with both ENDS and HTP (dual use) than quitting smoking.ConclusionsExperts in tobacco control and/or smoking cessation recommend differential regulation for ENDS and HTP. The results of this survey may be useful for health authorities, decision makers and researchers of the tobacco use and cessation field.

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Perceptions and Use of Electronic Nicotine Delivery Systems Among Floridian Middle and High School Students: Secondary Analysis of Cross-sectional Survey Results

Tobacco Use Insights ◽

10.1177/1179173x20953402 ◽

2020 ◽

Vol 13 ◽

pp. 1179173X2095340

Author(s):

Anastasiya Ferrell ◽

Linda Hadddad ◽

Jennifer Harrison Elder ◽

Cyndi Garvan ◽

Christa L Cook ◽

...

Keyword(s):

High School ◽

High School Students ◽

Secondary Analysis ◽

Delivery Systems ◽

The State ◽

School Students ◽

Cross Sectional ◽

Electronic Nicotine Delivery Systems ◽

Nicotine Delivery ◽

Minimum Age

Introduction: Rapid increase in youth use of Electronic Nicotine Delivery Systems (ENDS) led the state and the federal governments to implement minimum-age policies to restrict minors’ access to vaping products. Limited success of the age restrictions fueled efforts to increase the distribution age of all tobacco products to 21 (ie, Tobacco 21 or T21 policies). With limited data on the T21 policies, the current study examines the prevalence of ENDS use and the perceptions about ENDS among youth in the pre- and post-policy-implementation periods for one of these bans in the state of Florida. Methods: This study conducted secondary analysis on the responses from the 2014 and 2015 Florida Youth Tobacco Survey, which collected cross-sectional data. Results: Compared to the data from spring of 2014, the minimum-age policy enacted on July 1, 2014 did not lead to a significant decrease in Florida’s high school and middle school students’ ever ENDS use (14.9% in 2014 vs 25.8% in 2015) and current ENDS use (7.5% in 2014 vs 12.4% in 2015). There was some ambiguity among students regarding the ENDS harm—more students in 2015 thought of ENDS as both equally (11.0% vs 7.7%) and less (32.4% vs 28%) harmful than cigarettes. There was a decrease in the proportion of students who were unsure about their answer to this question (51.5% vs 59.2%). Conclusions: Policy change alone may not be effective in shifting the trend of ENDS use among middle and high school students. Although students may know about some of the ENDS effects, many of them are still not aware about the harms. Interventions in school and in the community should be aiming to raise this awareness.

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