Strong rhetoric on the two sides of e-cigarettes debate but tiny proof

A woman smoking an electronic cigarette. Photograph: Rex Characteristics

E-cigarettes are either going to save hundreds of thousands of lives by helping folks to quit smoking or they are going to destroy millions of lives by luring youngsters and younger folks into the habit. It is extremely challenging for the onlooker to know what to feel, when the rhetoric is flying in the two directions from very eminent folks who all have a passionate commitment to public overall health.

The most current letter to Margaret Chan, director basic of the Planet Well being Organisation, swings the pendulum firmly back to the place of the opponents of a cost-free industry in e-cigarettes. The language is challenging and uncompromising. It is signed by these who concern, primarily based on decades of proof of negative behaviour, that the tobacco companies are obtaining concerned in the nicotine delivery units in buy to undermine bans on cigarette marketing and smoking in public locations.

The letter is a response to a single from 53 scientists to Chan, sent on 3 June, which stated in no less direct language that treating e-cigarettes like tobacco would deprive smokers of a new and increasingly popular way to quit. E-cigarettes, the scientists say, are a really useful harm reduction instrument, permitting smokers to get their nicotine resolve without having the deadly tar in cigarettes. Amongst these who signed the earlier letter have been Professor Gerry Stimson, of Imperial University, who has been at the forefront of harm reduction advocacy in medication the former government drugs adviser David Nutt and Michel Kazatchkine, ex-head of the Global Fund, whose primary interest is HIV.

The opposing letter has twice the amount of signatories, from all over the planet. They fear a comeback by Massive Tobacco, which is turning into the most significant player in the e-cigarette industry. They do not think claims that the market wants to diversify. E-cigarettes could demonstrate to be a rewarding market place, but globally tobacco is massive, and increasing in the developing world. Why would Huge Tobacco support e-cigarettes if they are probably to shrink that market, the opponents inquire.

The WHO has been moving in their direction. Some smaller European countries, this kind of as Slovenia, have been asking for suggestions, and there are stories of e-cigarette shops opening outside colleges. In October, the WHO will meet to go over no matter whether to carry e-cigarettes into the framework convention on tobacco control, a single of the proudest achievements of the WHO, despite the fact that the guy who played the lead role in its improvement whilst at the WHO, Derek Yach, now of the Vitality Institute in New York, is 1 of the 53 signatories opposing that.

There are imagined to be two million men and women employing e-cigarettes in the Uk, and a lot of of them say they have managed to cease smoking as a result. A lot of argue passionately that they have been rescued from harm and that everyone must have a correct to use them if they want to. Powerful feelings have led to outbursts of anger and even vitriol on Twitter, and some public health medical doctors say they have been threatened. That has increased their personal conviction that malign forces – in the form of the tobacco business – should be pulling the strings.

In the end, only very good scientific proof will persuade the critics of e-cigarettes that they are not a danger. The studies that have been carried out, this kind of as a recent a single by Professor Robert West, from University College London, which showed that e-cigarettes had been far more effective than nicotine substitute treatment in helping people quit smoking, are not ample, opponents say. Their argument is that, till we know, we ought to opt to be secure rather than sorry.

Strong rhetoric on the two sides of e-cigarettes debate but tiny proof