Opinion: The future of e-cigarettes

A ban on the sale of e-cigarettes in San Francisco reflects growing national concern about the health dangers of the electronic devices, according to a September 11, 2019 JAMA Forum commentary co-authored by Howard Koh, Harvey V. Fineberg Professor of the Practice of Public Health Leadership at Harvard T.H. Chan School of Public Health, and Clifford Douglas of the American Cancer Society.

The San Francisco ban arose out of fears among parents and policymakers that a dramatic rise in youth vaping in recent years, spurred by e-cigarettes that look like USB flash drives and that come in kid-friendly flavors, could lead to a lifetime of nicotine addiction among millions of youths and cause long-term health problems. The recent emergence of acute vaping-related lung illnesses across the U.S., and a handful of vaping-related deaths, has added urgency to the debate about e-cigarettes, the authors wrote.

Those opposing the ban are worried that it will incentivize adult vapers to revert back to traditional cigarettes. The authors noted, however, that recent studies have raised questions about the usefulness of e-cigarettes in leading smokers to quit.

Koh and Douglas recommended that the U.S. Food and Drug Administration (FDA) ban flavored e-cigarettes, ensure product safety, and prevent youth initiation. They also called for continued focus on ending smoking by maximizing proven interventions, such as FDA-approved cessation medications and counseling, taxation, clean indoor air policies, raising the minimum age of sale to 21, and countermarketing.

Read the JAMA Forum commentary: The San Francisco Ban and the Future of e-Cigarettes