Electronic Cigarette Industry Trade Association
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We are dismayed to see such a potentially influential publication using carefully selected parts of the evidence base, including ignoring all of the extremely detailed work conducted and published in the UK by a variety of expert organisations and individuals. Much of the evidence cited for the harm caused by nicotine is from studies that looked at the harms caused by smoking, creating a dangerous level of miscommunication which may actually result in more people continuing to smoke.
The report is unfortunately a far from neutral examination of the science. It, apparently deliberately, conflates the proven harm caused by smoking with the potential for harm to be caused by nicotine, ignores all of the detailed evidence gathered in the UK, and exaggerates potential harms far beyond any possible scientific justification. Since electronic cigarettes do not contain any tobacco, and involve no combustion, the reports description of them as tobacco products is itself misleading and inaccurate.
The report ignores the recent dramatic declines in youth smoking, in favour of raising alarm about the small number of youths who use electronic cigarettes. While in an ideal world no one would start using nicotine, if electronic cigarette use is reducing the number of people taking up smoking, then there are clear public health gains. The data gathered in the UK, which is much more detailed than that from the US, indicates that regular vaping is confined almost entirely to young people who already smoke, allaying concerns about the potential for a gateway effect.
One of the key areas of evidence ignored in the Surgeon General's report is the recent publication by the Royal College of Physicians on the relatively low risks of electronic cigarettes, including in young people. This is somewhat ironic, since in 1962 the RCP published a report detailing the harms caused by smoking. It was not until two years later, in 1964, that the US Surgeon General followed suit. We may well see a similar delay in the US recognising the evidence on e-cigs and other vaping products, much to the detriment of the health of the US population.
There is a distinct trend over time for people to increasingly over-estimate the risk associated with electronic cigarettes and vaping products, and the publication of such a skewed document can only make this worse. Over-stating the risks of alternatives can only favour the existing nicotine delivery method - cigarettes. This not an outcome that anyone in the vaping industry would want, and it is baffling to us that it would be an outcome supported by anyone in public health.
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