Nature Medicine: E-cigarettes can help quit smoking but stop young people

The debate about the usefulness of electronic cigarettes (e-cig) as an aid for the cessation of cigarette smoking is very heated in our country, and this editorial, published in Nature Medicine tries to take stock of the situation and reach conclusions based on available evidence.

The editorial

The authors comment on the available evidence, from the recent systematic review of the literature conducted by the Cochrane Library (which underlines that there is a high level of certainty about the effectiveness of e-cigarettes in achieving significantly higher quit rates than nicotine replacement therapy) to examination of the main data obtained in population studies that integrate the evidence obtained in randomized studies: the use of e-cigarettes has been accompanied, both in the UK and in the USA, by an increase in the percentage of cessation from 10 to 15%. This has led the British Health Authorities to introduce e-cigarettes into the strategies adopted in anti-smoking centers throughout the country.

Market data also indicate that the introduction of e-cigs has made it possible to reduce the sale of cigarettes much faster than in the past. There is also evidence that policies that have restricted e-cigarette use have, unintentionally, increased cigarette smoking (as occurred in Minnesota).

The risk/benefit ratio

E-cigarettes are not zero risk products but the amount of evidence produced so far shows that they are certainly less dangerous than cigarettes and suggest that this is also true in the long term, given that their aerosol contains levels of harmful or potentially harmful substances , up to 95% less than cigarette smoke. The absolute risk on the cardiovascular, pulmonary and reproductive systems exists but must always be placed in relation to the significantly higher risk of cigarette smoking.

Conflicting health policies

The authors of the article summarize the different approaches in various countries whose health policies range from restrictions on e-cig flavors to outright bans on the sale of e-cigarettes, from marketing regulations to nicotine content restrictions and e-taxes. -cig to the laws on the minimum age of sale. In general, a policy of broad opening has been adopted by the UK and New Zealand and partial opening by Canada, the USA with respect to, for example, Australia historically on positions of rigid prohibition.

The conclusions

While e-cigarettes may pose a risk of nicotine addiction for some young people, in adults already addicted to cigarettes, they also serve as an important and less dangerous alternative to habitual cigarette smoking. Strong evidence indicates that e-cigarettes help some adults quit smoking. The bottom line is that governments, the medical and scientific community and individual health professionals in countries such as the US, Canada and Australia should take greater consideration of the potential of e-cigarettes to enhance smoking cessation. Of course, e-cigarettes are not the ultimate solution to ending the devastation caused by cigarette smoking, but they can contribute to this public health goal. However, acceptance of the promotion of e-cigarettes as a smoking cessation tool will likely depend on continued efforts to reduce access to and use of the products by young people who have never smoked.