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Dr Konstantinos Farsalinos is interviewed by Brent Stafford on RegulatorWatch.com

After a first round on Diacetyl and on the war that is engaged to bring discredit to what is considered by some researchers as the most advanced treatment to smoking, Dr Farsalinos comes back to the screen in order to highlight, with his expert eye, some of the controversial aspects of the e-cigarette.

“E-cigarettes without flavors are not e-cigarettes, no one is gonna use them.”
There is a lot of controversy for the ingredients used in e-liquids. Everything inside e-liquids are well-known chemicals coming from the food industry. One of the issues is that they may not be good when inhaled. On this point, the cardiologist responds that the best possible choice is to use food approved flavors. The behavorial aspect is very important in the choice of the device and the taste greatly contributes to the pleasure people have with it. People select it and keep on using it because they enjoy it.

 

“The e-cigarette has two major problems: The term “cigarette” and its visual aspect.”
The ideological position is another issue that is demystified by the researcher. What are considered disadvantages for some people become real advantages for some others, and the patronym that the device shares with its serial killer sibling probably reassures people when switching from tobacco to e-cigarette.

 

The gateway effect is a legitimate concern and the attractiveness of flavors to the youth is an issue. However, the surveys indicate that despite a lot of experimentation by the youth, regular use of e-cigarette by teenagers and young adults is scarce. And in contrast, the increase of e-cigarette use by teenagers and young adults that has been recently noticed in the US is accompanied by what the researcher considers the biggest decline ever noticed in cigarette smoking for 40 years, for the first time below 10%, which is incompatible with a gateway effect.

If the issue is that kids are using e-cigarettes, the simple solution he supports is to ban the sales of the device to the kids, and it is what the State of Hawaii has done, restricting sales to adults over 21 years old on January 1st, 2016. And it is no reason to ban flavors.

The cardiologist reminds that the high demand for flavors comes from the users themselves. Most of the e-juice makers are, themselves, vapers who decided to share their juices with other vapers and to market their receipts. Detractors who pretend that the candy flavors were designed to attract the youth are not in phase with the market history, yet extremely contemporary.

Second-hand vaping or the risk for bystanders is not confirmed by scientific studies, he says. The levels of potentially harmful components, when diluted in the vaping space, are generally non-mesurable. And second-hand exposure to nicotine is so low that it has no biological effect to a non-vaper sharing the same space; the researcher compares the quantity absorbed by the non-vaper to his eating 300 g of eggplants.

“Public Health is about preventing disease and death, not about judging personal behaviour”
The addictive effect of nicotine, as a concern for public health, is also reviewed by the expert. He considers that his prerogatives, as a heath professional, with regard to people who want to consume nicotine, are to give some advices, not to judge anyone. He states that “nicotine has never killed a single smoker” and he adds that “smoking is the worst available product to obtain nicotine”.

 

“They re saving lives”
Konstantinos Farsalinos recalls that in Europe, there are 6.1 million smokers who have quitted smoking with the use of e-cigarettes; their quit rate is 47% which is unprecedented for anything else. In his practice of medicine, he says he saw people who, within one day or a couple of days, switched from smoking to vaping and abandoned smoking definitely.

 

In conclusion, the message is clear, preventing people from using e-cigarettes by discouraging them to use it or exaggerating harmfulness is like sentencing people to death. And we are confident that some health professionals are staying on course despite of a rough context.