JAMA: The Global Health Implications of e-Cigarettes
Andrew Chang of the Stanford University School of Medicine, and Michele Barry, director of Stanford’s Center for Innovation in Global Health

“…Eighty-four percent of the world’s smokers live in [low- and middle-income countries (LMICs)]. … The health effects of [e-cigarettes and electronic nicotine delivery systems (ENDS)] can stress LMIC health systems relatively more than health systems in high-income countries. … Developing nations should not underestimate the availability and targeted marketing of ENDS within their borders and should place e-cigarettes under the purview of their medical and pharmaceutical regulatory boards. … Even though e-cigarettes may have a future as smoking cessation tools, evidence to support this indication is lacking. More rigorous studies must be conducted regarding the awareness, usage patterns, and potential for harm of these devices in low-income countries, particularly Africa and South Asia, where data are currently missing” (8/18).