Smoking related diseases result in 100,000 deaths every year. The number of users of electronic cigarettes or Nicotine Containing Products (NCPs) in UK has steadily risen and stands at close to one million. Against this backdrop, there seems to be a huge opportunity to reduce the harm caused by tobacco smoking. Another study revealed that e-cigarettes were as effective as nicotine patches.
One study found that almost a tenth of smokers with no intention of quitting had stopped smoking within a year of switching to electronic cigarettes.
There are also justified claims that the lack of regulation on the manufacturing of these products can put users at risk.
The tobacco industry itself seems to be united, putting forth strong arguments against the regulation of the electronic version. They also seem to be pushing for toning down the efforts to restrict the harmful effects of tobacco.
Some feel that going cold turkey is the only way for smokers to quit whereas others take a mid-path by allowing smoking in some places while prohibiting it in other places. The National Institute for Health and Care Excellence (NICE) acknowledges that quitting smoking entirely is the best solution but recognises that many smokers may not be ready for such drastic measures. Harm reduction is a process starting with temporary abstinence (cutting off for a short time), reducing and reducing to quit. Products containing nicotine help in these efforts. Simply reducing smoking does not lower the harm caused, but a smoker doing so is more likely to give up.
Some say that regulators stress too much on harm reduction. Those who are not convinced of the efficacy of harm reduction recommend strict regulation of the manufacture, sale, advertising and promotion as well as the use of electronic cigarettes.
Action on Smoking and Health advocates a ban on advertising and imposing of age restrictions on the sale of the product. Yet others say that a total prohibition on advertising as well as sale and use of the product should be imposed.
Looking at the situation practically, the demand for e-cigarettes has been growing exponentially and the need of the hour is to embrace the benefits of the product while curtailing the harmful effects. However, this is countered by those who firmly believe that e-cigarettes will be the first step, leading an increasing number of people to taking up smoking tobacco.
Concerns have been expressed about the lack of industry-wide standards for measuring quality, nicotine levels and effectiveness of the product. There have also been instances of harm caused from exploding batteries and batteries catching fire. The lack of long term clinical studies adds to the confusion.
For some, any joint efforts with tobacco companies is a strict no-no while others feel that efforts to encourage them to switch to manufacturing e-cigarettes will be beneficial.
According to the available data, smokers want e-cigarettes to be regulated better as this will improve the safety and effectiveness of the device. Presently only one out of every three smokers who try out electronic cigarettes, continue using the electronic product.
It is obvious that serious debate is required to sort out pertinent issues like whether the aim is to make people tobacco-free or nicotine-free, how to identify the method that will give best results, whether regulation should involve the acceptance of products like electronic cigarettes and whether these products have the potential to increase the number of smokers.
Public health is an area which throws up such unfamiliar challenges, which needs collective thinking, intelligent discussion and mutual respect even in the event of disagreement.