According to the Center for Disease Control and Prevention, smoking is the leading preventable cause of death in United States. The World Health Organization list tobacco use as a risk factor for the leading causes of death, accounting for some 6 million deaths per year worldwide. Smoking increases the risks of diseases such as coronary heart disease, stroke and several types of cancers in addition to being responsible for overall diminished health and fitness. In many countries in the developing world smoking rates are now declining. However, cigarette smoking remains a major public health challenge and reduction or elimination of tobacco smoking is a priority for public health.
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I recently attended an international congress in Amsterdam organized by the European Respiratory Society (ERS). No lecture I went to stirred up more emotions and passionate arguments than a talk on electronic cigarettes (e-cigarettes). The ERS have issued an official position statement opposing the use of unapproved nicotine delivery products, amongst others e-cigarettes.
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The proponents of e-cigarettes as a smoking cessation device claim that e-cigarettes are less harmful than regular cigarettes, effective for smoking cessation and therefore could prevent ill health and death. The opponents of e-cigarettes state that there is a lack of solid scientific evidence regarding their harm and long term side effects, their exact contents are unknown and they are not sufficiently regulated, currently being registered neither as a tobacco nor as a pharmaceutical product. They further argue that effective smoking cessation assistance already exists and there is need to rush into the unknown before convincing scientific evidence regarding the safety of these products is obtained.
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Public Health England has recently issued a review, which reported that e-cigarettes are 95% less harmful than tobacco. A similar debate to what I witnessed in Amsterdam seems to have been going on since, also in medical journals as evidenced by an editorial in The Lancet (Aug 29 2015). VG reported online (Oct 26 2015) that e-cigarettes may be legalized for sale in Norway. A debate on anything that can curb tobacco smoking is a step in the right direction.
Lars Aakerøy, PhD candidate at CERG