"Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes" - is the title of a study conducted by the research group led by Prof Riccardo Polosa at the University of Catania, and recently published in Discovery Medicine.The asthmatic smoker represents a distinct disease phenotype, with increased susceptibility of exacerbations and poor asthma-specific health.Increased disease severity and marked impairment in asthma control is more frequently reported in people with asthma who have smoked more than 20 pack years.Most studies show an accelerated decline in lung function and increased airflow obstruction and even worse, asthma patients who smoke appear to have a reduced response to anti-asthma drugs, compared to asthmatics who do not smoke.Although quitting smoking can reverse the negative impact of tobacco smoke on asthma symptoms and lung function, many smokers will keep smoking, because when given only the options of smoking or completely giving up nicotine, many will not give it up.

The group hypothesized that electronic cigarettes could not only assist asthmatic smokers to quit, but they could also contribute to harm reversal of subjective and objective asthma outcomes.The research group investigated changes in the health status and respiratory function of 18 smokers with mild to moderate asthma who quit smoking by switching to daily electronic cigarette use.Baseline measurements were taken prior to switching and were compared with those obtained at 6, 12, and 24 months follow-up visits.Long-term monitoring of respiratory symptoms, lung function, airway hyper-responsiveness, asthma control, asthma exacerbations and tobacco consumption in daily electronic cigarette users with asthma is of great importance to patients, consumers, manufacturers, health professionals and policy makers.“Significant improvements in respiratory symptoms and lung function have been consistent” - noted the lead author of the study, Prof Riccardo Polosa - with similar positive results being reported in dual users, that is, those who smoked and vaped simultaneously".

Polosa says that switching to daily use of electronic cigarettes may ameliorate clinical, functional and therapeutic outcomes for many asthma patients who smoke and that beneficial effects persist in the long-term.According to the researchers, the use of electronic cigarettes can even reverse the damage caused by tobacco smoke in asthma patients who smoke.Of note, deterioration in methacholine PC20, lung function, ACQ scores and exacerbation rates was noted in the two patients who relapsed to exclusive tobacco smoking.Quitting smoking is an essential step for asthma patients, crucial for the effective treatment of their disease.However it is not always easy for them.In these cases, a less harmful alternative to tobacco smoking can be a valid option.This evidence-based notion that substitution of conventional cigarettes with electronic cigarettes is unlikely to raise significant respiratory concerns can improve counselling between physicians and their asthmatic patients, who are using or intend to use electronic cigarettes.

Vaping, the practice of inhaling vaporized liquid as a substitute for smoking, constitutes the latest chapter in the deeply interwoven history of America, tobacco and technology.But does it represent actual progress from the public health crisis caused by cigarettes, or is this new nicotine delivery system just a more-fashionable, yet similarly harmful drain on our health – both physical and financial?vaporizer vp300It’s already a multi-billion dollar market, after all.vicks vaporizer v100sgAlthough vaping has not yet been put under quite the same microscope as cigarettes, the research done to date paints a fairly consistent picture of the habit’s effects.grasshopper vaporizer vimeo

For starters, vaping appears to be a relatively benign alternative to smoking cigarettes, which are far more dangerous given the carcinogens they contain and the chemicals that are released through the combustion of plant matter.According to a 2014 study by a team of researchers from the UK Centre for Tobacco and Alcohol Studies, “Smokers who had used an e-cigarette in their most recent quit attempt were more likely to report abstinence than those who used [a nicotine replacement therapy] bought over-the-counter.” That, however, does not mean the practice is entirely safe.vaporizer carburetorAlthough vaping lacks the cancer-causing elements of cigarette smoking, new data show that it’s actually more harmful to one’s immune system, inhibiting the function of 358 genes associated infection-fighting, compared to just 53 for smoking.omicron vaporizer uk

