Background Electronic cigarettes (e-cigarettes) are relatively new products with substantial public health impacts. Evidence on their effects is diverse and emerging rapidly, presenting challenges to high-quality policymaking and decision-making. This paper addresses these challenges by developing and presenting a framework for the public health assessment of e-cigarettes, using the Australian context as an example.
Methods Framework development involved stakeholder engagement, development of guiding principles, and consideration of existing relevant frameworks and the evidence requirements of current policy options, identified in published and grey literature.
Results Guiding principles include the need for the framework to: be evidence based; include consideration of the likely balance of benefits and risks of e-cigarettes, uncertainty and safety; support equity; support the ongoing application of evidence to high-quality policy and practice; and consider potential competing interests. The framework draws upon: health technology assessment; health impact assessment; environmental health risk assessment; healthcare recommendations evidence evaluation; consumer goods regulation; medicine and chemical scheduling; tobacco product evaluation; previous reviews and the precautionary principle. Final framework components are: (1) characterisation of products under consideration; (2) definition of populations of interest; (3) characterisation of tobacco smoking, control and impacts on health and well-being; (4) review of evidence on patterns of e-cigarette use; (5) review of evidence on e-cigarette use and health outcomes; (6) assessment of likely risks, benefits and safety; (7) identification and assessment of policy options to optimise health outcomes.
Conclusions Structured and ongoing public health assessment of e-cigarette use is likely to support health through enhancing evidence-based decision-making.
- public policy
- electronic nicotine delivery devices
Data availability statement
The data used in this paper are from publicly available sources.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Contributors EB received funding for the work. EB and MH developed the framework. All authors contributed to drafting and revisions and have approved the final version of the manuscript.
Funding This assessment framework was developed as part of an independent programme of work examining the health impacts of e-cigarettes, funded by the Australian Government Department of Health. EB is supported by a Principal Research Fellowship from the National Health and Medical Research Council of Australia (reference: 1136128).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.