Alternative Nicotine Delivery Systems (ANDS)

The importance of science-informed policy and what the data really tell us about e- cigarettes

IsraelJournalofHealthPolicyResearchS(2a0m1p5l)e4:22 doi:10.1186/s13584-015-0021-z
David B. Abrams ( Raymond Niaura ( – 24 April 2015

  • David B. Abrams 1,2,* * Corresponding author Email:
  • Raymond Niaura 1 Email: 1
  • Department of Health, Behavior and Society, Bloomberg School of Public Health, The Johns Hopkins University, 624 N. Broadway, Suite 280, Baltimore, MD 21205, USA 2
  • Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA

“If properly regulated and responsibly made and marketed, especially by independent manufacturers who have less conflict as Big Tobacco does by also selling lethal cigarettes, ANDS have the potential to improve the public health. Together with traditional tobacco control strategies ANDS can speed the demise of the lethal cigarette by deterring progression to lethal cigarettes among non-users and by providing smokers who do not want to, or have tried and cannot “just quit”, with a substantially safer alternative – without causing the suffering from the devastating health consequences imposed on them by the need to inhale toxic cigarette smoke. As Dr. Russell stated so prophetically 40 years ago and which is still true today, “people smoke for the nicotine but die from the tars” [37].

ANDS raise legitimate fears of possible risks and these need to be watched and managed, but misinterpreting or selectively presenting negative preliminary data does not serve the public health. The precautionary principle is potentially violated if ANDS are prematurely demonized and are then seen by the public as simply another dangerous tobacco product instead of a way to make lethal cigarettes obsolete. Then we may well have missed the tobacco control opportunity of the century [35]”

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