June 15, 2014

Stanton A. Glantz, PhD

129 public health and medical authorities from 31 countries write WHO DG Chan urging evidence-based approach to ecigs

The following letter, signed by 129 public health and medical experts from 31 countries, representing every WHO region,  was delivered to WHO Director General Margaret Chan earlier today.  (PDF of letter)
I also submitted the letter to the FDA dockett on e-cigs; the tracking number is 1jy-8cp3-dzmg.
June 16, 2014
Dr. Margaret Chan
Director General
World Health Organization
Dear Dr. Chan,
We, the 129 signatories to this letter, are writing to express our support for WHO’s evidence-based approach to determine the best way forward for public health to respond to Electronic Nicotine Delivery Systems (ENDS), as expressed in WHO's June 3, 2014 statement.[1]
Recently, media attention was focused on a statement by a group of “specialists in nicotine science and public health policy.”[2] Unfortunately, the statement makes several assertions about ENDS’ marketing, emissions, harms, and use that are either contradicted by available evidence or for which no evidence is currently available. (Indeed, the statement does not cite a single scientific study.)
The statement also included several policy recommendations, including effectively exempting ENDS from FCTC Articles 8 and 13 and ignoring Article 5.3.
It is fundamental that WHO and other public health authorities not buy into the tobacco industry's well-documented strategy of presenting itself as a "partner."[3] If the tobacco industry was committed to reducing the harm caused by tobacco use, it would announce target dates to stop manufacturing, marketing and selling its "more harmful" products rather than simply adding e-cigarettes to its product mix and rapidly taking over the e-cigarette market.[4]-[5] It would also immediately desist from its aggressive opposition to tobacco control policies such as tax increases, graphic health warnings and plain packaging.
By moving into the e-cigarette market, the tobacco industry is only maintaining its predatory practices and increasing profits. As stated in the guidelines for Article 5.3 of the WHO FCTC, there is a “fundamental and irreconcilable conflict of interest” between the tobacco industry’s interests and public health’s interests.”[6]
Public health embraced cigarette filters and “low tar” cigarettes as harm reduction strategies before manufacturers provided evidence and at a time when the manufacturers were well aware that these technologies did not actually reduce harm but were designed to promote cigarette sales by reassuring a concerned public that the new products were safer.[7]-[8] The negative consequences of these acts remain in cancer and heart disease hospital wards throughout the world. Ignoring the link between ENDS and the tobacco industry is overlooking the WHO FCTC Parties’ legal obligation to protect government policies against tobacco industry interference.
The aggressive marketing and promotion of e-cigarettes to youth is well-documented[9]-[10]-[11]-[12] and evidence from the US[13]-[14] and Korea[15] shows rapid growth in youth e-cigarette use, including disturbing rates among youth who have never smoked a cigarette. One e-cigarette manufacturer warns parents that “kids may be particularly vulnerable” to the flavoring in its products.[16]
Manufacturers of ENDS are making a range of false and unproven claims,[17]-[18]-[19] misleading the public into thinking these products are harmless (they are not) and effective cessation aids (unknown). Most ENDS users are "dual users" who continue to smoke cigarettes.[20] Reviews of evidence about reducing smoking (instead of quitting) show that dual users are unlikely to see any health benefit in terms of cardiovascular disease.[21]-[22] Population studies of all smokers consistently show that smokers who use ENDS are less likely to stop smoking.[23]-[24]-[25]-[26]-[27]-[28]
