E-cigarettes: scientific and political controversies
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National Council Against Smoking, South Africa
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A774
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ABSTRACT
Background and challenges to implementation:
The e-cigarette is touted as a disruptive
technology that could make combustible cigarettes obsolete. The product, its science
and politics though are controversial.
Intervention or response:
Published
journal articles, reports and conference presentations on e-cigarettes were
located using PubMed, plus conference, industry and other websites. These were critically reviewed.
Results and lessons learnt:
A number of contentious issues
regarding e-cigarettes were identified:
Its use is recommended by some public health bodies (UK Royal College of
Physicians) but not by others (World Health Organization).
The product may not be fit-for-purpose, with low consumer acceptance. In 2016, 72% of those who had
tried an e-cigarette in the UK no longer used it, A majority of users combined smoking
with vaping and are thus unlikely to obtain
significant health benefits.
E-cigarettes do not deliver nicotine as rapidly and
effectively as combustible cigarettes. Vaping was reportedly less "satisfying"
than smoking. The development of 'heat not burn' and other novel products by the
industry is testimony to its deficiencies.
E-cigarettes have divided the anti-smoking community, with
some regarding the tobacco companies as essential partners while others shun
it.
Finally, the profit-driven multinationals regard affluent
countries as the prime market for novel products, while simultaneously seeking
to maintain and expand the conventional cigarette market in poor continues.
Conclusions and key recommendations:
There are many
unresolved scientific, policy and political concerns about the role of e-cigarettes in tobacco control.
A continued focus on supply and demand reduction instead of
harm reduction is the best option for low-income countries.