Should smokers use vaping as a method to quit tobacco?
As scientific studies increasingly find more benefits in quitting cancer-causing tobacco (regular) cigarettes with the aid of vaping (also known as e-cigarettes), the case for using vapes as a harm-reduction tool is becoming exponentially stronger.
Researchers have found, for example, that switching from regular cigarettes to vaping improves blood vessel function by 20% as quickly as within a month, and people that make the switch go halfway back to having blood vessel function on a par with non-smokers.
Vaping has come a long way since it first appeared in its modern form in the 2000s. The form has evolved, as it became more modern and better as a device. But most importantly, it has emerged as one of the most powerful tools to help cigarette smokers quit.
No doubt, it would be ideal if people could just quit smoking without any external help. But that kind of wishful thinking serves no purpose other than wishful thinking. And evidence-based policies are breaking away from that kind of absurd idealism, as is clearly visible in the UK.
Not only has the UK embraced vaping as a quit-smoking tool, but hospitals are now setting up vape shops within the hospital premises. And there are good reasons for that. Public Health England found that vaping is 95% safer than regular cigarettes. The widely respected National Health Service recommends vaping to help quit smoking based on this finding.
There are studies where people who switch completely from regular cigarettes to vaping show reduced exposure to the harmful chemicals in tobacco smoke. There is increasing evidence to show that vaping can help people reduce or stop smoking.
Scientists continue to find supporting evidence that vaping is significantly less harmful. Studies published in 2019 showed that vaping helps smokers quit and can benefit cardiovascular health.
The cardiovascular health study found that regular cigarette smokers, particularly women, demonstrated significant improvement in vascular health within one month of switching from tobacco to vaping. The study concluded that switching from regular cigarettes to vaping may be considered a harm reduction measure.
Given the factual evidence supporting vaping’s role in helping smokers quit, it only makes sense to employ this as a quitting tool instead of banning it. The dangerously illusory notion that everyone will quit smoking if high enough tax is imposed on tobacco products has been proven wrong.
On the other hand, there is factual and scientific evidence for the effectiveness of vape as a quitting tool. A recent study found that vaping may help 70,000 smokers in England quit each year. In the face of what can now only be considered clear factual evidence pointing toward the success of vaping as a quit smoking tool, it makes no sense to ban it.
Not to mention the inevitable consequence that a ban will make people go after dodgy black-market products, which in turn is likely to become another public health concern.
In Bangladesh, the move toward a ban recently has been in the news. One of the reasons cited for the ban was vape-related illnesses and deaths in the US. But the real culprit behind the outbreak was not vaping, but illicit THC products used by the victims, as FDA now points out.
The FDA -- the US agency responsible for protecting and promoting public health -- found that “... most of the patients impacted by these illnesses reported using THC-containing products, suggesting THC vaping products play a role in the outbreak.” Despite the health scare the recent outbreak has caused, the FDA is actually quite clear on the matter.
Its latest recommendations for the public include avoiding products containing THC, not buying any vaping product off the street or from other illicit or social sources, and to not modify or add any substances, such as THC or other oils, to vaping products.
The FDA also explicitly urges the public to not quit vaping in order to go back to cigarette smoking. “If you are an adult who uses e-cigarettes instead of cigarette smoking, do not return to smoking cigarettes,” information released on the FDA website says.
So, to put the rhetorical question forth, why should policy-makers not take into account the relevant available facts when making extremely important policy decisions on vaping? The answer is of course, they should.
It is important to note that vaping is not for non-smokers, as any harm reduction advocate will strictly maintain, and neither is it for underage individuals, as regulators must ensure through policy and implementation.
Its purpose, from a harm reduction perspective, is nothing more than helping smokers quit the fatal tobacco cigarette, which causes a devastating 100,000 odd deaths in Bangladesh every year.
Allowing an evidence-based policy that enables use of vaping as a quit-smoking tool will not only make Bangladesh healthier, but it will save costs and potentially boost the economy.
Mithun Alamgir is a Professor and Head of Department of Community Medicine at Enam Medical College.