Abstract

There is no consensus if electronic nicotine delivery systems (ENDS) should be used to reduce harm among the smoking population. Physicians, who represent a trusted source of health communication, are exposed to a range of often conflicting ENDS information and this information may be relayed to patients looking to quit smoking. Previous studies have examined ENDS content of various sources of media but there is a lack of knowledge about ENDS content in medical journals. We analyzed 421 ENDS publications printed between 2012 and 2018 from PubMed’s Core Clinical Journal list. Publications were analyzed based on publication type, journal type, study design, geographic focus, theme, terminology, outcomes, and positive/negative statements. The number of ENDS publications grew since 2012, and peaked in 2015. Across all years, negative statements about ENDS outnumbered positive statements, though this difference decreased over time. Over time, negative statements about “toxins and carcinogens” were made less frequently, while negative statements about “gateway effects” and “youth appeal” became more prevalent. UK journals had fewer negative statements relative to US journals. Only 12.6% of publications included guidance for healthcare professionals about ENDS. As published ENDS topics change over time, physicians’ communications with patients may be impacted.

Highlights

  • Electronic nicotine delivery systems (ENDS) are battery-powered devices that deliver nicotine and flavors to a user through an inhaled aerosol generated by vaporizing a heated liquid

  • The purpose of this study is to examine the frequency of ENDS publications, trends in ENDS terminology used, and topics/themes covered, and ENDS risk and benefit statements included in medical journals over time

  • Searching the core clinical journals on PubMed for our keywords resulted in 555 publications

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Summary

Introduction

Electronic nicotine delivery systems (ENDS) are battery-powered devices that deliver nicotine and flavors to a user through an inhaled aerosol generated by vaporizing a heated liquid. ENDS have been available in the United States since 2006 [1], and became a common product in traditional retail environments in 2010 [2]. ENDS represent a heterogeneous group of products that come in different styles, and a users’ exposure to toxicant and nicotine levels can depend on the type of device and how the device is used [3]. ENDS are predominantly used by smokers for smoking cessation, smoking reduction, and harm reduction [4]. Smokers find ENDS more appealing than traditional nicotine replacement therapy products [5,6]. There is no consensus among healthcare providers regarding recommending ENDS to patients who smoke as a means to reduce harm. Public Health 2020, 17, 2201; doi:10.3390/ijerph17072201 www.mdpi.com/journal/ijerph

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