Thursday, July 31, 2014

Many Anti-Smoking Advocates Actually Do Not Want Smokers to Quit Smoking Using E-Cigarettes

One lesson that has become apparent in the past few months is that for many anti-smoking advocates and groups, it doesn't matter whether you quit, the only thing that is important is how you quit. According to the thinking of these groups, there is a right way to quit and a wrong way to quit. Forget about the fact that you've just quit smoking and possibly saved your life. If you quit the wrong way, you are to be scorned.

And what are the right and wrong ways to quit? The wrong way to quit is using electronic cigarettes, which have been so effective in reducing cigarette consumption that some tobacco analysts have predicted that there could be as much as a 50% decline in the combustible tobacco market due to e-cigarettes. The right way to quit is using FDA-approved medications that have been proven to be quite ineffective, with long-term success rates of less than 10%.

In fact, it appears that many anti-smoking advocates and groups do not actually want smokers to quit using e-cigarettes. They would rather smokers continue to smoke than to use a device which looks like a cigarette but is actually much safer. After all, for most smokers who quit using e-cigarettes, advice telling them not to use the e-cigarette is tantamount to instructing them to return to cigarette smoking. The chances that such smokers will succeed with FDA-approved methods is near nil. In fact, the very reason that most of them have tried e-cigarettes in the first place is because they had tried FDA-approved methods in the past and failed or they had little confidence that such methods would work.

A recent op-ed piece from the Grand Island Independent demonstrates this phenomenon. In the article, a physician with the St. Francis Cancer Treatment Center strongly discourages smokers from using e-cigarettes to quit smoking. Instead, he insists that smokers rely only upon FDA-approved drugs.

After blasting electronic cigarettes, the author writes:

"The best advice for smokers is to stop using any form of tobacco and/or nicotine as soon as possible. Smokers who want to quit can try stopping on their own with or without other guidance. They can also try one or more of the options that can help them quit, such as a telephone quitline; one or a combination of the seven FDA-approved cessation medications (five nicotine replacements [gum, patch, inhaler, lozenges, and nasal spray] and two prescription medications [bupropion and varenicline]); and/or counseling from their physician, nurse, pharmacist, or other qualified health care professional."

This advice is all fine and dandy for smokers who feel confident that they can quit using FDA-approved drugs. However, what about smokers who don't have the self-efficacy to quit using such drugs? What about smokers who have tried and failed with these approaches and are quite sure that it would be a waste of time to try the same dismal methods again? And what about smokers who are particularly excited about the possibility of using electronic cigarettes in a quit attempt?

In my mind, it is virtually malpractice to recommend to such patients that they stick with the traditional FDA-approved therapy and do not give electronic cigarettes a chance.

Not only does this column provide bad medical advice, but the advice itself is based on misinformation. For example, the article claims that e-cigarettes have been shown to be a gateway to smoking: "Most dangerous of all is the appeal to children. Vapor is less irritating than smoke, and comes in flavors such as bubble gum, cola and chocolate. Some children who would not try regular cigarettes will be tempted by e-cigarettes. As soon as they start, they will become addicted to nicotine and suffer from the health effects and expense of that addiction. Others who start with e-cigarettes will go on to use real cigarettes, and face the deadly diseases they cause."

There is absolutely no evidence that youth who try e-cigarettes will progress to cigarette smoking and face the deadly diseases associated with tobacco cigarettes. But if you just make up this evidence, then of course it makes sense to argue against electronic cigarettes. Anyone can make a persuasive argument if they are allowed to just make up the supporting evidence.

At the Rest of the Story, I don't have that luxury. I make the call based on what I see as the most credible scientific evidence available. And at the current time, I believe that for many smokers, electronic cigarettes are a reasonable option for smoking cessation or dramatic smoking reduction. These benefits of electronic cigarettes are demonstrable and there is no evidence that they are being undermined by these products serving as a gateway to tobacco cigarette addiction. In fact, all the evidence at the current time points to a strong relationship between e-cigarette use and decreased overall use of tobacco products, not the other way around.

1 comment:

Humaun Kabir said...

Delighted that I found your site, fantastic info. Smoking is harmful for health. We should say no for smoking. Thanks for the great post on your blog, it really gives me an insight on this topic.
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