What’s more, a 2016 study by researchers at the University of Southern California showed that 13.7% of high-school students either smoked or vaped in 2014 compared to just 9.0% who smoked in 2014, indicating that vaping is a more attractive gateway to nicotine than cigarettes.But with all of that being said, this debate is far from settled.So in the interest of advancing the discussion, we invited a panel of public health and addiction experts to weigh in.volcano vaporizer equivalentWe asked them whether vaping is unhealthy or safe (at least compared to cigarettes), and you can check out their responses below.pax vaporizer wikiAll in all, twelve experts say vaping is safer than smoking cigarettes, six believe vaping is bad and three contend that there’s just not enough reliable data yet.vaporizer 19468

“The vapor is not completely safe compared to having no vapor – it has propylene glycol and small amounts of some other toxic chemicals, mostly for flavoring.However, studies show very small amounts of harmful chemicals in the vapor compared to the very large harmful properties of burned tobacco.E-cigarette use has been shown to reduce exhaled carbon monoxide and self-reported respiratory symptoms over time.top portable vaporizer for weedTherefore, while non-smokers should not have to be exposed to vapor, for smokers to switch to e-cigarettes would greatly reduce their exposure to toxic chemicals and particles.” - Damaris J. Rohsenow, Ph.D.// Associate Director of the Center for Alcohol and Addiction Studies, Brown University School of Public Health "In discussing the safety of e-cigarettes, it is important to recognize that nothing is absolutely safe; for example, prescription medicines lead to over 30,000 deaths each year in the U.S.

Even over-the-counter medicines like aspirin and related pain relievers cause thousands of deaths per year.Therefore, a more relevant question is whether e-cigarettes are reasonably safe for current smokers to use in place of conventional combustible cigarettes.Based on available evidence, e-cigarettes are almost certainly far less harmful than combustible cigarettes.Surgeon General and other experts have linked the vast majority of smoking-related disease to the combustion products of smoke, not to the nicotine per se."- Jed E. Rose, Ph.D.// Director of the Center for Smoking Cessation, Duke University Medical Center “Choosing between ‘safe’ or ‘unsafe’ labels for e-cigarettes misses the point.No consumer product is absolutely safe.Those terms are especially meaningless for 39 million U.S.smokers who know they should quit but have not.Smokers have been seriously misinformed about the relative safety of vapor products; only one-quarter of them know vaping is less harmful than smoking.

Tragically, misinformation keeps people smoking and keeps smokers dying.” - Brad Rodu, D.D.S.// Endowed Chair for Tobacco Harm Reduction Research at the University of Louisville’s James Graham Brown Cancer Center & Senior Fellow at The Heartland Institute “Compared to cigarettes, there should be no debate that vaping is much safer.However, compared to breathing the air, vaping is probably riskier, although one might be able to debate this depending upon where you live these days.The concept of separating the nicotine from cigarette smoke is an old idea, but a good one, since smokers smoke for the nicotine but end up dying as a result of their repeated exposure to the many dangerous chemicals in cigarette smoke.” - K. Michael Cummings, Ph.D.// Co-Director of the Hollings Cancer Center’s Tobacco Research Program, Medical University of South Carolina Jed E. Rose Damaris J. Rohsenow K. Michael Cummings Riccardo Polosa Jason Downing Brad Rodu Brian Carter Jonathan Foulds Jeff Stier Thomas J. Glynn Peter R. Killeen Laura E. Crotty Alexander Jed E. Rose In discussing the safety of e-cigarettes, it is important to recognize that nothing is absolutely safe; for example, prescription medicines lead to over 30,000 deaths each year in the U.S.

Surgeon General and other experts have linked the vast majority of smoking-related disease to the combustion products of smoke, not to the nicotine per se.E-cigarettes appear to be an effective technology for replacing the nicotine in smoke while producing very few of the chemicals associated with combustion.Some studies have exaggerated the fears about e-cigarettes by focusing on small amounts of potentially toxic chemicals that are also delivered in e-cigarette vapor.However, not only are the amounts of these chemicals much lower than with cigarette smoke but there are many fewer toxic compounds than in cigarette smoke.There is as yet no evidence showing that this low level exposure causes the serious diseases that are linked to conventional cigarettes.Studies have also shown that e-cigarettes can help people quit smoking, and that they are more effective in reducing smoking than conventional nicotine replacement therapy, e.g., the nicotine skin patch.By replacing the habit of smoking and delivering the nicotine to the user more rapidly, it is not surprising that e-cigarettes can be efficacious for smoking reduction and cessation.

