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Areas for further research

Research needs have been identified in a number of articles and reports (Etter et al., 2011; Warner, 2009; Hatsukami et al., 2012). The following list, derived from these reports and other gaps identified in the literature, is not intended to be exhaustive but rather to indicate priority areas.

In vitro research

  • The composition of e-cigarette fluids and vapor.
  • In vitro assessment of cytotoxicity of e-cigarette fluid and vapor.
  • Puff topography studies of e-cigarettes.

Animal research

  • Studies of the pharmacodynamics and pharmacokinetics of e-cigarettes to investigate the disposition of e-cigarette component substances following inhalation.
  • Toxicology studies, in particular those of the effects of long-term exposure and fetal exposure to toxins with maternal use of e-cigarettes.

Clinical research

  • Safety studies in humans, especially studies of long-term users including follow up to identify harms from prolonged exposure to the contents of e-cigarette vapor.
  • Studies of the effect of e-cigarettes on motivation and self-efficacy to quit smoking, including cohort studies of smokers to measure the extent of switching to e-cigarettes and dual use of e-cigarettes and tobacco.
  • Cessation efficacy trials in a range of population groups, including groups more vulnerable to tobacco dependence, such as people with mental illness and indigenous peoples.
  • Smoking reduction efficacy trials.
  • Studies of the potential for e-cigarettes to be a gateway product to tobacco use, including cohort studies to measure initiation to using e-cigarettes compared to initiation to smoking tobacco cigarettes.
  • Studies that examine if e-cigarette only users have difficulty stopping their use and experience withdrawal symptoms.
  • Studies that investigate if e-cigarette use leads to nicotine dependence in novices more or less rapidly than tobacco products.
  • Studies that explore the known predictors of initiation of cigarette smoking, (such as risk taking) in regard to e-cigarette use among adolescents.
  • Studies of the abuse liability potential of e-cigarettes.

Public health research

  • Surveillance of e-cigarette marketing
  • Surveillance of e-cigarette labeling
  • Studies of the involvement of the tobacco industry in e-cigarette production and marketing.
  • Studies of consumer perceptions of e-cigarettes for smoking cessation.
  • Studies of public perceptions of e-cigarette use in settings that are designated  ‘smoke-free’.
  • Studies of the risks from e-cigarette modifications.
  • Studies of e-cigarette use in specific population groups with high vulnerability, such as indigenous peoples and people with mental health conditions
  • Behavioral economics studies of e-cigarettes to assess the effects of price on purchasing behaviors.
  • Economic evaluations of e-cigarettes under a range of scenarios.
  • Policy analysis of a range of regulatory options.

Etter JF, Bullen C, Flouris AD, Laugesen M, Eissenberg T. Electronic nicotine delivery systems: a research agenda. Tob Control. 2011 May;20(3):243-8.

Hatsukami DK, Biener L, Leischow SJ, Zeller MR. Tobacco and nicotine product testing. Nicotine Tob Res. 2012 Jan;14(1):7-17.

Mayer B. How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century. Arch Toxicol. 2014 Jan;88(1):5-7.

Warner KE. Tobacco research methodology: first things first. Cancer Epidemiol Biomarkers Prev. 2009 Dec;18(12):3140-2. logo
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