E-cigarettes: Experience is a gloomy lantern that does not even illuminate its bearer.
Gornall questioned why e-cigarettes are dividing the public health community. The right question should be: is the public health community insane? Indeed, both sides are doing the same things over and over again, expecting different results, which is insanity according to Einstein.
Once more, many are fooled by the “harm reduction” motto, as before with low tar and light cigarettes! Medicine is not about hope. If do not know we must not do or include patients in randomized controlled trials. How can we forget that hope arms patients (Eg. the prone position to prevent cot death, the bone marrow transplant to treat metastatic breast cancer)? The e-cigarette, a young bastard, has been rapidly made legitimate by the tobacco industry, which is now buying e-cigarette companies and applying for patents.(3) Is this to reduce cigarette smoking prevalence or incidence? More sadly, the craze for electronic cigarettes only is an indicator that the system is unable to assist smokers and provide them access to evidence-based treatment for cessation!(3)
Others call for a ban as “shooting up” with an e-cigarette nicotine plus flavor is freeway to addiction.(4) In fact, current regulations is characterised by inertia or ineffective measures, entire ban being the exception (eg. Brazil, Indonesia, Singapore, the Seychelles, and Uruguay). Could e-cigarette control be effective? It is already too late and the model, the one of tobacco control, is out of breath: since 2004, the year after the adoption of the World Health Organization Framework Convention on Tobacco Control, any change in the prevalence of daily smoking has levelled off and the 2012 annualized rate of change in prevalence of daily smoking was almost null.(4,5)
Ruyan marketed electronic cigarettes in China in 2004 and in the world including Europe by 2007 but no robust evidence based data, only hope or fear! The debate have lasted too long, it is a waste of time resulting in an obviously zero sum game. It is now time for a paradigm shift: e-cigarette now makes banning cigarettes possible!
1 Gornall J. Why e-cigarettes are dividing the public health community. BMJ 2015;350:h3317.
2 Braillon A. Electronic cigarettes: From History to Evidence-Based Medicine. Am J Prev Med. 2014;47:e13.
3 Braillon A. Curbing the tobacco epidemic: Employing behavioral strategies or rearranging the deckchairs on the Titanic? Prev Med. 2015 Apr;73:28-9.
4 Kandel ER, Kandel DB. Shattuck Lecture. A molecular basis for nicotine as a gateway drug. N Engl J Med. 2014 4;37:932-43.
5 Ng M, Freeman MK, Fleming TD et al. Smoking prevalence andcigarette consumption in 187 countries, 1980-2012. JAMA. 2014;311:183-92.
Rapid Response:
E-cigarettes: Experience is a gloomy lantern that does not even illuminate its bearer.
Gornall questioned why e-cigarettes are dividing the public health community. The right question should be: is the public health community insane? Indeed, both sides are doing the same things over and over again, expecting different results, which is insanity according to Einstein.
Once more, many are fooled by the “harm reduction” motto, as before with low tar and light cigarettes! Medicine is not about hope. If do not know we must not do or include patients in randomized controlled trials. How can we forget that hope arms patients (Eg. the prone position to prevent cot death, the bone marrow transplant to treat metastatic breast cancer)? The e-cigarette, a young bastard, has been rapidly made legitimate by the tobacco industry, which is now buying e-cigarette companies and applying for patents.(3) Is this to reduce cigarette smoking prevalence or incidence? More sadly, the craze for electronic cigarettes only is an indicator that the system is unable to assist smokers and provide them access to evidence-based treatment for cessation!(3)
Others call for a ban as “shooting up” with an e-cigarette nicotine plus flavor is freeway to addiction.(4) In fact, current regulations is characterised by inertia or ineffective measures, entire ban being the exception (eg. Brazil, Indonesia, Singapore, the Seychelles, and Uruguay). Could e-cigarette control be effective? It is already too late and the model, the one of tobacco control, is out of breath: since 2004, the year after the adoption of the World Health Organization Framework Convention on Tobacco Control, any change in the prevalence of daily smoking has levelled off and the 2012 annualized rate of change in prevalence of daily smoking was almost null.(4,5)
Ruyan marketed electronic cigarettes in China in 2004 and in the world including Europe by 2007 but no robust evidence based data, only hope or fear! The debate have lasted too long, it is a waste of time resulting in an obviously zero sum game. It is now time for a paradigm shift: e-cigarette now makes banning cigarettes possible!
1 Gornall J. Why e-cigarettes are dividing the public health community. BMJ 2015;350:h3317.
2 Braillon A. Electronic cigarettes: From History to Evidence-Based Medicine. Am J Prev Med. 2014;47:e13.
3 Braillon A. Curbing the tobacco epidemic: Employing behavioral strategies or rearranging the deckchairs on the Titanic? Prev Med. 2015 Apr;73:28-9.
4 Kandel ER, Kandel DB. Shattuck Lecture. A molecular basis for nicotine as a gateway drug. N Engl J Med. 2014 4;37:932-43.
5 Ng M, Freeman MK, Fleming TD et al. Smoking prevalence andcigarette consumption in 187 countries, 1980-2012. JAMA. 2014;311:183-92.
Competing interests: No competing interests