The evidence is insufficient to accept the assertions that ENDS are effective as a smoking cessation device. There is a single randomized controlled trial of early generation e-cigarettes that found no difference between ENDS delivered directly to experimental subjects compared with mailing subjects a voucher that they could take to a pharmacy to obtain nicotine replacement therapy.[29] One population-based cross-sectional study found that highly motivated smokers using ENDS to quit were less likely to be still smoking than smokers making unassisted quit attempts with over-the-counter NRT.[30] However, this cross-sectional study[31] showed a point prevalence of 80% of smokers using ENDS in a cessation attempt having failed, compared to 84.6% of those who tried to quit unassisted. Significantly, the former study is biased against conventional therapy (because of the additional barrier to getting the NRT) and the latter did not report a comparison with well-supervised approved cessation therapies.
There is already good evidence that ENDS emissions release several toxic substances into the environment that cause harm to health.  These substances include ultrafine particles, propylene glycol, tobacco-specific nitrosamines; nicotine; volatile organic compounds (VOCs), and carcinogens and reproductive toxins, including benzene, lead, nickel, and others.[32]-[33]-[34]-[35]-[36]-[37]-[38]-[39]-[40] Proposals to allow ENDS use in indoor spaces like workplaces, bars and transportation could see significant exposure to these substances.
It is important to note that nicotine itself is not harmless, which is why strict regulatory measures are in place to control the marketing of Nicotine Replacement Therapy for smoking cessation. The 2014 U.S. Surgeon General Report includes an extensive review of acute and long-term effects of nicotine exposure. It concludes, among other things, that nicotine exposure has adverse effects on fetal growth and development, including fetal brain development.[41] The manufacturer of one electronic cigarette in the U.S. acknowledges in its product labeling that nicotine is not harmless.[42] Acute poisoning from nicotine is well established, and there has been an increase in documented cases of children being accidentally poisoned by ingesting the liquid content of ENDS cartridges.[43]
Remaining unregulated, risk profiles and potential harms these products may pose to the public are unknown. The absence of detailed evidence on adverse health effects is not evidence that no effect exists. Rather, insufficient time has elapsed to determine what effects exist and their magnitude on a population level. 
Manufacturers have not secured regulatory approval for claims that ENDS are effective products for smoking cessation or harm reduction from regulatory authorities in any country. From a population perspective, it is important to know what new risks a consumer product may introduce in the market.
We applaud WHO’s commitment to listen to the experience from Member States that have successfully implemented tobacco control and regulated sales, marketing and use of ENDS. Implementation of the WHO FCTC by its 178 parties demonstrates great progress in decreasing the harm caused by tobacco use and decreasing the burden from NCDs.
There is evidence of success from many countries, including Australia, Brazil and Turkey. The former prohibits import and sales of cartridges containing nicotine, the latter two banned import, sales and marketing of e-cigarettes until, and unless, manufacturers present safety information.