Still, it would be ideal for smokers to quit smoking entirely using extremely safe and well-proven agents such a nicotine replacement therapies, varenicline or bupropion (and/or behavioral treatments).But if these do not work for a given smoker, and if the choice is between switching to e-cigarettes, or continuing to expose oneself to the enormous and known risk of continued smoking -- which kills 2 out of 3 long-time users -- then it is entirely reasonable to switch to e-cigarettes.Author disclosure: I have devoted my career over the past 35 years to the development of more effective smoking cessation treatments.I have contributed to the development of the nicotine skin patch, provided data supporting the rationale underlying the development of varenicline, and developed personalized, adaptive smoking cessation treatment algorithms.The worldwide annual death toll from smoking and the limited long-term success rates of abstinence-oriented cessation treatments has convinced me that harm reduction has an important role in reducing the adverse public health impact of smoking.

In recent years, I have also contributed to the invention of novel approaches to nicotine inhalation for tobacco harm reduction or cessation.Along with the U.S.Food and Drug Administration and proponents of the Family Smoking Reduction and Tobacco Control Act, I have accepted that the tobacco industry has a valid and major role in developing reduced risk tobacco products.I have accepted research funding from the tobacco industry, under conditions that provide transparency and oversight to ensure research integrity, and currently serve as a paid consultant to Philip Morris International, specifically to support development of reduced risk products.I am listed as an inventor on a nicotine inhalation technology sold to that company, but have no financial interest in the future sale of products.Damaris J. Rohsenow K. Michael Cummings Riccardo Polosa Jason Downing When we consider the concept of harm reduction, it’s important to realize that the goal is to mitigate potential risks if they cannot be eliminated.

For example, we look to needle exchanges for drug users, or condoms to prevent the spread of STIs.We understand that the underlying behavior has an element of risk, but steps can be taken to minimize potential harm.Researcher Michael Russell said in a study published in 1976, “People smoke for nicotine but they die from the tar.” No study to date that I am aware of demonstrates any level of tar contained in e-cigarettes.In 2014, Mitch Zeller of FDA’s Center for Tobacco Products testified before the United States Senate, “If we could get all of those people [who smoke] to completely switch all of their cigarettes to noncombustible cigarettes, it would be good for public health”.In the UK, both Public Health England and the Royal College of Physicians have reviewed the available scientific literature and found vaping to be at least 95% less harmful than smoking.In the United States, however, the public health focus has been very different.Rather than embracing technology with potential to all but eradicate combustible tobacco use, some take the bizarre approach of encouraging smokers not to quit.

Medical doctors with years of training somehow believe “e-cigarettes are just as bad”.The complete contradiction of both common sense and the growing body scientific evidence is nothing short of staggering.Regrettably, much of the pseudo-science surrounding e-cigarettes is produced right here in the United States.A study published in the New England Journal of Medicine was widely criticized by experts as being misleading, and yet reporting to the public warned of the dangers of vaping, rather than the confirmation provided that e-cigarettes produce near-zero levels of formaldehyde when used as intended.While long term study of vaping is without question reasonable and needed, the body of short term data we do have strongly supports the notion that vapor products eliminate nearly all of the harm from smoking.The evidence is clear that e-cigarette aerosol contains either significantly less or none of the toxins found in cigarette smoke with few exceptions.“The dose makes the poison”, the most basic tenet of toxicology, seems to have been put on the back burner.

