Shahid Akhter, editor, ETHealthworld spoke to Prof Robert West
, professor of health psychology at the department of behavioural sciences and health at University Law College
, London, to know more about the research behind e-cigarettes and if it can help one in quitting smoking
. Can e-cigarettes help you quit smoking?
There is a lot of noise going around e-cigarettes but the evidence that is emerging now is very clear that it helps people to stop smoking. The only question is 'how much does it help?' So we have evidence from randomised controlled trails, showing the e-cigarettes were more effective than licensed nicotine products in helping people to stop smoking in a clinic. We also have evidence in the United Kingdom, where e-cigarettes have become popular, that the population's rate of quitting smoking has become higher as the prevalence of e-cigarettes use has gone up. So, we have population-level evidence and we also have evidence that people who use e-cigarettes, when they were trying to stop smoking in the population were more likely to succeed then if they use nothing at all. Now it is extremely rare to have evidence from all these three sources including clinical files, observational studies and population-level data and all of them showing a very similar thing. Does e-cigarette encourage the young generation to quit smoking?
There is a lot of controversy whether e-cigarettes might encourage people to stop smoking. The evidence in both the United States (US) and United Kingdom (UK) at the population level is very clear that it doesn't. The rates at which smoking prevalence have gone down in the UK and in the US are at least faster and following the introduction of e-cigarettes than it was before e-cigarettes came in the market. So, what you hear is that the young people who use e-cigarettes are more likely to smoke but this is due to the fact that these young people have a common predisposition to buy either smoke or use e-cigarettes, is not to cause a relationship. E-cigarettes are not completely safe, you are inhaling a material into the lungs (propylene glycol glycerol flavorings), and other things that will irritate and potentially cause harm to lung tunnel. Any form of tobacco smoke is extremely dangerous however, when it is compared with cigarettes, the concentration of toxic chemicals in the e-cigarette vapour is substantially less and most of the harmful chemicals that are present in cigarettes are not present in e-cigarette vapour. Again, you see lots of stories in the press and papers out in the scientific literature which are claiming that e-cigarettes are as harmful as cigarette smoke. However, these are highly misleading because they are not making appropriate comparisons with cigarette smoke.Message to the regulators
My message to the regulators is that don't trust, what so-called experts are telling you. As a regulator, you cannot afford to. The reason for that is the so-called experts are coming to such conclusions with preconceptions and biases, unfortunately. So, you have to look at it dispassionately and look at the evidence on-ground to understand "what is it that the evidence is telling us?" So, unfortunately, many of the stories that we get told, and if I can understand is that it gets very difficult for the regulator to say who is telling the truth or what is going on here. Many of the stories that experts are putting forward are false. Now, one way, which I think, that you can tell whether an expert is someone to be trusted or not is if they caveat their remarks.
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