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E-cigarette debate lights up

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Debate about the health risks and benefits of electronic cigarettes is intensifying with the publication of a study challenging expert concerns the devices could encourage smoking and slow the rate at which people give up the deadly habit.

The study, published in the journal of the Society for the Study of Addiction, questioned calls for e-cigarettes (EC) to be regulated as strictly as conventional cigarettes.

After reviewing all available research on the use, content and safety of EC and their effects on users, the study found that allowing EC to compete with cigarettes in the market-place might actually decrease smoking-related illness and deaths.

“Regulating EC as strictly as cigarettes, or even more strictly, as some regulators propose, is not warranted on current evidence,” the authors said.

“Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to EC as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use.”

The controversial finding comes just weeks after medical experts across the world warned against the use of e-cigarettes, citing a lack of scientific evidence as to their health and behavioural effects.

The Society for the Study of Addiction study addressed a number of key arguments against e-cigarettes and gathered the available evidence to examine the claims.

It found the evidence did not support the claim that the chemicals in EC cause excess illness and death.

“Health effects of long-term EC use are currently not known and a degree of risk may yet emerge,” the authors said. “However, based on the data available regarding the toxicant content of EC liquid and aerosol, the long-term use of EC, compared to smoking, is likely to be much less, if at all harmful to users or bystanders. This is because, unlike cigarettes, EC do not deliver combustion-generated toxicants that are linked to cancer, chronic lung disease and cardiovascular disease.”

The study also found the argument that EC encouraged smokers who would otherwise quit to continue with their habit was yet to be substantiated.

“EC use is associated with smoking reduction, and there is little evidence that it deters smokers interested in stopping smoking tobacco cigarettes from doing so,” the authors said.

It found that there was no evidence to support the argument that e-cigarettes were acting as a ‘gateway’ to smoking for young people.

“Regular use of EC by non-smokers is rare and no migration from EC to smoking has been documented (let alone whether this occurred in individuals not predisposed to smoking in the first place).

“The advent of EC has been accompanied by a decrease rather than increase in smoking uptake by children.”

The authors did admit, however, that ongoing surveillance was needed to address this important point.

The study also found that there were no indications that the advance of EC was increasing the popularity of smoking or sales of cigarettes.

They did warn, however, that it was too soon to say whether EC had a positive effect on reducing the smoking rate in the population.

The authors said more research was needed to monitor the link between EC use and smoking behaviour, as well as on the long-term health safety outcomes of EC use.

The publication of the study comes just weeks after public health experts worldwide urged the World Health Organisation to ignore tobacco industry claims about e-cigarettes and instead focus on the evidence in assessing their health implications.

Leading Australian public health advocates Professor Stephen Leeder, Professor Alan Lopez, Professor Ian Olver, Professor Mike Daube, Professor Simon Chapman and Associate Professor Freddy Sitas were among 129 international public health physicians and campaigners who wrote to the WHO Director General Dr Margaret Chan in support of the organisation’s evidence-based approach to electronic nicotine delivery.

The experts warned that the WHO should be wary of the tobacco industry’s role moving into and driving the e-cigarette market.

The experts said there was “good evidence” that e-cigarettes released several toxic substances, including carcinogens.

The World Medical Organisation has also previously warned against the e-cigarettes, citing a lack of evidence as to their effects.

In Australia, it is illegal to sell e-cigarette liquids that contain nicotine.

Debra Vermeer