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The vape is less harmful than tobacco and could ultimately outcompete it

Harmfulness of products containing nicotine
Harmfulness of products containing nicotine

The vape is less harmful than tobacco and could ultimately outcompete it, declared Public Health England (PHE) in a study that acknowledges for the first time that the e-cigarette is less harmful than tobacco.

The British agency concludes that the best current estimate shows that the electronic cigarette is about 95% less harmful than conventional cigarettes and could lead to its  future approval as an alternative drug to tobacco withdrawal such as nicotine patches.

While emphasizing that e-cigarette is not without risk, PHE estimated it however has the potential to contribute significantly to the replacement of conventional cigarettes.

The opinion of PHE is supported by Dame Sally Davis, Chief Physician for the British government, who remains cautious when adding that the long-term use of e-cigarette has not proven innocuousness and, until further demonstrated, it should only be used in the frame of weaning from tobacco.

The Dr. Davis recalls that recognizing these products as licensed medicine would provide a safety assurance for consumers regarding quality and efficacy, especially in relation with e-liquid quality.

Pharmaceutical Culture

The 111-page study raises questions on the duration and the cost of the approval procedure, which is are key factors in the strategy to reduce the use of tobacco cigarettes in the UK.

No electronic cigarette brand has yet been approved, unlike other nicotine replacement therapies such as chewing gum, lozenges and patches. Pilot programs launched in Leicester and in London City allow tobacco control specialists to prescribe electronic cigarette kits. Which implies that the e-cigarette would be offered to future ex-smokers falling into this program.

The Medicines and Healthcare Products Regulatory Agency has initiated work in this domain more than two years ago and manufacturers have complained that the process could cost them millions.

Jane Ellison, the British Minister of Health, reminded smokers that the best way not to succumb to the first cause of mortality in the country was to totally stop smoking. She pointed out the necessity to accompany smokers in their weaning process by giving them access to the e-cigarette, but also to protect the youth by making it illegal for the under-18s.

Not a gateway to tobacco

The study found that almost all of the 2.6 million adult users of electronic cigarettes in the UK are current or former smokers who use it as a way to stop smoking. Most of them are using the e-cigarette to help them wean themselves or prevent them from stepping back to smoking.

Nothing suggests that e-cigarettes are a gateway to smoking as less than 1 % of adults or young people who have never smoked are regular vapoteurs.

The PHE decision comes after well-orchestrated actions by anti-tobacco activists and public heath specialists to incite NHS to offer more efficient smoking cessation support and to promote e-cigarettes. The cited example in UK is that of the of the north-east region that offers behavioural support in addition to personal vaporizers to get smokers off tobacco.

8 million smokers to inform

Tobacco is responsible for the death of 100,000 people each year in the UK, mostly in England where eight million smokers have been numerated. However, figures suggest that smoking rate is at its lowest prevalence level since the onset of official surveys in the 1940s.

Deprived areas of England show the highest smoking rates and efforts in cessation are considered the privileged way to reduce health inequalities.

But an increasing proportion of smokers, from 8% in 2013 to 22% in 2015, are still reluctant to swap for the vaporizer because they wrongly consider it equally or more harmful than tobacco. This points out the crucial need, before acting, to educate these future users to the e-cigarette with emphasis on the relative benefits for health compared to smoking products.

“… smokers who switch to vaping remove almost all the risks” – Peter Hajek

PHE aims at having a better control on the market and on companies closely involved with tobacco in order to do its duty in protecting public health policy from the commercial interests of the tobacco industry.

Peter Hajek, an independent expert who reviewed the PHE recommends, in his quality of Professor of Clinical psychology, to smokers who are not convinced by their first try, to give e-cigarettes a second chance to get used to it.

The ban of e-cigarettes in the public places of Wales, the pubs and restaurants across UK may drive a growing number of people to wrongly think the harm is the same as for tobacco without considering the long-term benefits to taxpayers.

Smoker groups like FOREST remind that e-cigarette is a recreational device that allows people to enjoy vaping. According to the smokers association, prescribing e-cigarettes on the NHS may become questionnable by the taxpayers who are neither smokers nor vapers.

Simon Clark, its director, said that the state shouldn’t interfere with the free choice of smokers to start vaping that has proven the success to what he qualifies “a game-changing product”. He thinks that public health campaigners should pay more attention in fighting against to unnecessary restrictions on the sale, marketing and promotion, than to turn it as a medicinal product.

The government’s policy towards e-cigarette arose after the publication in the Journal of the American Medical Association of research carrying conclusions potentially misleading with regard to the use of e-cigarette with high-school US students. While puritans see a highway to tobacco, many others in UK see a behavioural evolution and Hajek to say: “It just shows that people who are attracted to e-cigarettes are the same people who are attracted to smoking. People who drink white wine are more likely to try red wine than people who do not drink alcohol.”