By any reasonable standard, vaping must be viewed under the lens of harm reduction.The available body of evidence we have today unequivocally indicates that vaping is safer than smoking.Brad Rodu Is driving safe?Traffic accidents kill more than 32,000 Americans every year, according to the U.S.That’s why modern autos have seatbelts, airbags, anti-lock brakes, explosion-resistant gas tanks and shock-absorbing frames.American drivers know these products reduce harm and save lives.According to the Centers for Disease Control and Prevention (CDC), smoking kills 480,000 Americans every year.Most smokers, however, don’t know they can reduce harm and save lives by easily transitioning to smoke-free products.Smoke efficiently delivers nicotine, which is addictive but doesn’t cause serious harm.Smoke also delivers thousands of toxic chemicals that lead to cancer, heart attack, stroke, and deadly lung disease.For many smokers, complete abstinence from nicotine and tobacco is a pipedream.

But switching to vastly safer, non-combustible tobacco products such as smokeless tobacco or e-cigarettes reduces harm nearly as effectively as quitting altogether.This isn’t an empty claim.The British Royal College of Physicians, one of the oldest and most prestigious medical societies, has been encouraging smokers to switch to safer tobacco/nicotine products for nearly a decade.The Royal College acknowledged extensive research documenting the risks of smokeless tobacco amount to about 1 percent of those of smoking.Their message is clear and unequivocal: “[t]hat smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.” E-cigarettes are acceptable and effective as cigarette substitutes; they are used by 4.9 million current smokers and 2.5 million former smokers in the United States, despite their near-universal condemnation by American health authorities.

Why are e-cigarettes safer than cigarettes?Cigarette smoke contains thousands of toxins, while e-cigarette vapor contains only water, nicotine, propylene glycol or glycerin, and flavorings.Vapor may also contain contaminants, but they exist only at minuscule levels that are far lower than those found in cigarette smoke.Earlier this year, the Royal College issued a report on e-cigarettes, in which it concluded, “[T]he hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.” Choosing between “safe” or “unsafe” labels for e-cigarettes misses the point.Tragically, misinformation keeps people smoking and keeps smokers dying.Brian Carter Jonathan Foulds Electronic cigarettes have been widely available for less than ten years and so, unlike cigarettes, data on their long term effects is not available.However, we can estimate their harmfulness relative to smoking tobacco by comparing the amount of toxic chemicals in e-cig vapor with that in cigarette smoke.

Cigarette smoke contains thousands of chemicals, including dozens of known carcinogens.Electronic cigarette vapor typically contains a handful of chemicals and although these are unlikely to be harmless, the ones suspected of potential harm are generally at much lower levels than found in cigarette smoke.Another way to compare potential harmfulness is to examine biomarkers in the body fluids of people who use different products.A few recent studies have examined the concentration of toxicants in the urine of vapers and compared this with the concentration of toxicants in the urine of cigarette smokers.A study by Hecht and colleagues at University of Minnesota compared 28 e-cig users (various e-cig brands) who had not smoked for over 2 months with over 200 cigarette smokers, and examined the concentration of 6 markers of carcinogenic toxicants.The e-cig users had much lower levels of harmful toxicants in their urine than the smokers, and, in fact, their levels were no greater than never tobacco users.

More recently, Goniewicz and colleagues at Roswell Park Cancer Institute measured 13 biomarkers of major carcinogens and toxicants in 20 cigarette smokers who then tried to completely switch to a single brand of e-cigs for 2 weeks.About half the participants completely switched and half continued to smoke at a much lower level while using the e-cigs.The levels of 13 harmful toxicants fell significantly within two weeks of switching from cigarettes to e-cigs.These studies demonstrate that switching from cigarettes to e-cigs dramatically and quickly reduces exposure to numerous harmful toxicants, including known carcinogens.It is evidence like this that prompted an international panel of experts to estimate that use of e-cigs is likely to be around 95% less harmful than smoking cigarettes.E-cigs deliver nicotine and so can be addictive, although the evidence to date suggests that most e-cigs deliver less nicotine and are less addictive than cigarettes.Nicotine is not carcinogenic but it is not harmless, and, for example, is harmful to the unborn fetus if absorbed during pregnancy.

