HealthDay News — Flavorings and television advertisements for e-cigarettes should be banned, according to a position paper released by the American College of Physicians in the Annals of Internal Medicine.

Electronic nicotine delivery systems (ENDS), which include e-cigarettes, have grown in popularity since they were made available in 2007. It is estimated that the use of ENDS has doubled among adult patients from 2010 to 2013.

Despite manufacturers’ claims, there is little evidence that ENDS help patients quit smoking. And the chemicals used in these devices may be harmful to both smokers and bystanders, Ryan Crowley, senior associate for health policy at the American College of Physicians (ACP), told HealthDay.

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“There are over 7,000 different flavorings in e-cigarettes, and the evidence shows that young people are attracted to these products because of the flavors,” Crowley said.

“There are also concerns that there are harmful chemicals in the flavorings themselves.”

Calling for a ban on television advertisements for e-cigarettes follows the ACP’s continuing policy supporting bans on all tobacco advertising. The organization also recommends taxing e-cigarettes and banning their use in both indoor and outdoor public areas, and urges more research on e-cigarettes.

The ACP joins a number of other organizations — including the American Medical Association, the American Heart Association, the American Association for Cancer Research, the American Society of Clinical Oncology, and the U.S. Surgeon General — in urging the FDA to start regulating e-cigarettes.

The e-cigarette industry, however, sees the ACP’s recommendations as overreaching. “The ACP’s policy recommendations read like a step-by-step guide to handing the vapor industry over to ‘Big Tobacco’ and making vaping a less effective alternative to smoking,” Gregory Conley, president of the American Vaping Association, told HealthDay.

“The ACP justifies this by cherry-picking studies that support its ideology, while ignoring many of those that do not.”

The ACP acknowledges that “this paper is not intended to offer clinical guidance or serve as an exhaustive literature review of existing ENDS-related evidence but to help direct the College, policymakers, and regulators on how to address these products.”


  1. Crowley RA et al. Ann Intern Med. 2015; doi:10.7326/M14-2481