Health outcomes associated with the use of e-cigarettes, heated tobacco products, and nicotine pouches
Abstract
Tobacco consumption is the single most preventable cause of illness and death in the European Union, accounting for almost 520 000 deaths in 2021. The emergence of new tobacco and nicotine-related products, including electronic cigarettes (e-cigarettes), heated tobacco products, and nicotine pouches, has raised concerns about their potential health effects and role in smoking initiation and cessation. This report synthesises the evidence and interpretations from authoritative public health organisations, national health authorities, and official risk assessment bodies, on the associations between these emerging products and health outcomes, smoking initiation, and smoking cessation. Given the limited time these products have been on the market, the current evidence is largely restricted to short- and medium- term health outcomes, while there is lack of long-term evidence, for which the assessed reports highlight the need for further research to enable accurate risk estimation. E-cigarettes are not harmless and are associated with adverse short- and medium-term health outcomes, including cardiovascular and respiratory outcomes. There are also concerns surrounding the inhalation of nicotine, together with metals and other substances with unclear toxicity. Heated tobacco products, though there is less evidence available, have been associated with similar health risks as e-cigarettes. In turn, nicotine pouches lack sufficient evidence regarding their health effects due to…
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