So non-smokers should not start using e-cigs.But it is clear that switching from cigarettes to e-cigs is likely to reduce the risk of serious disease and premature death.Jeff Stier Thomas J. Glynn Peter R. Killeen Laura E. Crotty Alexander “Listening to some e-cigarette advocates you would think that vaping was no more dangerous than inhaling purified water vapor.However, there is nothing natural about deeply inhaling a mist of propylene glycol and/or glycerin deeply into the lungs on a daily basis for years.The vaporization process involves a heating element which, especially in higher -powered advanced vaporizers, produces formaldehyde - a known carcinogen.Almost all e-juice flavors contain aldehydes, ketones, and natural extracts, which are felt to be safe when ingested.Nevertheless, the toxicity spectrum of the lung is very different from that of the gut.Many flavors, especially sweet and creamy flavors, contain diacetyl compounds which, when inhaled, are known to be a cause of serious lung disease among flavor manufacturing workers.” - Robert K. Jackler, M.D.

// Principal Investigator, Stanford Research Into the Impact of Tobacco Advertising, Stanford University School of Medicine “Big Tobacco and its allies have been trying to obscure the emerging science on the dangers e-cigarettes pose to public health.But claims that “vaping” is a healthier alternative to cigarettes, instead of a gateway, were disproven by a recent American Journal of Public Health study that found smokers who have used e-cigarettes are less likely to cut back on cigarettes in the future than smokers who haven’t used them.” - Larry Cohen // Founder & Executive Director of the Prevention Institute Robert Tarran Robert K. Jackler Lena D. Matthias Larry Cohen Larry N. Williams Matthew L. Myers Robert Tarran Robert K. Jackler Lena D. Matthias Larry Cohen Big Tobacco and its allies have been trying to obscure the emerging science on the dangers e-cigarettes pose to public health.But claims that “vaping” is a healthier alternative to cigarettes, instead of a gateway, were disproven by a recent American Journal of Public Health study that found smokers who have used e-cigarettes are less likely to cut back on cigarettes in the future than smokers who haven’t used them.

I was involved in the work to pass the nation’s first multi-city smoking ban — in Contra Costa County, California — and we saw the same tactics from the tobacco industry then: denying that its products were killing off customers, and sowing doubt about solid science, in an attempt to stall anti-tobacco regulations that swept the country and saved millions of lives.California, along with eight other states, has connected the dots, and now classifies e-cigarettes as tobacco products, making them subject to smoke-free laws, age restrictions and other rules governing tobacco products.This came on the heels of a report issued last year by the California Department of Public Health (CDPH) shedding light on the public health risks of e-cigarettes.The risks include: The vapor alone contains at least 10 toxic chemicals known to cause cancer or birth defects, including benzene, formaldehyde, and lead.E-cigarettes contain nicotine, a neurotoxin that affects the cardiovascular and central nervous systems, causing blood vessels to constrict and raising blood pressure.

Nicotine also adversely affects maternal and fetal health during pregnancy, contributing to low birth weight, preterm delivery, and stillbirth.In California, e-cigarette poisonings of young children tripled in 2014 alone.From 2012 to 2013, the number of calls to poison control centers involving e-cigarette exposures rose from 7 to 154 in children five and under.Using an e-cigarette with nicotine for just five minutes causes similar lung irritation and inflammation, and has a similar effect on blood vessels, as smoking a traditional cigarette.The health hazards of e-cigarettes are being discovered in tandem with a 1,200 percent jump in e-cigarette advertising between 2011 and 2013.A study in the journal Pediatrics found 12- to 17-year-olds were exposed to 256% more TV ads for e-cigarettes in 2013 than they were in 2011.Not surprising, then, that the use of e-cigarettes more than doubled among middle- and high-school students in 2013 alone.And, e-cigarette use among teens surpassed that of traditional cigarettes in 2014.