Both scientific evidence and best practices are available to support a regulatory framework that will best prevent initiation of use among youth and other non-tobacco users, protect bystanders in public areas from involuntary exposure, regulate marketing, and prohibit unsubstantiated claims.
Such a regulatory framework would require manufacturers to present safety and efficacy data. In this case, the use of these products as cessation aids (if the evidence supports such use) would operate under the supervision of a health authority that could control manufacturers’ claims, impose health warnings about risks, require disclosure of ingredients and safety data and regulate product engineering as well as mandate surveillance.
This is the path that the WHO has been pursuing and encouraging. We urge you to continue doing so.
Professor Özdemir Aktan
Turkish Medical Association
Professor Kristina Alexanderson
Peter Allebeck
Professor of Social Medicine
Department of Public Health Sciences
Karolinska Institute
Alberto Jose de Araujo MD, PhD
Nucleus of Research on Tobacco Treatment
Thorax Diseases Institute
Federal University of Rio de Janeiro
Dr. Monika Arora PhD, MSc (PH), MSc (CD)
Director, Health Promotion &
Adjunct Associate Professor
Public Health Foundation of India &
Executive Director
HRIDAY (Health Related Information Dissemination Amongst Youth)
Carlos M. Artundo MD
EASP, Andalusian School of Public Health
Professor John Ashton CBE
President, UK Faculty of Public Health
United Kingdom
Dr Ozen Asut
Associate Professor of Public Health
Former President of the Turkish Medical Association
Former member of Hacettepe University Medical Faculty
Editor, "Continuing Medical Education Journal" of the Turkish Medical Association
Professor Rifat Atun
Professor of Global Health Systems
Director, Global Health Systems Cluster
Department of Global Health and Population
Harvard School of Public Health
Harvard University
Dileep G Bal MD  MS MPH
Founder/Director of California's Tobacco Control Program (1981 to 2005)
Former American Cancer Society President (2000-2001)
Kauai District Health Officer,
Special Advisor to the Director on Tobacco and Chronic Disease,
Hawai’i State Department of Health.
Clinical Professor, Hawai’i Cancer Center and College of Medicine,
University of Hawaii
Robert L Balster PhD
Butler Professor of Pharmacology and Toxicology
Research Professor of Psychology and Psychiatry
Co-Director, Center for the Study of Tobacco Products
Virginia Commonwealth University
Richmond, VA
Joaquin Barnoya MD
Research Director 
Unidad de Cirugia Cardiovascular de Guatemala
Robert Beaglehole MD
Professor Emeritus
University of Auckland
Chair, Lancet NCD Action Group
New Zealand
Jay E Berkelhamer MD FAAP
Adjunct Professor of Pediatrics, Emory University School of Medicine
Adjunct Clinical Professor of Pediatrics
Morehouse College of Medicine Past President (2006-2007)
American Academy of Pediatrics
Dr Mitchel Blair
Officer for Health Promotion
Royal College of Paediatrics and Child Health
United Kingdom
Ruth Bonita MPH PhD MD (hon)
Emeritus Professor
University of Auckland
New Zealand
Helmut Brand
Jean Monnet Professor in European Public Health
Head of the Department of International Health
President EHFG (European Health Forum Gastein)
Past President ASPHER (Association of Schools of Public Health in the European Region)
Maastricht University
The Netherlands
Professor Sir Harry Burns
Prof of Global Health
University of Strathclyde
Former Scottish Chief Medical Officer
United Kingdom
Professor Reinhard Busse
Technical University Berlin
Simon Capewell MD DSc
Professor of Clinical Epidemiology
University of Liverpool
Department of Public Health & Policy,
Institute of Psychology, Health & Society.
United Kingdom
Dr Hilary Cass
Royal College of Paediatrics and Child Health
United Kingdom
Frank J Chaloupka PhD
