Science backs up use of e-cigarettes

Based on what we’ve heard at this US summit, enacting the Vaping Bill into law could help millions of Filipino smokers

(First of two parts)

We attended a science-packed summit on electronic cigarettes (e-cigs), participated in by independent scientists, researchers and renowned experts in the academe, as well as officials from the United States Food and Drug Administration and other regulatory agencies.

Updated information and research data about the safety and effectiveness of e-cigs as a cigarette smoking-cessation tool were presented, and arguments for and against it were tackled in an objective and dispassionate manner, so we could really appreciate where the science on e-cigs actually stands at the moment.

The key takeaway one got from the summit was that updated scientific data indicates that e-cigs are more effective than the currently used nicotine-replacement therapy (NRT) in the form of nicotine patches or gums to help smokers quit smoking.

E-cigs may help millions of smokers worldwide in the weaning process from the use of conventional cigarettes, which have been implicated as a leading cause of deaths in males worldwide.

It has been established that thousands of harmful and potentially harmful substances are released with the burning or combustion of tobacco leaves. E-cigs and other alternative tobacco products (ATPs), which do not burn but only heat the tobacco leaves or liquid containing nicotine (vaping solution), are associated with exposure of the smoker to significantly less toxic substances. They’re called smokeless alternatives since only vapors are inhaled.

E-cigs and other ATPs can presumably translate to better long-term health outcomes, but more data is needed to prove this, although the experts agree that they’re less harmful than cigarette smoking.

Behavioral counseling

Whatever smoking cessation aid is used, the quit rate is higher if this is accompanied by behavioral counseling support to motivate the smoker to stand firm in his/her decision to quit and sustain it for good.

It was emphasized that the “relapse” rate in smokers attempting to quit smoking is very high in the first year, which highlights the need for continuing behavioral counseling from the physician or other healthcare providers.

We’ve also suggested in previous commentaries that family support is very important, particularly in the case of curbing the smoking problem in the youth.

There will be a modeling problem, though, if either or

both parents or other older members of the family are smoking. In such a situation, we recommend that the whole family makes a joint decision to undergo smoking cessation intervention, including counseling, and provide moral support for each other.

It’s good to note that some independent scientists and researchers are doing a “living” systematic review and meta analysis on e-cigs, pooling all data, adding new ones as they come, and updating their analyses of the data.

It’s still an evolving science and admittedly, the numbers

are not that robust yet, but from where we currently stand, there’s already good reason and science to believe that e-cigs and the other ATPs can help our smokers lick the habit for good, or at the very least, significantly reduce the harm that they get from cigarette smoking.

It’s clear, though, that e-cigs and other ATPs still have some residual harm, compared to not smoking at all.

Preventable disease and premature death

Complete smoking cessation is still the safest and best move a smoker could make.

However, at best, the experts pointed out that this could only be attained in 20 percent of smokers, even with the help of nicotine replacement therapy, or other drug treatments, plus behavioral counseling.

So, in the far bigger majority of smokers who fail to lick the vice, the use of e-cigs and other ATPs puts them in a less risky position than maintaining cigarette smoking.

As Dr. David Ashley, professor of public health at the Georgia State University, said: “Substantially reducing the number of people smoking combusted tobacco products and minimizing the initiation of their use by nonsmokers, especially youth, presents an objective that would have a profound impact on reducing the preventable disease and premature death from tobacco product use.”

He explained that because the use of e-cigs mimics smoking, delivers substantial amounts of nicotine quickly, and delivers significantly less harmful and potentially harmful constituents during exclusive use compared to smoking, e-cigs are “a tool that could make a major impact on overall population health.”

However, Ashley, who is a retired consultant of the US Public Health Service, lamented that, to date, e-cigs have not met their full potential or optimal use.

We agree that this is so because of the many false perceptions many still have about them and the other ATPs. Sadly, the false perceptions are even fueled by statements from some well-meaning physicians.

We admit that we, too, had reservations about e-cigs when they were just new in the market, simply because there was very little data to support their being less harmful than cigarette smoking. When reports of Evali (electronic vaping induced acute lung injury) were published, our apprehensions were heightened all the more.

The use of tetrahydrocannabinoil or THC, a marijuana derivative, and its additive, vitamin E acetate, has been implicated as the cause of Evali. With proper regulatory safeguards, which the local Vaping Bill provides, this should not be a major issue.

The Vaping Bill has been approved by both the Senate and the House of Representatives, and it now awaits President Duterte’s final approval. Based on the presentations and discussions we’ve heard in this summit, the President has very good reasons to sign the bill and enact it into a law that could help millions of our smokers.

(To be continued)