The industry claims their products are intended for adults, but flavors such as “cotton candy,” “gummy bear,” and “cinnamon roll” suggest otherwise.Without strict limits on the marketing and sale of e-cigarettes and the extension of smoke-free policies to cover them, we will see more children getting hooked on nicotine, more poison control emergencies, and a mounting burden of preventable illness and injury.That’s why the FDA prohibits retailers from selling e-cigarettes to people under age 18, noting that e-cigarette use among high school students jumped to 16% in 2015 from 1.5 percent in 2011.The truth is out: vaping is not safe.Larry N. Williams First and foremost, there is no safe form of tobacco.There is no known correlation as to how much tobacco exposure (whether vaped, smoked, chewed, sniffed or exposed secondhand) will lead to disease.Electronic cigarettes (e-cigarettes) were declared tobacco products by the U.S.Food and Drug Administration (FDA) on May 5, 2016.

Toxicologists have warned that vaping or e-liquids — nicotine in liquid form — pose a significant risk to public health.It also has been found e-cigarettes contain detectable levels of known carcinogens and toxic chemicals, as well as inconsistent levels of nicotine.The e-liquid is derived from insecticide grade nicotine - the exact same chemical found in insecticide poisons.Studies by leading labs have found inconsistent levels of nicotine with approximately 10% of the toxins and carcinogens found in smoked tobacco.(Notice I said "insecticide" grade as compared to pharmaceutical grade purified nicotine found in nicotine gum, smoking patches, etc.).E-cigarette vapor contains formaldehyde.Formaldehyde is present as a dissolved gas in the water-based solution called formalin, which is used during embalming processes as a disinfectant and preservative.There is a significant risk of explosion and fire involving an e-cigarette.There is a growing body of evidence that shows fires, explosions and significant burns associated with the use of e-cigarettes.

It goes without saying that it’s important to put a stop to the ease of access of e-cigarettes by children and young adults.The FDA is striving to do this — on Aug.8, 2016, the FDA began regulating e-cigarettes, and it became illegal nationwide to sell cigars, hookah tobacco and e-cigarettes to anyone younger than age 18.Watermelon and blueberry are not the flavors a college student would buy.E-cigarettes have not been approved by the FDA as a safe or effective method to help smokers quit.Matthew L. Myers Electronic cigarettes could benefit public health if: they are properly regulated; found to be effective at helping smokers quit completely; and are responsibly marketed to adult smokers.Those are big “ifs.” The fact is that we still have a lot to learn about the full health effects of e-cigarettes and whether they truly help smokers quit.In any event, they are not safe, especially for kids.Kids should not use any tobacco products, including e-cigarettes.Unfortunately, youth use of e-cigarettes in the United States has skyrocketed in recent years.

The CDC’s latest survey showed that almost one-quarter of all high school students were current (past-month) users of e-cigarettes in 2015, compared to 10.8 percent who smoked regular cigarettes.That trend is not surprising as e-cigarettes have been irresponsibly marketed using tactics long used to promote regular cigarettes to kids and are sold in an assortment of kid-friendly flavors such as gummy bear and cotton candy.E-cigarette use can put kids at risk of nicotine addiction.The CDC has warned that nicotine exposure could also harm adolescent brain development and lead to sustained tobacco use.Some studies have also found other harmful or potentially harmful chemicals and toxins in some e-cigarettes, even if at lower levels than cigarettes.Further, while some of the flavorings used in e-cigarettes might be safe for ingestion, they are not necessarily safe when inhaled.Researchers have raised concerns that the chemical flavorings found in some e-cigarettes and e-liquids could cause respiratory damage.