Distinguished Professor of Economics and Public Health
Director, Health Policy Center
University of Illinois at Chicago
Simon Chapman AO PhD FASSA HonFFPH (UK)
Sydney School of Public Health
University of Sydney
Emeritus Editor, Tobacco Control
Prof Luke Clancy BSc  MB MD  PhD  FRCPI  FRCP (Edin)  FFOMRCPI
Director General
TobaccoFree Research Institute
Peter Cooper MD
Professor and Head
Department of Paediatrics
University of the Witwatersrand & Charlotte Maxeke Johannesburg Academic Hospital
Treasurer and Member of Executive Committee, International Pediatric Association
South Africa
Professor Elif Dagli
Pediatric Pulmonologist, Turkey
Chair, Health Institute Association, Turkey
Chair, Pediatric Pulmonology Society, Turkey
Past Chair, National Coalition on Tobacco or Health
Professor Mike Daube AO
Professor of Health Policy and Director, Public Health Advocacy Institute
Curtin University, Perth
President, Australian Council on Smoking and Health
Sean P David  MD SM DPhil
Clinical Associate Professor of Family & Community Medicine
Division of General Medical Disciplines
Stanford University School of Medicine
Marisa de Andrade PhD
Impact Research Fellow
Stirling Management School
Institute for Social Marketing
University of Stirling
United Kingdom
Pascal Diethelm MSc
President, OxyRomandie
Peter Donnelly MD
Professor of Public Health Medicine
University of St Andrews
Former Deputy Chief Medical Officer, Scottish Government
United Kingdom
Richard Edwards MB BChir, MRCP, FCPHM(NZ), MPH, MD
University of Otago
New Zealand
Thomas Eissenberg PhD
Professor of Psychology and Co-director
Center for the Study of Tobacco Products
Virginia Commonwealth University
Esteve Fernández MD PhD
Head, Tobacco Control Unit, Catalan Institute of Oncology/ Bellvitge Institute of Biomedical Research - ICO-IDIBELL
Associate Professor of Epidemiology and Public Health, University of Barcelona
Valeska C Figueiredo MD PhD
Center for Studies on Tobacco and Health
National School of Public Health
Fiocruz Foundation
School of Public Health, University of the Witwatersrand, Johannesburg
Co-director Consortium for Advanced Research Training in Africa
Vice President Association of Schools of Public Health in Africa
South Africa
Becky Freeman PhD
Research Fellow
School of Public Health
University of Sydney
Karine Gallopel-Morvan PhD
Professeure des Universités - Marketing social
Professor - Social marketing
Equipe de recherche Management des Organisations de Santé (MOS)
Institut du Management
Stanton A Glantz PhD
Professor of Medicine
American Legacy Foundation Distinguished Professor of Tobacco Control
Director, Center for Tobacco Control Research and Education
Director, WHO Collaborating Centre on Tobacco Control
University of California, San Francisco
Professor Dr Helmut Gohlke MD FESC FACC
Chairman of the taskforce of cardiovascular prevention
German Cardiac Society
Mark Gottlieb
Executive Director
Public Health Advocacy Institute
at Northeastern University School of Law
Boston MA
Prakash C Gupta
Healis - Sekhsaria Institute for Public Health
Sir Andy Haines MD
Professor of Public Health and Primary Care
London School Of Hygiene & Tropical Medicine
United Kingdom
Bonnie Halpern-Felsher PhD FSAHM
Professor of Pediatrics
Director of Research
Associate Director, Adolescent Medicine Fellowship Program
Division of Adolescent Medicine, Department of Pediatrics
Stanford University
Professor Gerard Hastings OBE
The Institute for Social Marketing
University of Stirling, the Open University and
L’École des Hautes Etudes en Santé Publique
United Kingdom
Professor Dr Reiner Hanewinkel
Institute for Therapy and Health Research,
Todd Harper
Chief Executive Officer
Cancer Council Victoria
Norbert Hirschhorn MD
In-Kind Consultant, Faculty of Health Sciences Tobacco Control Research Group
