There are some things in my professional life I can be absolutely certain about:
- Smoking kills
- Obesity is a ticking time bomb that threatens future generations of Brummies
- We would have a much healthier city if we were all more active
But other issues are not so straightforward of course and a topic where I believe there is no definitive answer as yet is that of e-cigarettes.
It seems there is a new story every week about these devices and experts are lined up to do battle on either side of the debate.
Earlier this year, a total of 53 experts from 15 countries including the UK wrote to the World Health Organisation (WHO) to urge it not to ‘control and suppress’ e-cigarettes, saying they have the potential to save millions of lives.
That was followed up by more than 100 leading public health doctors and specialists from around the world also writing to the WHO, calling for e-cigarettes to come under the same tight controls as tobacco products, with bans on advertising and promotion.
Now I'm not one to sit on the fence but I can see both sides of this argument and, as the city's Director of Public Health, I feel it's important that I should clarify my position. So here goes.
Every year over 4,500 people die in Birmingham from a smoking related disease and smoking is directly attributable to:
- 1 in 4 of all cancers,
- 1 in 5 deaths from cardiovascular disease (heart disease and stroke),
- 1 in 3 of all deaths from respiratory disease
So for obvious reasons I want as many people as possible to quit. I want them to quit inhaling tar and tobacco smoke. We know that this causes lung cancer and heart disease: nearly all the harms due to smoking are due to the products in tobacco leaves. Nicotine may cause some harm but it pales into insignificance when compared to the misery caused by tar and tobacco.
How people choose to quit smoking is a matter of personal choice and the best method is the one that works for you.
Some people can simply 'go cold-turkey', stub out a final cigarette and decide they will have no more. Others need help and our Stop Smoking Service offers a range of support for people who want to quit the deadly habit.
The support might involve nicotine replacement therapy (NRT) including patches, gum, lozenges and microtabs. But at the moment e-cigarettes are not available on the NHS.
That doesn't mean people aren't turning to these devices though and according to research from ASH earlier this year:
- An estimated 2.1 million adults in Great Britain currently use electronic cigarettes.
- About one third of users are ex-smokers and two-thirds are current smokers.
- The main reason given by current smokers for using the products is to reduce the amount they smoke while ex-smokers report using electronic cigarettes to help them stop smoking.
So should e-cigarettes become a new weapon in our fight against smoking?
I'm starting to think maybe they should.
Yes we need more research into the long-term effects, yes we need to ensure e-cigarettes are not marketed to children and young people, yes we need to make sure they are safe and yes we must be careful not to re-normalise smoking.
But ideally I want people not to be addicted to tobacco and its products including nicotine. Most of all I want people who smoke tobacco to stop their intake of tar and tobacco smoke and stop the major harm due to tobacco. If this means that people choose to transfer their nicotine addiction to e cigs or 'vaping' then this must be better than continuing to smoke tobacco.
Am I right? What do you think?