Balancing Consideration of the Risks and Benefits of E-Cigarettes

Am J Public Health. 2021 Sep;111(9):1661-1672. doi: 10.2105/AJPH.2021.306416. Epub 2021 Aug 19.


The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes' risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public-including most smokers-now consider e-cigarette use as dangerous as or more dangerous than smoking. By contrast, the National Academies of Science, Engineering, and Medicine concluded that e-cigarette use is likely far less hazardous than smoking. Policies intended to reduce adolescent vaping may also reduce adult smokers' use of e-cigarettes in quit attempts. Because evidence indicates that e-cigarette use can increase the odds of quitting smoking, many scientists, including this essay's authors, encourage the health community, media, and policymakers to more carefully weigh vaping's potential to reduce adult smoking-attributable mortality. We review the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youths with the potential benefits of increasing adult smoking cessation.

MeSH terms

  • Adolescent
  • Adult
  • Cigarette Smoking / prevention & control*
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Humans
  • Smoking Prevention / methods*
  • Tobacco Smoking / therapy*
  • United States
  • Vaping / prevention & control*