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European health body 'cannot back vaping as safe way to quit smoking'

By Jemma Crew, PA Health and Science Correspondent

A European health body has said it cannot back vaping as a safe aid to quitting smoking.

The European Respiratory Society (ERS) said it cannot recommend tobacco harm reduction strategies and that there is no evidence alternative nicotine products are safe.

They say a reduced but continued exposure to toxicants is a "bad alternative to quitting smoking" and that harm reduction should be used for a minority of high-risk smokers rather than the general population.

In an editorial, the ERS Tobacco Control Committee said current health policies are based on "well-meaning but incorrect or undocumented claims or assumptions".

The authors write: "It must be acknowledged that many health professionals, tobacco control professionals and decision-makers who recommend the harm reduction strategy have very good intentions.

"They focus on the smokers and see harm reduction as a pragmatic way of reducing the devastating health effects of the tobacco epidemic.

"However, good intentions must always be supported by strong evidence before large-scale implementation.

"Evidence on the safety and the effectiveness of alternative nicotine delivery products as a smoking cessation tool is still lacking, while use of nicotine-containing products is spreading to non-smokers, which is most alarming."

The authors of the editorial list seven arguments detailing their position.

They say there is a lack of evidence that nicotine delivery products are effective or safe smoking cessation tools, dual use is frequent, and the devices may have a "unfavourable" net effect on society with non-smokers being tempted to vape.

They also say there are many other effective strategies to reduce smoking at a population level - which they call one of public health's "greatest successes".

They conclude: "Therefore, ERS strongly supports implementation of WorldHealth Organization's Framework Convention on Tobacco Control, which also provides regulation tonovel products, and cannot recommend tobacco harm reduction as a population-based strategy."

But Professor John Britton, director of the UK Centre for Tobacco & Alcohol Studies and consultant in respiratory medicine at the University of Nottingham, said every argument made in the editorial was wrong.

He said: "They (the authors) are so opposed to nicotine dependency in any form that they are risking the lives of smokers who would benefit by switching completely to e-cigarettes.

"There is nothing in this new paper that should change advice to smokers. If you smoke, switch. If you don't smoke, don't vape.

"And just as you wouldn't buy unlicensed alcoholic drinks, don't vape cannabis or other bootleg products."

Last month cardiologists warned countries should consider banning vaping as they published new research suggesting it could damage the brain, heart, blood vessels and lungs.

Public Health England has continued to stand by its 2015 claim that e-cigarettes are 95% less harmful than smoking.

The intervention comes alongside a case study, also published in the European Respiratory Journal, which claims that a rare form of scarring in the lungs of a 49-year-old woman was likely caused by vaping.

Hard-metal pneumoconiosis, which can result in permanent scarring, breathing difficulties and chronic coughing, was reported by academics from the University of California in the US.

The woman vaped cannabis oil, which is what many of the hundreds of cases of lung illness in the US have been linked to.

The researchers found cobalt and other toxic metals in the vapour produced by the device, which they believe comes from the heating coils found inside.

They believe it is the first example of metal-induced toxicity in the lung following vaping.

Co-author of the editorial Jorgen Vestbo, professor of respiratory medicine at the University of Manchester, said: "E-cigarettes are harmful, they cause nicotine addiction and can never substitute for evidence-based smoking cessation tools.

"The medical profession as well as the public should be concerned about a new wave of lung diseases caused by a product which is heavily promoted by the tobacco industry."

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