Electronic nicotine delivery systems (ENDS), which include electronic cigarettes, deliver nicotine in an aerosolized form and are quickly gaining in popularity among youth and adults. The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) have issued a policy statement on the risks of ENDS use and its potential benefits as a smoking cessation aid.
Because of an overall lack of evidence supporting the use of ENDS as a proven cessation aid for smokers and research on potential adverse effects of inhaling ENDS aerosol by patients with cancer undergoing treatment, the AACR/ASCO recommends that oncologists not recommend ENDS to patients as a first-line therapy for smoking cessation. AACR/ASCO strongly encourage all healthcare providers to provide or refer patients who use tobacco (including patients with cancer) to evidence-based cessation treatments, along with recommending the use of FDA-approved cessation methods.
Other recommendations include:
- Support of regulation of all ENDS that meet the statutory definition of tobacco products, as well as their component parts, by the FDA Center for Tobacco Products, using its authority under the Family Smoking Prevention and Tobacco Control Act.
- Support of research on ENDS to guide future federal, state, and local regulatory and policy decisions with regard to taxation, indoor e-cigarette use, flavorings and other product standards, and e-cigarette marketing, among other issues.
- Initiatives to prevent youth from initiating use of ENDS products, including restriction of youth-oriented marketing of ENDS, age verification at point of purchase, and a prohibition on NDS and ENDS liquid containing candy and other youth-friendly flavors unless there is evidence demonstrating that these products do not encourage youth uptake of ENDS.
- Support for prohibiting the use of ENDS in places where combustible tobacco product use is prohibited by federal, state, or local law until the safety of second- and third-hand aerosol exposure is established.
- Support for a product standard that would require all e-liquid refill bottles to be childproof, including childproof caps for eye-dropper refill bottles.