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E-cigarette, Changing Paradigm: ‘Trojan Horse’ or ‘Harm Reduction’
J Korean Soc Res Nicotine Tob 2018; 9(2): 61-70
Published online December 15, 2018
© 2018 The Korean Society for Research on Nicotine and Tobacco.

Yoo-Seock Cheong*

Department of Family Medicine, Dankook University College of Medicine, Cheonan, Korea
Correspondence to: 정유석
단국대학교 의과대학 가정의학교실 천안시 동남구 단대로 119 (우) 31116
Tel: 041-550-6952 Fax: 041-550-6955 E-mail: drloved@hanmail.net
Received November 1, 2018; Revised December 11, 2018; Accepted December 12, 2018.
 Abstract
There is ongoing debate within the public health community as to whether e-cigarettes have a potential role in smoking cessation; whether use of e-cigarettes can reduce harm for individual users; whether widespread use of the devices has the potential to reduce or increase population-level harm; and how best to regulate e-cigarettes to minimize both individual and population-level harm. but Although the long-term effects of e-cigarette use are not known, producing nicotine aerosol from a solution rather than by burning tobacco gives rise to fewer harmful substances than cigarette smoke does to smokers and non-smokers. Because of the likely lesser health risks associated with vaping, some experts advocate wider availability and softer regulation, and see e-cigarettes as holding great potential to help smokers quit or switch to a harm-reducing way to consume nicotine. Others argue that it is not sound public health policy to allow e-cigarettes onto the market until such time as robust evidence is available supporting the safety of e-cigarettes and their efficacy in reducing harm. They cite the addictiveness of nicotine, and the potential for harm from ongoing use of e-cigarettes compared with complete cessation of all nicotine and tobacco products. Other serious issues include the possibilities that e-cigarette use might promote nicotine use among non-smokers, especially children; serve to renormalise smoking; or serve as a gateway to the use of combustible cigarettes or illicit drugs. On the bases of the scientific evidence on e-cigarette, this article explore benefits and harms to public health to guide practice, policy, and regulation through reviewing two major reports and special debate articles. A reframing of societal nicotine use through the lens of ‘harm reduction’ is an extraordinary opportunity to enhance the impact of tobacco control efforts in Korea.
Keywords : E-cigarette; Harm reduction
References
  1. House of Commons, Science and technology committee. E-cigarettes seventh report of session 2017-19. 2018 July 16.
  2. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems; Eaton DL, Kwan LY, Stratton K, editors. Public Health Consequences of E-cigarette. Washington (DC): National Academies Press (US); 2018 Jan 23.
  3. Glantz SA, Bareham DW. E-cigarettes: Use, effects on smoking, risks, and policy implications. Annu. Rev. Public Health 2018; 39: 215-35.
    Pubmed KoreaMed CrossRef
  4. Lee S, Grana R, Glantz S. Electronic cigarette use among Korean adolescents : a cross-sectional study of market penetration, dual use, and relationship to quit attempts and former smoking. J. Adolesc. Health 2014; 54: 684-90.
    Pubmed KoreaMed CrossRef
  5. Dutra LM, Glantz SA. Electronic cigarettes and conventional cigarette use among U.S. adolescents: a cross-sectional study. JAMA Pediatr. 2014; 168: 610-17.
    Pubmed KoreaMed CrossRef
  6. Singh T, Arrazola RA, Corey CG, Husten CG, Neff LJ, et al. 2016. Tobacco use among middle and high school students-United States, 2011-2015. MMWR 65: 361-67.
    CrossRef
  7. Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013; 382: 1629-37.
    CrossRef
  8. Kalkhoran S, Glantz SA. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir. Med. 2016; 4: 116-28.
    CrossRef
  9. Talal A, Pena I, Temesgen N, Glantz SA. 2018. Association between electronic cigarette use and myocardial infarction: results from the 2014 and 2016 National Health Interview Surveys. Presented at Annu. Meet. Res. Nicotine Tob., 24th, Baltimore, MD
  10. Abrams DB, Glasser AM, Pearson JL, Villanti AC, Collins LK, Niaura RS. Harm minimization and tobacco control: Reframing societal views of nicotine use to rapidly save lives. Annu. Rev. Public Health 2018; 39:193-213.
    Pubmed CrossRef
  11. US Dep. Health Hum. Serv. 2017. FDA announces comprehensive regulatory plan to shift trajectory of tobacco-related disease, death. News Release, July 28. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm568923.htm
  12. Polosa R, Morjaria JB, Caponnetto P, Caruso M, Campagna D, et al. Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes. Discov. Med. 2016; 21: 99-108.
