10.2. SR 09-08-2015 - Laserfiche WebLink

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The US Food and Drug Administration (FDA) has already announced its intention to regulate e-cigs as tobacco products. About $2.2 billion was spent on e-cigs in America last year, exceeding the amount spent on NRT but still representing a small part of the $85 billion cigarette market. At the same time, however, the FDA seems to favour a transition away from lethal combustible products. Mitch Zeller, director of its Centre for Tobacco Products, wants us to look at nicotine differently. People ‘smoke for nicotine but die from tar’, he says, and new products represent a public health opportunity. The FDA’s measured approach is in contrast to the continued unscientific approach of the US Centres for Disease Control and Prevention, whose director Dr Tom Frieden stated last year that ‘many kids are starting out with e-cigarettes and then going on to smoke conventional cigarettes’. They have yet to produce evidence that this is the case. In November, Penny Woods from the British Lung Foundation said ‘[new] data should again alleviate the fears expressed by some over an e-cig gateway effect’. Let’s spell this out. Unsupported statements are accepted as truth by policymakers and are used as the basis for stringent regulation of e-cigs in many jurisdictions. This may well end up causing more public health harm than good. The benefits of e-cigs in helping smokers quit or cut down should be weighed against the danger of either recruiting new smokers or creating e-cig addicts. So far, there is no evidence that either of these things is happening. Studies in both Britain and America suggest that, as e-cig use increases, youth cigarette consumption declines. Why are we in this position? One reason is that governments have become addicted to tobacco excise tax and may fear that, as e-cigs take off, they will lose a valuable source of revenue. Many leading NGOs and academics exert strong influence at WHO, within governments, in the media and among the general public. In the past, they helped bring tobacco control out of the shadows and into the mainstream of health policy. Now, alas, their intransigence threatens more profound progress. We need clear, unambiguous messages to smokers about the safety and benefits of e-cigs. An example is the March 2014 statement on the Royal College of Physicians website that ‘the main benefit of e-cigarettes is that they provide inhalable nicotine in a formulation that mimics the behavioural components of smoking but has relatively little risk… Switching