Should scientists, who are supposed to use precise and accurate language, describe e-cigarettes as tobacco products? Is the World Health Organization (WHO)’s term of choice, Electronic Nicotine Delivery System – ENDS for short – really better?
The answer to both those questions is a resounding “no”, according to the editor-in-chief of a leading journal, Nicotine & Tobacco Research.
Marcus Munafò has issued a short but important editorial that says the journal will now adopt a policy of describing all products using terminology that is “clear, unambiguous, and scientifically appropriate” – and that means not describing e-cigs as “tobacco products”.
Munafò writes in “Are e-cigarettes tobacco products?” that in 2014 the US Food and Drug Administration (FDA) concluded that e-cigs were tobacco products, but this definition is US regulatory usage and is not used in some other countries.
As he says: “In Europe, while some elements of e-cigarette regulation are contained within the EU Tobacco Products Directive, the devices themselves are not referred to as tobacco products.
“If all products containing nicotine derived from tobacco were labelled as ‘tobacco products’ internationally, then nicotine replacement therapies would be classified as tobacco products, which they are clearly not. As a scientific journal, definitions matter, and a legal ruling in a single country is not a sound basis for determining whether a certain definition is valid.”
The journal’s preference, he adds, is for the term “tobacco products” to be reserved only for products that contain tobacco, rather than constituents such as nicotine.
Powerful US lobby
And as Munafò also points out, there are further problems in using the phrase “nicotine-containing products” as of course many vapers use liquids that do not contain nicotine – and adding the word “electronic”, as in the often-used ENDS, is problematic too because not all such devices are electronic.
A simpler approach, he says, would be to refer to “cigarettes”, “e-cigarettes” and so on, without reference to broader categories.
He also notes that with heat-not-burn (HnB) products around now there is more complexity, so getting terms right is even more important. An exception “would be cases where e-cigarettes are being referred to in a specific policy context (e.g. in relation to the FDA)”.
But he recognises that some readers of the journal may disagree with this approach. Although he does not mention this directly, there is clearly a powerful lobby not just in the US but worldwide that brands e-cigs as part of the tobacco industry and as tobacco products, and to be resisted in the same way as conventional cigarettes.
Much of the literature continues to call e-cigs tobacco products, including influential publications such as the US Surgeon General’s report, “E-cigarette use among youth and young adults”, where it is stated that “e-cigarettes are now the most commonly used tobacco product among youth”.
Other journals such as JAMA Pediatrics carry papers with the words “noncigarette tobacco product use” that includes e-cigs.
What This Means: While scientific language and regulatory language do not have to match exactly, there is clearly an extent to which the terms scientists use help to frame the debate, especially when repeated in mainstream media.
“E-cigarettes” is a useful, broad and largely neutral term, even if there are some who worry that the “cigarettes” element causes confusion with combustibles.
We agree that language matters, and try to be precise and non-prejudicial with it in ECigIntelligence. The commitment to accurate, scientific terminology is a good step forward by Nicotine & Tobacco Research, and we hope other journals – not to mention other media, politicians, and regulators – take note.
– Marc Beishon ECigIntelligence health correspondent
Photo: Charlotte de Garavan