A consensus statement on electronic nicotine delivery systems (ENDS)

Introduction Electronic nicotine delivery systems (ENDS) use has dramatically increased in Spain since 2014, especially among younsters. There has been an important marketing campaign claiming their presumed benefit as a harm reduction tool or as a strategy to quit tobacco. Influencers have promoted their use in social networks. Spanish regulation allows the use of ENDS in most public places, and some means of marketing. Therefore, the Spanish National Committee for Smoking Prevention (CNPT) developed a consensus statement to develop advocacy actions to prevent and control the use of ENDS. Objective To describe the elaboration of the consensus statement and its recommendations. Material and Methods A group of experts in tobacco from different disciplines reviewed the literature concerning: • Health issues in ENDS users and bystanders. Impact on tobacco prevalence and tobacco initiation. • Potential benefits in tobacco cessation or in harm reduction. • Marketing strategies to promote their use. • Current regulatory measures and their caveats. Recommendations were evidence based. The statement was reviewed by the scientific societies gathered in the Spanish National Committee for Smoking Prevention. Results We reviewed 129 papers related to ENDS use. The statement was divided in 4 parts: • Scale of the problem. • Safety issues, toxicity, and health issues. • Potential therapeutic properties. • Regulation and control. Recommendations and conclusions were evidence-based and in line with to FCTC (Framework Convention on Tobacco Control). The statement was published in Spanish and English in the CNPT website (https://cnpt.es/) and was sent to the Ministry of Health. Dissemination of the statement was made in the media and social networks. Conclusions Evidence does not support the safety profile of ENDS, nor their utility as a smoking cessation or harm reduction strategy. The statement counterbalances the misleading messages and manipulation from the vaping industry. It also promotes advocacy and the need for a stronger regulation of ENDS use. The statement supports that regulatory measures should be the same as for to tobacco control. Actions to prevent the use of ENDS are warranted.