Commentary — Is There a Place for E-Cigarettes in Tobacco Addiction Treatment Policy?

Tobacco remains a leading cause of preventable disease and premature death in the world, responsible for 5.4 million deaths annually. Diseases include but are not limited to cancer, cardiovascular and pulmonary diseases, respiratory tract infections, osteoporosis, reproductive disorders, gastrointestinal ulcers, and diabetes. A lifelong smoker has an approximately 50% chance of dying prematurely from a complication of smoking. Overall, smoking causes 1 in 10 adult deaths worldwide (Benowitz, 2010; Rom, Pecorelli, Valacchi, & Reznick, 2015; World Health Organization, n.d.). In the United States, about 45 million Americans smoke tobacco. Many smokers, 70% would like to quit but annually only 3% do. Smoking-related diseases take about 480,000 lives prematurely each year in the United States. Unfortunately, the rate at which persons become daily smokers almost matches the quit rate, so the prevalence of cigarette smoking has declined slowly in recent years (Benowitz, 2010; Centers for Disease Control and Prevention (CDC), 2009; Doll, Peto, Boreham, & Sutherland, 2004; Shiffman et al., 2006).

Policies such as cigarette taxes, marketing restrictions, smoke-free air laws, and comprehensive tobacco control programs to address smoking reduction have had some success. Other policies such as graphic health warnings and cessation treatment policies also reduce smoking when combined with other policies (Levy, Tam, Kuo, Fong, & Chaloupka, 2018). The burden of smoking-related…