The addictiveness of nicotine depends on how it is delivered. Smoking is highly addictive due to rapid nicotine delivery and other chemicals in smoke. Vaping is significantly less addictive than smoking
3/ doctors should be focused on getting people off cigarettes and nicotine completely
Ideally yes. But many smokers can't quit nicotine and switching to a safer alternative is lifesaving. The focus of #THR is reducing disease, not ceasing nicotine
What?
A recent meta-anaysis of RCTs found that vaping is 70% more effective than NRT bit.ly/304SfyK. Effectiveness is supported by observational studies, population studies and declines in national smoking rates
If there is a gateway into smoking from vaping it is very small. The motorway out of smoking is much greater
The benefit to public health in helping smokers quit far exceeds any potential gateway in
What!
There is OVERWHELMING evidence that vaping is FAR safer than smoking due to a dramatic reduction in inhaled toxins, biomarkers and clinical improvements bit.ly/2G0T5FE
7/ And the dangers are really quite profound
What dangers?
Not one person has died from nicotine vaping yet 8 million die every year from smoking. Serious effects are extremely rare
8/ doctors would face a difficult task assessing if patients
have another motivation to vape
Vaping by non smokers is rare, <0.7% in Australia. Regular vaping is almost exclusively used by smokers to quit or reduce smoking or reduce harm from smoking
This is because nicotine liquid is not a medicine. It is a consumer product designed to replace another consumer product, deadly smoking. No western country requires medicines-standard assessment by the Medicines Regulator bit.ly/365HShQ
10/ The aim has got to be to get the patient off the nicotine addiction
No. The aim is to reduce the death and illness from smoking. Nicotine dependence on its own is of relatively minor importance. Once the patient has stopped smoking, your job as a doctor is over
11/ a potentially harmful poison
All chemicals are 'potentially' harmful. Vaping nicotine is substantially less risky than smoking which it replaces. Harm from low concentrations of nicotine liquid for vaping is extremely rare
12/ The most important thing is calling the Quitline
Quitline helps some people, but was used by only 1.8% of Aussie smokers in 2019. Vaping is by far the world's most popular quitting aid and has a much higher reach and pubic health impact
13/ all of the nation's peak cancer bodies oppose vaping
Why?
Vaping has <0.5% of the cancer risk from smoking. Nicotine does not cause cancer. Carcinogens are greatly reduced compared to smoking and biomarkers are much lower in vapers
▪️The evidence does not support a significant pathway
▪️Most youth vaping is experimental
▪️Smoking usually precedes vaping
▪️Regular vaping rare in never-smokers
▪️Vaping diverts young people FROM smoking
🧵1/9
Everyone agrees young people should not #vape or smoke
However, the current fear and panic about youth vaping is not based on the evidence, according to our paper published today in @ijdrugpolicy
Co-author Prof Wayne Hall
🧵2/9
In adolescents who have never smoked most #vaping is occasional and short-term
Frequent vaping in this group is uncommon: 1-2% in most international surveys eg England ⤵️
🧵3/9
Rather than being a gateway into smoking, #vaping is diverting young people AWAY from smoking overall. Increased vaping is accompanied by an accelerated decline in youth smoking
Eg in the US ⤵️
🧵1/4
41 leading tobacco control and addiction experts from Australia and NZ have written an open letter to Health Minister @Mark_Butler_MP asking him to reconsider the proposal to further restrict access to nicotine #vaping colinmendelsohn.com.au/butler-4/
🧵2/4
Their concern is that
“this approach will have serious and harmful unintended consequences for public health, will slow the decline in smoking and will ultimately be unsuccessful”
🧵3/4
The experts say that "a well-designed adult consumer regulatory model is most likely to achieve the two goals we all seek, i.e., making vaping products available as a quitting aid for adults who smoke and minimising access by young people"
Gross misinformation from 2 anti-vaping activists. No pro-vaping expert consulted to challenge or correct
No response to my letter to editor to fix it, so here are my corrections
Pls share
Thread...
1/ 'Switching has not been shown to reduce proven health harms’
Response
NASEM 18-2: 'There is substantial evidence that completely switching from ... cigarettes to #ecigs results in reduced short-term adverse health outcomes in several organ systems' nap.edu/24952
-BT did not invent vaping
-Vapes are a direct competitor to cigarettes and are a huge disruptive threat to the industry
-BT is mostly focussed on #HTPs
-If BT switches from #cigs to #ecigs, that is good for public health. vaping is 95% safer
2. Popcorn lung has been long discredited
There has never been a single case of 'popcorn lung' from vaping or smoking, and diacetyl levels are hundreds of times higher in smoke than vapour
▪️Smoking is the largest risk factor for cancer
▪️Vaping is estimated to be <0.5% the cancer risk of smoking
▪️Most of the carcinogens in smoke are absent from vapour or in very small amounts