Royal College of Physicians Report Recommends Widespread Promotion of Electronic Cigarettes for Smoking Cessation

Moments ago, the Royal College of Physicians released a new report that summarizes the scientific evidence on e-cigarettes and public health and concludes that these products should be widely promoted as a substitute for real tobacco cigarettes. The RCP also issued a summary statement regarding the report, which is entitled "Nicotine Without Smoke: Tobacco Harm Reduction."

The major conclusion of the report is that: "e-cigarettes are likely to be beneficial to UK public health. Smokers can therefore be reassured and encouraged to use them, and the public can be reassured that e-cigarettes are much safer than smoking."

This conclusion is based on a number of key findings:

• "E-cigarettes are not a gateway to smoking – in the UK, use of e-cigarettes is limited almost entirely to those who are already using, or have used, tobacco.
• E-cigarettes do not result in normalisation of smoking – there is no evidence that either nicotine replacement therapy (NRT) or e-cigarette use has resulted in renormalisation of smoking. None of these products has to date attracted significant use among adult never-smokers, or demonstrated evidence of significant gateway progression into smoking among young people.
• E-cigarettes and quitting smoking - among smokers, e-cigarette use is likely to lead to quit attempts that would not otherwise have happened, and in a proportion of these to successful cessation. In this way, e-cigarettes can act as a gateway from smoking.
• E-cigarettes and long-term harm - the possibility of some harm from long-term e-cigarette use cannot be dismissed due to inhalation of the ingredients other than nicotine, but is likely to be very small, and substantially smaller than that arising from tobacco smoking. With appropriate product standards to minimise exposure to the other ingredients, it should be possible to reduce risks of physical health still further."

The chair of the RCP's Tobacco Advisory Group - Professor John Britton - said:

"The growing use of electronic cigarettes as a substitute for tobacco smoking has been a topic of great controversy, with much speculation over their potential risks and benefits. This report lays to rest almost all of the concerns over these products, and concludes that, with sensible regulation, electronic cigarettes have the potential to make a major contribution towards preventing the premature death, disease and social inequalities in health that smoking currently causes in the UK. Smokers should be reassured that these products can help them quit all tobacco use forever." 

The ultimate recommendation of the report is that electronic cigarettes should be promoted "as widely as possible" as an alternative to smoking.

The Rest of the Story

This is an outstanding report with a meticulous and balanced review of the relevant scientific literature, an enlightened perspective on the evaluation of current data on smoking and its harms, the use of nicotine replacement therapy, and the potential role of e-cigarettes, and evidence-based recommendations that aim to protect the public's health rather than to promote any particular bias or ideology.

It is also a breath of fresh air that helps to clean out some of the stench we have been getting from the completely non-evidence-based rhetoric and propaganda we have been getting for the past six years from anti-nicotine organizations and researchers in the U.S. and from numerous health agencies and regulatory bodies, including the FDA and the CDC.

The report also presents an enlightened view on regulation of vaping products, as it astutely points out that regulations must maximize the potential benefits while minimizing the potential harms of these products, rather than banning a huge segment of the products on the market, as the FDA is poised to do, and to give cigarettes a huge boost by virtually eliminating competition from a much safer alternative.

The report acknowledges that there are some potential long-term risks associated with vaping, but that these are certainly much lower than the risks of continued smoking. It also dispels the absurd assertion, widespread in the U.S., that e-cigarettes are going to re-normalize smoking. Finally, it provides strong evidence against the claim that e-cigarettes are a gateway to youth smoking and argues that vaping is actually a gateway away from smoking.

The report confirms what real-live vapers have been telling us all along, but what we in the U.S. have completely ignored because we don't "approve" of people getting any enjoyment from nicotine or improving their health through the use of a product that looks and works like a cigarette. It vindicates the vapers who have been repeatedly attacked by anti-nicotine groups in the U.S. for the past six years and hopefully, it will reassure vapers that they are truly to be congratulated and celebrated for having taken an action that will greatly improve their health and their lives.