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Tobacco Control Experts Claim Vaping Products Are Harmful and Do Not Help Smokers Quit

The European Respiratory Society (ERS) Tobacco Control Committee, an international group of respiratory doctors and scientists, recently issued a statement warning that tobacco harm reduction strategies that involve the use of alternatives like electronic cigarettes do not work and are based on undocumented claims.

Seemingly ignoring the dozens of studies that have come out in the last few years, the members of ERS claim that there is a lack of proof that e-cigarettes can help smokers quit, arguing instead that there is growing evidence that such products are harmful to our health. As a result, they are asking policymakers and public health officials to reconsider programs that encourage smokers to switch to vaping as a less harmful alternative to tobacco cigarettes.

“Tobacco harm reduction strategies are based on incorrect assumptions that smokers cannot or will not quit smoking, but in reality, the majority of smokers want to quit and they dislike being nicotine dependent,” said Charlotta Pisinger, Chair of the ERS Tobacco Control Committee and clinical professor of tobacco control at Bispebjerg and Frederiksberg Hospital and University of Copenhagen, Denmark. “Most of the new products, including heated tobacco and e-cigarettes, are devices of nicotine inhalation, and therefore do not help smokers to beat their addiction to nicotine.”

“There is also a lack of evidence to support the claims that e-cigarettes are more effective than established smoking cessation medications or nicotine replacement therapies, but the few independent studies that have been published indicate that e-cig and heated tobacco device use undermines quit attempts outside of a clinical setting, and show that most people use alternative nicotine delivery products alongside conventional cigarettes, rather than as a replacement,” Pisinger added.

The statement put out by the ERS argues that there have been very few clinical trials to verify whether vaping products are more effective than traditional nicotine replacement therapy, and that the studies conducted so far either show no real difference between e-cigarettes and NRTs, or suggest that vaping actually undermines smoking cessation. Citing a prospective study conducted in the UK, which showed that e-cigarette use is associated with an increased rate of attempts to quit smoking, but not smoking cessation, the authors claim that because vaping is promoted as a “safe” way to consume nicotine, it can actually discourage cessation.

“In conclusion, there is lack of evidence proving the effect of alternative nicotine delivery products as effective smoking cessation tools. In a real – life setting, use seems to undermine smoking cessation instead,” the statement reads.

ERS members also claim that a majority of vapers are actually dual-users (continue to smoke tobacco as well), which they say offers no benefit to their health, and may indeed cause more harm due to exposure to toxicants not previously designated as harmful, such as those in e-liquid flavorings.

“In conclusion, most persons use alternative nicotine delivery products as a supplement to conventional cigarettes, not as an alternative to smoking. Therefore, there will be no health benefit for the majority of smokers, and for some there might even be an increased risk of harm,” the members of the committee write.
But even in cases where smokers manage to completely switch to vaping, the danger of significant harm to health is very high, according to the ERS statement. Because some studies have shown that e-cigarettes vapor contains traces of metals, it can cause acute endothelial cell dysfunction and promote formation of reactive oxidative stress/inflammation, as well as DNA damage and mutagenesis. Furthermore, some in vivo studies and animal experiments have shown that e-cigarette aerosol can cause airway inflammation and impairment in lung function. Human studies have shown airway obstruction and dysregulation in normal human lung homeostasis after short-term inhalation, as well as asthma exacerbation, increased coughing and wheezing. The long-term effects of vaping are unknown, but the ERS believes that the evidence we currently have shows that vaping is hazardous to our health.

“In conclusion, there is no evidence that alternative nicotine delivery products are safe – on the contrary, many studies have documented adverse health effects and the uncertainty seems to be around the degree of harm rather than the presence of harm related to these products,” the ERS Tobacco Control Committee writes.

Professor Tobias Welte from Hannover University in Germany, the President of the European Respiratory Society, believes that nothing should enter human lungs besides clean air, so even though exposure to harmful toxicants may be lower among e-cigarette users compared to smokers, that doesn’t mean vaping is safe.

“Although exposure to potentially harmful ingredients from e-cigarettes and heated tobacco devices may be lower than cigarettes, this does not mean that they are harmless,” Welte said. “Until we know more about the long-term effects of their use on human health, it is irresponsible to recommend that they be used in population-wide tobacco control strategies. Evidence-based tobacco dependence treatments already exist and are safe and cost-effective, and we must utilise this. Nothing should enter the lungs besides clean air – we must not give up on smokers.”

“We understand that many health professionals, tobacco control professionals and policy makers who recommend harm reduction strategies may have good intentions, but there is very little evidence to support the claims that e-cigarettes and heated tobacco devices are helping smokers to quit conventional cigarettes for good,” the German professor added.

You can read the entire statement published by the European Respiratory Society Tobacco Control Committee here. They go over several points offering research results to justify their main conclusion, which is that alternative nicotine delivery products like electronic cigarettes do not help smokers quit and are harmful to our health.

I will be the first to agree that vaping is not 100 percent safe. As Prof. Tobias Welte says, the only thing that should enter our lungs is clean air, but unfortunately nowadays that is merely an utopian idea. Air pollution in most urban centers around the world is a huge public health issue, and the most we can do right now is try to reduce the damage it causes, you know, harm reduction. It’s not like we can ban cars and industrial plants to prevent respiratory and cardiovascular diseases, but we can make sure that the emissions have a lower negative impact on our health. But apparently, tobacco harm reduction is a big no-no.

The ERS Tobacco Control Committee makes it very clear that they would rather people rely solely on willpower or traditional smoking cessation aids to quit smoking, rather than try alternative nicotine delivery devices like e-cigarettes, snus or heated tobacco products. Never mind the millions of people who fail and ultimately succumb to lethal diseases caused by years of smoking, you either succeed with what we consider appropriate or, well, tough luck.

I’m not saying that traditional NRTs don’t work. Studies have shown that combining several smoking cessation therapies, like e-cigarette use and counselling is much more effective than relying on a single quit-smoking aid, but the authors of this statement aren’t even willing to consider vaping as a possible solution. Yes, they cite numerous studies, but those are cherry-picked to make their conclusion appear valid. In reality, there are plenty of studies, many of which we’ve featured on this site, that show just how much of a difference in health harm there is between smoking and vaping.

The one thing that convinced my of the bias the authors of this statement have against vaping was the fact that the only time they referred to the now famous argument that e-cigarettes are 95 percent safer than tobacco cigarettes, was when they wrote “Other independent studies have shown that harmful substances are not reduced by 95%, as often claimed by the tobacco industry”. The tobacco industry may use that claim, but it was first issued in a thorough review carried out be researchers from King’s College London and Queen Mary University of London. It has since been confirmed in other highly-respected scientific reviews, but they just had to tie it to the tobacco industry…

By the logic of the ERS, just because electronic cigarettes do pose some danger to health, they are no better than tobacco cigarettes. That’s like comparing falling off a chair to falling off a cliff. Neither can be considered a good thing, but one is clearly less dangerous than the other. That’s literally the definition of harm reduction.

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