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16.09.15

Health experts warn e-cigarettes debate is ‘far from over’

A recent Public Health England (PHE) report which concluded that e-cigarettes are roughly 95% less harmful than tobacco was “flawed” and “not based” on reliable evidence, health experts have warned. 

Researchers from the London School of Hygiene & Tropical Medicine and the University of Liverpool argue that the available evidence about e-cigarettes “suggests that the debate is far from over and questions remain about their benefits and harms”. 

Writing in the British Medical Journal, Professor Martin McKee and Professor Simon Capewell claim that the headline figure for the PHE report comes from a single meeting of 12 people, involving several known e-cigarette champions and sponsored by companies with links to the tobacco industry. 

They said they might expect that the prominently featured “95% less harmful” figure was based on a detailed review of evidence, supplemented by modelling. 

“In fact, it comes from a single meeting of 12 people convened to develop a multicriteria decision analysis (MCDA) model to synthesise their opinions on the harms associated with different nicotine containing products; the results of the meeting were summarised in a research paper.” 

They also described the report’s dismissal of the possibility that e-cigarettes may be a gateway to smoking as “premature”. And they argue that the report has many other omissions, such as concerns about product safety, and the lack of evidence of risks from long term dual use with conventional cigarettes. 

The experts said: “A fundamental principle of public health is that policies should be based on evidence of effectiveness. So does the available evidence show clearly that e-cigarettes are as effective as established quitting aids? Unfortunately not.” 

Although the PHE report was welcomed by bodies like Action on Smoking and Health (ASH) and the Royal College of Physicians of London, other leading health bodies - including the British Medical Association, the UK Faculty of Public Health, the European Commission and the World Health Organization, have expressed caution. 

The health experts conclude that directors of public health and the wider community “desperately need advice on e-cigarettes that is evidence based and free from any suspicion of influence by vested interests”. 

But a joint statement from health bodies, including PHE, Cancer Research UK and the Royal College of Physicians, say the concerns raised are “not new” and have “been covered and fully responded to before”. 

“We should not forget what is important here. We know that smoking is the number one killer in England and we have a public health responsibility to provide smokers with the information and the tools to help them quit smoking completely and forever,” said the health bodies. 

“There is no circumstance in which it is better for a smoker to continue smoking – a habit that kills one in every two and harms many others, costing the NHS and society billions every year. We will continue to share what we know and address what we don’t yet know, to ensure clear, consistent messages for the public and health professionals.”

Comments

Dale   28/04/2016 at 20:36

I stopped reading as soon as I got to the bit where it read Martin McKee and Simon Capewell because as soon as you see their names attached to anything you just know it's going to be nonsense.

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