British Doctors' Group Warms to E-Cigs for Harm Reduction

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April 28 — Electronic cigarettes have the potential to play an important part in reducing the harm associated with smoking, an influential British medical group says.

Concerns “about e-cigarettes helping to recruit a new generation of tobacco smokers through a gateway effect are, at least to date, unfounded,” the Royal College of Physicians said in a report released April 28.

Similarly, concerns about e-cigarette use making conventional cigarette smoking more acceptable aren't borne out, the group said.

Nicotine itself isn't highly hazardous, the RCP said. And the long-term effects from inhaling e-cigarette vapor, though currently unknown, are “unlikely to exceed 5% of the harm from tobacco smoke,” it said. The report is entitled, “Nicotine Without Smoke: Tobacco Harm Reduction.”

“Large-scale substitution of e-cigarettes, or other non-tobacco nicotine products,” such as nicotine replacement therapy (NRT), “for tobacco smoking has the potential to prevent almost all the harm from smoking in society,” the RCP said.

“Promoting e-cigarettes, NRT and other non-tobacco nicotine products as widely as possible, as a substitute for smoking, is therefore likely to generate significant health gains in the UK,” the report concluded.

Policy Recommendation

That recommendation is “a huge thing,” Cynthia Cabrera, executive director of the Smoke-Free Alternatives Trade Association, told Bloomberg BNA April 28. The association represents e-cigarette makers, distributors and others.

Cabrera said the suggestion that “governments push for e-cigarettes over combusted cigarettes” was particularly impressive coming from “the Royal College of Physicians, which were the ones that first found that combusted cigarettes caused cancer.”

“The bottom line is they absolutely endorse these products and believe that other governments should do so as well,” Cabrera said.

The RCP interacts with the U.K.'s National Health service “at various levels,” according to its website.

Role of FDA

Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, said in an e-mailed statement, “This report shows exactly why we need FDA regulation of e-cigarettes to minimize the risks they pose, especially to children, and maximize potential benefits.”

“If there is to be a public health benefit from e-cigarettes, it will only come if they are effective at helping smokers end the use of cigarettes and if they are responsibly marketed so they do not re-glamorize tobacco use among young people,” Myers said.

The RCP report, authored by its Tobacco Advisory Group, comes on the heels of a U.S. Centers for Disease Control and Prevention report finding that middle- and high-school students' use of e-cigarettes continued to rise in the latest National Youth Tobacco Survey.

“Three million middle and high school students were current users of e-cigarettes in 2015, up from 2.46 million in 2014” in the U.S., the CDC said in an online summary of its report.

Myers called for the White House to “promptly issue the final rule providing for FDA oversight of e-cigarettes.”

The Food and Drug Administration's so-called deeming rule, bringing e-cigarettes and some other products under FDA authority, is being reviewed by the Office of Management and Budget.

“Without such oversight, there will continue to be more questions than answers about the public health impact of e-cigarettes,” Myers said.

Meanwhile, a provision in an agriculture funding bill in the House of Representatives would allow some FDA regulation of e-cigarettes under the deeming rule but would limit the agency’s premarket review of the products (44 PSLR 437, 4/25/16).

[Correction:  This version of the story reflects that an amendment to an agriculture funding bill in the House of Representatives would allow some FDA regulation of e-cigarettes but would limit the agency’s premarket review of the products.]

To contact the reporter on this story: Martina S. Barash in Washington at

To contact the editor responsible for this story: Steven Patrick at

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