Electronic Nicotine Delivery Systems (ENDS) and Other Tobacco Products

PACT Recommendation: Recognize the potential health risks of electronic and other tobacco products and focus on tobacco-free and nicotine-free policies and regulations rather than smoke-free policies and regulations.

In recent years, use of smokeless tobacco products has increased at an alarming rate. Types of products include e-cigarettes, e-hookah, chewing tobacco, snuff, and snus. E-cigarette use among high school students increased 900% from 2011 to 2015; these products are now the most commonly used form of tobacco among youth nationwide, and the Surgeon General has declared their use a major public health concern.[i]

While ENDS generally emit fewer toxicants than combustible tobacco products, their aerosols are not harmless. [iv] Studies have shown formaldehyde, benzene and other items in secondhand e-cigarette emissions.  With over 470 brands and more than 7,700 flavored products available, there is little scientific based evidence of the long-range health impact on consumers.[v] The vast majority of current e-cigarette users are also current smokers, or dual users, including 59 percent of adult users and 76 percent of youth users.[vi] The CDC concluded that smokeless tobacco is not a safe alternative to smoking, and the FDA has not found any e-cigarettes to be safe and effective in helping smokers quit.

A number of steps have been taken towards regulating ENDS and other smokeless tobacco products. In 2014, Philadelphia categorized e-cigarettes the same as regular tobacco, meaning the vapor producing products would be banned in most public places and those under 18 would be prohibited from buying them.

In 2016, the Food and Drug Administration’s (FDA) final “deeming rule” was put into law, giving the FDA the authority to regulate the manufacture, sales and marketing of all tobacco products including e-cigarettes, cigars, hookah, little cigars and other tobacco products. This rule means that the FDA can crack down on industry marketing to youth, unproven health claims and sales to minors. Unfortunately, the tobacco industry continues its attempts to weaken this rule by successfully urging the House of Representatives to attach so-called appropriations “riders” to the FDA’s funding bill, which would prohibit FDA from implementing key provisions of the final rule. We continue to advocate with our partners against these riders in order to keep the Tobacco Control Act strong and effective.

Who Uses Ends?

Although only three percent of all adults currently use smokeless tobacco, use among men has been increasing since 2000, and seven percent of adult men reported currently smokeless tobacco products. [ii] This gender divide extends to youth. In Pennsylvania, eight percent of high school students and 12 percent of male high school students report using smokeless tobacco. [iii]

Foot Notes

[i] A Report of the Surgeon General. E-Cigarette Use Among Youth and Young Adults. Available https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf

[ii] Centers for Disease Control and Prevention (CDC). Smoking & Tobacco Use: Smokeless Tobacco Use in the United States. Available https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/use_us/

[iii] Centers for Disease Control and Prevention (CDC). State Tobacco Activities and Evaluation (STATE) System. YTS 2015. Available https://www.cdc.gov/statesystem/

[iv] A Report of the Surgeon General. E-Cigarette Use Among Youth and Young Adults. Available https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf

[v] American Lung Association. E-cigarettes and Lung Health. Available http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html

[vi] CDC, “Electronic Cigarette Use Among Middle and High School Students — United States, 2011 – 2012,” MMWR, 62(35), September 6, 2013; CDC, “Quick Stats: Cigarette Smoking Status Among Current Adult E-Cigarette Users, by Age Group—National Health Interview Survey, United States, 2015,” Morbidity and Mortality Weekly Report, 65(42): 1177. Available http://www.cdc.gov/mmwr/volumes/65/wr/mm6542a7.htm?s_cid=mm6542a7_w