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Are e-cigarettes perpetuating addiction?

Dubai: In the UAE, the Ministry of Health has banned the sale and use of electronic cigarettes and the World Health Organisation (WHO) does not consider Electronic Nicotine Delivery Systems (ENDS), of which e-cigarettes are the most widely known products, to be a legitimate therapy for smokers trying to quit. But do e-cigarettes help smokers quit the habit? The evidence remains inconclusive in its favour.

While users of e-cigarettes, mostly in the age group of 21-30, feel it affords them the pleasure of smoking even as it reduces the risk of inhaling carbon and tobacco toxins in cigarettes, those who oppose it feel it does not allow a person to completely quit smoking. Many smokers reportedly use both e-cigarettes and the real ones too.

Developed in China in 2004, the electronic cigarette gained popularity worldwide and is sold in numerous countries, including Brazil, USA, Canada, Finland, Israel, Lebanon, the Netherlands, Sweden, Turkey and the UK.

In 2008, Dr Ala'a Alwan, WHO's director for the Eastern Mediterranean region, rejected e-cigarettes as an aid for smoke cessation. "The electronic cigarette is not a proven nicotine replacement therapy. The WHO has no scientific evidence to confirm the product's safety and efficacy. Its marketers should immediately remove from their websites and other informational materials any suggestion that WHO considers it to be a safe and effective smoking cessation aid," Dr Alwan said.

More recently, in 2014, Margaret Chan, Director-General of WHO, directly implicated the tobacco lobby's involvement in marketing e-cigarettes and demanded better regulation. At the sixth session of the Framework Convention on Tobacco Control (FCTC) held in Moscow, she said: "Another milestone in tobacco control was adoption of the decision on electronic nicotine [and non-nicotine] delivery systems, also known as electronic cigarettes. This rather novel product was first launched by independent companies, but many of them are now being controlled by multinational tobacco companies. The decision acknowledges the need for regulations along the lines of policies concerning other tobacco products, including banning or restricting promotion, advertising and sponsorship of ENDS."

Closer home, doctors in smoke cessation clinics in the UAE say that while cessation aids such as nicotine patches, chewing gums and medicines to help those severely addicted, do help in managing withdrawal symptoms, e-cigarettes have been banned because they give the patient the pleasure of smoking the vapours of nicotine, keeping the addiction alive in their minds.

Can e-cigarettes be effective smoke cessation devices?

Dr Sree Kumar, specialist physician at Aster clinics, Al Karama, and an active anti-tobacco campaigner, told Gulf News: "For now, the evidence is inconclusive about e-cigarettes being an effective smoking cessation aid. They certainly have fewer chemicals compared to conventional tobacco, but still contain nicotine. Though it can be argued that nicotine is not the main culprit behind all smoke-related illnesses, it is highly addictive, and no authority wants someone trying to quit smoking addiction to get used to yet another highly addictive substance. Studies have shown that nicotine also causes nerve degeneration. "The studies related to e-cigarettes are fewer in number. Long-term association with problems like cancer are unclear, as the device is relatively new to the market."

Psychology of addiction

Dr Padma Raju Varry, Head of the Department of Specialist Psychiatry at NMC Speciality Hospital, Abu Dhabi, says that while e-cigarettes reduce the harmful effects of carcinogens of carbon and tobacco, they still keep smokers enslaved to the pleasure of puffing. "Vaping or inhaling nicotine vapours from e-cigarettes does not help smokers get off the habit. Majority of users of e-cigarettes are youngsters who actually end up vaping and actual smoking cigarettes because, like tobacco, nicotine dependency is a well established medical fact. There is addiction and craving at a cellular level.

"Addiction to cigarette smoking is similar to addiction to drugs or alcohol. Besides, e-cigarettes are more of a status syndrome and people continue to vape for pleasure and relaxation and the chances of these smokers reverting to actual smoking remain high."

Dr Varry feels it is important for those who really intend to quit smoking to seek help at smoke cessation clinics. "If one really wants to quit smoking, he or she has to have the determination and will power to give up completely. In smoke cessation clinics, the doctor follows a systematic plan to gradually wean the patient from tobacco addiction by giving him less and less of nicotine through a patch or chewing gum, and monitoring it until the patient is able to completely stave off the urge the smoke. The person's own motivation and family support play a very important part in de-addiction and vaping simply cannot help people quit smoking."

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Publication:Gulf News (United Arab Emirates)
Geographic Code:7UNIT
Date:Jun 17, 2015
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