Royal College of Physicians recommends e-cigarettes for smokers

A few months ago I wrote here about the rise of e-cigarettes. In that post I pointed out that e-cigarettes are far less harmful than tobacco, and should be marketed as a safer alternative to smoking. There has been an interesting update on this topic today, with the Royal College of Physicians (RCP) recommending that all smokers be offered and encouraged to use e-cigarettes.

You can read my previous post for some of background, but put simply, e-cigarettes vaporise nicotine to allow it to be inhaled (hence it being known as “vaping”). This differs from smoking, where tobacco is burned and the smoke inhaled. This accounts for the primary difference between vaping and smoking; tobacco burning creates thousands of chemicals, 10% of which are known to cause cancer. People inhale far fewer chemicals when vaping, making it 95% safer than smoking.

The RCP released a report today (April 28th) stating that

“e-cigarettes are likely to be beneficial to UK public health. Smokers can therefore be reassured and encouraged to use them, and the public can be reassured that e-cigarettes are much safer than smoking”

They go on to state that current evidence shows:

  • E-cigarettes are not a gateway to smoking.
  • E-cigarettes do not result in the normalisation of smoking.
  • E-cigarette use is likely to lead to quit attempts that would not otherwise have happened.
  • The dangers of long-term e-cigarette are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure.

An excellent Cancer Research UK blog post on this topic points out that this reduced harm of vaping is something we should focus on. They emphasise that a significant number of people may be unable, or simply not want, to give up smoking. For these people, the aim should be to reduce the danger of their habit by encouraging them to use e-cigarettes rather than traditional cigarettes. This harm reduction strategy has worked well in other cases, such as needle exchanges for intravenous drug users.

This is what the NHS already recommends, in the form of nicotine replacement therapy. It has been shown, however, that the delivery of nicotine to the brain via vaping is far more similar to smoking than in nicotine replacement therapy. As a result smokers seem to prefer vaping, and e-cigarettes have now replaced nicotine patches and gum as the most popular aid in quitting smoking in the UK.

It has been shown that an overwhelming majority of e-cigarette users are ex-smokers, or current smokers who are trying to cut down or quit. Considering the human toll of smoking (270 deaths in the UK every day), it is commendable that the RCP have recommended e-cigarettes to smokers. While there are still problems with vaping (particularly in marketing to children), the advantages for current smokers are undeniable. The use of alternative sources of nicotine is safer, and should be part of any strategy to reduce the harm of tobacco.

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