The World Health Organization, which has always denied the effectiveness of e-cigarettes in quitting smoking, is changing its attitude: the latest basic scientific report on tobacco product control: the eighth report of the who research group, published on the WHO official website, points out that in some cases, e-cigarettes can help some smokers quit smoking and have a positive impact on public health. E-cigarettes can be regarded as an opportunity for tobacco control to finally realize the “new era” of smoke-free future.
Figure: the report on the scientific basis of tobacco product control: the eighth report of the who research group wrote: “e-cigarettes can be regarded as an opportunity for tobacco control, so as to finally realize the ‘new era’ of smoke-free future.”
The report was written by the who research group on tobacco product control (tobreg), which was formally established by who in 2013 and is responsible for providing policy recommendations on tobacco product control to who officers. Its members are international scientific experts in the vertical field. Due to the objective and authoritative content, the report has a wide impact in the world. The Chinese version is mainly translated by Hu Qingyuan, director of Zhengzhou Tobacco Research Institute of China National Tobacco Corporation, and published by Science Press.
The seventh report released two years ago said that “it is difficult to translate the (current) evidence into the potential effect of e-cigarettes on quitting smoking”. However, the eighth report not only mentioned that e-cigarettes have the effect of helping smokers quit smoking, but also called on all walks of life to study the different roles of different types and flavors (such as fruit flavor) e-cigarettes in helping smokers quit smoking. “Who does not classify e-cigarettes as tobacco products, and the regulation of e-cigarettes should not be the same as that of cigarettes,” the report wrote.
Many evidences prove that e-cigarettes can help smokers quit smoking
The WHO report calls for enhanced research
The seventh report was released in 2019. At that time, there was evidence that e-cigarettes can help smokers quit smoking. If studies show that smokers use e-cigarettes to help quit smoking, the success rate of quitting smoking can be doubled. The report listed these evidences, but said that the research conclusions are more affected by smokers’ e-cigarette use patterns, regulatory environment and other factors, and the evidence can not be transformed into the potential effect of e-cigarette on quitting smoking.
The eighth report mentioned that e-cigarettes can help smokers quit smoking in the core contents of Chapters 7, 8 and 9 involving e-cigarettes. It is reported that there is a number of evidence that e-cigarettes help smokers quit smoking. Among dual users who use cigarettes and e-cigarettes at the same time, dual users with higher education or higher income are more likely to completely switch to e-cigarettes within two years.
Photo: screenshot of a research paper published in the New England Journal of medicine, which confirmed that “e-cigarettes can help smokers quit smoking”
Particularly noteworthy is the flavor electronic cigarette (such as fruit flavor electronic cigarette). The research cited in the International Journal of environmental research and public health shows that fruit flavor is the most recognized e-cigarette flavor for smokers and can play an important role in quitting smoking. After switching to flavor e-cigarettes, the average cigarette consumption of smokers decreased from 20 cigarettes / day to 4 cigarettes / day.
Figure: the research paper published in the International Journal of environmental research and public health shows that flavor e-cigarettes significantly reduce the cigarette use of smokers
However, many smokers who use e-cigarettes to help quit smoking are still using e-cigarettes, and the long-term impact on personal and public health is unknown. In the policy recommendations, the report pointed out that we should study the different smoking cessation effects of e-cigarettes with different flavors, and listed future research directions such as “which type of smokers use e-cigarettes to quit smoking most effectively” and “whether e-cigarettes without flavor can help smokers quit smoking”.
E-cigarettes are not tobacco products
The harm caused by cannabis e-cigarette has nothing to do with regular e-cigarette
In addition to providing evidence to prove the effectiveness of e-cigarettes in assisting smoking cessation, the eighth report also made clear the attitude towards e-cigarettes. If the main components of electronic cigarettes are nicotine, propylene glycol, glycerin, essence, and no tobacco, who has not classified it as tobacco products.
Figure: Chapter 9 of the eighth report indicates that who does not classify e-cigarettes as tobacco products
In the relevant chapter of “impact of different e-cigarette product forms on health”, the report recommends that the regulatory authorities subdivide different types of e-cigarette products: open e-cigarette and closed e-cigarette should be distinguished. Increasing the power of e-cigarette will increase the emission of toxic substances, and the power of open e-cigarette is higher; We should distinguish between cannabis (top) e-cigarettes and regular e-cigarettes. The harm caused by cannabis e-cigarettes to users has nothing to do with regular e-cigarettes.
Figure: Chapter 8 of the eighth report states: “e-cigarettes should be distinguished from inhalation devices used to transport cannabis diphenol and other substances according to their pharmacological or physiological reactions. For example, the health risks and injuries caused by unconventional liquid components and improved devices used to inhale drugs cannot be regarded as adverse consequences of the use of e-cigarettes.”
The situation of e-cigarette users should not be generalized. The report said that flavor e-cigarettes are attractive to teenagers and can help old smokers quit smoking. Both situations should be paid attention to. In addition, e-cigarette users are still dominated by smokers. If they are ill, it is likely that they have smoked too many cigarettes before, which is not necessarily related to e-cigarettes.
Figure: Chapter 9 of the eighth report states: “some adult smokers claim that flavored e-cigarettes can help them quit smoking or reduce smoking. Therefore, adding different flavors to e-cigarettes may help reduce the burden on public health. Policymakers should consider this when regulating the flavor of tobacco products.”
Of course, the report does not shy away from the main controversy about e-cigarettes. As an emerging thing, the long-term impact of e-cigarettes on users’ bodies is still unclear. The different harm reduction and auxiliary smoking cessation effects of different types of e-cigarettes need to be explored. Including how to find a balance between protecting teenagers and helping smokers quit smoking is a subject that policy makers should continue to study.
“E-cigarettes should not be regulated in the same way as cigarettes.” the report wrote: “we emphasize the product characteristics of e-cigarettes and their impact on users and public health. Member states of (who) can obtain relevant knowledge from the report and refer to the report to formulate effective control strategies for nicotine and tobacco products.”
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