Professor Des Cox says it’s tempting to see e-cigarettes as a solution to smoking but he says that’s just not the case.
LAST WEEK, THE JOURNAL published the opinion article “why are we waging war on e-cigarettes when they help smokers quit”.
I have been given the opportunity to explain why this is a war that should be pursued.
In 2013, the government launched a bold plan for Ireland to become Tobacco Free by reducing the prevalence of tobacco smoking to 5% by 2025. As of 2021, 18% of the Irish adult population are current smokers so we will not meet this ambitious target.
The opinion piece last week argued that Ireland needs to embrace e-cigarettes as a way to help more people quit tobacco but is there evidence to support such an approach?
Recently, the Oireachtas Health Committee published its report on the Public Health (Tobacco and Inhaled Nicotine Products) bill. In addition to recommending a ban on the sale of e-cigarettes to children under 18 years of age, the committee has also recommended a ban on the sale of all flavours except tobacco flavours, the introduction of plain packaging and the prohibition of all forms of advertising for e-cigarettes.
This has restarted the conversation on where e-cigarettes fit into Ireland’s tobacco control policy. In medicine, rather than looking at the findings of one paper on a topic, we need to examine systematic reviews and meta-analyses which identify and critically appraise many papers on a topic. These types of reviews offer a more robust scientific analysis of a particular issue and several systematic reviews have been published on e-cigarettes in recent years.
The first point to address is e-cigarettes and adolescent use. The findings from the European Schools Project on Alcohol and other drugs (ESPAD) published by the TobacccoFree Research Institute in 2020, reported a 50% rise in e-cigarette current use in adolescents aged 16-17 years, since the previous study in 2015.
Nearly four in 10 (39%) adolescents have tried them and one in 5 (18%) were found to be current users. The ASH UK survey on vaping in adolescents was recently published and found that ever use of e-cigarettes in 11- to 17-year-olds rose from 11.2% in 2021 to 15.7% in 2022.
Des Cox – The Journal – 2022-08-01