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OtherRebuttal

Rebuttal: Can electronic cigarettes assist patients with smoking cessation?

Yes

Alan Kaplan
Canadian Family Physician June 2015, 61 (6) e255;
Alan Kaplan
Family physician practising in Richmond Hill, Ont, a staff physician at Brampton Civic Hospital, and Chair of both the Family Physician Airways Group of Canada and the Respiratory Medicine Program Committee of the College of Family Physicians of Canada.
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Electronic cigarettes (e-cigarettes) should allegedly not be used owing to lack of evidence of safety; because they are being produced and marketed by tobacco companies; and because they are potentially a gateway to smoking.1 All plausible concerns, but what about that smoking patient (15% of our population) in front of you?2

If smoking cessation were easy, this would be moot. A substantial barrier to cessation is the sensation of smoking and having something to do with the hands. It is not solved by pharmacotherapy, gum, or eating (which is a common issue and leads to weight gain—another health issue). Electronic cigarettes seem to have had some success, even in the absence of nicotine, because they deal with the habit! The increasing popularity of e-cigarettes has led to a decrease in tobacco sales in the United States.3 In addition, e-cigarettes have been shown to be as efficient as nicotine patches in assisting with cessation efforts.4 There is no evidence that they are a gateway product; in fact, the opposite is true, as they assist cessation.

The levels of carcinogens in e-cigarettes are thousands of times lower than in cigarettes, so we are talking about using them for harm reduction initially and hopefully cessation after that. As for safety, what about second-hand smoke exposure? This is a hazard for non-smokers with cigarette smoke, but not with e-cigarette vapour!

Legislate safety and remove nicotine, fancy flavours, and marketing, but use e-cigarettes to help your patients quit smoking. That is what is important; smoking tobacco kills.

Footnotes

  • La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro de juin 2015 à la page e257.

  • These rebuttals are responses from the authors of the debates in the June issue (Can Fam Physician 2015;61:499–501 [Eng], 502–5 [Fr]).

  • Competing interests

    Dr Kaplan has served on advisory boards for and received honoraria for giving lectures from Pfizer and Johnson and Johnson.

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    1. Levitz S
    . Can electronic cigarettes assist patients with smoking cessation? No [Debates]. Can Fam Physician 2015;61:500-1. (Eng), 503–5 (Fr).
    OpenUrlFREE Full Text
  2. 2.↵
    1. Health Canada
    . Summary of results from 2013. Canadian Tobacco, Alcohol and Drugs Survey. Ottawa, ON: Statistics Canada; 2013. Available from: http://healthycanadians.gc.ca/science-research-sciences-recherches/data-donnees/ctads-ectad/summary-sommaire-2013-eng.php. Accessed 2015 May 7.
  3. 3.↵
    1. Adelman DJ,
    2. Grainger M,
    3. Ayala V,
    4. Paxton K
    . Tobacco: New Year’s resolutions + e-cigs = weaker volumes? New York, NY: Morgan Stanley Research North America; 2013.
  4. 4.↵
    1. Bullen C,
    2. Howe C,
    3. Laugesen M,
    4. McRobbie H,
    5. Parag V,
    6. Williman J,
    7. et al
    . Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013;382(9905):1629-37.
    OpenUrlCrossRefPubMed
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Canadian Family Physician: 61 (6)
Canadian Family Physician
Vol. 61, Issue 6
1 Jun 2015
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Rebuttal: Can electronic cigarettes assist patients with smoking cessation?
Alan Kaplan
Canadian Family Physician Jun 2015, 61 (6) e255;

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