The Australian Government is taking a precautionary approach to e-cigarettes and is considering the overall potential impact of e-cigarettes on population health. In its June 2020 response to a report by the Parliament’s Standing Committee on Health, Aged Care and Sport on the use and marketing of e-cigarettes and personal vaporisers in Australia, the Government noted evidence linking e-cigarettes to tobacco use and nicotine addiction, and the risks of e-cigarette use leading to future smoking in the young adult population. The response concluded:
"The Government will continue to monitor the impact of e-cigarettes on smoking cessation. However, at a population level, there is currently insufficient evidence to promote the use of e-cigarettes for smoking cessation. The Government will also continue to monitor emerging evidence 1 the direct harms e-cigarettes pose to human health, their impacts on smoking initiation, uptake among youth and dual use with conventional tobacco products. Finally, the Government’s current approach to e-cigarettes is premised on ensuring flexibility to change in light of new evidence."
Previous statements by various Government agencies are described in Section 18B10.1 below. In addition, a number of well-respected Australian and global health agencies have issued position statements on e-cigarettes. Excerpts from some of these are included in Sections 18B10.2 and 18B10.3 below; it’s impracticable to provide an exhaustive list, or to reproduce them in full. Readers should refer to the original position statements for further detail.
Some overseas organisations have published position statements, and a selection of these, with web links, is listed in Section 18B.10.4. The majority of these statements come from agencies based in the UK or the US, where usage of the products is more widespread. Regulation of e-cigarettes in other countries is discussed in Chapter 18B.9.
18B.10.1 Australian Government agencies
Several Government agencies have released individual position statements on e-cigarettes, as summarised below.
The Therapeutic Goods Administration
The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health, and is responsible for regulating therapeutic goods, including prescription medicines. This includes regulating supply, import, manufacturing and advertising of therapeutic goods; and ensuring that therapeutic goods meet required standards of safety, quality and efficacy.2
The TGA notes that:3
The Australian Government Department of Health
In September 2019, Australia’s Chief Medical Officer and the State and Territory Chief Health Officers presented a joint statement about the emerging link between e-cigarette use and lung disease (see Section 18B.5.5).
The statement reported that:
A similar statement was made in December 2019 in a meeting of the Ministerial Drug and Alcohol Forum (MDAF). It noted there was growing evidence for “the direct harms e-cigarettes pose to human health, their impact on smoking initiation and cessation, uptake among youth and dual use with conventional tobacco products.” The ministers agreed to continue monitoring developing evidence.1
The MDAF statement received support from Cancer Council Australia, Lung Foundation Australia, the Public Health Association of Australia and the Thoracic Society of Australia and New Zealand in a joint statement which commended the ministers “for standing firm on evidence-based health policy and ignoring recent lobbying from commercial interests.”5
The Australian Competition & Consumer Commission (Product Safety Australia)
The ACCC's role is to identify and address the risk of serious injury and death from safety hazards in consumer products. In 2019 it stated:
National Health and Medical Research Council
Among other roles, the National Health and Medical Research Council (NHMRC) has responsibility for developing health advice for the Australian community, health professionals and government.7 The CEO of the NHMRC released a statement on e-cigarettes in 2017,8 noting that:
CSIRO (Commonwealth Scientific and Industrial Research Organisation)
In 2018, the CSIRO released a major review of the evidence on e-cigarettes, smoking and health. Regarding the impacts of the use of e-cigarettes, personal vaporisers and nicotine on individual and population health, it concluded:
National Industrial Chemicals Notification and Assessment Scheme
Based on it study of the chemistry of liquids used in e-cigarette devices in Australia, the National Industrial Chemicals Notifications and Assessment Scheme has concluded the following about potential health concerns and health effects:
18B.10.2 Australian non-government agencies
In 2018, the Australian Medical Association, Cancer Australia, Cancer Council Australia, National Heart Foundation of Australia, and the Thoracic Society of Australia and New Zealand released a joint statement,11 concluding:
Cancer Council Australia and Heart Foundation
These agencies issued a joint position statement in 2015.12 In their overview, the agencies state that:
The agencies make the following recommendations:
Australian Medical Association
