Wednesday, 23 December 2015

A public health failure

The NZ Drug Foundation points to an excellent write-up on e-cigs at Rolling Stone. A snippet:
While the e-cig industry was jumpstarted by entrepreneurs like Walsh, big tobacco companies have since waded into the fray — which might be part of the problem. They don't want to be shut out of a growing business that some predict may eventually overtake their own, but given that cigarette sales still generate a staggering $35 billion in annual profits for the world's six largest tobacco companies, they remain incentivized to keep smokers drawn to their bedrock product. With electronic offerings like MarkTen — made by Altria, manufacturers of Marlboro — now among the most visible brands, it's understandable that some view e-cigs as the latest ploy of an industry with a well-documented history of manipulation and subterfuge. Whereas 84 percent of smokers believed e-cigs to be safer than ordinary cigarettes in 2010, by 2013 that figure had dropped to 63 percent. A study last year found that a third of people who had abandoned e-cigs and resumed smoking tobacco did so out of concern for the health effects of vaping.
The crux of the British report is that such misconceptions represent a public health failure, one that could be reversed by highlighting the comparative safety of e-cigs for current smokers, while making it clear that nonsmokers should steer clear of vaping. But the biggest hurdle for e-cigs in the U.S. is the very thing that makes them so appealing: by mimicking the hand-to-mouth ritual of smoking and delivering the same drug — nicotine — found in tobacco, they look and feel a whole lot like smoking. As a result, concerns about e-cigs center on whether encouraging people with a deadly habit to switch will rollback a decades-long trend of historically low smoking rates. Are e-cigs used by smokers to augment their habit rather than abstain? Could they prove to be a gateway toward "re-normalizing" tobacco smoking, especially among impressionable teens? Legitimate as such questions are, at this point they may be eclipsing the most pressing one of all: Is the United States, in applying the same tactics used to demonize smoking on a safer substitute, missing out on a chance to save the lives of millions of its citizens?
New Zealand's public health community might ask itself the same question.

The piece also shows how FDA regulations could wind up killing the industry in the US: if they deem each new flavour cartridge as a new product needing approval, and each approval costing about $5 million....

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