Maintaining a comprehensive and continuous awareness of the science is critical to any winning legal strategy – especially when it comes to cases involving products like electronic cigarettes (e-cigarettes) where the science is constantly changing and emerging. The best science-based defenses are those that are informed and constantly up-to-date on the science.
E-cigarettes, sometimes referred to as Electronic Nicotine Delivery Systems (ENDS), function by heating up a liquid that contains nicotine, propylene glycol, glycerin, and varying flavoring components to create an aerosol inhaled by the user. These devices can take on a variety of sizes, shapes, and flavors – some designed to look just like conventional cigarettes while others take on the form of pipes, pens, or cigars – each targeted to attract a specific type of user.
The science surrounding e-cigarettes has skyrocketed over the last few years, and we have written quite a few previous posts about the safety and effectiveness of e-cigarettes in a variety of contexts (post 1, post 2, post 3, and post 4). E-cigarettes are often advertised as a safe way to quit smoking tobacco cigarettes; however, the data as to whether these claims are substantiated is still new and emerging.
To help you keep up with e-cigarette science, we provide below a brief update on some of the more important recently published studies, including the following topics: how young adults view e-cigarettes in comparison with tobacco-based products; how those views effect social interactions; and whether e-cigarettes are effective in helping users quit more traditional tobacco-based products.
Litigators should find this new information important because it demonstrates the benefits of e-cigarettes and identifies potential liability areas.
Surveyed Opinions on Benefits of E-cigarettes
A number of scientific studies have been published over the course of the last several months relating to user-based opinions on e-cigarette use. In general, these studies reported that users view e-cigarettes as safer than tobacco products as well as less addictive. These studies may be used by e-cigarette opponents to challenge the scientific basis of e-cigarette safety, and hence the validity of the perception that these products are safer than more traditional tobacco products.
In one study, 734 college students were administered a “Risks and Benefits of E-cigarettes (RABE) questionnaire.” The investigators reported that a statistically significant number of the surveyed students who were smokers reported benefits associated with e-cigarette use as compared to tobacco.
Another study found that e-cigarettes were viewed as safer and more beneficial than tobacco cigarettes and that these beliefs were even higher among current e-cigarette users. This study demonstrates the general opinion on e-cigarette safety and efficacy, and these beliefs could even be a driving force towards e-cigarette use.
Finally, another group reported that while a majority of people believe that tobacco cigarettes and cigars are addictive, less than half believe that e-cigarettes or hookah are addictive. Although, exposure to certain media sources seemed to cause people to view both products as addictive. This study shows that the general perception is that e-cigarettes are less addictive, an opinion that could potentially drive more e-cigarette use.
Taken as a whole, these studies may be used to demonstrate that e-cigarettes are generally viewed as safer, less addictive, and more beneficial than tobacco-based products. These findings could conceivably be used by opponents of e-cigarette manufacturers and marketers in various contexts.
E-cigarettes Changing Social Interactions
Current scientific studies can be used to support the view that e-cigarette usage is also changing social interactions between young adults. As social smoking becomes more prominent, more and more people are starting to smoke e-cigarettes without ever having used tobacco products.
Some recent studies have assessed the role of e-cigarettes in the context of social interactions. One study found that nearly one in five subjects were “social smokers.” This statistic cold be used by e-cigarette opponents to show how social interactions are causing teens to start smoking and is an important driving factor towards e-cigarette usage, especially if they are viewed as safer alternatives.
In another study, 8th and 11th graders in Oregon reported that e-cigarettes were the most common form of smoking (as opposed to tobacco products). The study also reports the introductory use of e-cigarettes was commonly reported among youths of all ages in Oregon.
Given the growing prominence of e-cigarettes in social interactions, e-cigarette opponents may assert that e-cigarettes are causing people, especially adolescents, to smoke who otherwise wouldn’t and may inappropriately use data such as these to present e-cigarettes as a gateway into tobacco.
E-cigarettes: Gateway to Tobacco or Effective Quitting Tool?
These recent studies raise the debate as to whether e-cigarettes are a gateway to tobacco use or if instead they are effective in reducing tobacco usage among adolescents and teenagers. More rigorously designed studies have recently addressed this issue and have generally found that e-cigarettes are at least moderately effective as alternatives for people actively trying to quit tobacco; however there is limited data to support the view that e-cigarettes are increasing the number of quit attempts.
One randomized controlled trial reported that e-cigarettes were just as effective as nicotine patches or placebo e-cigs in helping smokers quit. All three interventions were found to be “modestly effective” at helping smokers to quit.
In a recent British study, the investigators reported that e-cigarettes were helpful for people already attempting to quit tobacco, but their presence as an alternative did not increase the overall number of quit attempts or usage of other quitting aids
A recent German study reported that e-cigarettes were used primarily as alternatives to tobacco and nicotine substitutes. It was also noted that positive health changes were more visible.
These recent studies evaluating the role of e-cigarettes in helping users quit traditional tobacco use are critical to litigators because they serve a key role in demonstrating the potential benefits of e-cigarettes. It will be critical for litigators to demonstrate these benefits in any case involving allegations that e-cigarettes caused personal injury or that they were ineffective in various contexts.
Of course, these studies must be viewed in the broader historical context of the science. A review study published in 2015 concluded that e-cigarettes were, in fact, associated with smoking cessation and reduction rates. However, the study noted that there was not enough data to say if e-cigarettes were more effective than other quitting methods.
In contrast, a review published in 2016 concluded that there was no statistically significant evidence between e-cigarettes and smoking cessation because the studies were of very low quality. This article notes that many more high-quality studies need to be completed before a conclusion can be drawn.
The science is clearly still emerging over the efficacy of e-cigarettes and their claim that they assist in quitting tobacco. However, staying up to date on this emerging science is key, as new discoveries and liabilities are constantly emerging.
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