The Australian Medical Association (AMA) released Tobacco smoking and e-cigarettes in December 2015.13 The statement notes that ‘the AMA has significant concerns about e-cigarettes. E-cigarettes and the related products should only be available to those people aged 18 years and over and the marketing and advertising of e-cigarettes should be subject to the same restrictions as cigarettes. E-cigarettes must not be marketed as cessation aids as such claims are not supported by evidence at this time.’ Elsewhere in the document, it states that:
Public Health Association Australia
The Public Health Association of Australia stated in 2018:14
Lung Foundation Australia
In its statement of June 2014, Lung Foundation Australia declared that:15
In 2017, Lung Foundation Australia released a joint submission with the Thoracic Society of Australia and New Zealand to the government inquiry into the use of electronic cigarettes and personal vaporisers in Australia. Its summary stated that:
Royal Australasian College of Physicians
The RACP’s May 2018 policy on e-cigarettes states:
In March 2020 the RACP made a submission to the New Zealand Health Select Committee regarding the Smokefree Environments and Regulated Products (Vaping) Amendment Bill. In the background information RACP state its current position on e-cigarettes:
Australian Council on Smoking and Health (ACOSH)
In its March 2019 statement to the Select Committee on Personal Choice and Community Safety, Legislative Council, Parliament of Western Australia, ACOSH summates that:
VicHealth, in its 2017 submission to the Standing Committee on Health, Aged Care and Sport, recommended:
Australian Dental Association
In July 2017, the Australian Dental Association submitted a comment on the government inquiry into the Use and Marketing of Electronic Cigarettes and Personal Vaporisers in Australia:
Royal Australian and New Zealand College of Psychiatrists (RANZCP)
In contrast to the above organisations, in its October 2018 position statement,22 the RANZCP stated its support for the legalisation and regulation of nicotine-containing e-cigarettes and other vaporised nicotine products to facilitate their use as harm reduction tools. It recommends:
Royal Australian College of General Practitioners (RACGP)
In the RACGP’s updated guide from 2019 on Supporting Smoking Cessation for health professionals it states under Recommendation 15:
18B.10.3 Global agencies
For the most part, position statements of global agencies express caution about e-cigarettes, generally acknowledging that while they could have the potential to benefit public health, there is currently insufficient evidence to be sure that e-cigarettes assist smokers in quitting, do not cause some level of physical harm, and will not serve to undermine long-standing and effective tobacco control measures.
The World Health Organization and the Framework Convention on Tobacco Contro
In response to the increase in e-cigarette use, in 2009 the WHO Study Group on Tobacco Product Regulation reviewed the evidence to date, and recommended that ENDS should be ‘regulated as combination drugs and medical devices and not as tobacco products.’24
At the Fifth Session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control (FCTC) in November 2012, the WHO was invited to report on the ‘control and prevention of smokeless tobacco products and electronic nicotine delivery systems, including electronic cigarettes’,25 and to present this report to the Sixth Session of the Conference of Parties, to be held in 2014.
In the lead-up to the release of this report, Dr Margaret Chan, Director-General of the WHO, was sent a letter signed by 53 ‘specialists in nicotine science and public health policy,’ urging the WHO to consider the potential for tobacco harm reduction products to reduce the burden of smoking-related disease.26 In the following weeks a second letter signed by 129 ‘public health and medical authorities from 31 countries’ was sent to Dr Chan, countering the arguments put forward in the first letter and encouraging the WHO to maintain its evidence-based approach to shaping an appropriate regulatory framework for ENDS.27
In October 2014, the WHO presented its report Electronic nicotine delivery systems to Sixth Session of the FCTC Conference of the Parties in Moscow.28 The report included the following clauses:
General considerations (clauses 33–38)
The Conference of the Parties accepted the WHO report and requested that the WHO be further invited to prepare ‘an expert report, with independent scientists and concerned regulators… with an update on the evidence of the health impacts of ENDS/ENNDS, potential role in quitting tobacco usage, impact on tobacco control efforts, and to subsequently assess policy options’ for the prevention and control of ENDS.29
The updated report was presented to the Seventh Session of the Conference of the Parties, which took place in India in November 2016.30 As to the potential role of e-cigarettes in tobacco control, it concludes that:
The decision following the report:
