World No Tobacco Day is on 31 May 2019. On the surface, it seems hard to quibble with the World Health Organisation when it warns that tobacco smoke is harmful to the lungs, and to health in general. It certainly is, though I’m not convinced we need a special day to remind us of that.
In another example, the WHO has formally endorsed traditional and alternative therapies for which there is limited or no scientific evidence, and whose practitioners actively resist scientific methods of establishing efficacy and safety. This encourages patients to seek out chiropractors, acupuncturists, osteopaths, reflexologists, naturopaths, homeopaths, traditional healers or any number of other practitioners of therapies of questionable ethical legitimacy.
Rules that protect non-smokers from the unpleasant and unhealthy smoke produced by smokers are laudable. In a free society, one’s right to do as one pleases ends where it begins to infringe on the same right of others. Its standing decision, dating back to 2014, recommends restricting the sale and banning the advertising of vapes. The WHO in 2016 claimed that these restrictions are justified by the lack of evidence of harm reduction and the ability of e-cigarettes to help tobacco smokers quit. This position is rather ironic, given how little concern it has for scientific evidence in the case of alternative medicines.
Yet many governments, including that of South Africa, adopted the WHO recommendations without much critical engagement. The supposed socio-economic impact assessment on the Control of Tobacco Products and Electronic Delivery Systems Bill, for example, was more an advocacy document than an objective, evidence-based impact assessment.
A 2017 study funded by Cancer Research UK found “substantially reduced levels of measured carcinogens and toxins” in vapers, compared to smokers. Another 2017 study found that e-cigarette vapour contains less than 1% the carcinogens present in tobacco smoke. A study of more than 60,000 teenagers in 2017 found that most e-cigarette experimentation does not turn into regular use, and levels of regular use in young people who have never smoked remain very low.
A study published in February 2019 found that e-cigarette users were almost twice as likely to quit successfully as people who used traditional nicotine-replacement therapy .
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