Tobacco use is associated with cancers, lung and cardiovascular diseases and many other risks that increase the mortality of ex-smokers for years. This has been well known for decades, which is why alternatives in the form of e-cigarettes and smokeless tobacco have emerged in recent years.
1. There is no solid evidence that vaping helps to quit smoking, but there are other options to do it
Available studies and reviews do not show that e-cigarettes are effective for smoking cessation. Moreover, observational studies in real-life conditions show that the effect shown by some clinical trials under ideal conditions is lost over time.
In contrast, other studies show that drugs such as varenicline have similar or superior effectiveness to e-cigarettes.
2. The anteroom to smoking (and relapse)
Numerous studies have shown that e-cigarettes can serve as a gateway to smoking for many users, including adolescents. They may also encourage relapse to smoking among those who have quit smoking.
3. They are not harmless
A Ministry of Health report published in 2020 warned of the risks of smoking e-cigarettes and so-called “heated tobacco”, where the product is not burned by combustion. In addition to pointing out that there is no robust evidence that these products help to quit smoking and that their use has increased among young people, the document recalled that these devices are not harmless either.
It thus reminded readers that e-cigarette aerosols contain carcinogenic substances that can cause short-term health effects such as so-called “vape-associated lung injury” (VALI).
4. Harm reduction?
Proponents of e-cigarettes argue that e-cigarettes can be used for “harm reduction”, as they are less harmful than traditional tobacco and could prevent some of the hundreds of deaths caused by tobacco each year.
Critics of this argument argue that e-cigarettes have not been shown to be effective, that they are not harmless and that they may attract new —and old— smokers. In addition, they point out that their use is not advocated in an anti-smoking framework, for example by making them available on prescription.
5. Beware of conflicts of interest, also in studies.
It is obvious that to talk about tobacco is to talk about a multi-billion-dollar industry with numerous economic interests. However, these can permeate the scientific literature and complicate its analysis.
A study published in the Tobacco Induced Diseases journal found that one third of the papers published on e-cigarettes did not show potential conflicts of interest. Moreover, those whose conclusions were favourable towards these devices were more likely to have them.
To find out more:
-WHO.
-ECDC.
-CDC.
