Electronic cigarettes and public health

Experts at the American Association for the Advancement of Science Discuss E-Cigarette’s Positive Public Health Impact

Most vapers already know the benefits of switching from cigarettes to electronic cigarettes, in fact they feel them every day. When a person decides to improve their own personal health by using electronic cigarettes rather than smoking they are not only making a decision to better their own lives, they are improving the lives of all the people around them. The impact that e-cigarettes have on personal health is amazing, but their contribution to the greater public health is what now has many experts encouraging their use and development.

Whether you look at e-cigarettes as devices to aid in quitting or as just a replacement for combustible cigarettes, they provide an opportunity for healthier living that cannot be ignored, despite the fact that many people still consider them a potential risk. Experts gathered recently at the 2015 American Association for the Advancement of Science meeting, discussing, among other topics, the potential impact of a general shift away from traditional smoking to vaping. In a news briefing titled “E-Cigarettes: Public Health Threat or Opportunity?”

Dr. Wilson Compton of the National Institute of Health’s Drug Abuse division was one of many that discussed the potential e-cigarettes have despite the limited scientific information available. “It turns out the amount of information we have about what’s in these products, how they’re used, what’s the exposure of nicotine and other components of these products is surprisingly limited. Yet, they hold great promise as a way to potentially reduce exposure to the incredibly harmful constituents in combustible tobacco, by contrast, to what appears to be a relatively clean nicotine delivery system.” Dr. Compton is clear that he believes e-cigarettes are a far cleaner method of delivering nicotine than smoking tobacco, a fact clear to other presenters at the meeting as well.

Dr. Kevin Bridgman also discussed the potential health benefits of e-cigarettes in his presentation, “E-Cigarettes: What’s the Real Medical Innovation Breakthrough?” Dr. Bridgman is an MD and the chief medical officer of Nicovations, a subsidiary of British American Tobacco. Dr. Bridgman cited a study conducted on Epi-Airway, a highly differentiated in vitro human epithelial tissue culture. In this study, cigarette smoke reduced cell viability to a mere 12% in 6 hours. E-cigarettes showed no such decrease and displayed results similar to untreated air controls.

This study, as well as countless others, support Bridgman’s beliefs that e-cigarettes present a compelling public health opportunity. He emphasized the importance of more testing, ingredient screening, quality control in manufacturing, and responsible marketing and packaging. Dr. Bridgman finds many of his colleagues share his position. “There is growing consensus among public health professionals that e-cigarettes are significantly less risky than conventional cigarettes.” He goes on to support the idea of regulation, citing in a press release that proper regulation, ”would provide greater confidence without stifling innovation while enabling these products to compete effectively with cigarettes.”

Dr. Bridgman also delved into the specific profile of an e-cigarette that would provide an adequate vaping experience discussing such issues as adequate nicotine delivery, qualified and quantified vapor, a toxicant load offering real benefits vs. smoking, and attractiveness to smokers. Bridgman said a desirable product would appeal to smokers in more than just a way to inhale nicotine. A successful e-cigarette would satisfy a user emotionally as well satisfy their senses. It would be functional and efficient, as well as financially reasonable – these factors all affect a user’s decision to vape or not; if an e-cigarette is not satisfying to a former smoker, it will never stand a chance of being that public health benefit that many are hoping for.

In another presentation, Deborah Arnott, chief executive of Action on Smoking and Health, addressed the question of whether or not e-cigarettes can play a role in ending the smoking epidemic. The Action on Smoking and Health (ASH) is a British public health charity established by the Royal College of Physicians which is described as “anti-smoking, not anti-smoker.” The ASH is a nongovernmental organization funded by the British Heart Foundation, Cancer Research UK, and the UK Department of Health.

Arnott said that e-cigarettes could be viewed as major tools in the war against smoking, but that also depends on who you are talking to. Those who believe in harm reduction would of course believe in e-cigarette’s potential to end the smoking epidemic as they are an alternative to regular cigarettes. Traditionalists’, however, goal would be to eliminate the product altogether. Arnott said ASH’s position is to minimize the risk of e-cigarettes by discouraging their use for young people and those who have never smoked. At the same time, the organization believes in encouraging traditional smokers to quit, or switch, using e-cigarettes if necessary to discourage relapse.

Arnott does not believe that e-cigarette will draw in new users. She said that in Britain for example, two-thirds of vapers are smokers and one-third are ex-smokers. She went on to say that, for every three individuals who try e-cigarettes, only one continues to use them. “Those who have never smoked appear to be heavily protected from e-cigarette experimentation,” Arnott said in her presentation.

To Arnott, e-cigarettes really don’t seem to be a huge threat to non-smokers, even adolescents. Although experimentation with e-cigarettes among youth is on the rise, Arnott reports that this experimentation is almost entirely among smokers. Arnott also discussed findings of a Cochrane Review of two randomized trials, which found that more than twice as many smokers who used e-cigarettes were able to stop smoking for up to a year than those who used nicotine-free placebo e-cigarettes. Moreover, this review found that in smokers who did not quit, roughly 36% of e-cigarette users were able to decrease their usage by half.

Arnott states, “Cochrane reviews are world renowned for their systematic analysis of the evidence, and our findings at population, level are consistent with their conclusions that electronic cigarettes have the potential to help smokers quit.” Arnott cautioned against regulatory practices against e-cigarettes that are based on “prejudice rather than evidence.” She believes “there is a danger that the precautionary principle is being used to deny smokers access to products which can save their lives.” Arnott continued, “Over 1,000 people will die worldwide from tobacco during this 90-minute session alone. E-cigarettes have the potential to dramatically reduce this deadly toll.”

Overall these experts, as well as many others, continue to fight for the progress of e-cigarettes as an industry and as a product that can change lives and improve the overall health and wellbeing of our world. Many expert continue to report on the potential that these devices can have to change our world, if only they are given the chance to.

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