Former WHO scientist: ‘Smoking kills, nicotine doesn’t’

A great article in today’s spectator.

Dr Derek Yach, who developed the World Health Organisation’s Framework Convention on Tobacco Control, talks about vaping in no unclear terms.

Why are we in this position? One reason is that governments have become addicted to tobacco excise tax and may fear that, as e-cigs take off, they will lose a valuable source of revenue. Many leading NGOs and academics exert strong influence at WHO, within governments, in the media and among the general public. In the past, they helped bring tobacco control out of the shadows and into the mainstream of health policy. Now, alas, their intransigence threatens more profound progress.

And further down the page

His support for electronic cigarettes and vaping products rests on what he regards as the stark truth: that they help people quit smoking more effectively than other remedies. It is therefore not just unfortunate but scary that the World Health Organisation persists in treating them as if they were almost as dangerous as cigarettes.

Counseling Patients on the Use of Electronic Cigarettes

Published: January 2015

Positive: No

Link to publication: http://www.mayoclinicproceedings.org/article/S0025-6196%2814%2900989-6/fulltext#sec7

DOI: http://dx.doi.org/10.1016/j.mayocp.2014.11.004

Authors:

Jon O. Ebbert, MD, MS
Amenah A. Agunwamba, ScD, MPH
Lila J. Rutten, PhD, MPH


Summary

Electronic cigarettes (e-cigarettes) have substantially increased in popularity. Clear evidence about the safety of e-cigarettes is lacking, and laboratory experiments and case reports suggest these products may be associated with potential adverse health consequences. The effectiveness of e-cigarettes for smoking cessation is modest and appears to be comparable to the nicotine patch combined with minimal behavioral support. Although a role for e-cigarettes in the treatment of tobacco dependence may emerge in the future, the potential risk of e-cigarettes outweighs their known benefit as a recommended tobacco treatment strategy by clinicians. Patients should be counseled on the known efficacy and potential risks of e-cigarettes.


Conclusions

Clinicians are ethically obligated to promote smoking cessation using evidence-based treatment strategies. Smokers will ask about e-cigarettes, and we must be prepared to offer appropriate counseling. With the evidence available to date, clinicians must be circumspect in recommending e-cigarettes for use by cigarette smokers interested in quitting smoking for the following reasons:

1. They are not demonstrably superior to FDA-approved medications for smoking cessation.

2. They may not be effective for smoking cessation and dual use (ie, using e-cigarettes and continuing to smoke) will prolong exposure to tobacco.

3. They are not FDA-approved for the treatment of tobacco dependence.

4. Short-term safety data suggest they may cause airway reactivity.

5. The long-term health risk of exposure to e-cigarette constituent chemicals is unknown.

6. No regulatory oversight, such as requirements for good manufacturing practices, is currently in place for e-cigarette devices or e-juice.

More clinical safety data and increased product reliability and regulation are needed before e-cigarettes can assume a place in the standard clinical approaches to the treatment of tobacco dependence.

Continuer la lecture de Counseling Patients on the Use of Electronic Cigarettes

Use of e-Cigarettes among Current Smokers: Associations among Reasons for Use, Quit Intentions, and Current Tobacco Use.

Research has documented growing availability and use of e-cigarettes in the U.S. over the last decade.

We conducted a national panel survey of current adult cigarette smokers to assess attitudes, beliefs, and behaviors relating to e-cigarette use in the U.S. (N=2254).

Published: 14 January 2015

Positive: Yes

Link to publication: http://www.ncbi.nlm.nih.gov/pubmed/25589678

PMID:25589678

Authors:

Rutten LJ
Blake KD
Agunwamba AA
Grana RA
Wilson PM
Ebbert JO
Okamoto J
Leischow SJ


Summary

Among current cigarette smokers, 20.4% reported current use of e-cigarettes on some days and 3.7% reported daily use. Reported reasons for e-cigarette use included: quit smoking (58.4%), reduce smoking (57.9%), and reduce health risks (51.9%). No significant differences in sociodemographic characteristics between e-cigarette users and non-users were observed. Prior quit attempts were reported more frequently among e-cigarette users (82.8%) than non-users (74.0%). Intention to quit was reported more frequently among e-cigarette users (64.7%) than non-users (46.8%). Smokers intending to quit were more likely to be e-cigarette users than those not intending to quit (OR=1.90, CI=1.36-2.65). Those who used e-cigarettes to try to quit smoking (OR=2.25, CI=1.25-4.05), reduce stress (OR=3.66, CI=1.11-12.09), or because they cost less (OR=3.42, CI=1.64-7.13) were more likely to report decreases in cigarette smoking than those who did not indicate these reasons. Smokers who reported using e-cigarettes to quit smoking (OR=16.25, CI=8.32-31.74) or reduce stress (OR=4.30, CI=1.32-14.09) were significantly more likely to report an intention to quit than those who did not indicate those reasons for using e-cigarettes.


Conclusions

Nearly a quarter of smokers in our study reported e-cigarettes use, primarily motivated by intentions to quit or reduce smoking. These findings identify a clinical and public health opportunity to re-engage smokers in cessation efforts.

Continuer la lecture de Use of e-Cigarettes among Current Smokers: Associations among Reasons for Use, Quit Intentions, and Current Tobacco Use.