Electronic nicotine delivery systems: the need for continued regulatory innovation

2021 ◽  
pp. tobaccocontrol-2021-056622
Author(s):  
Brian J Miller ◽  
Andrew B Meshnick ◽  
Boris D Lushniak
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Product Distribution ◽  
Tobacco Product ◽  
Delivery Systems ◽  
Electronic Nicotine Delivery Systems ◽  
The Public ◽  
Nicotine Concentration ◽  
Nicotine Delivery ◽  
Reduction Approach

The recent surge in electronic nicotine delivery systems (ENDS) or electronic cigarette use among both adolescents and adults challenged tobacco regulatory frameworks worldwide. In this article, we review recent US Food and Drug Administration regulatory approaches to tobacco products, including attempts to regulate nicotine concentration and address youth use. We examine recent drives to promote a harm reduction approach in other product markets such as opioids, where the use of methadone and related therapies promote the public health. We describe the potential of a harm reduction framework for ENDS regulation based on tiered nicotine exposure standards coupled with risk-based product distribution controls that would enable ENDS products to meet the ‘Appropriate for the Protection of the Public Health’ standard required for tobacco product market entry. A harm reduction approach to ENDS regulation could help countries achieve the laudable public health goals of transitioning existing combustion cigarette users to ENDS products while preventing adolescent ENDS use and subsequent nicotine addiction.

Government intervention in the market for electronic nicotine delivery systems (ENDS). The known, the unknown and challenges

2020 ◽  
Vol 20 (3) ◽  
pp. 283-294
Author(s):  
Ayda A. Yurekli ◽  
Patricia Kovacevic ◽  
Emil Sunley ◽  
Karthik Ranganathan
Keyword(s):  
Simulation Analysis ◽  
Health Impact ◽  
Delivery Systems ◽  
Economic Research ◽  
Electronic Nicotine Delivery Systems ◽  
Content Type ◽  
The Public ◽  
Premature Deaths ◽  
Nicotine Delivery ◽  
The Impact

Purpose This paper aims to describe the various government measures that regulate the market for novel tobacco harm reduction products (THRPs), with an emphasis on e-cigarettes [electronic nicotine delivery systems (“ENDS”)], and evaluates the public health impact of excise taxes levied on these products. Design/methodology/approach The paper reviews the economic research on the impact ENDS. Using cited evidence, the paper compares the tax treatment of ENDS and cigarettes and provides a simulation of potential lives that can be saved under alternative tax treatment of ENDS. Findings ENDS are considerably less harmful than cigarettes. Imposing the same tax burden on them (per unit of “harm”) as on cigarettes leads to poorer health outcomes. Differential tax treatment of ENDS will encourage more cigarette smokers to switch to ENDS and could save millions of lives worldwide. Research limitations/implications Country experiences with regulatory measures on ENDS are limited to those with high THRP penetration. The paper’s simulation analysis used evidence from a limited number of studies. Rigorous economic analysis is needed to understand how ENDS could save lives and could prevent expected one billion premature deaths by the end of this century. Originality/value The paper uses research evidence in its analysis of the impact that the differential taxation of cigarettes and ENDS would have. It also provides a rough estimate of the number of lives that could be saved if more smokers who are trying to quit can make the switch to ENDS.

Electronic Nicotine Delivery Systems

2017 ◽  
pp. 4-12
Author(s):  
Keyword(s):  
Electronic Cigarettes ◽  
Child Death ◽  
Tobacco Product ◽  
Delivery Systems ◽  
Handheld Devices ◽  
Poison Control ◽  
Electronic Nicotine Delivery Systems ◽  
Legislative Action ◽  
Nicotine Delivery ◽  
New Generation

Electronic nicotine delivery systems (ENDS) are rapidly growing in popularity among youth. ENDS are handheld devices that produce an aerosolized mixture from a solution typically containing concentrated nicotine, flavoring chemicals, and propylene glycol to be inhaled by the user. ENDS are marketed under a variety of names, most commonly electronic cigarettes and e-cigarettes. In 2014, more youth reported using ENDS than any other tobacco product. ENDS pose health risks to both users and nonusers. Nicotine, the major psychoactive ingredient in ENDS solutions, is both highly addictive and toxic. In addition to nicotine, other toxicants, carcinogens, and metal particles have been detected in solutions and aerosols of ENDS. Nonusers are involuntarily exposed to the emissions of these devices with secondhand and thirdhand aerosol. The concentrated and often flavored nicotine in ENDS solutions poses a poisoning risk for young children. Reports of acute nicotine toxicity from US poison control centers have been increasing, with at least 1 child death reported from unintentional exposure to a nicotine-containing ENDS solution. With flavors, design, and marketing that appeal to youth, ENDS threaten to renormalize and glamorize nicotine and tobacco product use. There is a critical need for ENDS regulation, legislative action, and counter promotion to protect youth. ENDS have the potential to addict a new generation of youth to nicotine and reverse more than 50 years of progress in tobacco control.

