21 February 2015 Issue Cover Feature, by Derek Yach
I understand why anti-smoking activists so distrust vaping. I’m one of them. But the evidence is clear.
In the 1970s, a group of students in South Africa were planning a campaign against tobacco. I was one of them. We paid a visit to Rembrandt, the countrys leading cigarette manufacturer, to hear their side of the story.
They showed us shiny floors, introduced us to well-paid employees of all races a rarity in apartheid South Africa and proudly described their extensive support for the arts, culture and the environment. We replied that this was great, but it failed to address the core issue: their products killed half their regular users and harmed many more.
So the campaign went ahead. For me, it was the start of decades of battles with tobacco companies that led to strong regulations in South Africa and culminated in the World Health Organisation (WHO) Framework Convention on Tobacco Control, now in effect in almost 180 countries.
Along the way, I learnt to distrust every move by tobacco companies and felt fully justified when an inquiry, supported by WHO and the World Bank, declared: Evidence reveals that tobacco companies have operated for many years with the deliberate purpose of subverting the efforts of WHO to control tobacco use. The attempted subversion has been elaborate, well financed, and usually invisible.
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Now we have electronic cigarettes. Is this the latest ruse, or is it really an innovation we should welcome?
Lets review the appalling statistics. There are about 1.3 billion smokers in the world and roughly six million smoking-related deaths every year. In the United Kingdom alone, smoking causes 80,000 deaths. Thats 18 per cent of all deaths. Whats more, for every death there are 20 smokers suffering from tobacco-related diseases, resulting in 450,000 hospital admissions each year. No other single cause of death and disease can so easily be prevented.
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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 completely from tobacco to e-cigarettes achieves much the same in health terms as does quitting smoking and all nicotine use completely. Furthermore risks associated with passive exposure to e-cigarette vapour are far less than those associated with passive exposure to tobacco smoke.
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Other market sectors need to adapt to the reality of e-cigs as a force for good. Retailers should voluntarily withdraw cigarettes from stores, or at least reduce their prominence, in favour of e-cigs and NRTs. CVS Health has yet to offer e-cigs, despite the fact that they work better than pharmaceutical products. Life insurers still treat e-cig users as regular smokers when they calculate premiums. This is short-sighted and misses a golden opportunity to spell out the benefits of quitting smoking and the positive impact of switching to e-cigs on peoples longevity.
At the moment, its estimated that there will be a billion tobacco-related deaths before 2100. That is a dreadful prospect. E-cigs and other nicotine-delivery devices such as vaping pipes offer us the chance to reduce that total. All of us involved in tobacco control need to keep that prize in mind as we redouble efforts to make up for 50 years of ignoring the simple reality that smoking kills and nicotine does not.
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