At the Eighth Session of the Conference of the Parties that took place in Switzerland in 2018 the decision was made to formally recognise heated tobacco products as tobacco products and therefore were made subject to the provisions of the WHO FCTC and domestic legislation. Parties were also reminded to prioritise protecting tobacco-control policies and activities from the commercial interests of novel and emerging tobacco product industries, in accordance with Article 5.3 of the WHO FCTC. In addition to applying measures in Article 13 of the WHO FCTC to the advertising, promotion and sponsorship of novel and emerging tobacco products.33
In 2019, the WHO Report on the Global Tobacco Epidemic made the following statement:
World Federation of Public Health Associations
The World Federation of Public Health Associations (WFPHA) has announced its support for the recommendations provided by the WHO in its 2014 report, Electronic nicotine delivery systems.28 In its position statement, the WFPHA:35
In support of the WHO approach, the WFPHA calls for regulations to:
International Union Against Tuberculosis and Lung Disease
The International Union Against Tuberculosis and Lung Disease (the Union) recognises tobacco use as a global public health challenge. The Union issued a position statement on ECs/ENDS in 2013,36 and an update in October 2014.37
Key messages of the updated statement include that:
Forum of International Respiratory Societies
The Forum of International Respiratory Societies (FIRS) is composed of professional organisations and experts in respiratory disease. Member societies include Asociacio´n Latinoamericana del To´rax, the American College of Chest Physicians, the American Thoracic Society, the Asian Pacific Society of Respirology, the European Respiratory Society, the International Union Against Tuberculosis and Lung Disease and the Pan African Thoracic Society. FIRS’ 2014 position on electronic nicotine delivery devices includes the following statements:38
The FIRS released a further position statement in 2018,39 specifically addressing e-cigarette use in youth. It concludes:
World Medical Association
The World Medical Association (WMA) is an independent federation of 111 national medical associations, including the Australian Medical Association.40 In its 2012 statement Electronic cigarettes and other electronic nicotine delivery systems,41 the WMA recommended:
18B.10.4 Overseas agencies
- Many overseas agencies have issued position statements. Some of these include:
- American Academy of Family Physicians42
- American Academy of Pediatrics43
- American Association for Cancer Research and the American Society of Clinical Oncology44
- American Cancer Society45
- American College of Cardiology46
- American College of Obstetricians and Gynecologists47
- American College of Physicians48
- American College of Preventive Medicine49
- American Heart Association50
- American Lung Association51
- American Medical Association52
- American Public Health Association53
- American Society of Addiction Medicine54
- British Medical Association55
- California Department of Public Health56
- Canadian Cancer Society57
- Cancer Society New Zealand58
- Council of Chief Medical Officers of Health (Canada)59
- European Public Health Association60
- European Respiratory Society61 ,62
- House of Commons (UK)63
- National Academies of Science, Engineering and Medicine64
- National Alliance for Hispanic Health65
- National Institute for Health and Care Excellence (UK)66
- New Zealand Ministry of Health67
- Public Health England68 ,69
- Royal College of Midwives (UK)70
- Royal College of Physicians (UK)71
- Royal College of Physicians (UK) and 10 other UK health agencies writing in support of Public Health England’s position72
- Royal College of Psychiatrists (UK)73
- Society for Adolescent Health and Medicine74
- Truth Initiative (US)75
- US Department of Health and Human Services76
- US Food and Drug Administration77 ,78
- US National Institute on Drug Abuse79
- US Preventive Services Task Force80
- US Surgeon General76 ,81
A 2018 review of international position statements found five major recommendation types:
- Statements encouraging the use of e-cigarettes as cessation aids or alternatives for smokers;
- Statements supporting individuals who use e-cigarettes for cessation;
- Statements recommending avoiding e-cigarettes until further information is available;
- Statements advising access to e-cigarettes be restricted;
- Statements advising e-cigarette use be prohibited.82
Overall, compared to Australian health agencies, the use of e-cigarettes as a device for harm reduction is more widely supported in the UK and New Zealand (see also Section 18B.9). The recommendations Australian organisations express greater concern about e-cigarettes and the current lack of safety and efficacy evidence. In particular, the addictive potential of nicotine in e-cigarettes as a gateway to tobacco for non-smoking youth and potential undermining of progress made in tobacco control.83
Relevant news and research
For recent news items and research on this topic, click here. (Last updated July 2020)
1. Australian Government. Australian Government response to the Standing Committee on Health, Aged Care and Sport Report on the Inquiry into the Use and Marketing of Electronic Cigarettes and Personal Vaporisers in Australia. 2020. Available from: https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/ElectronicCigarettes/Government_Response.
