WHO's Call for E-Cigarette Ban Criticized

From the WebMD Archives

Sept. 5, 2014 -- A report commissioned by the World Health Organization (WHO) into e-cigarettes, which called for them to be banned in public places and workplaces, has been criticized as misleading by a group of U.K. tobacco and addiction specialists.

The WHO report says use of e-cigarettes could increase levels of toxins and nicotine in the air.

But experts writing in the journal Addiction say the evidence behind the WHO report is riddled with errors, misinterpretations, and misrepresentations.

Furthermore, they say, it could persuade policymakers to ignore the potential public health benefits of e-cigarettes.

Asked for a response to the criticism, a WHO spokesman referred WebMD to its report and background paper.

Health Benefits

Ann McNeill, PhD, the lead author of the article in Addiction, says in a statement: "We were surprised by the negativity of the commissioned review, and found it misleading and not an accurate reflection of available evidence.

"E-cigarettes are new and we certainly don't yet have all the answers as to their long-term health impact, but what we do know is that they are much safer than cigarettes, which kill over 6 million people a year worldwide," says McNeill, deputy director of the U.K. Centre for Tobacco & Alcohol Studies.

Saving Lives

Meanwhile, another group of health experts says that encouraging today's smokers to switch to e-cigarettes could save tens of thousands of lives each year.

Writing in the British Journal of General Practice, Robert West, PhD, director of tobacco studies at University College London, says persuading a million smokers to switch to an e-cigarette could lead to 6,000 lives being saved each year "even in the event that e-cigarette use carries a significant risk of fatal diseases.”

He writes, "Given that smokers smoke primarily for the nicotine but die primarily from the tar, one might imagine that e-cigarettes would be welcomed as a means to prevent much of the death and suffering caused by cigarettes."


The article by McNeill and colleagues takes 9 key statements in the WHO-commissioned review and provides an alternative conclusion and a commentary. For instance:

  • The review implies that e-cigarette use among young people is a major problem and could be acting as a gateway to smoking. But in the U.K, use of e-cigarettes in nonsmoking youngsters is very low, and there is virtually no regular use in children who have never smoked or used tobacco, they write. (In the U.S., this is not true: E-cigarette use in kids and teens has doubled; a quarter of a million kids who had never smoked tried e-cigarettes last year, according to the CDC.)
  • The review fails to acknowledge that e-cigarettes are not just less harmful than tobacco cigarettes but that the concentrations of toxins are mostly a tiny fraction of what is found in cigarette smoke.
  • The review infers that bystanders can inhale significant levels of toxins from the vapor when the concentrations are too low to present a significant health risk.

The authors criticize those behind the WHO-commissioned report for using alarmist language to describe findings and to present opinion as though it were evidence.

WebMD Health News Reviewed by Sheena Meredith, MD on September 05, 2014



McNeill, A. Addiction, published online Sept. 4 , 2014.

West, R. British Journal of General Practice, published online Sept. 5, 2014.

CDC: "Notes from the Field: Electronic Cigarette Use Among Middle and High School Students — United States, 2011–2012."

American Lung Association: "E-Cigarette Use Among Non-Cigarette Smoking Youth Triples."

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