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RCP Renews E-Cig Advocacy

Britain's Royal College of Physicians has reiterated its advocacy of electronic cigarettes as smoking cessation or harm reduction devices.

In a new report, published on March 20, 2014, co-authors Dr. Ilze Bogdanovica, Professor Linda Bauld, and Professor John Britton (of the UK Centre for Tobacco and Alcohol Studies) argue that potential dangers, although not yet fully known, are certain to be slight, while the tobacco dangers that can be reduced by e-cigs are known to be great, indeed deadly.

For this reason, they continue to argue for a harm reduction policy, rather than a deadly prohibition claiming "better safe than sorry" (as advocated by US tobacco regulator Dr. Tim McAfee at the Centers for Disease Control). The authors note that 15% of UK smokers experiment with e-cigs as of November 2014, up from 2% in 2011. "Use among non-smokers in the UK, and particularly among young non-smokers, is rare," they observe. The RCP report concludes that: "Switching completely from tobacco to e-cigarettes achieves much the same in health terms as does quitting smoking and all nicotine use completely.... and risks associated with passive exposure to e-cigarette vapour are far less than those associated with passive exposure to tobacco smoke."

Regarding dangerous substances in e-cig vapor, the authors agree that more information is necessary, but conclude that the risks are "probably slight". "Even in the absence of regulation to ensure product standards, the direct hazard to users – irrespective of smoking status – and others, from e-cigarettes is low. However, the introduction of product standards to avoid or minimize contamination could further reduce any ill effects." Such standards are already a matter of course at e-cig companies that are members of the E-Cigarette Industry Trade Association (ECITA) and other reputable trade groups.

Regarding fears of "dual use", they note that "no evidence as yet shows that dual use results in reduced quit rates." Fears that vaping will become a gateway to smoking, particularly among youth, are also dismissed: "no evidence suggests that [this] is occurring to an appreciable degree." Noting that 20% of older teens in the UK are already smokers, the physicians argue that "progression to tobacco use will thus be a problem only if it adds to the total number taking up tobacco smoking." Data both in the UK and in Poland indicates that youth interest in e-cigs occurs almost exclusively among those who already smoke.

To those who are anxious about, or offended by, the similarity of e-cig advertising to the cigarette adverts of yore, the authors express confidence that this can be handled with oversight and regulation, but they see as more sinister the involvement of Big Tobacco companies in the sale and advertising of e-cigs, an involvement that could afford opportunities to bypass existing controls on deadly tobacco. "E-cigarettes thus appear to be providing smokers with a valuable alternative route to smoking cessation," the authors conclude. Hear Hear!