2. Therapeutic Goods Administration. TGA Basics. Canberra: Department of Health, 27 November 2015. Last update: Viewed Available from: https://www.tga.gov.au/tga-basics.
3. Therapeutic Goods Administration. Electronic cigarettes. Canberra: Department of Health, 30 March 2015. Last update: Viewed Available from: https://www.tga.gov.au/community-qa/electronic-cigarettes.
4. Department of Health. E-cigarettes linked to severe lung illness, in Australian Government 2019. Available from: https://www.health.gov.au/news/e-cigarettes-linked-to-severe-lung-illness.
5. Cancer Council Australia. Independent experts back stronger government stance on e-cigarette threat, 2019. Available from: https://www.cancer.org.au/news/media-releases/independent-experts-back-stronger-government-stance-on-e-cigarette-threat.html.
6. Australian Competition & Consumer Commission. Electronic cigarettes. Available from: https://www.productsafety.gov.au/products/health-lifestyle/personal/tobacco-related-products/electronic-cigarettes
7. National Health and Medical Research Council, NHMRC Home Page. Canberra: NHMRC; 2015. Available from: https://www.nhmrc.gov.au/.
8. NHMRC CEO Statement: Electronic Cigarettes (E-Cigarettes). Australia 2017. Available from: https://nhmrc.gov.au/about-us/publications/ceo-statement-electronic-cigarettes.
9. Byrne S, Brindal E, Williams G, Anastasiou K, Tonkin A, et al. E-cigarettes, smoking and health. A Literature Review Update. CSIRO, Australia, 2018. Available from: https://www.csiro.au/en/Research/BF/Areas/Nutrition-and-health/Public-health-and-wellbeing/Case-studies/E-cigarettes-report.
10. National Industrial Chemicals Notification and Assessment Scheme (NICNAS). Non-nicotine liquids for e-cigarette devices in Australia: chemistry and health concern. Australian Governement Department of Health, 2019. Available from: https://www.nicnas.gov.au/_disabled20200701/chemical-information/Topics-of-interest2/subjects/non-nicotine-e-cigarette-liquids-in-australia/summary-and-key-findings.
11. Statement on e-cigarettes in Australia. Australian Medical Association, Cancer Australia, Cancer Council Australia, National Heart Foundation of Australia, Thoracic Society of Australia and New Zealand, 2018. Last update: Viewed Available from: https://canceraustralia.gov.au/sites/default/files/statement_on_e-cigarettes_february_2018_0.pdf.
12. Cancer Council Australia and Heart Foundation, Position statement - electronic cigarettes. Cancer Council Australia; 2015. Available from: http://wiki.cancer.org.au/policy/Position_statement_-_Electronic_cigarettes.
13. Australian Medical Association. Tobacco smoking and e-cigarettes. 2015. Available from: https://ama.com.au/position-statement/tobacco-smoking-and-e-cigarettes-2015
14. Public Health Association Australia. E-cigarettes: Policy Position Statement. 2018. Last update: Viewed Available from: https://www.phaa.net.au/documents/item/2949.
15. Lung Foundation Australia, E-cigarettes. Brisbane: Lung Foundation Australia; 2014. Available from: http://lungfoundation.com.au/wp-content/uploads/2014/05/Lung-Foundation-Australia-E-Cigarettes-Position-Statement-18-June-2014.pdf.
16. Thoracic Society of Australia and New Zealand and Lung Foundation Australia. Submission to Inquiry into the Use of Electronic Cigarettes and Personal Vaporisers in Australia 2017. Available from: https://www.thoracic.org.au/documents/item/1051.
17. Royal Australasian College of Physicians. Policy on Electronic Cigarettes. 2018. Available from: https://www.racp.edu.au/docs/default-source/advocacy-library/policy-on-electronic-cigarettes.pdf
18. The Royal Australasian College of Physicians. The Royal Australasian College of Physicians’ submission to the Health Select Committee in Smokefree Environments and Regulated Products (Vaping) Amendment Bill Paenga-whāwhā 20202020. Available from: https://www.racp.edu.au/docs/default-source/advocacy-library/racp-submission-to-the-health-select-committee-smokefree-environments-and-regulated-products-vaping-amendment-bill.pdf?sfvrsn=fe0ce81a_6.
