The British Royal College of Physicians released a report Thursday encouraging smokers to switch to e-cigarettes, and claiming they are likely beneficial to overall public health. They specifically urge uptake of vapor products by smokers as a harm reduction strategy.
“Harm-reduction approaches, by promoting substitution of tobacco with less hazardous sources of nicotine,” the report states, “thus represent a potentially powerful complement to existing prevention policy.”
The 200-page report delves into all of the controversies surrounding vaping, including debunking the claim that e-cig use in the UK is a gateway to smoking. It also states that there is no evidence that vapor products lead to the “normalization” of smoking. The report looks at the science, public policy, regulation and ethics of e-cigs and other reduced-risk nicotine products, and at nicotine itself. It is easily the most detailed and comprehensive review of the topic to date.
“The growing use of electronic cigarettes as a substitute for tobacco smoking has been a topic of great controversy, with much speculation over their potential risks and benefits,” said Prof. John Britton, chair of the RCP’s Tobacco Advisory Group. “This report lays to rest almost all of the concerns over these products, and concludes that, with sensible regulation, electronic cigarettes have the potential to make a major contribution towards preventing the premature death, disease and social inequalities in health that smoking currently causes in the UK. Smokers should be reassured that these products can help them quit all tobacco use forever.”
Like last year’s report commissioned by Public Health England, this one estimates the risk of using e-cigs to be no more than five percent that of smoking traditional combustible cigarettes. “Although the long-term hazards of e-cigarette use are not yet clearly defined,” says the report, “e-cigarettes are probably close to NRT in the harm that their use confers on the user and others.”
And like the PHE report, this one illustrates the vast difference in attitude between the British and American medical establishments. Although many individual doctors in the US recommend e-cigs to their smoking patients, no American medical organization has yet adopted a vapor-friendly or pro-harm reduction stance.
Opposition to vaping by the Centers for Disease Control and Prevention (CDC) — and by many medical associations and public health groups — has been, in the opinion of vapor advocates, the biggest roadblock to widespread acceptance of vaping in the United States. So far, US public health officials have been largely silent on the position taken by their British counterparts. Perhaps this report will help to change some minds, and offer cover to doctors willing to try a new approach to smoking cessation.
Of course, the ideological opponents of vaping won’t change their minds. Stanton Glantz, professor of medicine at the University of California-San Francisco, was horrified. “These guys, in my view, are going off a cliff,” Glantz told the New York Times. “They are taking England into a series of policies that five years from now they all will really regret. They are turning England into this giant experiment on behalf of the tobacco industry.”
Dr. Michael Siegel, writing in his blog Wednesday night, had a different take. The report, he said, “vindicates the vapers who have been repeatedly attacked by anti-nicotine groups in the US for the past six years and hopefully, it will reassure vapers that they are truly to be congratulated and celebrated for having taken an action that will greatly improve their health and their lives.”
While American proponents of vapor products cheer the enlightened attitude in the UK, we have to wonder when US medical organizations will decide that nearly a half-million premature deaths a year from smoking is enough to warrant trying a different approach.