Former WHO tobacco control official has new outlook on stemming the lethal toll of smoking

Back in the days when anti-tobacco/anti-smoking advocates and public health officials all pulled together against the evil Big Tobacco industry and its deadly, addictive product (to little avail, unfortunately), Dr. Derek Yach was a major force in that uphill battle. He was a high-level official with the World Health Organization, and helped to craft the anti-tobacco treaty, the Framework Convention on Tobacco Control, (FCTC) which has been signed by over 180 nations (although not by the U.S.). The FCTC has numerous stringent regulations and policy recommendations, some of which have proven to be effective (to a degree) in the battle against tobacco. Unfortunately, since the treaty was crafted, it has become apparent that many of its strictures would actually be detrimental to reducing smoking s toll. That s because the underlying philosophy of the drafters was one of abstinence only: the continuing use, by smokers, of nicotine in any form, for any reason (for pleasure or for maintaining abstinence from smoking) was unacceptable to the original FCTC framers. This led to the incorporation within the document of strident warnings against harm reduction products those which deliver nicotine without the deadly smoke and tar including smokeless/snus and e-cigarettes. Dr. Derek Yach of South Africa was among those early advocates of the treaty, and helped to promulgate it to many of those countries which have signed it. However, over the past decade or so, he has come to see that the campaign against harm reduction enshrined in the document has proven to be antithetical to public health, and will be even worse in the future. He wrote about his perceptions and concerns in the UK magazine The Spectator, in an essay entitled, simply, E-cigarettes save lives. (Dr. Yach is currently president of The Vitality Institute). It s impossible to summarize this excellent discussion, so I d merely urge everyone to read the entire essay. Here however are a few of the most powerful statements [emphases are mine]: The FDA s measured approach is in contrast to the continued unscientific approach of the US Centres for Disease Control and Prevention, whose director Dr Tom Frieden stated last year that many kids are starting out with e-cigarettes and then going on to smoke conventional cigarettes . They have yet to produce evidence that this is the case. In November, Penny Woods from the British Lung Foundation said [new] data should again alleviate the fears expressed by some over an e-cig gateway effect . Let s spell this out. Unsupported statements are accepted as truth by policymakers and are used as the basis for stringent regulation of e-cigs in many jurisdictions. This may well end up causing more public health harm than good. The benefits of e-cigs in helping smokers quit or cut down should be weighed against the danger of either recruiting new smokers or creating e-cig addicts. So far, there is no evidence that either of these things is happening. Studies in both Britain and America suggest that, as e-cig use increases, youth cigarette consumption declines. Why are we in this position? One reason is that governments have become addicted to tobacco excise tax and may fear that, as e-cigs take off, they will lose a valuable source of revenue. Many leading NGOs and academics exert strong influence at WHO, within governments, in the media and among the general public. In the past, they helped bring tobacco control out of the shadows and into the mainstream of health policy. Now, alas, their intransigence threatens more profound progress. We need clear, unambiguous messages to smokers about the safety and benefits of e-cigs. An example is the March 2014 statement on the Royal College of Physicians website that the main benefit of e-cigarettes is that they provide inhalable nicotine in a formulation that mimics the behavioural components of smoking but has relatively little risk ¦ Switching completely from tobacco to e-cigarettes achieves much the same in health terms as does quitting smoking and all nicotine use completely. Furthermore ¦ risks associated with passive exposure to e-cigarette vapour are far less than those associated with passive exposure to tobacco smoke.