“Threat to public health, adolescents and fetuses”, “Exposure in non-smokers and their entourage to nicotine and a number of toxic carcinogens”, “Aromas inciting minors” … In a report published this summer, the opinion of the World Health Organization (WHO) is scary. To quit smoking, the organization recommends using “treatments already approved, other than electronic cigarettes”. That is to say nicotine gums, lozenges and patches, buproprion (Zyban) or varenicline (Champix). “
According to the WHO, the e-cigarette, by seducing young people with its aromas of candy, fruit, alcoholic beverages … would encourage them to vape, to become nicotine addicts and possibly thereafter, to smoke. The form of the product and the body language are also factors that may contribute to nicotine dependence. Finally, authorizing it in public places would constitute an incentive to smoke and expose those around them (in particular adolescents and pregnant women) to dangerous toxins.
A gateway to tobacco, not so sure
In France, the sale of e-cigarettes to minors is already prohibited, as is the sale of tobacco. However, “that has never prevented them from smoking”, specifies Dr. Philippe Presles, doctor, tobacco specialist. Is vaping a gateway to tobacco? Nothing proves it to date. While many young people want to try it, less than 1% of users are non-smokers. And according to the “Paris Sans Tabac 2014” survey, the proportion of smokers among 12-15 year olds has been halved and has fallen among 16-19 year olds. “The more young people vape, the less they smoke,” concludes Dr Presles.
According to Professor Bertrand Dautzenberg, professor of pneumology, president of the French Office for the prevention of smoking, the English, American and French data seem to show that the e-cigarette is rather a product of “denormalization” but he considers that it must be careful and that prohibition on minors is always a good thing.
Should we prohibit fruit flavors, candies and alcoholic drinks? No according to Professor Bertrand Dautzenberg, “the electronic cigarette must be popular within the first five seconds of taking it to be adopted as an exclusive mode of consumption”. However, the more it pleases, the more it keeps away from tobacco. “If an aroma manages to distract from tobacco, it is a good aroma,” adds the doctor. Certain flavors (such as fruit) should not be banned, a priori, but rather “put them under surveillance and regulate them according to the facts observed”.
Is passive vaping carcinogenic?
A priori, no. According to an expert report from the French Office for the Prevention of Tobacco (OFT), unlike a place where tobacco is smoked, there is no exposure to solid particles in a room where there is vapot (except in the presence of very many vapers). The only significant passive exposure is that to chemicals in gaseous form (nicotine or others) which is still poorly understood and needs to be studied. Some traces of carcinogenic products (at rates identical to those identified in nicotine substitutes) were detected, but these concentrations are of no clinical significance.
While it has just been authorized in Great Britain in public places, the regulations in this area are not yet clear in France. For Jacques Le Houezec, advisor in public health and tobacco dependence, president of the Society for research on nicotine and tobacco (SRNT), banning it in companies could discourage or send vapers to tobacco. Because a vaper must use his electronic cigarette throughout the day to get his dose of nicotine. For Professor Bertrand Dautzenberg, “in the collective interest, a non-smoker has the right not to be“ envapoté ”by his neighbor in a closed place. And in the name of exemplarity, we must not vape in public places ”.
Professor Dautzenberg observes that cigarette sales have declined over the past two years and that many smokers have succeeded in quitting thanks to the e-cigarette. If he says he is less “worried” about this product than before, he thinks that we must remain cautious, because we still lack data for the moment.
For Dr Presles, there are 10 million smokers who fail to quit and for whom this is a solution that works very well. For him, “the WHO report may arouse suspicion while the e-cigarette is infinitely less dangerous than the tobacco “. He reminds us that it is not nicotine that kills but the combustion of tobacco. Nicotine is not responsible for any tobacco disease and does not cause heart attacks, cancer, stroke, nor any respiratory disease.
Jacques Le Houezec is more critical of the WHO, “its strategy is to eradicate the tobacco industry through a series of measures while forgetting its primary goal: to reduce diseases and mortality linked to smoking”. She takes a more moral than scientific position: she warns non-smokers and leaves smokers aside by “preventing the development of a product that reduces considerable risk”.
The toxic e-cigarette for the fetus?
No data is available to date, says Professor Dautzenberg. “Compared to tobacco, the e-cigarette does not provide a significant amount of carcinogens, microparticles or even carbon monoxide, three substances that are particularly deleterious for the fetus. “
The supply of nicotine (identical to that found in nicotine substitutes) is a priori no more important than with cigarettes, but the “vapor” provides potentially irritating substances which we do not know if they are present. are more or less toxic in pregnant women. Some manufacturers affix the logo on their packaging prohibiting the use of the product during pregnancy. For our expert, “this precautionary principle must prevail in pregnant women as long as the data are insufficient. “
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