E-cigarettes may do more good than harm: experts

Use of vapourised nicotine products, especially e-cigarettes, may reduce overall smoking and potentially lower deaths from cigarette smoking, a team of international tobacco control experts has claimed.
The experts are prompting regulators at the US Food and Drug Administration (FDA) to have a broad "open-minded" perspective when it comes to regulating e-cigarettes.
The experts analysed much of the evidence published to date on e-cigarettes, and suggested that use of these products can lead to reduced cigarette smoking overall with a potential reduction in deaths from cigarette smoking.
"We're concerned the FDA, which has asserted its right to regulate e-cigarettes, will focus solely on the possibility that e-cigarettes and other vapour nicotine products might act as gateway to cigarette use," said David T Levy, professor at the Georgetown University in the US.

"We believe that the discussion to date has been slanted against e-cigarettes, which is unfortunate, because the big picture tells us that these products appear to be used mostly by people who already are or who are likely to become cigarette smokers," said Levy.
Experts, including those from Medical University of South Carolina in US, University of Waterloo in Canada, and Cancer Control Victoria in Australia said the 2014 Surgeon General's Report stated, "the burden of death and disease from tobacco in the US is overwhelmingly caused by cigarettes and other combusted tobacco products."

E-cigarettes may counteract those health risks and experts estimate that exclusive e-cigarette use is associated with about five per cent of the mortality risks of smoking, Levy said.

The evidence also suggests a strong potential for e-cigarette use to improve population health by reducing or displacing cigarette use in countries where cigarette prevalence is still high and smokers are interested in quitting, he said.
Levy and his colleagues reported research in the US, Canada and the UK, that shows cigarette smoking rates have fallen more in the last two years than they have in the previous four or five years and that this trend has coincided with the increase in e-cigarette use.
"While e-cigarettes may act as a gateway to smoking, much of the evidence indicates that e-cigarette use encourages cessation from cigarettes by those people who would have otherwise smoked with or without e-cigarettes," Levy said.

The experts anticipate that their suggested framework will be controversial due to an ongoing debate about whether e-cigarettes will complement or undermine tobacco control efforts.
"We don't want to encourage e-cigarette use by youth and young adults who would not have otherwise smoked. However, the primary aim of tobacco control policy should be to discourage cigarette use while providing the means for smokers to more easily quit smoking, even if that means switching for some time to e-cigarettes rather than quitting all nicotine use," the experts wrote in the journal Addiction.