TY - JOUR
T1 - Critical appraisal of the European Union Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) Preliminary Opinion on electronic cigarettes
AU - the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR)
AU - O’Leary, Renée
AU - Polosa, Riccardo
AU - Li Volti, Giovanni
AU - Alaimo, Salvatore
AU - Anfuso, Carmelina Daniela
AU - Barbagallo, Ignazio
AU - Basile, Francesco
AU - Battiato, Sebastiano
AU - Bertino, Gaetano
AU - Bianchi, Alberto
AU - Biondi, Antonio G.
AU - Brandi, Maria Luisa
AU - Cacciola, Emma
AU - Cacciola, Rossella R.
AU - Cacopardo, Bruno Santi
AU - Calogero, Aldo E.
AU - Cambria, Maria Teresa
AU - Campagna, Davide
AU - Caraci, Filippo
AU - Cariola, Agatino
AU - Caruso, Massimo
AU - Caponnetto, Pasquale
AU - Cibella, Fabio
AU - Di Mauro, Maurizio
AU - Di Nuovo, Santo
AU - Di Stefano, Adriana
AU - Drago, Filippo
AU - Failla, Salvatore
AU - Faraci, Rosario
AU - Ferlito, Salvatore
AU - Ferrante, Margherita
AU - Ferro, Alfredo
AU - Ferro, Giancarlo A.
AU - Frasca, Francesco
AU - Frittitta, Lucia
AU - Furneri, Pio M.
AU - Gallo, Giovanni
AU - Galvano, Fabio
AU - Gagliano, Antonio
AU - Grasso, Giuseppe
AU - Guarino, Francesca
AU - Gulino, Antonino
AU - Jannini, Emmanuele A.
AU - Vignera, Sandro L.A.
AU - Lazzarino, Giuseppe
AU - Longo, Antonio
AU - Lupo, Gabriella
AU - Malerba, Mario
AU - Marletta, Luigi
AU - Nicolosi, Guido
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: In preparation for the 2021 revision of the European Union Tobacco Products Directive, the Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) has posted its Preliminary Opinion on Electronic Cigarettes. They concluded that e-cigarettes only achieve a sub-optimal level of protection of human health. In this paper, we provide evidence that the Opinion’s conclusions are not adequately backed up by scientific evidence and did not discuss the potential health benefits of using alternative combustion-free nicotine-containing products as substitute for tobacco cigarettes. Methods: Searches for articles were conducted in PubMed and by citation chasing in Google Scholar. Articles were also retrieved with a review of references in major publications. Primary data from World Health Organization surveys, the conclusions of reviews, and peer-reviewed non-industry studies were cited to address errors and omissions identified in the Opinion. Results: The Opinion omitted reporting on the individual and population health benefits of the substitution of e-cigarettes (ENDS) for cigarette smoking. Alternative hypotheses to the gateway theory were not evaluated. Its assessment of cardiovascular risk is contradicted by numerous reviews. It cites ever-use data that do not represent current patterns of use. It did not report non-nicotine use. It presented erroneous statements on trends in ENDS prevalence. It over-emphasized the role of flavours in youth ENDS initiation. It did not discuss cessation in sufficient length. Conclusions: For the delivery of a robust and comprehensive final report, the members of the Working Group of the Scientific Committee on Health, Environmental and Emerging Risks will need to consider (1) the potential health benefits of ENDS substitution for cigarette smoking, (2) alternative hypotheses and contradictory studies on the gateway effect, (3) its assessment of cardiovascular risk, (4) the measurements of frequency of use, (5) non-nicotine use, (6) the role of flavours, and (7) a fulsome discussion of cessation.
AB - Background: In preparation for the 2021 revision of the European Union Tobacco Products Directive, the Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) has posted its Preliminary Opinion on Electronic Cigarettes. They concluded that e-cigarettes only achieve a sub-optimal level of protection of human health. In this paper, we provide evidence that the Opinion’s conclusions are not adequately backed up by scientific evidence and did not discuss the potential health benefits of using alternative combustion-free nicotine-containing products as substitute for tobacco cigarettes. Methods: Searches for articles were conducted in PubMed and by citation chasing in Google Scholar. Articles were also retrieved with a review of references in major publications. Primary data from World Health Organization surveys, the conclusions of reviews, and peer-reviewed non-industry studies were cited to address errors and omissions identified in the Opinion. Results: The Opinion omitted reporting on the individual and population health benefits of the substitution of e-cigarettes (ENDS) for cigarette smoking. Alternative hypotheses to the gateway theory were not evaluated. Its assessment of cardiovascular risk is contradicted by numerous reviews. It cites ever-use data that do not represent current patterns of use. It did not report non-nicotine use. It presented erroneous statements on trends in ENDS prevalence. It over-emphasized the role of flavours in youth ENDS initiation. It did not discuss cessation in sufficient length. Conclusions: For the delivery of a robust and comprehensive final report, the members of the Working Group of the Scientific Committee on Health, Environmental and Emerging Risks will need to consider (1) the potential health benefits of ENDS substitution for cigarette smoking, (2) alternative hypotheses and contradictory studies on the gateway effect, (3) its assessment of cardiovascular risk, (4) the measurements of frequency of use, (5) non-nicotine use, (6) the role of flavours, and (7) a fulsome discussion of cessation.
KW - ENDS
KW - European Union Tobacco Products Directive
KW - Gateway
KW - Risk assessment
KW - SCHEER
KW - Tobacco harm reduction
KW - e-cigarettes
UR - http://www.scopus.com/inward/record.url?scp=85102524335&partnerID=8YFLogxK
U2 - 10.1186/s12954-021-00476-6
DO - 10.1186/s12954-021-00476-6
M3 - Article
SN - 1477-7517
VL - 18
JO - Harm Reduction Journal
JF - Harm Reduction Journal
IS - 1
M1 - 31
ER -
