Internists' Paper Offers Policy Guidance on Electronic Nicotine Delivery System Regulation and Oversight

Provides recommendations for ACP, policymakers, and regulators considering electronic cigarettes and other products

(Washington, April 21, 2015)- A new position paper from the American College of Physicians (ACP) offers strong recommendations for regulating electronic nicotine delivery systems (ENDS), including banning characterizing flavors and television advertising. An executive summary of ACP's paper, Electronic Nicotine Delivery Systems: An American College of Physicians Policy Position Paper, is published in the April 21 Annals of Internal Medicine.

"This paper is not intended to offer clinical guidance or serve as an exhaustive literature review of existing electronic nicotine delivery system (ENDS)-related evidence," noted David A. Fleming, MD, MA, MACP, ACP president, "but to help direct the College, policymakers, and regulators on how to address these products. In this position paper, ACP offers a half-dozen policy recommendations on ENDS regulation and oversight, taxation, flavorings, promotion and marketing, indoor and public use, and research."

Electronic nicotine delivery systems, which include electronic cigarettes, or e-cigarettes, are growing in popularity, but their safety and efficacy as a smoking cessation aid are not well understood, the paper explains. There is concern that the health effects of ENDS use are unknown, that they may appeal to young people, and that they may encourage dual use of ENDS and traditional tobacco products. Many believe that ENDS may be useful as a smoking cessation aid and the paper calls for research to help determine the long-term health consequences of ENDS use and whether regulated products would have clinical merit. Although ENDS are currently unregulated the U.S. Food and Drug Administration has proposed regulations that would deem ENDS to be subject to the Family Smoking Prevention and Tobacco Control Act, which regulates cigarettes and other tobacco products.

"Despite the widespread popularity and availability of ENDS, little is known about the direct and second- hand long-term effects of their use or their potential as a smoking cessation aid," Dr. Fleming pointed out. "ACP supports strong regulations to ensure product safety and transparency, policies that prevent use among young people, increased research to better determine their health effects, strong limits on marketing and promotion, and application of indoor air laws to protect the health of bystanders."


The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

Contact: David Kinsman, (202) 261-4554