Vapear o...no vapear: "evidence-based approach to e-Cigs"?

129 public health and medical authorities from 31 countries write WHO DG Chan urging evidence-based approach to ecigs

Dear Dr. Chan,

We, the 129 signatories to this letter, are writing to express our support for WHO’s evidence-based approach to determine the best way forward for public health to respond to Electronic Nicotine Delivery Systems (ENDS), as expressed in WHO's June 3, 2014 statement.[1]

Recently, media attention was focused on a statement by a group of “specialists in nicotine science and public health policy.”[2] Unfortunately, the statement makes several assertions about ENDS’ marketing, emissions, harms, and use that are either contradicted by available evidence or for which no evidence is currently available. (Indeed, the statement does not cite a single scientific study.)

The statement also included several policy recommendations, including effectively exempting ENDS from FCTC Articles 8 and 13 and ignoring Article 5.3.

It is fundamental that WHO and other public health authorities not buy into the tobacco industry's well-documented strategy of presenting itself as a "partner."[3] If the tobacco industry was committed to reducing the harm caused by tobacco use, it would announce target dates to stop manufacturing, marketing and selling its "more harmful" products rather than simply adding e-cigarettes to its product mix and rapidly taking over the e-cigarette market.[4]-[5] It would also immediately desist from its aggressive opposition to tobacco control policies such as tax increases, graphic health warnings and plain packaging.

A US$2 billion global industry

US$2 billion global industry

US$2 billion global industry

By moving into the e-cigarette market, the tobacco industry is only maintaining its predatory practices and increasing profits. As stated in the guidelines for Article 5.3 of the WHO FCTC, there is a “fundamental and irreconcilable conflict of interest” between the tobacco industry’s interests and public health’s interests.”[6]

Public health embraced cigarette filters and “low tar” cigarettes as harm reduction strategies before manufacturers provided evidence and at a time when the manufacturers were well aware that these technologies did not actually reduce harm but were designed to promote cigarette sales by reassuring a concerned public that the new products were safer.[7]-[8] The negative consequences of these acts remain in cancer and heart disease hospital wards throughout the world. Ignoring the link between ENDS and the tobacco industry is overlooking the WHO FCTC Parties’ legal obligation to protect government policies against tobacco industry interference.

The aggressive marketing and promotion of e-cigarettes to youth is well-documented[9]-[10]-[11]-[12] and evidence from the US[13]-[14] and Korea[15] shows rapid growth in youth e-cigarette use, including disturbing rates among youth who have never smoked a cigarette. One e-cigarette manufacturer warns parents that “kids may be particularly vulnerable” to the flavoring in its products.[16]

Manufacturers of ENDS are making a range of false and unproven claims,[17]-[18]-[19] misleading the public into thinking these products are harmless (they are not) and effective cessation aids (unknown). Most ENDS users are "dual users" who continue to smoke cigarettes.[20] Reviews of evidence about reducing smoking (instead of quitting) show that dual users are unlikely to see any health benefit in terms of cardiovascular disease.[21]-[22] Population studies of all smokers consistently show that smokers who use ENDS are less likely to stop smoking.[23]-[24]-[25]-[26]-[27]-[28]

Such a regulatory framework would require manufacturers to present safety and efficacy data. In this case, the use of these products as cessation aids (if the evidence supports such use) would operate under the supervision of a health authority that could control manufacturers’ claims, impose health warnings about risks, require disclosure of ingredients and safety data and regulate product engineering as well as mandate surveillance. This is the path that the WHO has been pursuing and encouraging. We urge you to continue doing so. (Ver carta)

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Día Mundial sin tabaco: Dos "ligaditos"

Vapear no mata. Prohibirlo, sí