Column 05-2017

Onderstaande column van Thomas Brandon is gepubliceerd in nummer 5 van de Nieuwsbrief Tabaksontmoediging van 4 juli 2017. Plaatsing betekent niet automatisch dat het Trimbos-instituut de mening van de auteur deelt.

Electronic Cigarettes: Helpful or Harmful?

The use of electronic cigarettes (e-cigarettes) has increased dramatically in America over the last decade. There seem to be far fewer “vape shops” in the Netherlands, and I have noticed fewer “vapers” here as well. Nevertheless, the public health impact of e-cigarettes is equally important. The topic of e-cigarettes has divided the tobacco research and control field like no other issue over my 35 years in the field. This division is driven mostly by the large number of unknowns about this relatively new product.

First, although there is widespread agreement that e-cigarettes are probably much less dangerous than traditional combustible cigarettes, it is unlikely that they are completely safe, and we do not yet know the consequences of long-term use. Second, we do not know if vaping by adolescents will lead to increased smoking or re-normalize the act of smoking. It currently appears that vaping is replacing, rather than promoting, smoking among adolescents, but we await more definitive, longitudinal research. Finally, although most adult users report that they started vaping to quit or reduce their smoking, we do not yet know if e-cigarettes are in fact an effective smoking-cessation aid (similar to nicotine replacement therapies, such as the gum or patch), although indirect positive evidence is starting to emerge.

As a smoking-cessation researcher, I am very interested in this last question, and my team is conducting studies in this area. With 5 million annual smoking-related deaths worldwide, we have an obligation to investigate the potential of this product to reduce harm and save lives. Pending better answers on these topics, we must take care to develop policies that acknowledge the current unknowns while attempting to promote public health for the entire population. This can be challenging. For example, banning flavored e-cigarette solutions may have the benefit of reducing initiation by youth, but it may also reduce the motivation among adults to make the harm-reducing switch from combustible cigarettes. 

At this time, it is best to remain open-minded about both the potential risks and benefits of e-cigarettes. Meanwhile, it is good to be in the Netherlands, which has long been seen as a world leader in progressive, harm reduction innovations and policy.

Thomas H. Brandon, Ph.D., is a tobacco researcher at Moffitt Cancer Center and Professor of Psychology and Interdisciplinary Oncology at the University of South Florida, in Tampa, Florida, USA. He is on sabbatical in the Netherlands for 6 months, collaborating with researchers at the Trimbos Institute.


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