19. Australian Council on Smoking and Health. Statement from Australian Council on Smoking and Health to the Select Committee on Personal Choice and Community Safety, Legislative Council, Parliament of Western Australia. 2019. Available from: http://www.parliament.wa.gov.au/parliament/commit.nsf/(Evidence+Lookup+by+Com+ID)/85582C1C0806EF1E482583CC001FB1DE/$file/cs.ccs.190327.tbp.001.kf.002.pdf.
20. VicHealth. Submission to the Standing Committee on Health, Aged Care and Sport. Inquiry into the use and marketing of electronic cigarettes and personal vaporisers in Australia. 2017. Available from: https://www.vichealth.vic.gov.au/-/media/ResourceCentre/PublicationsandResources/VicHealth-submission.pdf?la=en&hash=0D8552AC1541862BFB197248FB3C28D05CEB7817.
21. Australian Dental Association. Re: Inquiry into the Use and Marketing of Electronic Cigarettes and Personal Vaporisers in Australia. 2017. Available from: https://www.ada.org.au/News-Media/News-and-Release/Submissions/Use-and-Marketing-of-E-Cigarettes-and-Personal-Vap/20170706-E-cigarettes.
22. The Royal Australian and New Zealand College of Psychiatrists. Position Statement 97: E-cigarettes and vaporisers in RANZCP2018. Available from: https://www.ranzcp.org/News-policy/Policy-submissions-reports/Document-library/E-cigarettes-and-vaporisers.
23. The Royal College of General Practitioners. Supporting smoking cessation: A guide for health professionals. East Melbourne, Vic: RACGP, 2019. Available from: https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/supporting-smoking-cessation/about-this-guideline.
24. World Health Organization. WHO Study Group on Tobacco Product Regulation: report on the scientific basis of tobacco product regulation: third report of a WHO Study Group. WHO technical report series no. 955. Geneva: World Health Organization, 2009. Available from: http://whqlibdoc.who.int/publications/2009/9789241209557_eng.pdf.
25. Conference of the Parties to the WHO Framework Convention on Tobacco Control. FCTC/COP5(10). Control and prevention of smokeless tobacco products and electronic nicotine delivery systems, including electronic cigarettes. Fifth session, Seoul, Republic of Korea, 12–17 November 2012. Geneva: WHO, 2012. Available from: http://apps.who.int/gb/fctc/PDF/cop5/FCTC_COP5(10)-en.pdf.
26. Abrams D, Axello T, Bartsch P, Bauld L, Borland R, et al. Reducing the toll of death and disease from tobacco - tobacco harm reduction and the Framework Convention on Tobacco Control 2014. Available from: https://nicotinepolicy.net/documents/letters/MargaretChan.pdf
27. Aktan O, Alexanderson K, Alleback P, de Araujo AJ, Arora M, et al., Letter to Dr Margaret Chan, Director General, World Health Organization, signed by 129 public health and medical authoroities from 31 countries urging evidence-based approach to ecigs. 16 June 2014. Available from: https://tobacco.ucsf.edu/129-public-health-and-medical-authorities-31-countries-write-who-dg-chan-urging-evidence-based-appro.
28. World Health Organization. Electronic nicotine delivery systems. Report by WHO to the Conference of the Parties to the WHO Framework Convention on Tobacco Control. Geneva: World Health Organization 2014. Available from: http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf?ua=1.
29. Conference of the Parties to the WHO Framework Convention on Tobacco Control. FCTC/COP6(9). Decision. Electronic nicotine delivery systems and electronic non-nicotine delivery systems. Sixth session, Moscow, Russian Federation, 13–18 October 2014. Geneva: WHO, 2014. Available from: http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6(9)-en.pdf?ua=1.
30. WHO Framework Convention on Tobacco Control, India to host the seventh session of the Conference of the Parties (COP7) and the first session of the Meeting of the Parties (MOP1). Geneva: WHO; 2016. Available from: http://www.who.int/fctc/news/cop7tobehostedinindia/en/.
31. Conference of the Parties to the WHO Framework Convention on Tobacco Control. FCTC/COP/7/11. Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS). Seventh session, Delhi, India 2016. Last update: Viewed Available from: https://www.who.int/fctc/cop/cop7/FCTC_COP_7_11_EN.pdf?ua=1.
