Review on electronic cigarettes listed amongst most cited papers in Medical Journal of Australia

13 May 2024

A systematic review, led by Professor Emily Banks and her team at the National Centre for Epidemiology and Population Health (NCEPH), has emerged as one of the top 10 most-cited papers published in the prestigious Medical Journal of Australia (MJA) in the last two years.

Integrating findings from 400 publications, the review presented conclusive evidence linking e-cigarette use with various negative health outcomes, including poisoning, immediate inhalation toxicity and lung injury, as well as for malfunctioning device-related injuries and burns.

“It’s a really wonderful accolade to be in the top 10 of citations for our premier medical journal, which is also a leading medical journal worldwide,” remarks Professor Banks, “We need the citations to make that impact in the research world.”

Professor Banks also emphasises that the high citation count also reflects the complexities surrounding e-cigarette.

“It’s an incredibly challenging issue that requires attention from beyond the academic community,” she notes, “We need the impact in the real world, too.”

Since its publication, the review findings have been used to inform policy and practice across the globe.

In Australia, it informed the Therapeutic Goods Administration to make nicotine e-cigarettes as prescription-only medications. Internationally, the evidence has been cited in the World Health Organization's Call to Action to curb e-cigarette uptake among children, adolescents, and non-smokers. It has also influenced new legislation and media campaigns on the use of e-cigarettes and community health.

“We have received interest in our work from multiple jurisdictions worldwide, and it’s incredible to see this research being used to significantly impact policy and practice in Australia,” says Professor Banks, highlighting Australia’s role as a world leader in tobacco control.

Authors of the review. Top, left to right: Emily Banks, Amelia Yazidjoglou, Sinan Brown, Mai Nguyen. Bottom, left to right: Melonie Martin, Sai Campbell and Grace Joshy. Profile pictures of authors Katie Beckwith and Amanda Daluwatta haven't been provided.

As an epidemiologist and a public health physician, Professor Banks stresses the importance of not only generating evidence, but also making a tangible difference for the whole population.

To this end, the Health Impacts of Electronic Cigarettes Team, led by Professor Banks, has conducted research for organisations such as the Australian Government Department of Health, presented their findings to the World Health Organization, and informed the public with resources and visualised output through various mass and social media.

According to recent data from the National Drug Strategy Household Survey 2022–2023, almost 9 in 10 people (86%) supported prohibiting the sale of e‑cigarettes to people under 18 years of age, with 82% supporting strengthened restrictions on the advertising and promotion of e‑cigarettes.

Reflecting on such massive support across the community for stricter controls on e-cigarettes as a collective experience, Professor Banks stresses the need for collective actions based on collective evidence.

“Public health really is about understanding the main health problems that are facing the community, generating evidence to inform what we need to do, and then working with policy agencies, practitioners and ultimately the community itself to make a positive difference on the ground,” she says.