    Pubmed
  13. Polosa R, Campagna D, Sands MF. 2016. Counseling patients with asthma and allergy about electronic cigarettes: an evidence-based approach. Ann. Allergy Asthma Immunol. 116: 106-11.
    Pubmed CrossRef
  14. RPC (R. Coll. Phys.). 2016. Nicotine Without Smoke: Tobacco Harm Reduction. London: RPC.
  15. Strong DR, Pearson J, Ehlke S, Kirchner TR, Abrams D, et al. Indicators of dependence for different types of tobacco product users: descriptive findings from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study. Drug Alcohol. Depend. 2017; 178:257-66.
    Pubmed CrossRef
  16. Russell C, McKeganey N. 2017. Patterns of cigarette smoking and e-cigarette use among 20,676 adult frequent e-cigarette users in the United States. Cent. Subst. Use Res., Glasgow, UK. http://substanceuseresearch.org/usvaperssurvey
  17. Warner K. The remarkable decrease in cigarette smoking by American youth: further evidence. Prev. Med. Rep 2015; 2: 259-61.
    Pubmed KoreaMed CrossRef
  18. Bauld L, MacKintosh AM, Ford A, McNeill A. E-cigarette uptake amongst UK youth: experi￾mentation, but little or no regular use in nonsmokers. Nicotine Tob. Res. 2016; 18: 102-3.
    Pubmed
  19. Friedman AS. How does electronic cigarette access affect adolescent smoking? J. Health Econ. 2015; 44: 300-8.
    Pubmed CrossRef
  20. Pesko MF, Currie JM. The effect of e-cigarette minimum legal sale age laws on traditional cigarette use and birth outcomes among pregnant teenagers. NBER Work. 2016. Pap. 22792.
  21. Giovenco DP, Delnevo CD. Prevalence of smoking cessation by electronic cigarette use status in a national sample of recent smokers. Addict Behav 2018; 76: 129-34.
    Pubmed CrossRef
  22. Levy DT, Yuan Z, Luo Y, Abrams DB. 2017. The relationship of e-cigarette use to cigarette quit attempts and cessation: insights from a large, nationally representative U.S. survey. Nicotine Tob. Res. https://doi.org/10.1093/ntr/ntx166
    CrossRef
  23. Parks SH, Duncan DT, Shahawy OE, Lee L, Shearston JA, et al. Characteristics of adults who switched from cigarette smoking to e-cigarettes. Am. J. Prev. Med. 2017; 53(5): 652-60.
    Pubmed KoreaMed CrossRef
  24. Zhu S-H, Zhuang Y-L, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys. BMJ 2017; 358: j3262.
    Pubmed KoreaMed CrossRef
  25. Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, et al. Overview of electronic nicotine delivery systems: a systematic review. Am. J. Prev. Med. 2017; 52: e33-66.
    Pubmed KoreaMed CrossRef
  26. Villanti AC, Johnson AL, Ambrose BK, Cummings KM, Stanton CA, et al. Flavored tobacco product use in youth and adults: findings from the first wave of the PATH study (2013-2014). Am. J. Prev. Med. 2017;53: 139-51.
    Pubmed KoreaMed CrossRef
  27. Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, et al. Overview of electronic nicotine delivery systems: a systematic review. Am. J. Prev. Med. 2017; 52: e33-66.
    Pubmed KoreaMed CrossRef
  28. Biener L, Hargraves JL. A longitudinal study of electronic cigarette use among a population-based sample of adult smokers: association with smoking cessation and motivation to quit. Nicotine Tob. Res. 2015; 17:127-33.
    Pubmed KoreaMed CrossRef
  29. Farsalinos KE, Poulas K, Voudris V, Le Houezec J. Electronic cigarette use in the European Union: analysis of a representative sample of 27,460 Europeans from 28 countries Addiction 2016; 111(11):2032-40.
    Pubmed CrossRef
  30. Levy DT, Borland R, Lindblom EN, Goniewicz ML, Meza R, et al. 2017. Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tob Control 2017; 27: 18-25.
    Pubmed KoreaMed CrossRef
  31. Chapman S. Should e-cigarettes be as freely available as tobacco cigarettes? No. BMJ 2013; 346: f3840
    Pubmed CrossRef
  32. Siegel M. As E-Cigarettes Re-normalize Smoking, Adult Smoking Prevalence in 2015 Plummets. The Rest of the Story: Tobacco News analysis and Commentary. Sept. 3, 2015.
  33. Rodu Brad. 30 Million U.S. Adults Have Used E-Cigarettes, Unpublicized CDC Data Reveals. Tobacco Truth. July 14, 2015.