32. Conference of the Parties to the WHO Framework Convention on Tobacco Control. Decision FCTC/COP7(9) Electronic nicotine delivery systems and electronic non-nicotine delivery systems. Seventh session. Delhi, India 2016. Last update: Viewed Available from: https://www.who.int/fctc/cop/cop7/FCTC_COP7_9_EN.pdf?ua=1.
33. Conference of the Parties to the WHO Framework Convention on Tobacco Control. DECISION FCTC/COP8(22) Novel and emerging tobacco products Eighth session. Geneva, Switzerland 2018. Available from: https://www.who.int/fctc/cop/sessions/cop8/FCTC__COP8(22).pdf?%22&ua=1.
34. World Health Organization. WHO Report on the Global Tobacco Epidemic, 2019. Geneva 2019. Available from: https://www.who.int/tobacco/global_report/en/.
35. World Federation of Public Health Associations, Statement by the World Federation of Public Health Associations on electronic cigarettes. Geneva: World Federation of Public Health Associations; 2015. Available from: http://www.wfpha.org/images/events/141218_WFPHA_ECig_Statement_FINAL.pdf.
36. International Union Against Tuberculosis and Lung Disease. Position statement on electronic cigarettes (ECs) or electronic nicotine delivery systems (ENDS). October 2013. Paris: International Union Against Tuberculosis and Lung Disease, 2013. Available from: https://www.theunion.org/what-we-do/publications/official/body/E-cigarette_statement_FULL.pdf.
37. International Union Against Tuberculosis and Lung Disease. Summary Position Statement on e-cigarettes (ECs) and electronic nicotine delivery systems (ENDS) 2014. Paris: International Union Against Tuberculosis and Lung Disease, 2014. Available from: https://www.theunion.org/what-we-do/publications/technical/english/The-Union-Summary-Position-Statement-ECs-ENDS-Update-2014-dec-2015.pdf.
38. Schraufnagel D, Blasi F, Drummond M, Lam D, Latif E, et al. Electronic cigarettes. A position statement of the Forum of International Respiratory Societies. American Journal of Respiratory and Critical Care Medicine, 2014; 190:611–18. Available from: http://www.atsjournals.org/doi/pdf/10.1164/rccm.201407-1198PP
39. Ferkol TW, Farber HJ, La Grutta S, Leone FT, Marshall HM, et al. Electronic cigarette use in youths: a position statement of the Forum of International Respiratory Societies. European Respiratory Journal 2018; 51(5). Available from: https://www.ncbi.nlm.nih.gov/pubmed/29848575
40. World Medical Association, World Medical Association Members' List. Geneva: World Medical Association; 2016. Available from: http://www.wma.net/en/60about/10members/21memberlist/index.html.
41. World Medical Association, Statement on Electronic Cigarettes and Other Electronic Nicotine Delivery Systems. Geneva: World Medical Association; 2012. Available from: https://www.wma.net/policies-post/wma-statement-on-electronic-cigarettes-and-other-electronic-nicotine-delivery-systems/.
42. American Academy of Family Physicians. Electronic Nicotine Delivery Systems (ENDS). 2019. Available from: https://www.aafp.org/about/policies/all/e-cigarettes.html.
43. American Academy of Pediatrics. E-Cigarettes and Similar Devices. 2018. Available from: https://pediatrics.aappublications.org/content/pediatrics/143/2/e20183652.full.pdf.
44. Brandon T, Goniewicz M, Hanna N, Hatsukami D, Herbst R, et al. Electronic Nicotine Delivery Systems: A policy statement from the American Association for Cancer Research and the American Society of Clinical Oncology. Journal of Clinical Oncology, 2015; 33(8):952–63. Available from: http://jco.ascopubs.org/content/33/8/952.long
45. American Cancer Society. American Cancer Society Position Statement on Electronic Cigarettes. Stay Away from Tobacco, 2018. Available from: https://www.cancer.org/healthy/stay-away-from-tobacco/e-cigarette-position-statement.html.
46. American College of Cardiology. ACC Encouraged by FDA's Commitment to Reducing Youth Vaping. 2018. Available from: https://www.acc.org/about-acc/press-releases/2018/11/15/12/29/acc-encouraged-by-fdas-commitment-to-reducing-youth-vaping.
