Read articles from Global

There is too much emotion driving public policy on e-cigarettes, says leading tobacco control researcher Dr. Jasjit Ahluwalia. A physician, public health scientist, and professor at Brown University’s Schools of Public Health and Medicine, Dr. Ahluwalia has deep experience researching health disparities and smoking cessation and nicotine addiction in African-American smokers. He has been continuously funded by the NIH for 25 years and has published over 400 manuscripts. Hear his assessment on the efficacy and relative safety of e-cigarettes and other safer nicotine products.

[...] the World Health Organization released two new publications, “Freedom from tobacco and nicotine: guide for schools,” and “Nicotine- and tobacco-free school toolkit” to help protect children’s health just in time for back-to-school season in many countries.

The tobacco industry relentlessly targets young people with tobacco and nicotine products resulting in e-cigarette use increasing and 9 out of 10 smokers starting before the age of 18. Products have also been made more affordable for young people through the sale of single-use cigarettes and e-cigarettes, which typically lack health warnings.

How often have you seen a health body talk about smoking alternative products and then hand-wave them away because we don’t have enough long-term research to say they are safe? I’ve personally lost count. The frustrating thing about these arguments is that novel products will never come with 20 years of clinical research behind them. Instead, health experts will sit on their hands and let people smoke combustible cigarettes instead of recommending alternative harm-reduction products. Deaths and smoking-related illnesses pile up because many medical professionals are afraid to stick their necks out.

This is a contribution to a consultation and parliamentary deliberation held in Brazil in September 2023. I make five brief points in three minutes.

Vaping could lead to narrowing or blocking of blood-vessels, heart disease and premature ageing, a leading oncologist and specialist in lung cancer has warned. Ken O’Byrne [...] said “we all have to have concerns” about the explosion in vaping in recent years. “It is still nicotine and is addictive. Nicotine itself may be cancerous, the way it works in the cell. But, also, it may encourage cigarette smoking later on. So, we all have to have concerns about that. Certainly, in my own view, there needs to be much more strict legislation and control of the fashion of vaping.

The World Health Organization’s Framework Convention on Tobacco Control (FCTC) aims to combat global tobacco-related deaths. While it has reduced smoking in some regions, its overall effectiveness is debated, especially regarding alternative nicotine products like e-cigarettes and Swedish snus. Although the WHO views these as threats, evidence suggests they could aid harm reduction. With differing smoking trends in various countries and emerging evidence supporting alternatives, the upcoming 10th Conference of the Parties (COP10) in Panama represents a crucial juncture to reassess and potentially redefine global tobacco control strategies.

Cigarette smoke is deadly and contains at least 69 known carcinogens (cancer-causing chemicals), many in high doses. [...] Most carcinogens are broken down to other chemicals in the body, known as 'biomarkers'. The dose or level of a biomarker is what determines its cancer risk. This is the key principle of  'the dose makes the poison'. By comparing the levels of cancer biomarkers from smoking and vaping we can compare the cancer risk from smoking versus vaping.

The National Institute of Health Research (UK) study also found some evidence that these products compete against cigarettes and so may be speeding up the demise of smoking, but this finding is only tentative, and more data are needed to determine the size of this effect. University of Ottawa Faculty of Law Professor and Advisory Committee Chair at the uOttawa Centre for Health Law, Policy David Sweanor is among the co-authors. The study compared the time course of use and sales of electronic cigarettes with that of smoking rates and cigarette sales in countries with historically similar smoking trajectories but differing current e-cigarette regulations [...]

Despite measures intended to limit nonsmokers' access to ECs, young people are increasingly utilizing them to stop smoking. Youth EC marketing has changed, with appealing, readily hidden, and addicting gadgets contributing to growing use. Researchers concur, however, that young individuals who do not smoke suffer possible health and psychological consequences, such as respiratory problems and the weight of addiction. EC usage has also been connected to later smoking.

A potential tenfold reduction in smoking-attributable deaths is possible if people who currently smoke were to switch to smoke-free products, Jacek Olczak, CEO of Philip Morris International Inc. [...] will explain the role smoke-free products can play in ending cigarette smoking globally and the human consequences of inaction. “For over a decade, PMI has championed a smoke-free future. Having invested more than $10.5 billion to scientifically research, develop, and commercialize smoke-free products—which today account for more than a third of our total net revenues—we are living this future,” says Olczak. [...]