• As more governments grapple with how to tame the fast-growing vaping culture, scientists are still debating whether heated tobacco can help fight diseases including cancer.
• Earlier this month in Paris, the International Conference on Harm Reduction in Non-Communicable Diseases (NCDs) was grappling with this same issue with Khayat defending his position.
In 2018, French Oncologist Professor David Khayat mounted a defense on the use of e-cigarettes to tame tobacco-related diseases.
According to Khayat at the time, the use of technology and innovation to tame smoking was more effective than the bans and high costs imposed by governments on cigarettes.
"I believe that technology will bring us the future, that is to say, that I believe in the fact that we will have less harmful and less carcinogenic means of smoking than cigarettes," Khayat said at the time.
Two years later, as more governments grapple with how to tame the fast-growing vaping culture, scientists are still debating whether heated tobacco can help fight diseases including cancer.
Earlier this month in Paris, the International Conference on Harm Reduction in Non-Communicable Diseases (NCDs) was grappling with this same issue with Khayat defending his position.
"As an oncologist, I encourage my patients to quit. But if they can't, I must offer them alternatives. Even when people know that smoking is bad for their health, they continue to smoke. 64% of people with lung cancer continue to smoke," he said.
He added; "When you tell your patient to eat less fat, you do harm reduction. When you put your seatbelt in a car, you do harm reduction. New technologies have given us the tools to do so."
According to Khayat, the role of oncologists is not to eradicate tobacco but rather eradicate cancer and today's alternative are heated tobacco and e-cigarettes.
Other participants agreed with Khayat in calling for innovation as a means of dealing with tobacco consumption and related illnesses.
They also disagreed with recent information released by the World Health Organisation saying it misrepresents available scientific evidence.
The health experts, however, agreed with WHO that quitting smoking was the best solution at the end of the day.
On January 29, the WHO issued a fact-sheet titled 'e-cigarettes: how risky are they?' which concludes that these products are "harmful to health and are not safe."
"However, it is too early to provide a clear answer on the long-term impact of using them or being exposed to them," the fact sheet states.
According to WHO, the scientific evidence regarding the effectiveness of electronic cigarettes as a smoking cessation aid is still being debated.
"To date, in part due to the diversity of ENDS products and the low certainty surrounding many studies, the potential for ENDS to play a role as a population-level tobacco cessation intervention is unclear," WHO says in the fact-sheet.
However, Prof. John Britton, director of the Centre for Tobacco & Alcohol Studies and consultant in Respiratory Medicine at the University of Nottingham, begs to differ with this position.
"There is no strong evidence that vaping is an effective means of quitting smoking. There is clinical trial evidence of the highest standard demonstrating that vaping is more effective than the nicotine replacement therapies that the WHO endorses," Britton said.
Kenyan physician Anthony Kiamati said that industries have to view Africa as a continent that can afford science-based innovative solutions to reduce harm.
"It would be a missing opportunity not to consider innovative alternatives in Africa. The population, policymakers, governments and the medical world should give it a try," he said.
He added; "The aim is to save the lives of those already smoking and who are unwilling or unable to quit. Smoke-free alternatives should be promoted even though health regulatory policies are fragile."
WHO says that it is difficult to generalize on the risk to health of ENDS as compared with cigarettes or other tobacco products, as this is contingent on a range of factors.
"Both tobacco products and ENDS pose risks to health. The safest approach is not to use either. The levels of risk associated with using ENDS and/or tobacco products are likely to depend on a range of factors, some relating to the products used and some to the individual user," WHO said on January 29.
Where they are not banned, WHO recommends that ENDS be regulated.
Regulatory objectives include:
- Preventing initiation of ENDS use by non-smokers and children, such as by preventing or restricting advertising, promotion and sponsorship, and restricting flavours that appeal to children
- Minimizing as far as possible potential health and/or risks to ENDS users, such as by regulating product characteristics
- Protecting non-users from exposure to their emissions, such as by prohibiting ENDS use in indoor spaces where smoking is not permitted
- Preventing unproven health claims
- Protecting public health policies from commercial and other vested interests