Smoking Debate Heats Up

September 6, 2016

The Cape Argus headline by the Health Writer, Sipokazi Fokazi, on 5th May this year was “Smoking Debate Heats Up – Seeing e-cigarettes in shops and in adverts may influence teenagers into lighting up.” The article highlighted a study conducted by two universities on smoking trends amongst teenagers in Scotland. The findings have added fuel to the already hotly debated and highly controversial use of the e-cigarette as a product to help quit smoking.

The research showed that teenagers who had smoked before were more likely to try e-cigarettes than their non-smoking counterparts but it also revealed that young people who recalled seeing e-cigarette point-of-sale displays were more likely to try the product at some point in the future. It would appear that seeing e-cigarette displays in the local environment increases experimentation with the devices.

Electronic cigarettes (ECs) or e-cigarettes have seen a rapid growth in market share over the last few years and are gaining ground on conventional cigarettes mostly due to a perception that they are a less harmful alternative to smoking tobacco and because they can be freely used in many smoke-free areas.

The growing popularity amongst adults suggests that smokers are keen on using an alternative technological form of smoking either to reduce cigarette smoking or to quit smoking altogether. It also demonstrates that the EC is viewed as an easy way to stop smoking as it may relieve nicotine withdrawal symptoms. Initial evidence indicates that ECs may well be helping smokers reduce or quit smoking and as such could play an important role in tobacco harm reduction and smoking cessation. However, the public health community is deeply divided over the appropriateness of endorsing ECs as products to help stop smoking when their safety and efficacy remain unclear.

The vapour toxicology, under normal conditions of use of ECs shows significantly lower urine levels of tobacco smoke toxins and carcinogens when compared to smokers. ECs typically contain a solution of propylene glycol or glycerine, with or without nicotine plus additives to enhance flavour and fragrance. Cigarette smokers inhale and absorb thousands of by-products of burning tobacco when smoking a cigarette including carbon monoxide and toxins which smokers of ECs are not exposed to. The most frequently reported adverse reactions to inhaling EC vapour are nausea, throat and mouth irritation, headache and dry cough, all of which were found to resolve over time. ECs are believed to have similar toxicity to existing nicotine replacement therapies but without long term safety data and no standardisation of manufacturing practices, they remain beliefs without a sound evidence base.

Several important ethical issues around the use of ECs as recreational products, harm reduction devices and stop smoking products have been identified including their appeal to non-smokers, their potential to act as a gateway to future cigarette smoking and a possible renormalisation of a public smoking culture.

While the existence of a gateway effect for non-smokers and especially the youth remains uncertain, the product remains non-standardised and advertising remains unrestricted, the whole debate will continue.

Tips on stopping smoking

Currently the best way to quit smoking is an evidence based tobacco cessation program which includes support, behavioural modification and traditional nicotine replacement therapy such as medical nicotine gum or patches.

You can triple your chance of successfully stopping smoking by using a combination smoking cessation programme such as GoSmokefree. Visit www.gosmokefree.co.za or email info@gosmokefree.co.za for more information.

Resources:
http://www.gosmokefree.co.za
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0298-3
https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-016-0370-3

This article contains opinions and facts and references to other information sources. You should always consult a registered healthcare professional for any personal advice.

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