This week the World Health Organization (WHO), along with the American Federal Drug Administration (FDA), appear to be on the cusp of classifying electronic cigarettes (ECs) as tobacco products, in a move dubbed “hugely unhelpful for the public health.” The decision comes despite a major new survey of EC users showing that electronic cigarettes help people quit smoking.
If the WHO and FDA classification prevails, then ECs will be subject to the same restrictions as tobacco. Advertising bans, indoor restrictions and high taxation is the only outcome as 168 countries have signed up to the Framework Convention on Tobacco Control (FCTC), which underpins smoking restrictions.
I was able to interview Katherine Devlin, President Electronic Cigarette Trade Association (ECITA) on her reactions.
On the WHO and FDA initiative she said “…hugely unhelpful for public health.”
She continued “Freedom of access to ECs has already demonstrated better results than pre-existing measures. The study further underscores the dramatic population-level public health gains that could – and should – be accrued by the proper, rational and proportionate regulation of electronic cigarette products, so that they remain as widely available as possible to smokers around the world.”
The new paper is called “ECs Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers” and is written by Dr Konstantinos Farsalinos, a Cardiologist.
Certainly, this is one of the largest and most comprehensive studies done into ECs so far. On the uptake of ECs by non-smokers, only 88 out of 19,141 people, or 0.5 percent, said they had not previously smoked normal tobacco before taking up ECs. This backs up the finding of another paper published by Professor Robert West, a Trustee of Action on Smoking and Health (ASH).
Eighty-one percent of participants ended up quitting smoking, while current smokers had cut down from 20 to four cigarettes per day. Farsalinos goes onto say: “Participants experienced significant benefits in physical status and improvements in pre-existing disease conditions (including respiratory disease such as asthma and chronic obstructive lung disease).
“The results of this worldwide survey of dedicated users indicate that ECs are mostly used to avoid the harm associated with smoking. Side effects are minor and health benefits are substantial.”
The invention of the electronic cigarette independently in America in 1963 and China in 2003 is viewed by many as a saviour of smokers, an opinion held by the “vaping” community (EC users), although some anti-smoking organisations still argue that they “normalise” smoking, thus creating new smokers.
Ireland’s Health Services Executive under Dr Stephanie O’Keeffe yesterday banned ECs from all health facilities including hospital grounds.
In fact, Dr. O’Keefe is quoted as saying “e-cigarettes pose a challenge to smoke-free campus enforcement and come with safety concerns for a healthcare environment”.
Certainly, other governments are eager to get involved in regulating or restricting ECs. The European Union (EU) wanted to classify them as medicines, but was defeated in the EU Parliament. Nicotine concentrations will be kept to 20mg/ml, with many arguing that weakening the nicotine delivery for heavy smokers may cause an unsatisfying experience, leading to them remaining smokers.
In the UK, the Committee of Advertising Practice (CAP) is holding a consultation with all interested parties as to the standards for print and media advertising for ECs. Submissions are due by 28th April.
The participants in the Farsalinos survey may be self-selecting, and there was no control group, yet many people say allowing the smoking of ECs is better than the “quit or die approach” of offering no choice for quitting through a substitute medium.
If a product which is, according to some, as harmless as “drinking a cup of coffee”, then surely it is worth allowing people use it in order to wean them off their tobacco habit.
Perhaps Ronald Reagan’s prophetic words of “the nine most terrifying words in the English language, I’m from the government and I’m here to help,” are never more memorable.