E-cigs for quitting smoking? A cautious thumbs-up from American Cancer Society

The American Cancer Society is recommending — with caution — to health care clinicians that they add electronic cigarettes and vaporizers as a smoking-cessation option.

The nonprofit group stressed Tuesday its policy statement is directed strictly at adults, including strongly recommending against its use by the young. It said it will closely monitor e-cigs innovations and research.

"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," the group said.

"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 group's shift on e-cigs "is very encouraging," said David Sweanor, an adjunct law professor at the University of Ottawa and the author of several electronic-cigarette studies.

"To see the most significant health focused non-governmental organization in America recognizing the importance of the continuum of risk that FDA Commissioner (Scott) Gottlieb has identified as an essential component to reducing the toll from smoking."

On July 28, Gottlieb announced plans for a sweeping regulatory “road map” on tobacco and nicotine products.

It calls for lowering the nicotine level in traditional cigarettes to nonaddictive levels; limiting or eliminating flavorings, such as menthol in traditional cigarettes and candy and fruit flavors in e-cigs and vaporizers, which the FDA says appeal to young people; and establishing rules to make product review more efficient, predictable and transparent for manufacturers, while upholding the agency’s public-health mission.

The ACS said it encourages the federal agency to use its full authority to regulate tobacco products, including reducing tobacco use through regulation.

Scott Ballin, past chairman of the anti-smoking alliance Coalition of Science or Health, said he hopes the ACS will expand its statement to include potential reduced-risk tobacco and nicotine products such as snus.

On Nov. 30, the FDA announced creating a nicotine steering committee to “re-evaluate and modernize” its regulatory approach. Gottlieb and other FDA senior managers said  the committee’s main focus will be on the development and regulation of nicotine-replacement products.

Most of those products are sold over the counter as gum, patches and lozenges, including Zonnic, a gum made by Reynolds American Inc. subsidiary Niconovum.

The ACS said clinicians should advise their patients to use FDA-approved cessation aids that have been proven to support successful quit attempts.

"Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA-approved cessation mediations," the ACS said.

"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."

The ACS said it "strongly discourages the dual use of e-cigarettes and combustible cigarettes, a behavior that is far more detrimental to a person’s health compared to the substantial health benefit of quitting smoking."

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