E-cigarettes a less harmful alternative to tobacco

Puffing on slim metal tubes loaded with pale yellow liquid, two London businessmen say they have between their lips a cure for what the UN calls “one of the biggest public health threats the world has ever faced.”
Electronic cigarettes are the future, they argue. Cheaper, cleaner and cooler than smoking, “vaping” — using a vaporizer to inhale nicotine infused with exotic flavors ranging from pina colada to bubblegum — will spell the end of tobacco.
“After I first tried this, I left half a cigarette in the ashtray and never went back,” says Zoltan Kore, who co-runs the newly opened London e-cigarette shop “Smoke No Smoke.”
“I’m not a smoker now, I’m a vaper,” says business partner Gabor Kovacs. “The awful morning coughing fits have gone, and the waking up in the night struggling to breathe has gone, too.”
Such stories — and hopes of persuading the rest of the world’s billion smokers to stub out their tar and toxin-loaded cigarettes, cutting a catalogue of chronic disease risks as they do — are tantalizing for public health experts.
And since “vaping” doesn’t entail kicking the addiction — either to the stimulant nicotine or to the behavioral habits of smoking — some say it can help smokers quit much more effectively than nicotine gum or patches.
All the top tobacco companies are now placing bets on e-smokes, which some analysts predict may outsell conventional cigarettes in 10 years, raising the counter-intuitive prospect that Big Tobacco could actually help people quit smoking.
Celebrities like Bruno Mars and Courtney Love are also endorsing them, a further inducement to makers of iconic cigarette brands like Marlboro and Camel to invest.
Yet e-cigarettes are far from universally accepted as a public health tool; regulators are agonizing over whether to restrict them as “gateway” products to nicotine addiction and tobacco smoking, or embrace them as treatments for would-be quitters. A big issue is the lack of long-term scientific evidence to support the safety and effectiveness of e-cigarettes, prompting critics like the British Medical Association (BMA) to warn of the dangers of their unregulated use.
“These devices may also undermine efforts to prevent or stop smoking by making cigarette use seem normal in public and at work,” argues the BMA, which has called for vaping to be banned in public places in Britain, just as smoking is.
The World Health Organization (WHO) is equally wary, saying that until e-cigarettes have been endorsed as safe and effective by national regulators, “consumers should be strongly advised not to use any of these products.”
Supporters of e-cigarettes scoff at suggestions they are a hazard or could be a slippery slope for previously addiction-free young people to get hooked on nicotine.
There is, they argue, no evidence of any harm from nicotine consumption and it would be crazy to impose tougher restrictions on e-smokes than on toxic “death sticks” that are freely available to buy on almost every street corner worldwide.
As Adrian Everett, chief executive of Britain’s leading e-cigarette company E-Lites put it in a comment to Reuters: “Comparing electronic cigarettes to tobacco is like comparing playing football to juggling live hand grenades.”
While the debate rumbles, smoking is killing half of all those who do it. Tobacco has an annual death toll of 6 million people, and that could exceed 8 million by 2030 unless something urgent is done to stop people smoking, according to the WHO.
As well as causing lung cancer and other chronic respiratory diseases, smoking is also a major contributor to cardiovascular diseases, the world’s number one killer.
“This could be the most effective method of smoking reduction that we have ever had,” says Konstantinos Farsalinos of the Onassis Cardiac Surgery Center in Greece, who has conducted several studies exploring the risks of vaping.
His work, some of which has had some funding from makers of e-cigarettes, has found no adverse effects on heart function, nor any notable cancer risks to cells in the lungs.
Other research, however, suggests “vaping” may reduce lung capacity, and the German Cancer Research Center said last month it was concerned e-cigarette liquids contained ingredients that can irritate the airways, while poor quality products could contain carcinogens.
Against this background, a growing number of regulators see a need to control standards in a largely unregulated sector.
Britain became the latest to take the plunge this week by opting to regulate e-cigarettes as non-prescription medicines, after finding widely varying nicotine levels and contaminants in some existing products. This means manufacturers will need a license from 2016, though they will still be sold in general stores.