Smoking, vaping and public health: Time to be creative

Abstract

The development of policies on vaping in health care organizations (HCOs) needs to be based on a solid understanding of science and a recognition of individual rights. It should also be seen in the broader public health context of innovative alternative nicotine delivery systems playing a key role in ending the immense devastation of combustible cigarettes. Opposition to vaping based on inaccurate and incomplete information, or fear of unlikely and avoidable hypothetical unintended consequences, will invariably cause great harm to individuals, impede rather than assist the attainment of public health objectives, and unnecessarily prolong the epidemic of cigarette-caused diseases.

Résumé

La formulation de politiques sur le vapotage dans les organismes de soins de santé (OSS) doit être fondée sur de solides connaissances scientifiques et sur la reconnaissance des droits individuels. Elle devrait également être vue dans le contexte général de la santé publique, où des innovations dans les dispositifs d’apport de nicotine peuvent jouer un rôle clé pour mettre fin aux dégâts immenses des cigarettes combustibles. L’opposition au vapotage fondée sur des données inexactes et incomplètes ou sur la peur d’hypothétiques conséquences imprévues, lesquelles sont improbables et évitables, causera invariablement de graves préjudices aux particuliers, entravera plutôt que de favoriser l’atteinte des objectifs de santé publique et prolongera inutilement l’épidémie de maladies causées par la cigarette.

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References

  1. 1.

    Shaw D. Hospitals are wrong to ban e-cigarette use. BMJ 2015;351:h5063. PMID: 26423310. doi: 10.1136/bmj.h5063.

    Article  Google Scholar 

  2. 2.

    Russell MAH. Low-tar medium-nicotine cigarettes: A new approach to safer smoking. BMJ 1976;1:1430–33. PMID: 953530. doi: 10.1136/bmj.1.6023.1430.

    CAS  Article  Google Scholar 

  3. 3.

    Royal Society for Public Health. Nicotine “no more harmful to health than caffeine”. August 13, 2015. Available at: https://www.rsph.org.uk/en/about-us/latest-news/index.cfm/pid/32B2FF71-A11A-42F6-A0C8EF19BA0E0C4F (Accessed January 19, 2016).

    Google Scholar 

  4. 4.

    Public Health England. E-cigarettes: an evidence update. August 19, 2015. Available at: https://www.gov.uk/government/publications/e-cigarettes-an-evidence-update (Accessed January 19, 2016).

    Google Scholar 

  5. 5.

    Tucker JB. Scourge: The Once and Future Threat of Smallpox. New York, NY: Atlantic Monthly Press, 2001.

    Google Scholar 

  6. 6.

    Toronto doctors seek investors for nicotine inhaler. Toronto Star, 2013 Aug 3. Available at: http://www.thestar.com/business/2013/08/03/toronto_doctors_ seek_investors_for_nicotine_inhaler.html (Accessed January 19, 2016).

  7. 7.

    Warner KE, Slade J, Sweanor DT. The emerging market for long term nicotine maintenance. JAMA 1997;278(13):1087–92. PMID: 9315768.

    CAS  Article  Google Scholar 

  8. 8.

    Burstyn I. Peering through the mist: Systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks. BMC Public Health 2014;14:18. doi: 10.1186/1471-2458-14-18.

    Article  Google Scholar 

  9. 9.

    Farsalinos KE, Polosa R. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: A systematic review. Ther Adv Drug Saf 2014;5:67–86. PMID: 25083263. doi: 10.1177/2042098614524430.

    CAS  Article  Google Scholar 

  10. 10.

    Hajek P, Etter JF, Benowitz N, Eissenberg T, McRobbie H. Electronic cigarettes: Review of use content, safety, effects on smokers and potential for harm and benefit. Addiction 2014;109:1801–10. PMID: 25078252. doi: 10.1111/add. 12659.

    Article  Google Scholar 

  11. 11.

    McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev 2014;12: CD010216. doi: 10.1002/14651858.CD010216.pub2.

  12. 12.

    Royal College of Physicians. RCP statement on e-cigarettes. June 25, 2014. Available at: https://www.rcplondon.ac.uk/news/rcp-statement-e-cigarettes (Accessed January 19, 2016).

  13. 13.

    Will you permit or prohibit electronic cigarette use on your premises? London, UK: Action on Smoking and Health October 2015. Available at: http://www.ash.org.uk/files/documents/ASH_900.pdf (Accessed January 19, 2016).

  14. 14.

    Reefer Madness, 1936’s Most Unintentionally Hilarious “Anti-Drug” Exploitation Film Free Online. Film, November 13, 2012. Available at: http://www.openculture.com/2012/11/ireefer_madnessi_1936s_most_ unintentionally_hilarious_anti-drug_exploitation_film_free_online.html (Accessed January 19, 2016).

  15. 15.

    Okrent D. Last Call: The Rise and Fall of Prohibition. New York: Scribner, 2010.

    Google Scholar 

  16. 16.

    Precautionary Principle. Available at: http://www.sehn.org/precaution.html (Accessed January 19, 2016).

  17. 17.

    10 ways to improve Matt Myers’ letter to the New York Times. The counterfactual. Available at: http://www.clivebates.com/?p=3379#more-3379, Section 3,1-4 (Accessed January 19, 2016).

  18. 18.

    Chaloupka FJ, Sweanor D, Warner KE. Differential taxes for differential risks - toward reduced harm for nicotine containing products. N Engl J Med 2015;373:594–97.

    CAS  Article  Google Scholar 

  19. 19.

    Impact of e-cigarettes on smoking cessation in England STS150530. Available at: http://www.smokinginengland.info/sts-documents/ (Accessed January 19, 2016).

  20. 20.

    Shiffman S, Paty J, Gnys M, Kassel JA, Hickcox M. First lapses to smoking: Within-subject analysis of real-time reports. J Consult Clin Psychol 1996;64(2):366–79. PMID: 8871421.

    CAS  Article  Google Scholar 

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Correspondence to David T. Sweanor JD.

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Conflict of Interest: None to declare.

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Sweanor, D.T. Smoking, vaping and public health: Time to be creative. Can J Public Health 106, e464–e466 (2015). https://doi.org/10.17269/CJPH.106.5389

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Keywords

  • Smoking
  • vaping
  • harm reduction
  • HCOs
  • tobacco
  • e-cigarettes

Mots Clés

  • tabagisme
  • vapotage
  • réduction des dangers
  • organismes de soins de santé
  • tabac
  • cigarettes électroniques