E-cigs the ‘last resort’ to help quit smoking

The American Heart Association’s first policy statement on electronic cigarettes backs the view that the devices are a last resort to help smokers quit.

E-cigs the ‘last resort’ to help quit smoking

The American Cancer Society has no formal policy, but took a similar stance in May.

Both groups express great concern about the popular nicotine-vapour products and urge more regulation, especially to keep them away from youth. They also stress that proven smoking cessation methods should always be tried first.

If those fail, “it is reasonable to have a conversation” about e-cigarettes, said the Heart Association’s president, Elliott Antman.

The Cancer Society said e-cigarettes “may be a reasonable option” for people who could not quit after trying counselling and approved methods, such as nicotine patches.

Neither group recommends e-cigarettes for smoking cessation, and makers of the devices do not market them that way.

E-cigarettes are battery-powered devices that vaporise nicotine. They have been sold in America since 2007 and now have millions of users worldwide and nearly €$2bn (€1.5bn) in annual sales. They contain fewer toxic substances than traditional cigarettes do, but little is known about their health effects.

Whether they help or hurt anti-smoking efforts is hotly debated. Some say they encourage smoking by letting people maintain their habit in places where cigarettes are banned. Others say they are a less risky way to satisfy a nicotine craving for people who want to quit, similar to how methadone is used to curb heroin abuse.

This concept, called harm reduction, “is probably the most important and the most contentious issue that the tobacco community is dealing with right now”, said Tom Glynn, who recently retired as the Cancer Society’s top scientist on the e-cigarette issue.

No solid evidence shows that e-cigarettes aid smoking cessation, unlike the nicotine patches, gums, and medications approved now.

“We need hard-nosed regulation for e-cigarettes and we need more research,” Dr Glynn said, but mostly, “we need to have people stop smoking combustible cigarettes.”

The Heart Association stressed the toll — 20m deaths in the US alone from tobacco use over the last 50 years.

“We are fiercely committed to preventing the tobacco industry from addicting another generation of smokers,” says a statement from the association’s chief executive, Nancy Brown.

Besides nicotine — “a highly addictive chemical no matter what form it comes in” — some e-cigarettes form other products such as formaldehyde, a carcinogen, said Dr Antman.

“There are many things we see as dark clouds on the horizon” about e-cigarettes’ effects on blood vessels and secondhand exposure, especially to pregnant women, he said.

The Heart Association policy was published yesterday in its journal Circulation. The Cancer Society statement was accompanied an article on e-cigarettes in the group’s journal for doctors.

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