As physicians and health professionals we see everyday patients who are severely affected by tobacco smoking, many of whom will eventually die or have their health severely affected despite our help and advice. Tobacco smoking remains the most serious public health issue in the world.
People smoke for the nicotine but die from the chemicals produced when tobacco is burned 1 . Unfortunately, currently available smoking cessation medications have limited efficacy and acceptability for the majority of smokers. However, we believe that there is a solution: the use of electronic cigarettes clearly has huge potential to help many smokers turn their backs on tobacco.
To this end, we strongly believe that ethically and scientifically speaking it is our responsibility to draw attention to the following:
E-cigarettes do not ‘renormalise smoking’ – ‘vaping’ is not smoking. In many countries the rise in e-cigarette use has been accompanied by a continued decline in tobacco sales and prevalence of smoking 7.
The characteristics of electronic cigarettes should always be compared to those of conventional cigarettes, and discussion about the absolute long-term safety of electronic cigarettes must be contrasted ethically and scientifically with the absolute certainty of the harmfulness of smoked tobacco.
Already estimated 29m consumers in Europe use e-cigarettes 8. But we believe that the individual and public health gains associated with electronic cigarette use are held back by misconceptions about the product.
In light of the numerous studies undertaken to date we – as health professionals – cannot remain passive in the face of the clear public health benefits of electronic cigarettes.
We therefore recommend that our colleagues actively learn more about electronic cigarettes as a new public health tool in the ongoing global health campaign against tobacco-related diseases.
We call on our colleagues to sign this declaration in support of the merits of electronic cigarettes based on scientific evidence and ethical debate.
1 Russell, M. A. Low-tar medium-nicotine cigarettes: a new approach to safer smoking (1976) BMJ 1 (6023) 1430-1433
2 Farsalinos, K. E., & Polosa, R. (2014). Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Therapeutic Advances in Drug Safety, 5(2), 67–86. doi:10.1177/2042098614524430
3 Hajek P, Etter J-F, Benowitz N, McRobbie H (2014) Electronic cigarettes: review of use, content, safety, effects on smokers, and potential for harm and benefit. Addiction.
4 McRobbie, H., Bullen, C., Hartmann-Boyce, J., & Hajek, P. (2014). Electronic cigarettes for smoking cessation and reduction. The Cochrane Database of Systematic Reviews, 12, CD010216. doi:10.1002/14651858.CD010216.pub2
5 Brown, J. et al (2014). Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction doi:10.1111/add.12623
6 West, R. B. J. (2014). Electronic cigarettes : fact and fiction. British Journal of General Practice, (September), 442–443.doi:10.3399/bjgp14X681253
7 West R, Brown J, Beard E. Trends in electronic cigarette use in England. Smoking Toolkit Study 140122. 2014.www.smokinginengland.info/latest-statistics
8 Vardavas, C.et al (2014). Determinants and prevalence of e-cigarette use throughout the European Union: a secondary analysis of 26 566 youth and adults from 27 Countries. Tobacco Control, 1–7. doi:10.1136/tobaccocontrol-2013-051394