American University of Beirut
Janet Hoek PhD
University of Otago
New Zealand
Winthrop Professor C. D'Arcy J Holman AM
Chair in Public Health
School of Population Health
University of Western Australia
Dr Zulkifli Ismail MD
President, Asia Pacific Pediatric Association (APPA)
Past President, Malaysian Paediatric Association (MPA)
Robert K Jackler, MD
Sewall Professor and Chair
Otolaryngology-Head & Neck Surgery
Director, Stanford Research Into the Impact of Tobacco Advertising
Stanford University School of Medicine
Professor Staffan Janson MD
Department of Public Health
Karlstad University
William J Keenan, MD
Executive Director
International Pediatric Association
Jonathan D Klein MD MPH FAAP
Director, Secretariat, NCD Child
Chair, Technical Assistance Group on NCDs, International Pediatric Association
Associate Executive Director, American Academy of Pediatrics
J Randy Koch PhD
Executive Director
Institute for Drug and Alcohol Studies
Assoc. Professor, Family Medicine and Population Health
Virginia Commonwealth University
Richmond, VA
Prof Andreas Konstantopoulos MD
President, International Pediatric Association (IPA)
Colleen A  Kraft MD FAAP
Professor of Pediatrics
Virginia Tech Carilion School of Medicine and Research Institute
Chair of the Richmond Center Advisory Committee
Professor Dr M Tezer Kutluk, MD PhD
Department of Pediatrics, Division of Pediatric Oncology
Hacettepe University Faculty of Medicine & Cancer Institute
President, National Coalition on Tobacco or Health, Turkey
Immediate Past President, European Cancer Leagues, Brussels
Past President, Turkish Association for Cancer Research and Control
Professor Dr med Ulrich Laaser DTM&H MPH
Section of International Public Health (S-IPH)
Faculty of Health Sciences
University of Bielefeld
Dr Gabrielle Laing
British Association for Community Child Health
United Kingdom
Harry A Lando PhD
Distinguished International Professor
University of Minnesota
Professor Stephen Leeder AO
Emeritus Professor of Public Health and Community Medicine
Menzies Centre for Health Policy and School of Public Health
University of Sydney
Editor-in-Chief, Medical Journal of Australia
Simon Lenton
British Association of Child and Adolescent Public Health (BACAPH)
United Kingdom
Professor Alastair H Leyland
Associate Director
MRC/CSO Social and Public Health Sciences Unit
University of Glasgow
United Kingdom
Pamela Ling MD MPH
Associate Professor of Medicine
Associate Director, Center for Tobacco Control Research and Education
University of California San Francisco
Robert Loddenkemper MD FCCP
Former Chief of Department of Pneumology
Lungenklinik Heckeshorn
Professor Emeritus of Charité University Medicine Berlin
Past-President of the European Respiratory Society
Alan D Lopez PhD
University of Melbourne Laureate Professor
Rowden-White Chair of Global Health and Burden of Disease Measurement
Director, Global Burden of Disease Group
Melbourne School of Population and Global Health
University of Melbourne
Former Chief epidemiologist, WHO’s Tobacco or Health Program (1992-1996)
Former Head, WHO Program on Substance Abuse (1996-1998)
Professor Dr Johan P Mackenbach
Department of Public Health
Erasmus MC
The Netherlands
Ruth E Malone RN PhD FAAN
Professor and Chair, Department of Social and Behavioral Sciences
Nursing Alumni/Mary Harms Endowed Chair
School of Nursing
University of California, San Francisco
Editor-in-Chief, Tobacco Control
Professor Julian Mamo MD MSc PhD MFPH(UK)
Head, Department Public Health
Faculty of Medicine & Surgery
University of Malta
Jose Maria Martin-Moreno MD PhD
Professor of Preventive Medicine and Public Health
University of Valencia
Bongani M Mayosi  DPhil FCP(SA)
Professor and Head
Department of Medicine
Groote Schuur Hospital & University of Cape Town
Cape Town
South Africa
