The Office of Disease Prevention and participating ICOs are issuing this Notice to communicate our interest in research on electronic nicotine delivery systems (ENDS). Research on alternative nicotine and tobacco delivery systems [e.g., heated tobacco products (also called heat-not-burn)] will also be considered. Research with a focus on other non-combustible nicotine and tobacco products will be considered on a case-by-case basis. Studies should examine population-based, clinical, and applied prevention of disease, including etiology and epidemiology of use, potential risks, benefits and impacts on other tobacco use behavior among different populations. Studies exclusively examining smokeless tobacco or combustible tobacco products (e.g., cigarettes, cigars) will be considered non-responsive.
Background:
Electronic Nicotine Delivery Systems (ENDS) are designed to heat a liquid solution, typically containing nicotine, into an aerosol to be inhaled by a user. ENDS represent a diverse class of products that include e-cigarettes, vapes, vaporizers, vape pens, hookah pens, and pods. In recent years, heated tobacco products, which do not involve combustion and are sometimes called “heat-not-burn", have become available in the United States. For the purposes of this Notice, research examining products within the entire class of ENDS and heated tobacco products is sought. Research focused on other emerging non-combustible products will be considered on a case-by-case basis.
Adult prevalence of ENDS in 2019 was 4.5%, with young adults having the highest prevalence among all age groups (2020 Morbidity and Mortality Weekly Report). Current electronic cigarette use among young adults aged 18-24 increased from 7.6% in 2018 to 9.3% in 2019 (2019 Morbidity and Mortality Weekly Report). Youth ENDS use is also a significant concern. According to the 2020 National Youth Tobacco Survey, 20% (3 million) of high school students and 4.7% (550,000) of middle school students reported current e-cigarette use.
The tobacco product landscape is continuously changing. Despite rapidly accumulating research, significant gaps remain in our understanding of the public health effects posed by ENDS and heated tobacco products. More information is needed to understand the risk profile of the various devices or products and the aerosols they generate. The constantly changing landscape presents additional challenges for understanding how variable patterns of use and exposure to ENDS aerosol affect biological, physiological, and behavioral health outcomes. Research is needed to understand how ENDS product characteristics, product user characteristics, as well as the communication and policy environment interact to affect ENDS use patterns (e.g., exclusive use vs. dual use with combustible cigarettes). For example, although many adult smokers report using ENDS to help them quit smoking or to reduce their cigarette consumption, as noted in the 2020 Surgeon General’s Report on Smoking Cessation, there is presently inadequate evidence to conclude that e-cigarettes, in general, increase smoking cessation. These and other research gaps introduce challenges for accurate and meaningful communication about ENDS and heated tobacco products’ impact on an individual’s health. Applied, clinical, and population-based research studies provide a significant opportunity to address many unanswered questions and advance our understanding of their impact on public health.