Whither the e-cigarette?

Excerpt

The safety and utility of electronic nicotine delivery systems (ENDS) is currently a topic of hot debate in the medical and public health communities (Künzli 2014), and policy-makers worldwide are grappling with ENDS-related decision-making. Developing public health policy and programming for ENDS at this point in time are uncomfortably akin to gambling, since we remain in the dark about far too many ENDS issues. Because the uncertainty and debate will persist until the evidence is comprehensive and irrefutable (to the extent that it can be), the IJPH launched a special call for e-cigarette research contributions. But, despite numerous innovative and well-executed articles in this issue, the contributions collectively constitute in essence, a plea for more research. Specifically, hypotheses warranting extensive and intensive investigation include (1) the Gateway Hypothesis [i.e., that e-cigarettes lead never smokers to begin using combustible tobacco products (Bunnell et al. 2014; Kandel and Kandel 2014)]; (2) the Renormalization Hypothesis [i.e., that public acceptance of e-cigarettes will lead to renormalization of smoking (Fairchild et al. 2014)]; and (3) the Quit Hypothesis [i.e., that e-cigarettes provide a way to help smokers quit (Adkison et al. 2013)]. Also under-researched is whether laws that treat ENDS and combustible cigarettes on the same footing are feasible and acceptable. …