E-cigarettes Questions & Answers: The Facts - Part two

  1. Do e cigarettes help people quit smoking?

Yes, it looks like it, and in the real world too – not just in the artificial world of clinical trials. In fact they appear to be more successful than established smoking cessation products like NRT.  A recent study found that people were 60% more likely to succeed using an electronic cigarette.

People attempting to quit smoking without professional help are approximately 60% more likely to report succeeding if they use e-cigarettes than if they use willpower alone or over-the-counter nicotine replacement therapies such as patches or gum, reveals new research published in Addiction.
Brown, Beard, Kotz, Michie & West, ‘Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study’Addiction, May 2014.

ASH’s 2014 survey showed that about a third of users were now ex-smokers – 700,000 in the UK or about 7% of the smoking population – implying that many people are successfully quitting.

+ An estimated 2.1 million adults in Great Britain currently use electronic cigarettes.
+ About one third of users are ex-smokers and two-thirds are current smokers.
+ The main reason given by current smokers for using the products is to reduce the amount they smoke while ex-smokers report using electronic cigarettes to help them stop smoking.

People should also take the trouble to listen to the thousands of accounts of the experiences of people switching. These are often dismissed as anecdote – but you hear the same message over and over again.  Take this for example:

I smoked for 45 years and tried every NRT product available, none of them worked. I continued to smoke even though my health was getting worse, resulting in COPD and using oxygen daily. September 2011 I discovered e-cigarettes and they worked. It was like someone handed me a miracle. In less than a week I stopped using regular cigarettes. I haven’t had a tobacco cigarette since. I wish the MP’s and MEP’s would understand how much e-cigarettes have helped thousands of people just like me.

See many more testimonies like this in my posting: Where is the empathy, where is the humility?

  1. Do people who switch continue vaping or move on to quit altogether?

We will have to wait longer for the data to come in on that, given that e-cigarettes are relatively new to most users.  The better question is whether it matters.  If the health risk of using a vapour product is very much lower than smoking, then the important transition is from smoking to not smoking.  Whether that means continued vaping or complete cessation of nicotine is a second order concern. One of the advantages of vaping is that it is a much easier transition than quitting completely: it is easier to do in the first place because it does not involve overcoming nicotine dependence and so withdrawal and craving are greatly reduced.  It may also mean relapse is less likely.

  1. The Minister of Health is not convinced of the safety of e-cigarettes – what now?

This is probably literally true: he is not convinced. But that doesn’t mean he has made a competent assessment or is applying the same standards he would apply to other risks in this field. What the minister needs to say is what would convince him. Nothing is ever entirely safe – we usually judge whether risks are tolerable, given the benefits and demand for the product.  By way of comparison, I wonder if he is convinced of the safety of, say, Varenicline (a stop smoking medical treatment marketed as Champix or Chantix)? I am not saying people shouldn’t use it by the way, just that its safety has been judged on a risk-benefit basis. You certainly couldn’t call it ‘safe’.

The health minister needs to examine his conscience and decide if all his negativity, doubts and worries are in fact discouraging people who smoke from trying an e-cigarette, and so supporting the cause of continued cigarette use. It is possible he has made himself one of the most powerful friends and allies of the tobacco industry, though without actually realising it. He led the European Council push to have e-cigarettes regulated as medicines, a move which would have virtually destroyed the existing industry and handed what remains to Big Tobacco.  In my view health ministers, lead by the James Reilly of Ireland displayed a particularly trite and cynical form of negligence. See: Negligence in tobacco policy.  The same criticism can be levelled at the rest of the public health establishment – exceedingly complacent with hugely exaggerated concerns about minor or hypothetical risks and apparent indifference to huge potential for health gains.

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