A panel of public health experts has found that teens who use e-cigarettes are more likely to try smoking, and devices that deliver nicotine can be addictive.

However, the experts said that e-cigarettes were less harmful than smoking.

The report comes from a panel at the National Academies of Science, Engineering and Medicine, which assessed more than 800 peer-reviewed studies.

“E-cigarettes cannot be simply categorized as either beneficial or harmful,” said David Eaton, chair of the committee that wrote the report, and dean and vice-provost at the University of Washington.

“In some circumstances, such as their use by non-smoking adolescents and young adults, their adverse effects clearly warrant concern,” he said. “In other cases, such as when adult smokers use them to quit smoking, they offer an opportunity to reduce smoking-related illness.”

The report stopped short of calling vaping healthy. E-cigarettes produce fewer toxic substances than smoking, but there is “conclusive” evidence e-cigarettes “emit numerous potentially toxic substances” in addition to nicotine, it said.

The long-term impacts of the devices are unclear, and could veer negative, the report warned.

“There is substantial evidence that e-cigarette use by youth and young adults increases their risk of ever using conventional cigarettes,” the report states.



Whether e-cigarettes will help or harm public health is intensely debated among researchers. American teens are already using e-cigarettes at high rates. The US’s largest survey of adolescent drug use, the Monitoring the Future survey, found one-third (35.8%) had tried vaping by the end of high school. Some 26.6% had tried smoking.

In the United States, critics argue e-cigarettes do more harm than good – encouraging teens to smoke or, at minimum, pick up a habit whose long-term health effects are unknown. The report found substantial evidence that vaping can lead teens to try smoking.

Proponents, especially in the United Kingdom, focus on e-cigarettes’ harm reduction potential. Current modeling, the report said, shows e-cigarettes could have a net positive effect, “at least in the short run”, if they help adults stop smoking.

Smoking is the leading preventable cause of death worldwide. Related illnesses kill 480,000 Americans and more than 7 million people worldwide each year.

The report comes at a crucial moment for the tobacco industry. Cigarette makers applied to the US Food and Drug Administration to sell vaping products with claims that e-cigarettes are less harmful than smoking.

Philip Morris International is also seeking approval from the FDA to sell IQOS “heat-not-burn” devices, and companies, including British American Tobacco, already own successful vape lines, including Vuse.