December 10, 2013

Stanton A. Glantz, PhD

International Union Against TB and Lung Disease issues strong and sensible policy statement on e-cigarettes

Here are the Union's recommendations.  The full document is available here.
• The International Union Against Tuberculosis and Lung Disease (The Union) has issued this position statement based on a careful review of the scientific evidence; the position statement will be reviewed by mid-2015.

• The safety of electronic cigarettes (ECs) or electronic nicotine delivery systems (ENDS) has not been scientifically demonstrated.

• Adverse health effects for third parties exposed (second-hand exposure) cannot be excluded because the use of electronic cigarettes leads to emission
of fi ne and ultrafine inhalable liquid particles, nicotine and cancer-causing substances into indoor air.

• The benefits of e-cigarettes have not been scientifically proven. To date, very few studies have assessed ECs/ENDS as a harm reduction and cessation aid, with conflicting findings.

• The Union is concerned that the marketing, awareness and use of ECs or ENDS is growing rapidly.

• A range of current and proposed legislative and regulatory options exists; some countries (such as Brazil, Norway, and Singapore) have banned ECs/
ENDS completely.

• ENDS could undermine the implementation of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) Article
12 (denormalisation of tobacco use); use of ENDS could also hamper the implementation of Article 8 (protection from exposure to tobacco smoke), as ENDS users in public places may claim that their electronic cigarette does not contain tobacco and/or does not produce second-hand tobacco smoke.

• The Union strongly supports the regulation of the manufacture, marketing and sale of electronic cigarettes or ENDS; the preferred option is to regulate ECs or ENDS as medicines.

• If regulation as medicines is not feasible, the following measures should be considered, pending the availability of reliable evidence:

— a comprehensive ban on all advertising, promotion and sponsorship;
— promotion of ECs/ENDS for tobacco cessation to be prohibited;
— display of ECs/ENDS in retail stores to be prohibited;
— sale to minors (persons under the age of full legal responsibility) to be prohibited;
— ECs/ENDS and their refills should not be sold in flavours that are appealing to children;
— packaging and labelling of EC/ENDS cartridges and disposable ECs/ENDS should include a list of all ingredients, stipulate the quantity of nicotine and include appropriate warning labels;
— ECs/ENDS should not be used in public places, workplaces or on public transportation;
— consumer safety standards for EC cartridges should be established, including ensuring manufacturing consistency and regulating the maximum
quantity/dosage of nicotine they may contain.

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