Conclusions

The needs of smokers for a safer alternative source of nicotine can be reconciled with common-sense steps to protect against youth vaping. This conclusion is grounded in the best available data on the use and consequences of e-cigarette use. That data is necessarily incomplete. It is possible that new data could change the risk/benefit calculus. But equally, and by the same standard, the evidence available now that restrictive policies have unintended consequences must also inform efforts to perpetuate and duplicate those policies. Failure on this front risks perpetuating the very harms that the precautionary approach seeks to avoid, namely smoking. The most stringent restrictions—bans—also risk forfeiting the opportunities afforded by regulation to make e-cigarettes safer and sacrifice a chance to age-gate sales. E-cigarette regulation is about more than simply the products’ potential to reduce smoking and the attendant risks: The science behind e-cigarette regulation must be communicated in such a way that it instills public confidence in the agencies of public health. Public health decisions that elevate plausible risks over the demonstrable benefit, risk jeopardizing the potential for those institutions to inform health-relevant decisions in other areas.