Electronic cigarettes. A position statement of the forum of international respiratory societies

Am J Respir Crit Care Med. 2014 Sep 15;190(6):611-8. doi: 10.1164/rccm.201407-1198PP.


Background: Awareness and usage of electronic cigarettes has exponentially increased during the last few years, especially among young people and women in some countries. The rapid acceptance of electronic cigarettes may be attributed in part to the perception created by marketing and the popular press that they are safer than combustible cigarettes.

Goals: To alert and advise policy makers about electronic cigarettes and their potential hazards.

Methods: Using The Union's position paper on electronic cigarettes as the starting template, the document was written using an iterative process. Portions of the manuscript have been taken directly from the position papers of participating societies.

Results: Because electronic cigarettes generate less tar and carcinogens than combustible cigarettes, use of electronic cigarettes may reduce disease caused by those components. However, the health risks of electronic cigarettes have not been adequately studied. Studies looking at whether electronic cigarettes can aid smoking cessation have had inconsistent results. Moreover, the availability of electronic cigarettes may have an overall adverse health impact by increasing initiation and reducing cessation of combustible nicotine delivery products.

Conclusions: The health and safety claims regarding electronic nicotine delivery devices should be subject to evidentiary review. The potential benefits of electronic cigarettes to an individual smoker should be weighed against potential harm to the population of increased social acceptability of smoking and use of nicotine, the latter of which has addictive power and untoward effects. As a precaution, electronic nicotine delivery devices should be restricted or banned until more information about their safety is available. If they are allowed, they should be closely regulated as medicines or tobacco products.

Keywords: electronic cigarettes; nicotine delivery devices; tobacco products.

Publication types

  • Practice Guideline

MeSH terms

  • Adult
  • Electronic Nicotine Delivery Systems / adverse effects*
  • Electronic Nicotine Delivery Systems / standards*
  • Electronic Nicotine Delivery Systems / statistics & numerical data
  • Female
  • Harm Reduction
  • Health Knowledge, Attitudes, Practice
  • Humans
  • International Agencies / organization & administration
  • Male
  • Nicotine / adverse effects*
  • Organizational Objectives
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / legislation & jurisprudence
  • Smoking Cessation / methods*
  • Societies / organization & administration
  • Young Adult


  • Nicotine