47. American College of Obstetricians and Gynecologists. Electronic nicotine delivery systems (ENDS). 2017. Available from: https://www.acog.org/-/media/Departments/Tobacco-Alcohol-and-Substance-Abuse/5AsENDSfactsheet.pdf?dmc=1&ts=20190503T2008209656.
48. American College of Physicians. Internists Encouraged by Surgeon General’s Declaration That Youth E-Cigarette Use is an Epidemic. 2018. Available from: https://www.acponline.org/acp-newsroom/internists-encouraged-by-surgeon-generals-declaration-that-youth-e-cigarette-use-is-an-epidemic.
49. Livingston CJ, Freeman RJ, Costales VC, Westhoff JL, Caplan LS, et al. Electronic Nicotine Delivery Systems or E-cigarettes: American College of Preventive Medicine's Practice Statement. American Journal of Preventive Medicine, 2019; 56(1):167–178. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30573147
50. Bhatnagar A, Whitsel LP, Ribisl KM, Bullen C, Chaloupka F, et al. Electronic Cigarettes: A policy statement from the American Heart Association. Circulation, 2014; 130(16):1418–1436. Available from: http://circ.ahajournals.org/content/130/16/1418.short
51. American Lung Association. E-Cigarettes. 2019. Available from: https://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html.
52. American Medical Association. Sales and Distribution of Tobacco Products and Electronic Nicotine Delivery Systems (ENDS) and E-cigarettes H-495.986. 2018. Available from: https://policysearch.ama-assn.org/policyfinder/detail/tobacco?uri=%2FAMADoc%2FHOD.xml-0-4518.xml.
53. American Public Health Association. Supporting Regulation of Electronic Nicotine Delivery Systems. 2018. Available from: https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2019/01/28/supporting-regulation-of-electronic-nicotine-delivery-systems.
54. American Society of Addiction Medicine. Public Policy Statement on E-Cigarettes. 2018. Available from: https://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2018/04/24/e-cigarettes.
55. British Medical Association's Board of Science and Occupational Medicine Committee, BMA calls for strong regulation of e-cigarettes. London: British Medical Association; 2014. Available from: https://www.bma.org.uk/collective-voice/committees/board-of-science/publications.
56. California Department of Public Health. Vaping Related Lung Illness: A Summary of the Public Health Risks and Recommendations for the Public, in Health Advisory2019. Available from: https://www.cdph.ca.gov/Programs/CCDPHP/CDPH%20Document%20Library/California%20Department%20of%20Public%20Health%20-%20Health%20Advisory%20September%2024,%202019.pdf.
57. Canadian Cancer Society, Our perspective on e-cigarettes. Toronto: Canadian Cancer Society; 2014. Available from: http://www.cancer.ca/en/about-us/news/national/2014/perspective-on-e-cigarettes/?region=on.
58. Cancer Society of New Zealand, Position statement on electronic cigarettes. 2011. Available from: https://auckland-northland.cancernz.org.nz/assets/Positions-Statements/E-cigarette-Position-statementFINALJul13.pdf.
59. Theresa T, Henry B, Brendan H, Fitzgerald J, Morrison H, et al. Statement from the Council of Chief Medical Officers of Health on Nicotine Vaping in Canada, in Public Health Agency of Canada2020. Available from: https://www.canada.ca/en/public-health/news/2020/01/statement-from-the-council-of-chief-medical-officers-of-health-on-nicotine-vaping-in-canada.html.
60. European Public Health Association. Facts and fiction on e-cigs 2018. Available from: https://eupha.org/repository/advocacy/EUPHA_facts_and_fiction_on_e-cigs.pdf
61. Loukides S. ERS Position Paper on Tobacco Harm Reduction, in European Respiratory Society 2019. Available from: https://www.ersnet.org/professional-development/respiratory-digests/digest-ers-position-paper-on-tobacco-harm-reduction.
62. Bals R, Boyd J, Esposito S, Foronjy R, Hiemstra PS, et al. Electronic Cigarettes - Task Force report from the European Respiratory Society. European Respiratory Journal 2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30464018
63. House of Commons Science and Technology Committee. E-cigarettes. Seventh Report of Session 2017–19, London: UK 2018. Available from: http://publications.parliament.uk/pa/cm201719/cmselect/cmsctech/505/505.pdf.
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