Discussions and Misinformation about Electronic Nicotine Delivery Systems and COVID-19 on Twitter (Preprint)

2020 ◽  
Author(s):  
Jaime Sidani ◽  
Beth Hoffman ◽  
Jason Colditz ◽  
Riley Wolynn ◽  
Lily Hsiao ◽  
...  
Keyword(s):  
Public Health ◽  
Delivery Systems ◽  
Early Presentation ◽  
Conspiracy Theories ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Ideal Tool ◽  
Use Behavior ◽  
Electronic Delivery ◽  
Health Messaging

BACKGROUND There exists an alarming amount of misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS). Some of this may stem from early reports suggesting a lower risk of severe COVID-19 in nicotine users. Additionally, a common conspiracy is that the E-cigarette, or Vaping Product Use-Associated Lung Injury (EVALI) outbreak of 2019 was actually an early presentation of COVID19 disease. This may have severe public health ramifications for both COVID-19 control and electronic delivery systems (ENDS) use. OBJECTIVE Twitter is an ideal tool for analyzing real-time public discussions related to both ENDS and COVID-19. This study sought to collect and classify Twitter messages (“tweets”) related to ENDS and COVID-19 to inform public health messaging. METHODS Approximately 2.1 million tweets matching ENDS-related keywords were collected from 3/1/2020 through 6/30/2020 and were then filtered for COVID-19-related keywords, resulting in 67,321 original tweets. A 5% subsample (n=3,366) was obtained for human coding using a systematically- developed codebook. Tweets were coded for relevance to the topic and four overarching categories. RESULTS A total of 1,930 (57.3%) tweets were coded as relevant to the research topic. Half (52.2%) of these discussed an association between ENDS use and COVID-19 susceptibility or severity, with 42.4% suggesting that ENDS use is associated with worse COVID-19 symptoms. One-quarter (24.8%) of tweets discussed the similarity/dissimilarity of COVID-19 and EVALI, and 13.8% discussed ENDS use behavior. Misinformation and conspiracy theories were present throughout all coding categories. CONCLUSIONS Discussions about ENDS use and COVID-19 on Twitter frequently highlight concerns about the susceptibility and severity of COVID-19 for ENDS users, however, many contain misinformation and conspiracy theories. Public health messaging should capitalize on these concerns and amplify accurate Twitter messaging.

scholarly journals Targeted Education for School Staff on Electronic Nicotine Delivery Systems: A Nurse Led Intervention

2021 ◽  
pp. 105984052110431
Author(s):  
Lorraine M. Smith ◽  
Lindsey Boehm ◽  
Lyndsey V. Strang ◽  
Chelsea DeMarre ◽  
Diane Marcyjanik
Keyword(s):  
Public Health ◽  
Educational Intervention ◽  
Electronic Cigarettes ◽  
Delivery Systems ◽  
School Staff ◽  
Electronic Nicotine Delivery Systems ◽  
Proactive Approach ◽  
Nicotine Delivery ◽  
Post Test ◽  
Level Of Knowledge

There is a public health epidemic in adolescents’ use of Electronic Nicotine Delivery Systems (ENDSs), also known as electronic cigarettes, vaping products, or JUULs. However, little is known about the level of knowledge school staff have about ENDS. The purpose of this study is to examine outcomes of a nurse-led educational intervention designed to increase school staff knowledge about ENDS. A descriptive, nonrandomly selected pre-test/post-test design was used with 125 Wisconsin school staff. Results revealed further educational needs of school staff in content areas including advertising to youth and flavoring of ENDS. Following the educational intervention, post-test results showed a significant overall improvement in participant knowledge scores. Recommendations include implementing nurse-led education about ENDS to a more diverse population of school staff. Providing nurse-led ENDS education to school staff offers an upstream, proactive approach for school nurses to help address this public health epidemic.

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