In a position statement released in February 2018, the American Cancer Society has changed its views on e-cigarettes and how they should be regulated. The policy statement will guide the non-profits efforts on tobacco control and smoking cessation efforts going forward.

American Cancer Society shifts stance on E-Cigs in Position Statement



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ACS

In a position statement released by the American Cancer Society, a non-profit and one the nation's largest non-governmental health advocacy groups, has adjusted its policy on e-cigarettes recognizing the devices are less harmful than smoking. 

The ACS statement opens by stating combustible tobacco (cigarettes mainly) is responsible for the deaths of 7 million people worldwide and is the greatest cause of cancer. It even says that 98% of tobacco related deaths are caused by cigarettes. 

"Based on currently available evidence, using current generation e-cigarettes is less harmful than smoking cigarettes, but the health effects of long-term use are not known." the statement reads in the scientific summary. 

The less harmful studies that could be referenced by the statement, found that e-cigs are 99% less carcinogenic than cigarettes and switching to vaping could save millions of lives. The U.K. government via Public Health England even states that e-cigarettes are 95% less harmful than cigarettes.

Since the ACS recognizes that smoking cigarettes is the main foe, does this mean that tobacco control groups will shift their focus back to cigarettes instead of trying to shut down the vaping industry, an ally to those trying to stop smoking? We will see.

American Cancer Society Stance on Using E-cigarettes to Quit Smoking


In the clinical recommendations section of the statement, meant to advise individuals on the ground trying to help people quit smoking, the ACS recognizes that people do in fact use vaping to break their smoking habit.

ACS statement:

The ACS has always supported any smoker who is considering quitting, no matter what approach they use; there is nothing more important that they can do for their health.  To help smokers quit, the ACS recommends that clinicians advise their patients to use FDA-approved cessation aids that have been proven to support successful quit attempts. Many smokers choose to quit smoking without the assistance of a clinician and some opt to use e-cigarettes to accomplish this goal. The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes.

Continuing: 

Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation mediations. These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.
-ACS Policy Statement

This is following the monumental shift from the U.K. government recommending that e-cigarettes be used in a clinical setting as an aid to those seeking to quit smoking in addition to other support. 

In the England, the government even has even endorsed vaping in their yearly campaign to stop smoking.

While this recommendation from the ACS seems to be a tepid first step towards what the British are doing, this is a huge advance from the traditional American tobacco control advocate's stance on vaping, which has been "It's just as bad as smoking and it must be treated exactly the same as cigarettes."

The ACS also is a very large policy advocate with a tremendous amount of influence with the United States regulatory agencies, particularly the FDA which regulates the vaping industry.

ACS Policy Recommendations

More of the Same?

 The American Cancer Society recommends implementing polices and public health measures known to prevent the initiation and use of all tobacco products, including appropriate taxation, retail policies (e.g., raising the minimum age of purchase to 21), tobacco and e-cigarette aerosol-free policies and funding of evidence-based prevention and cessation programs.  The ACS strongly recommends that every effort be made to prevent the initiation of e-cigarettes by youth.  The use of products containing nicotine in any form among youth is unsafe and can harm brain development. Furthermore, evidence indicates that young e-cigarette users are at increased risk for both starting to smoke and becoming long-term users of combustible tobacco products.

The ACS encourages the FDA to regulate all tobacco products, including e-cigarettes, to the full extent of its authority, and to determine the absolute and relative harms of each product.  The FDA should assess whether e-cigarettes help to reduce tobacco-related morbidity and mortality, and the impact of marketing of e-cigarettes on consumer perceptions and behavior.  Any related regulatory regime should include post-marketing surveillance to monitor the long-term effects of these products and ensure the FDA’s actions have the intended health outcome of significantly reducing disease and death.  Furthermore, the FDA should use its authorities to reduce the toxicity, addictiveness and appeal of tobacco products currently on the market.  The ACS also applauds the FDA for recognizing its significant role as a science-based agency in helping to address the addictiveness of nicotine in cigarettes.  Reducing nicotine in all combustible tobacco products to below addictive levels holds the potential to significantly accelerate reductions in the use of combustible tobacco products, which remain by far the leading preventable cause of cancer and preventable death in the United States.

ACS Policy Statement

After recognizing that e-cigarettes can be used to help people quit, the American Cancer Society assures us that it wants to keep moving forward with its mission to protect us from ourselves by raising taxes, vape free zones and keeping the products we use from ever hitting the market.

The ACS encourages the FDA to regulate all tobacco products, including e-cigarettes, to the full extent of its authority, and to determine the absolute and relative harms of each product.  The FDA should assess whether e-cigarettes help to reduce tobacco-related morbidity and mortality, and the impact of marketing of e-cigarettes on consumer perceptions and behavior.  Any related regulatory regime should include post-marketing surveillance to monitor the long-term effects of these products and ensure the FDA’s actions have the intended health outcome of significantly reducing disease and death.  Furthermore, the FDA should use its authorities to reduce the toxicity, addictiveness and appeal of tobacco products currently on the market.  The ACS also applauds the FDA for recognizing its significant role as a science-based agency in helping to address the addictiveness of nicotine in cigarettes.  Reducing nicotine in all combustible tobacco products to below addictive levels holds the potential to significantly accelerate reductions in the use of combustible tobacco products, which remain by far the leading preventable cause of cancer and preventable death in the United States.

While it is noble to try and prevent the youth from becoming addicted to nicotine, this will probably devolve into another 'save the children' raze the earth propaganda campaign. 

The statements from tobacco control advocates regarding the use of teen e-cigarette use leading to smoking just isn't justified. In fact a study from the U.K. states that teens who vape already smoke cigarettes and they didn't start smoking because of vaping.

A very large survey conducted and evaluated by a collaborative effort between UK Centre for Tobacco and Alcohol Studies, Public Health England, Action on Smoking and Health, and the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement at the University of Cardiff, found that regular e-cigarette use among youth who have never smoked is quite low. Regular (at least weekly) e-cigarette usage among all youth surveyed was around 3% and was highly concentrated among those who also smoke tobacco. 

The study's summary even states that the survey shows "a consistent pattern: most e-cigarette experimentation does not turn into regular use, and levels of regular use in you people who have never smoked remain very low."

Recent studies have generated alarming headlines that e-cigarettes are leading to smoking. Our analysis of the latest surveys from all parts of the United Kingdom involving thousands of teenagers shows clearly that for those teens who don’t smoke, e-cig experimentation is simply not translating into regular use
Linda Bauld, professor of health policy at the University of Stirling (UK Centre for Tobacco and Alcohol Studies)

Did the e-cigarettes are just as bad as smoking tactic not work? 

Are tobacco control advocates now refocusing to the e-cigarettes are getting the youth to start actual smoking tactic? 

Perhaps, this is indeed the case as we have been hearing about how candy and fruit flavored vape juice are just too enticing to young people for these products to be allowed to remain on the market. The FDA wants to eliminate appealing flavors from e-liquid because kids like candy. 

It seems regulators don't know or don't care that adults like good tasting e-juice also. 

Will making vaping unappealing prevent current smokers from switching to vaping? 

The published study regarding the survey and its findings can be found here on PubMed for those interested.