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October 20, 2017

US and UK Disagree Over E-Cigarette Consensus


Public Health England (PHE), the United Kingdom’s governmental body equivalent to the United States’ Centers for Disease Control and Prevention (CDC), has stated that their review of the evidence has found that electronic cigarettes are 95 percent less harmful to health than combustible cigarettes and should be recommended for smoking cessation and harm reduction. This is, however, the complete opposite stance taken by the United States anti-smoking activists who have since morphed into anti-nicotine activists, and have now began to demand that cigarette smokers engage in “abstinence only” when it comes to nicotine. An approach that works with almost nothing.

Currently there is an inadequate amount evidence in regards to just how successful e-cigarettes are for smoking cessation,  truly irrelevant, due to the fact it is currently illegal to market e-cigarettes as a smoking cessation tool. Truth be told, nothing works very well; gums and patches are also ineffective. What has been effective is having a multitude of choices. If each of the before mentioned cessation tools were only 10 percent effective, and there were multiple ways to quit, it covers 40 percent or more smokers.

However, instead of embracing anything that would lead to fewer lung cancers cases, e-cigarettes continue to be linked to adverse tobacco health risks. In a new “Perspective” in the New England Journal of Medicine, researchers from Columbia University’s Mailman School of Public Health draw on a history of harm reduction in the UK and U.S., comparing the UK’s conclusion in 1926 that drug addiction was an illness that should be treated by physicians with safe drug practices to the very different U.S. stance of refusing drugs to addicts as a treatment practice.

The Campaign for Tobacco-Free Kids — ASH’s U.S. equivalent and a powerful voice in anti-tobacco advocacy — has been unequivocal in its denunciations of e-cigarettes. Similarly, the Centers for Disease Control and Prevention hosted a Public Health Grand Rounds on e-cigarettes in which all five speakers focused on the possible health risks associated with e-cigarette use.

Comparisons like these led researchers to questions. Do electronic cigarettes work against reducing tobacco smoking or offer the possibility of minimizing harm for those who just cannot quit tobacco cigarettes?

Criticisms of Public Health England were in full force. In the editorial E-cigarettes: Public Health England’s evidence-based confusion, the The Lancet editors focused on the methodological limits of one of the many studies on which the review had relied. They concluded,

PHE claims that it protects and improves the nation’s health and well-being…. On this occasion, it has fallen short of its mission.

Within the U.S., opinions are more uniform – everyone simply denounces electronic cigarettes, and the CDC warns they may be associated with health risks, even if they can’t find any yet.

There is no end to the debate anytime soon and e-cigarette proponents have to share some of this blame. They continue to argue they should be used for recreation and to reprimand even sensible regulations related to kids and safety. This makes it more difficult to gain reliable data on who uses them and why.


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