Absolute and relative risks of electronic cigarettes

Time: 13:10 - 13:25

Date: Wednesday 8th December 2021

Despite the major impact of tobacco regulation on smoking prevalence, smoking conventional cigarettes continues to pose a significant public health concern. Among continuing efforts to mitigate this harm, methods to aid smoking cessation have an important role to play. Electronic nicotine delivery systems (ENDS or e-cigarettes) deliver nicotine at a rate and extent similar to those of conventional cigarettes and hence potentially provide an effective nicotine replacement. On request from the Department of Health and Social Care (DHSC) and Public Health England (PHE), the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) was asked to review the potential toxicological risks from ENDS to assist in the assessment of the possible public health benefit of these products. The Committee therefore assessed the relative risks, compared to smoking conventional cigarettes, in those switching products, as well as the absolute risks from use of ENDS to former cigarette smokers, naïve users, and bystander. ENDS are not without risk, although these are substantially less than those of conventional cigarettes, although the difference in risk depends on the health effect in question. There is little evidence that the short to medium term use of ENDS causes major harm, but there are significant data gaps, particularly on the effects of long-term use. In addition, the use of ENDS de novo by non-users of tobacco products is likely to be associated with some adverse health effects to which the user would not otherwise have been subject. The risks to bystanders for most health effects will be low in conventional exposure scenarios, although exposure to nicotine may result in pharmacological effects in some individuals. It is important that this information is not considered in isolation, but in the wider context of the public health consequences of smoking conventional cigarettes.


  • Prof Alan Boobis, OBE Emeritus Professor of Toxicology & Chair - UK Committee on Toxicity - Imperial College London

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