Wasim Maziak MD PhD
Professor and Chair, Department of Epidemiology
Robert Stempel College of Public Health and Social Work
Florida International University, Miami, Florida
Director, Syrian Center for Tobacco Studies
Jim McCambridge  PhD
Senior Lecturer in Behaviour Change
Faculty of Public Health & Policy
London School of Hygiene & Tropical Medicine
United Kingdom
Professor Martin McKee CBE
European Centre on Health of Societies in Transition
London School of Hygiene and Tropical Medicine
United Kingdom
Robert McMillen PhD
Associate Professor
Social Science Research Center, Coordinator of the Tobacco Control Unit
Department of Psychology
American Academy of Pediatrics, Julius B. Richmond Center of Excellence
Raúl Mejía MD
Investigador Titular
Centro de Estudios de Estado y Sociedad
Buenos Aires
John Middleton
Vice President
Faculty of Public Health
United Kingdom
José Pereira Miguel MD PhD
Full Professor of Preventive Medicine and Public Health
Faculty of Medicine
University of Lisbon
Professor of Public Health
University of Melbourne
Michael Moore
CEO Public Health Association of Australia
Vice President/President Elect World Federation of Public Health Associations
John F Murray MD FRCP
Professor Emeritus of Medicine
University of California San Francisco
Rima Nakkash DrPH MPH
Assistant professor
Health Promotion and Community Health Department (WHO Collaborating Center on Health Promotion and Behavioural sciences)
Coordinator of the AUB Tobacco Control Research Group
American University of Beirut
Professor Dr Manfred Neuberger MD
Professor emeritus
Medical University of Vienna
Thomas E Novotny MD MPH
Professor of Global Health
Graduate School of Public Health
San Diego State University
Former Assistant Surgeon General, US Public Health Service
Former US Representative to the WHO Executive Board
Medical Oncologist
Chief Executive Officer, Cancer Council Australia
Fred Paccaud MD MSc
Institute for Social and Preventive Medicine
University Hospital Center (CHUV)
Alexander A Padilla
President  and CEO, PHILHEALTH
Philippine Health Insurance Corporation
The Philippines
Cheryl L Perry PhD
Professor and Regional Dean
The Rockwell Distinguished Chair in Society and Health
University of Texas School of Public Health
Austin Regional Campus
Michael Pertschuk
Former Chairman, US Federal Trade Commission
Former Co-Director, The Advocacy Institute
John P Pierce PhD
Distinguished Professor in Cancer Prevention
Department of Family and Preventive Medicine
Director, Population Sciences Division
Moores Cancer Center
University of California, San Diego
Professor Allyson Pollock
Prof Public Health Research and Policy
Queen Mary, University of London
United Kingdom
Dr Martina Pötschke-Langer MD MA
Head of Unit Cancer Prevention and of
WHO Collaborating Centre for Tobacco Control
German Cancer Research Center (DKFZ)
Robert N Proctor PhD
Professor of the History of Science and
Professor, by courtesy, of Pulmonary and Critical Care Medicine
Stanford University
Professor Pekka Puska
Ex Director General
Terveyden ja hyvinvoinnin laitos – National Institute for Health and Welfare (THL)
K Srinath Reddy MD DM MSc DSc (Honoris Causa) DLitt (Honoris Causa)
President, Public Health Foundation of India
President, World Heart Federation
Dr Maria de Fátima Reis
Professor of Environmental Health
Faculty of Medicine
University of Lisbon.
James Repace MSc
Repace Associates, Inc.
Secondhand Smoke Consultants
Professor Juan M Rey-Pino
Associate Professor
Department of Marketing Research and Management
University of Granada
Professor Walter Ricciardi
Director of the Department of Public Health
Deputy Head (2010 - 2014) of the Faculty of Medicine "A. Gemelli"
Catholic University of the Sacred Heart
Ms Bungon Ritthiphakdee
Southeast Asia Tobacco Control Alliance (SEATCA)
Dr Harry Rutter
