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FCTC Framer comes out for Harm Reduction

FCTC Framer comes out for Harm Reduction

Derek Yach, a seasoned stalwart of the worldwide campaign against tobacco, has come out with a piece in the UK journal The Spectator, advocating a harm reduction approach to electronic cigarettes.

He takes this step reluctantly. "I understand why anti-smoking activists so distrust vaping. I'm one of them. But the evidence is clear" – he proclaims in the opening line of his article.

The South African medic has good reason to be suspicious about anything that looks like smoking. As Executive Director of a WHO division, he spearheaded the Framework Convention on Tobacco Control. His attitude toward tobacco companies is one of abiding distrust. "Early in [FCTC] development, we invited tobacco company scientists to provide evidence that their harm-reduction measures were real and not merely marketing ploys. Their responses were unconvincing."

So when it comes to vaping, he asks the question: "Is this the latest ruse, or is it really an innovation we should welcome?" For an answer, he turns to a digression on snus, packets of orally administered tobacco popular in Sweden, but banned in the rest of the EU as part of anti-tobacco policy. The evidence is overwhelming, admits Yach, that snus are responsible for the statistically demonstrable greater longevity of Swedish men.

"So what has this to do with the emerging e-cigarette debate?" he asks. "We’ve seen that snus is banned in most of Europe despite overwhelming evidence that it is harm-reducing. And now e-cigs . . . face the same challenge."

Next Dr. Yach looks at the downside of the traditional anti-tobacco strategy – higher taxes on cigarettes – which harm poor smokers who can't quit because of their need for nicotine as a narcotic. He compares that with the evident success of vaping in smoking cessation, citing statistics supplied by health psychologist Robert West of University College London.

"E-cigs could play a major role in helping those smokers most addicted to nicotine, who are shifting in increasing numbers from NRT products to ‘vaping’ as their means of quitting the tobacco habit," he concludes. He adds that a growing number of studies show "significant health benefits . . . [for] smokers who switch from tobacco to e-cigs." The resistance to vaping among anti-smoking activists, he decides, stems from the FCTC's ban on any interaction with tobacco companies. This "limits the potential to make use of scientific discoveries made by tobacco companies."

Yach praises the yank FDA for its "measured approach", viewing new, non-combustible products as a "public health opportunity", and excoriates the stateside CDC for an unscientific stance, which claims with zero evidence that vaping is a gateway to smoking for youth.

"Let’s spell this out," he says. "Unsupported statements are accepted as truth by policymakers and are used as the basis for stringent regulation of e-cigs in many jurisdictions. This may well end up causing more public health harm than good."

Yach calls for "clear, unambiguous statements" by public health officials on the potential benefits of vaping, and a supportive stance toward e-cig companies that share the goal of obsoleting smoking. He calls for his colleagues in tobacco control to "make up for 50 years of ignoring the fact that smoking kills and nicotine does not."

Also of note is a piece by Gilbert Ross of the American Council on Science and Health, published this week in the journal Spiked.