Our kids should not be the guinea pigs while we learn more about the health effects of e-cigarettes.As for the impact on current smokers, the evidence to date in the U.S.is limited and inconclusive as to whether e-cigarettes are effective at helping smokers quit.The CDC has reported that three out of four adult e-cigarette users are also cigarette smokers.Preventive Services Task Force recently conducted a thorough evaluation of the science and concluded that “the current evidence is insufficient to recommend electronic nicotine delivery systems for tobacco cessation…” Without regulation, manufacturers have produced many e-cigarette products that don’t help smokers quit and frustrate those who try to use them to quit.The Food and Drug Administration recently issued long-overdue regulations for e-cigarettes that prohibit sales to children under 18 and will help answer the many questions about these products.Under these rules, the FDA will be able to learn about the contents and health effects of e-cigarettes and evaluate the evidence whether these products can help smokers quit.

Effective regulation by the FDA is critical to minimizing the risks posed by e-cigarettes and maximizing the potential benefits.“Vaping exclusively (without smoking any cigarettes) is almost certainly less harmful than continuing to smoke conventional tobacco cigarettes, though the data to prove this hypothesis do not yet exist because e- cigs are such new products that entered the market without regulation (until very recently).” - Nancy A. Rigotti, M.D.// Director of the Tobacco Research and Treatment Center at Massachusetts General Hospital & Professor of Medicine at Harvard Medical School “The safety of vaping is not well established.There is no evidence showing that vaping is safe and that it does not have any significant health effects.No well-controlled short-term or long-term studies have been conducted to evaluate the health effects of vaping.While the results of some early studies have suggested that some of the acute cardiovascular and respiratory effects seen with smoking and not seen with vaping, it is unclear whether the health risks associated with repeated and frequent vaping are minimal.” - Aruni Bhatnagar, Ph.D.

// Smith and Lucille Gibson Chair in Medicine, University of Louisville Nancy A. Rigotti Aruni Bhatnagar Laurent Huber Michael Moore Nancy A. Rigotti Aruni Bhatnagar Laurent Huber Combustible tobacco products like cigarettes are extremely toxic, killing approximately 6 million people per year.Given that cigarettes are so ridiculously toxic, vaping has the potential of being less harmful.For a smoker who cannot overcome nicotine addiction, even using approved pharmaceutical and other therapies, vaping is likely to be a better alternative than continuing to smoke cigarettes.However, the scientific community is only beginning to look into the long term impact of vaping on health and, because there are so many vaping products on the market it is difficult to make a blanket statement about the safety of all vaping devices.Some researchers in the public health arena are concerned about claims that vaping is 95% safer than smoking cigarettes, noting that those claims are educated guesses at best.

And while vaping may be safer than using combustibles, this does not imply they are a hundred percent safe.Nicotine is not benign, and even if it was, addiction itself harms an individual, even if that harm is solely financial.It is immoral for any person or corporation to profit from causing someone’s lifetime addiction.For this reason, the role of the tobacco industry in this debate is a bit worrisome.A number of corporations that in the past focused on selling cigarettes are now marketing and selling the entire gamut of nicotine delivery products, including traditional combustible products such as cigarettes, various forms of oral tobacco, alternative nicotine delivery products such as e-cigarettes, and products that are intended to assist with cessation such as NRTs.While it would be useful for addicted smokers who cannot quit to have access to safer nicotine delivery products, it would not be ethical or good for overall public health to flood the market with vaping devices that could increase the prevalence of nicotine addiction among current non-smokers and future generations.

It is clear that vaping can have potentially both positive and negative impacts on public health.Policy should seek to mitigate the negatives and enhance the positives, and the public health community needs to have a robust discussion on how to accomplish this.Strong anti- or pro-vaping positions in the public health community make this dialogue more difficult, but from following these debates, I recognize that views from both sides come from a sincere desire to avoid harm.In determining policy, governments and the public health community should consider the following: Policy should be based on science (both medical and epidemiological) in order to determine the safety of the product, its effectiveness as a cessation tool, and its impact on nicotine initiation.Including vaping restrictions in most smoke free policies makes sense.The marketing of vaping products to non-smokers is problematic and should be addressed.Children should not be targeted, including with candy flavors, and restrictions similar to those for combustible tobacco products should be put in place.