London School of Hygiene and Tropical Medicine
United Kingdom
Maria Victoria Salgado MD
Family Medicine Resident
Hospital Italiano de Buenos Aires
Dr Yussuf Saloojee
Executive Director
National Council Against Smoking
South Africa
Professor Raul H Sansores MD
Departamento de Investigacion en Tabaquismo
Director, Smoking Cessation Program
National Institute of Respiratory Diseases
Linda Sarna PhD RN FAAN
Professor and Lulu Wolf Hassenplug Endowed Chair
Immediate Past Chair, Academic Senate
UCLA School of Nursing
Los Angeles, California
Dean E Schraufnagel MD
Pulmonary, Critical Care, Sleep, and Allergy
Depart of Medicine M/C 719
University of Illinois at Chicago
Dr Dr hc Rolf Schulte-Hermann
Professor of Toxicology
EUROPEAN Registered Toxicologist (ERT)
Former Director, Institute of Cancer Research,
Head, Unit Chemical Safety and Cancer Prevention
Medical University of Vienna
Alan Shihadeh
Professor, Department of Mechanical Engineering
Principal Investigator, Aerosol Research Lab
American University of Beirut
Project Director
Center for the Study of Tobacco Products
Virginia Commonwealth University
Richmond, Virginia
Associate Prof Freddy Sitas DPhil
Director, Cancer Research Division
Cancer Council NSW
Bernard W Stewart PhD FRACI DipLaw
School of Women’s and Children’s Health, UNSW and
Cancer Control Program
South East Sydney Public Health Unit
Maurice G Swanson
Chief Executive 
National Heart Foundation of Australia, WA Division
Deputy Chair,
Cancer Council Australia and National Heart Foundation of Australia Tobacco Issues Committee
Dr Naveen Thacker MD
President Elect, Asia Pacific Pediatric Association
Associate Professor Samantha Thomas
Principal Research Fellow Public Health
School of Health and Society
Faculty of Social Sciences
University of Wollongong
TH Tulchinsky MD MPH
Emeritus Professor, Braun School Public Health, Hebrew University-Hadassah, Ein Karem, Jerusalem, Israel
Deputy Editor, Public Health Reviews, EHESP, Paris
Silvana Rubano B Turci
Centro de Estudos sobre Tabaco e Saúde da Escola Nacional de Saúde Pública da Fundação Oswaldo Cruz (CETAB/ENSP/Fiocruz)
Professor Prakit Vathesatogkit MD ABIM FRCP (T) FRCP
Secretary-General, ASH Thailand
Russell Viner
Professor of Adolescent Health
UCL Institute of Child Health
United Kingdom
Vasiliy V Vlassov MD
Russian Society for Evidence Based Medicine
Russian Federation
Professor Melanie Wakefield PhD FASSA
Director and NHMRC Principal Research Fellow
Centre for Behavioural Research in Cancer
Cancer Council Victoria
Professor Kenneth D Ward PhD
Professor and Director, Division of Social and Behavioral Sciences
School of Public Health
The University of Memphis
Professor Alan White
Centre for Men's Health, Institute for Health & Wellbeing
Leeds Metropolitan University
United Kingdom
Martin White MD FFPH
Professor of Public Health, Institute of Health & Society, Newcastle University
Director, Fuse - UKCRC Centre for Translational Research in Public Health
United Kingdom
Prof Friedrich J Wiebel
formerly  Institute of Toxicology
German Research Center for Environmental Health,
James Wiley MD
Founder and chairman
Focus Pediatrics, Mobile, AL
Jonathan P. Winickoff MD, MPH
Director of Translational Research
American Academy of Pediatrics Julius B. Richmond Center
Associate Professor of Pediatrics
Harvard Medical School
Dr Ingrid Wolfe
Child Public Health Research Fellow
London School of Hygiene and Tropical Medicine
United Kingdom
Dr Salim Yusuf  DPhil  FRCPC FRSC OC
Professor of Medicine, McMaster University
Executive Director, Population Health Research Institute
McMaster University, Hamilton Health Sciences
Vice President Research, Hamilton Health Sciences
Heart and Stroke Foundation/Marion W. Burke Chair in Cardiovascular Disease
President Elect, World Heart Federation


