The American Academy of Pediatrics and the Journal must be commended for warning against electronic nicotine delivery systems (ENDS): “ENDS have the potential to addict a new generation of youth to nicotine and reverse more than 50 years of progress in tobacco control.”1
This contrasts with hope and even hype from Europe. Public Health England, the executive agency in charge of the nation’s health and well-being, recently claimed that “e-cigarettes were 95% less harmful than normal cigarettes.”2 Not only is the review not evidence based, but it also fails to model the epidemics.3
In France, “experts” even promote ENDS for smoking cessation and are abusive to those who challenge their opinion.4 As a clinician relying on evidence-based medicine, for smoking cessation, I simply prescribe psychotherapy plus a combination of various forms of nicotine replacement therapy with or without varenicline.
In Europe, experts are fooled by the “harm reduction” motto, just as happened before with low tar and “light” cigarettes. The e-cigarette has been rapidly legitimated by the tobacco industry, which purchased e-cigarette companies and applied for patents at an early stage. Who could believe the industry’s intent was to reduce cigarette-smoking prevalence and incidence? The craze for ENDS is also an indicator that the system is unable to assist smokers and provide them access to evidence-based cessation treatment.5 Finally, empiricism may cause deadly harm, even in preventive medicine (eg, the prone position to prevent cot death).
“Shooting up” nicotine plus flavor with ENDS is a freeway to addiction. I hope the American Academy of Pediatrics statement will modify the cognitive dissonance in Europe and the US Food and Drug Administration’s enduring inertia. Bans, even total, have been implemented (eg, Brazil, Indonesia, Singapore, the Seychelles, and Uruguay). Food and Drug Administration seems to have lost its way, granting authorization for newer products as the “heat-not-burn cigarette” (Revo “revolutionary cigarettes” and HeatSticks from R.J. Reynolds and Philip Morris, respectively).
POTENTIAL CONFLICT OF INTEREST: The author has indicated he has no potential conflicts of interest to disclose.
- Copyright © 2016 by the American Academy of Pediatrics