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An illustrative phtoto of cigarettes.(Photo by: INGIMAGE)
Electronic cigarettes – blessing or curse?
By SHIMON GLICK
09/03/2019
While e-cigarettes have been said to be less harmful than their regular counterparts, the remaining effects say otherwise. Sometimes they even lead back to the use of regular cigarettes as well
A recent article in the Israeli press criticized prominent physicians who act as lobbyists and members of an advisory committee for a company that sells electronic cigarettes to the public. The Israel Medical Association has appointed a committee to decide about the ethical behavior of these physicians.

I do not plan to enter into the ethical issues involved in this article, although I do have a strong opinion on the subject, which I have addressed to my colleagues. Instead I will try to present the medical facts as I have derived them from a detailed study of the medical and social issues, together with a clear proposal.

There is little question that e-cigarettes are less harmful to health than conventional cigarettes. Many of the carcinogenic materials released from ordinary cigarettes are not present in e-cigarettes. Nevertheless, e-cigarettes are not harmless. Just recently, the World Health Organization published a clear warning that said e-cigarettes are “undoubtedly harmful.” Even in countries such as the United Kingdom and New Zealand, where supporters of e-cigarettes were quoted to support their use, authorities clearly acknowledge that they are not harmless.

While there are some studies that indicate e-cigarettes may help wean some heavy smokers from the use of regular cigarettes, the results are far from dramatic, and there are few indications of long-term success. Nevertheless, when considering the incredibly serious dangers of heavy smoking, any agent that can reduce use of regular cigarettes should be encouraged.

Nicotine is an addictive substance, and this is sufficient reason to limit general use by non-smokers. Electronic cigarettes will almost certainly not cause the terrible curse of cancers of the respiratory system, but the long-term effect of nicotine on the cardiac, vascular and neurological systems are far from known. The brains of young people seem quite sensitive to the effects of nicotine. Before we casually dismiss the long term dangers of e-cigarettes, let’s remember how long it took for the connection between cigarettes and lung cancer to be clearly established.

The rise in use of e-cigarettes by high school-age youths in the US has been dramatic and frightening. Some of the manufacturers of these items have admitted to being responsible for these trends. Several have indeed apologized for their misleading advertisements, and have taken some limited steps to reduce such advertising campaigns. Many youngsters who start on e-cigarettes move on to regular cigarettes, in what has been called a gateway process. Yet these cigarettes are still widely advertised, especially in countries with weak regulatory laws.

In Israel, the campaign to reduce taxes on e-cigarettes would be a tragic mistake. At a time when Israel is faced with a serious budget deficit, such a step would be more than unwise.

The manufacturers of e-cigarettes make the claim now that they are promoting these items only for use by smokers of traditional cigarettes. May I suggest a simple test for their integrity and good intentions? This suggestion also applies to my colleagues who are working with the e-cigarette industry. The manufacturers should voluntarily decide to sell the cigarettes only to pharmacies, and advertise them only to physicians, until such time as the government forces them to do so.

That these items are available in every kiosk in the country is scandalous. Incidentally, New Zealand forbids any advertisements for e-cigarettes. My colleagues should be leading the battle against the widespread sale of these cigarettes, instead of their present activities in support of the companies.

The author is professor and former dean of the faculty of Health Sciences at Ben-Gurion University of the Negev, Beersheba.

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