The report by the UK’s Royal College of Physicians that this week came out strongly in favor of encouraging smokers to switch to electronic cigarettes as a harm-reduction strategy has been much praised. Some have condemned it and one commentator has predicted that it spells doom in the UK.
Jeff Stamler, the CEO and co-founder of the e-liquid manufacturer, Nicopure Labs, welcomed the report, Nicotine without smoke: Tobacco harm reduction. “Tobacco harm reduction can only be achieved if public health organizations and governments are completely transparent and proactive with respect to comparative risks of nicotine containing products,” Stamler said. “Our UK subsidiary and our European customers now have access to reliable guidance from the Royal College of Physicians regarding our products’ potential role in reducing the death and disease toll from cigarettes.”
Meanwhile, Patricia Kovacevic, general counsel and chief compliance officer of Nicopure, said that the report’s findings were clear: 1. e-cigarettes were not a gateway to smoking; 2. their use did not result in the normalization of smoking; 3. among smokers, e-cigarette use was likely to lead to quit attempts and eventually successful smoking cessation; and 4. that while the possibility of long-term harm could not be entirely dismissed it was likely to be very small, and substantially smaller than that arising from smoking.
“These findings should weigh heavily here, in the US, against the FDA’s decision to issue a deeming rule that may decimate the vaping industry,” said Kovacevic.
Meanwhile, the health expert, Konstantinos Farsalinos, writing at ecigarette- research.org described the report as “extremely important” and said it was expected to be highly influential.
In a piece relayed by the TMA, Farsalinos said the report provided a valid and unbiased approach to currently-available evidence, presented any uncertainties about long-term risk without hysteria and intimidation.
It recognized the huge potential of e-cigarettes in reducing smoking-related disease risk among smokers and the lack of evidence that e-cigarettes were acting as a gateway to smoking.
Farsalinos said the RCP first published a report advocating tobacco harm reduction in 2007. That report said harm reduction could be a complement to conventional tobacco control policies and offer a way to prevent millions of deaths among tobacco smokers in the UK. The latest report added e-vapor to the harm reduction approach.
But not everybody has been swept away by the report. According to an AAP Information Services story by Belinda Merhab and relayed by the TMA, health professor Simon Chapman of the University of Sydney, Australia, said UK researchers had an “extreme enthusiasm” for e-vapor products and were “quite blind to some of the concerns that people in other countries are expressing”.
Chapman said e-vapor products had been on the market only since about 2007, which was a short period in which to determine whether they were safe.
Stephen Parnis, vice president of the Australian Medical Association, said his association had not seen “evidence that contradicts the idea that putting something in your mouth, a stick-like device, and inhaling is not risky.”
The report does not say either that vaping is safe or that it does not entail risk; it says that it would seem to be very much less risky than is smoking.
In a story by Sabrina Tavernise in the New York Times, also relayed by the TMA, the University of Michigan’s Ken Warner commented on the difference between the US and the UK’s views of e-vapor. “This is two countries taking pretty much diametrically opposed positions…one is focused exclusively on the hypothetical risks, none of which has been established,” he said. “The other is focusing on potential benefits.”
Finally, the UCSF’s Stan Glantz said, presumably in reference to the authors, “these guys…are going off a cliff”.
Glantz claimed that the RCP report takes “England into a series of policies that five years from now they all will really regret” and that England was being turned into a “giant experiment on behalf of the tobacco industry”.