The rise of the Internet and social media has amplified the spread of misinformation on tobacco products.
The counterfactual on nicotine and tobacco
IN the last decade, alternative nicotine products like e-cigarettes and heated tobacco products (HTPs) have changed the already complex information landscape.
As these are still new fields, the public health effects remain under intense scientific study and public debate. Worse still, misinformation circulating the free web have claimed that these alternative products being just as harmful as smoking may deter current cigarette smokers who haven’t quit from considering them as an alternative.
Looking back, we took about a century for the entire scientific community and public to recognise that cigarettes had negative health effects on the human body. It was only in the 1960s when the evidence against smoking became more than irrefutable.
In a landmark hearing in 1964, the US Surgeon General released the first report on the health effects of smoking.[1] The Surgeon General concluded that smoking caused lung cancer and bronchitis after reviewing over 7,000 articles in the medical literature.
By then, the debate over cigarettes and smoking’s impact had gone on for more than a generation and medical experts all over the world had reached the same conclusion.
Needless to say in our current era, we could not afford to take another century to address the difference between cigarettes and the alternative nicotine products while having misinformation of these products circulating in the web. This leads to more confusion among the smokers which is why the scientific community is urged to look at it quickly.
The butt of the problem
As with any issue affecting public health, science should be leading the conversation on any health policies – not misinformation, sensationalism or misperception.
For instance, when it comes to nicotine products like HTPs (like an IQOS device) with harm reduction potential, scientific studies have shown that they are far less toxic compared to traditional combustible cigarettes – citing the high levels of harmful and potentially harmful constituents (HPHCs) in smoke from combustion as one of the biggest culprits of lung disease.
Since HTPs don’t combust, the “level of these harmful and potentially harmful constituents are on average reduced by 90-95% compared to cigarette smoke,” according to Philip Morris International (PMI)’s global head of professional channels Dr Tom McGrath.
Following the science will point to these devices being (potentially) tools to help the current smoking generation choose a better option than smoking cigarettes, as long as the alternatives are meticulously and properly regulated to avoid non-smokers from accessing them.
On the other hand, e-cigarettes and vapes work by heating up liquid into an aerosol that users inhale.
The "juice" that fills the cartridges is typically made up of nicotine (derived from tobacco), propylene glycol, flavourings and other chemicals. As the liquid heats up, vapour is formed.
According to Ciccarone Center for the Prevention of Cardiovascular Disease research director Dr Michael Blaha, while we’re not entirely certain of the types of chemicals in vape, “there’s almost no doubt that vaping exposes you to fewer toxic chemicals than smoking traditional cigarettes” – further driving the need for regulation on these products.
Lowest common denominator
The commonality between traditional cigarettes, HTPs and vapes is the addicting factor – nicotine.
Nicotine, the main psychoactive ingredient in tobacco products, is a stimulant that accelerates the transmission of signals between the brain and the body.[2] Usually, tobacco is smoked but there exist numerous forms of smokeless tobacco including snus and HTPs.
Understanding that nicotine is the driving factor will help lawmakers and the public to differentiate what is actually causing harm in this case.
Nicotine, while addictive, is not the primary cause of smoking-related diseases. Which is why it is used in Nicotine Replacement Therapy (NRT) such as nicotine gum and patches, which are recommended by health practitioners to kick the habit.
Knowing what we know now, one can easily disprove arguments or misinformation equating traditional cigarettes to HTPs.
Health experts currently argue for harm reduction methods to allow the current smokers to transition to a less harmful alternative, being the HTPs.
For example, Japan has seen an unprecedented drop in smoking cigarettes HTPs were introduced as a tool for harm reduction. Whereas countries like United Kingdom and New Zealand have seen a remarkable reduction in smoking prevalence when they encourage the use of vape for smoking cessation.
Reference:
1. History of the Surgeon General’s Reports on Smoking and Health, https://www.cdc.gov/tobacco/sgr/history/index.htm
2. Alcohol and Drug Foundation (ADF), Australia, https://adf.org.au/drug-facts/nicotine/
