Azim Chowdhury Published in the International Journal of Environmental Research and Public Health

Date: Mar 31, 2017


A Risk Assessment Matrix for Public Health Principles: The Case for E-Cigarettes

Azim Chowdhury, along with public health and medical experts from Italy, examined public health principles as they relate to e-cigarette regulations in the United States and European Union in the 14th volume, Issue 4 of the International Journal of Environmental Research and Public Health.

Abstract: Besides nicotine replacement therapies, a realistic alternative for smoking cessation or for smoking substitution may come from electronic cigarettes (ECs), whose popularity has been steadily growing. As for any emerging behaviour associated with exposure to inhalational agents, there is legitimate cause for concern and many health organizations and policy makers have pushed for restrictive policy measures ranging from complete bans to tight regulations of these products. Nonetheless, it is important to reframe these concerns in context of the well-known harm caused by cigarette smoking. In this article, we discuss key public health principles that should be considered when regulating ECs. These include the concept of tobacco harm reduction, importance of relative risk and risk continuum, renormalization of smoking, availability of low-risk product, proportionate taxation, and reassessment of the role of non-tobacco flavours. These public health principles may be systematically scrutinized using a risk assessment matrix that allows: (1) to determine the measure of certainty that a risk will occur; and (2) to estimate the impact of such a risk on public health. Consequently, the ultimate goal of responsible ECs regulation should be that of maximizing the favourable impact of these reduced-risk products whilst minimizing further any potential risks. Consumer perspectives, sound EC research, continuous post-marketing surveillance and reasonable safety and quality product standards should be at the very heart of future regulatory schemes that will address concerns while minimizing unintended consequences of ill-informed regulation.

To read the full article, click here.

Saitta D, Chowdhury A, Ferro GA, Nalis FG, Polosa R. A Risk Assessment Matrix for Public Health Principles: The Case for E-Cigarettes. International Journal of Environmental Research and Public Health. 2017; 14(4):363.


For more information on our tobacco and e-vapor regulatory practice in general, contact Azim Chowdhury (+1 202.434.4230, 
chowdhury@khlaw.com) and visit www.khlaw.com/evapor. Follow Keller and Heckman Tobacco and E-Vapor Partner Azim Chowdhury on Twitter.