[2] http://nicotinepolicy.net/n-s-p/1751-statement-who-052014

[3] Peeters S, Gilmore AB. Understanding the emergence of the tobacco industry's use of the term tobacco harm reduction in order to inform public health policy. Tob Control. 2014 Jan 22. doi: 10.1136/tobaccocontrol-2013-051502.

[4] http://www.cbsnews.com/news/tobacco-companies-bet-on-electronic-cigarettes/

[5] http://blog.euromonitor.com/2012/11/e-cigarettes-a-us2-billion-global-in...

[6] http://www.who.int/fctc/guidelines/article_5_3.pdf?ua=1

[7] http://www.usatoday.com/story/news/nation/2012/11/27/judge-orders-tobacc...

[8] Bialous SA, Sarma L.Electronic cigarettes and smoking cessation: a quandary? (letter) Lancet. 2014 Feb 1;383(9915):407-8. doi: 10.1016/S0140-6736(14)60143-4.

[9] de Andrade M, Hastings G, Angus K. Promotion of electronic cigarettes: tobacco marketing reinvented? BMJ. 2013 Dec 21;347:f7473. doi: 10.1136/bmj.f7473.

[10] McCarthy M. E-cigarette companies target youth, US congressional study finds. BMJ. 2014 Apr 22;348:g2871. doi: 10.1136/bmj.g2871.

[11] Legacy. Vaporized: E-Cigarettes, Advertising, And Youth. May 2014 http://legacyforhealth.org/content/download/4542/63436/version/1/file/LE...

[12] Jennifer C. Duke, Youn O. Lee, et al. Exposure to Electronic Cigarette Television Advertisements Among Youth and Young Adults. Pediatrics. Published online June 2, 2014. (doi: 10.1542/peds.2014-0269)

[13] Dutra LM, Glantz SA. Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents: A Cross-sectional Study. JAMA Pediatr. 2014 Mar 6. doi: 10.1001/jamapediatrics.2013.5488. [Epub ahead of print]

[14] Centers for Disease Control and Prevention (CDC). Notes from the field: electronic cigarette use among middle and high school students - United States, 2011-2012.MMWR Morb Mortal Wkly Rep. 2013 Sep 6;62(35):729-30.

[15] Lee S, Grana RA, Glantz SA. Electronic cigarette use among Korean adolescents: a cross-sectional study of market penetration, dual use, and relationship to quit attempts and former smoking.

[16] http://www.realparentsrealanswers.com/what-you-need-to-know-about-e-ciga...

[17] Grana RA, Ling PM. Smoking revolution": a content analysis of electronic cigarette retail websites. Am J Prev Med. 2014 Apr;46(4):395-403. doi: 10.1016/j.amepre.2013.12.010.

[18] Carr ER. E-cigarettes: facts, perceptions, and marketing messages. Clin J Oncol Nurs. 2014 Feb;18(1):112-6. doi: 10.1188/14.CJON.112-116.

[19] Rooke C, Amos A. News media representations of electronic cigarettes: an analysis of newspaper coverage in the UK and Scotland [published online ahead of print July 24, 2013]. Tob Control. doi:10.1136/tobaccocontrol-2013–051043.

[20] Grana R, Benowitz N, Glantz SA.Circulation. E-cigarettes: a scientific review. Circulation 2014 May 13;129(19):1972-86. doi: 10.1161/CIRCULATIONAHA.114.007667.

[21] ibid.

[22] Pisinger C, Godtfredsen NS. Is there a health benefit of reduced tobacco consumption? A systematic review. Nicotine Tob Res. 2007 Jun;9(6):631-46.

[23] Adkison SE, O'Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong HH, Cummings KM, McNeill A, Thrasher JF, Hammond D, Fong GT. Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med. 2013 Mar; 44(3):207-15.

[24] Grana R, Popova L, Ling P. A longitudinal analysis of electronic cigarette use and smoking cessation [published online ahead of print March 24, 2014]. JAMA Int Med. doi:10.1001/jamainternmed.2014.187.

[25] Vickerman KA, Carpenter KM, Altman T, Nash CM, Zbikowski SM. Use of electronic cigarettes among state tobacco cessation quitline callers. Nicotine Tob Res. 2013;15:1787–1791.

[26] Popova L, Ling PM. Alternative tobacco product use and smoking cessation: a national study. Am J Public Health. 2013;103:923–930.

[27] Choi K, Forster JL. Response to Letter to the Editor Regarding “Beliefs and Experimentation with Electronic Cigarettes: A Prospective Analysis Among Young Adults.” Am J Prev Med

[28] See reference #20.

[29] Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N. Electronic cigarettes for smoking cessation: a randomised controlled trial.
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[30] Brown J, Beard E, Kotz D, Michie S, West R. Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study.
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[31] Ibid

[32] Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, Prokopowicz A, Jablonska-Czapla M, Rosik-Dulewska C, Havel C. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014;23:133–139.

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The Spanish version of the letter is already available in Spanish, http://esmateria.com/2014/06/16/129-autoridades-de-salud-publica-piden-l... target="_blank";from the science news web "Materia".

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