It’s time to authorize the sale of electronic cigarettes
Iam writing on behalf of a group of doctors, professors and health advocates to say that we believe the time has come for the federal government to authorize the sale in Canada of electronic cigarettes containing nicotine.
These devices, which basically heat a propylene glycol or glycerine solution containing nicotine, offer a safer and more acceptable alternative for smokers to appease their addiction, compared to regular cigarettes.
No doubt, tremendous strides have been made over the years to impose a strict regulatory framework on regular cigarettes. More, though, obviously can be done. Unfortunately, it is wishful thinking that one day we will completely eradicate nicotine use. The vast majority of smokers want to quit. Unfortunately, only 10 per cent of them, when surveyed, are still abstinent after trying to quit in the past year.
In such a context, we believe that the time has come for tobacco control to move beyond the usual approaches of education, total nicotine cessation and prevention. In a landmark report published in 2007, the Royal College of Physicians makes a compelling case why harm reduction should no longer be ignored by health authorities to lower the death and disease caused by tobacco use. In the report the college says: Conventional preventive measures focus entirely on preventing uptake of smoking and helping smokers to quit smoking. This approach will be ineffective for the millions of smokers who, despite best efforts to persuade and help them to quit, will carry on smoking. Tobacco-control policy needs to be radically extended to address the needs of these smokers with implementation of effective harm reduction strategies. Harm reduction in smoking can be achieved by providing smokers with safer sources of nicotine that are acceptable, and effective cigarette substitutes. There is a moral and ethical duty to provide these products to addicted smokers.
Electronic cigarettes are such a substitute.
First, they cannot even remotely be as toxic as regular cigarettes because there is simply no combustion of tobacco, which produces the smoke containing, for example, the carbon monoxide and the bronchopulmonary irritants that are among the 7,000 chemical substances responsible for causing cardiovascular diseases, chronic obstructive lung diseases and at least 10 different cancers.
Secondly, sales data show that these products are widely accepted by smokers. In fact, there has never been a product that has generated so much enthusiasm on their part.
Such interest is not surprising since electronic cigarettes deliver nicotine much quicker than existing nicotine-replacement therapies and provide a similar behavioural experience as smoking.
Opponents view the fact that electronic cigarettes are well accepted by consumers as a threat because they fear they will be a gateway to regular smoking. Such a claim has yet to be confirmed, since current tobacco consumption trends are still dropping in countries such as France, the United Kingdom and United States, where electronic cigarettes containing nicotine are sold legally.
This is not to say that there are no risks of unintended consequences. But as with other health-policy interventions, there is a strong preponderance of evidence in favour of electronic cigarettes. The death rates from continued smoking are simply too high to accept a continued nicotine-abstinence policy orientation.
Electronic cigarettes need to be appropriately regulated so that good manufacturing practices are followed to protect consumers and that sales to minors are forbidden. However, any excessive regulations that could make it too difficult to communicate about the reduced risks of these products or to access them should be avoided.