A new study led by ACS shows adults in the United States using combustible cigarettes and electronic cigarettes (e-cigarettes), commonly referred to as dual-use, experienced the same tobacco-related nicotine and toxicant exposure compared to using cigarettes alone at the same intensity. This exposure indicates potential for cancer, cardiovascular, reproductive/developmental, and respiratory harms. The findings were published in the journal Nicotine and Tobacco Research (NTR).

“In the U.S., dual-use of combustible cigarettes and e-cigarettes is the most common multiple tobacco-use behavior. Some individuals try to cut back on cigarettes or work toward quitting cigarettes this way,” said Zheng (Ashley) Xue, senior associate scientist, tobacco control research, and lead author of the study. “However, our results highlight that dual-use is not an effective way to safeguard health and more evidence that tobacco use is harmful.”

“Clinicians and public health practitioners should increase awareness that dual use of cigarettes and e-cigarettes is not safe and may present similar risks as continuing to smoke cigarettes, especially if one does not reduce the number of cigarettes smoked,” Xue added. 

"It's essential that we continue to advocate for policies that have been proven to reduce tobacco usage," said Lisa A. Lacasse, president of ACS CAN. “We will continue to work with federal, state, and local lawmakers to pass strong laws and implement critical regulations that will increase access to barrier-free, culturally competent proven cessation services, end the sale of all flavored tobacco products, substantially increase tobacco taxes, and implement comprehensive smoke-free policies. These fact-based tobacco prevention and cessation programs are critical to help those addicted to quit and prevent anyone, especially youth, from ever starting. Additionally, the FDA must use the full weight of its authority to regulate all tobacco products, including removing the thousands of illegal products on the market that have not been shown to benefit the public health.” 

Other ACS researchers contributing to the study include Eva Orr, Dr. Nigar Nargis, Dr. Minal Patel, and senior author Dr. Tyler Nighbor.  

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