Tuesday, July 09, 2013

Addiction Expert Calls Countries that have Banned Electronic Cigarettes "Nuts"

In a BBC News article, world-renowned addiction expert - Professor Robert West of University College London - called countries that have banned electronic cigarettes "nuts."

According to the article:

"It's clear that some children have tried electronic cigarettes, but Prof Robert West, director of Tobacco Studies at University College London, says there is no sign they are becoming popular in the UK - the only country he knows where the uptake is monitored closely. He adds that if and when young people do start smoking e-cigarettes, public health experts will have to study the causes carefully. "If those young people are people who would have smoked but instead they're using e-cigarettes, then that's a huge public health gain. If they're people who would never have smoked but they've taken up e-cigarettes, frankly in public health terms it's not really an issue - it's like drinking coffee or something, there's no real risk associated with it. "The real risk is if they start using e-cigarettes and this acts as a gateway into smoking. Now which of those things happens none of us knows at the moment."

"As for the idea that e-cigarettes undo the work to de-glamorise tobacco smoking, West, who has done consultancy work for nicotine cessation medication, says the public health opportunity provided by e-cigarettes lies in their remaining trendy. "The opportunity here is for something that's seen in a different light," he says. "We never got communities of people really enthusing about nicotine patches or nicotine gum. You didn't get a sort of nicotine gum users' group, in which they'd rave about the gum and sort of say: 'This sort of gum's so much better, and I make my own gum,' and stuff like that."

"Ninety per cent of e-cigarette users are also smoking, he says, indicating that the devices are being used as a quitting aid. Countries that have banned them are, in his view, "nuts"."

The Rest of the Story

It is an absolute breath of fresh air to read such enlightened comments on the issue of electronic cigarettes. I praise Dr. West for having the courage to take a position that is well-supported by science, even though it may go against the mainstream of the tobacco control movement.

Dr. West is something of a hero to me, as he has always demonstrated the courage to take what are sometimes unpopular, but always well-supported positions. One of the best examples is this article, in which Professor West criticizes the almost obsessive use of the transtheoretical model in the addiction field, despite the fact that it fails to accurately predict human behavior.

Following West, I recently concluded that: "In practice and as supported by a growing body of literature, there is little support for the Transtheoretical Model as a valid description of typical smoking cessation behavior. ... Smoking cessation programs and policies therefore need to lessen their reliance upon the Transtheoretical Model and become open to alternative models which allow for sudden, spontaneous, unplanned behavior that does not require a gradual progression through various stages of change."

I wish that tobacco practitioners and organizations in the U.S. were able to open their eyes and remove the ideological blinders that are obscuring their vision. As Dr. West points out, a tool such as this which makes it a social, acceptable, and trendy behavior to quit smoking will do exactly the opposite of what electronic cigarette opponents are scaring the public about. Instead of normalizing smoking, they will actually normalize quitting.

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