title: NIH electronic cigarette workshop: developing a research agenda.
abstract: BACKGROUND
  Electronic cigarettes (e-cigarettes) represent an emerging public health issue. These devices deliver nicotine along with other constituents, including flavorants, via an inhalable aerosol. Their uptake is rapidly increasing in both adults and youths, primarily among current smokers. Public debate is increasing on how these devices should be regulated and used, yet only limited peer-reviewed research exists. To develop a informed policy for e-cigarettes, their effects on human behavior, physiology, and health need to be understood.
  
  
  OBJECTIVE
  This paper describes proceedings from a National Institutes of Health-sponsored workshop, which was held in November 2013, to identify research needs related to the effects of e-cigarettes. Discussion topics included e-cigarette risks and abuse potential; the potential role for e-cigarettes in harm reduction and smoking cessation; unintended consequences of e-cigarette use, such as becoming a gateway to conventional cigarettes; and dual use of both e-cigarettes and conventional cigarettes.
  
  
  CONCLUSIONS
  The research needs identified by the workshop participants included the following: standards to measure the contents and emissions of e-cigarettes; biomarkers of exposure; physiological effects of e-cigarettes on tissues and organ systems, including pulmonary and cardiovascular; information on e-cigarette users, how the devices are used, and identification of the best tools to assess these measures; factors that drive use and influence patterns of use; and appropriate methods for evaluating a potential role for e-cigarettes in smoking or nicotine cessation. To understand fully the challenges and the opportunities that e-cigarettes represent, expertise will be needed in basic, behavioral, translational, and clinical sciences.
authors.affiliation: Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD; kevin.walton@nih.gov.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Walton
authors.affiliation: Schroeder Institute at Legacy, Washington, DC, and Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, MD;
authors.forename: David B
authors.initials: DB
authors.lastname: Abrams
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL;
authors.forename: William C
authors.initials: WC
authors.lastname: Bailey
authors.affiliation: Behavioral and Social Sciences Research Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD;
authors.forename: David
authors.initials: D
authors.lastname: Clark
authors.affiliation: Schools of Law and Bouve Health Sciences , Northeastern University, Boston, MA;
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Connolly
authors.affiliation: Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD;
authors.forename: Mirjana V
authors.initials: MV
authors.lastname: Djordjevic
authors.affiliation: Department of Psychology, Virginia Commonwealth University, Richmond, VA;
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Eissenberg
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin, Madison, WI;
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fiore
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY;
authors.forename: Maciej L
authors.initials: ML
authors.lastname: Goniewicz
authors.affiliation: Child Development and Behavior Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD;
authors.forename: Lynne
authors.initials: L
authors.lastname: Haverkos
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN;
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Hecht
authors.affiliation: Pinney Associates, Bethesda, MD, and Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD;
authors.forename: Jack E
authors.initials: JE
authors.lastname: Henningfield
authors.affiliation: Department of Psychological Science, University of Vermont College of Medicine, Burlington, VT;
authors.forename: John R
authors.initials: JR
authors.lastname: Hughes
authors.affiliation: Department of Medicine, University of Connecticut Health Center, Farmington, CT;
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Oncken
authors.affiliation: Airway Biology and Disease Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD;
authors.forename: Lisa
authors.initials: L
authors.lastname: Postow
authors.affiliation: Center for Smoking Cessation, Duke University Medical Center, Durham, NC;
authors.forename: Jed E
authors.initials: JE
authors.lastname: Rose
authors.affiliation: Office of Disease Prevention, National Institutes of Health, Bethesda, MD;
authors.forename: Kay L
authors.initials: KL
authors.lastname: Wanke
authors.affiliation: Division of Nonprescription Clinical Evaluation, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD;
authors.forename: Lucie
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, MN.
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
mesh_terms: D000293:Adolescent; D000328:Adult; D004493:Education; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects*; D040261:Harm Reduction; D006801:Humans; D009316:National Institutes of Health (U.S.); D009538:Nicotine / Q000008:administration & dosage*; D012107:Research Design; D016540:Smoking Cessation / Q000379:methods*; D014481:United States
chemical_list: D009538:Nicotine