e-Cigs Don't Help People Quit, May Be Harmful, Clinicians Say

Marcia Frellick

May 31, 2019

Electronic cigarettes (e-cigarettes) and other heated tobacco delivery devices are harmful and they don't help people quit smoking, the European Respiratory Society (ERS) says in a new statement.

The international group of respiratory doctors and scientists said that programs that use the devices to help smokers quit "are based on incorrect assumptions and undocumented claims."

"[I]n reality, the majority of smokers want to quit and they dislike being nicotine dependent," Charlotta Pisinger, chair of the ERS Tobacco Control Committee and clinical professor of tobacco control at Bispebjerg and Frederiksberg Hospital and University of Copenhagen, Denmark, said in a press release. "Most of the new products, including heated tobacco and e-cigarettes, are devices of nicotine inhalation, and therefore do not help smokers to beat their addiction to nicotine."

The ERS says it cannot recommend tobacco harm reduction as a population-based strategy and is calling on policymakers and public health organizations to stop using that strategy.

Tobias Welte, MD, a professor in the department of respiratory medicine at Hannover University in Germany and ERS president, said in the press release that although people may inhale fewer harmful ingredients from such devices compared with cigarettes, that does not mean they are harmless.

"Until we know more about the long-term effects of their use on human health, it is irresponsible to recommend that they be used in population-wide tobacco control strategies," he said. "Evidence-based tobacco dependence treatments already exist and are safe and cost-effective, and we must utilise this. Nothing should enter the lungs besides clean air — we must not give up on smokers."

"We Know What Works"

In the full ERS report supporting the statement, authors say other smoking cessation strategies have been proven successful over many decades.

"In France," they write, "one million smokers have quit in a single year due to improved tobacco control (higher cigarette pricing, plain packaging, campaigns, national tobacco-free month and a dedicated national smoking-reduction programme), and a decline in smoking among teenagers and those on low incomes has also been observed."

"We know what works. We need brave leaders to implement the evidence-based effective methods," the authors add.

The report authors also make a comparison with substituting methadone for opioids in harm-reduction strategies.

They write, "While opioid substitution therapies such as methadone are given only to those who are addicted and at the highest risk and are administered by a health professional, the nicotine containing alternatives to smoking, such as e-cigarettes and heated tobacco, are mass-marketed consumer products. In most countries they are easily accessible for the general population, including those who were never addicted to nicotine."

Earlier this year, Medscape Medical News reported that an analysis from the National Academies of Sciences, Engineering, and Medicine found that e-cigarettes are less harmful than cigarettes and combustible tobacco products, but may also lead young people to go on to smoke conventional cigarettes.

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