Stakeholders have strongly criticised a recent EU study on electronic cigarettes for being selective in its findings when it comes to their health implications. The European Commission, though, insists that the study was based on the latest and up-to-date evidence.
The European Commission’s Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) published on 23 September its preliminary opinion on novel tobacco products as part of the Tobacco Products Directive (TPD) assessment due next year.
Electronic cigarettes and novel tobacco products have emerged as alternatives to traditional smoking, which is responsible for nearly 700,000 deaths every year in the EU.
However, the EU is still cautious when it comes to this rising trend amid a lack of evidence regarding their long-term implications.
Advocates cite several studies worldwide and insist that novel tobacco products are much less harmful compared to traditional smoking. On the other hand, EU policymakers emphasise that less harm is still harm.
In addition, the World Health Organisation (WHO) has been quite critical of electronic cigarettes saying evidence reveals 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 UN agency said.
Public health NGOs have also warned about negative implications of vaping, particularly amid the COVID-19 pandemic.
The European Network for Smoking and Tobacco Prevention (ENSP) launched in April a campaign warning that smokers and vapers face higher risks from COVID-19.
Referring to novel tobacco products particularly, ENSP said: “It is important to note here that regardless if they produce vapour or smoke, they can still produce infectious lung damage as traditional cigarettes do and therefore, they cannot be considered as ‘safer’ options”.
The Commission’s independent scientific committee concluded that there is strong evidence that electronic cigarettes are a gateway to smoking for young people, an argument with which the WHO also agrees.
In addition, the scientific body stressed that there is “weak evidence” for the support of electronic cigarettes’ effectiveness in helping smokers to quit while the evidence on smoking reduction is assessed as weak to moderate.
The tobacco industry reacted strongly to the opinion, saying it was biased.
A spokesperson for Imperial Brands, a British multinational tobacco company, said the opinion took into account only some of the scientific literature and from a limited period of time, leaving out of the analysis a robust part of independent science available.
Referring to the “gateway” argument, the spokesperson said this is in contrast with the real-world evidence in the UK and Canada and called on the EU executive to come up with credible evidence.
In its latest 2020 report, Public Health England said: “Current vaping is mainly concentrated in young people who have experience of smoking. Less than 1% of young people who have never smoked are current vapers”.
The tobacco industry also emphasised that the opinion considers e-cigarettes risky in general without putting them on the basis of the risk compared to traditional smoking.
“Looking to cardiovascular risks specifically, as raised in the SCHEER opinion, a recent and robust British Heart Foundation-funded clinical study demonstrated substantial benefits in cardiovascular measures and vascular function when adult smokers transitioned to vaping after only a month’s usage. This independent study was not even considered by SCHEER,” Imperial Brands stated.
An EU Commission spokesperson dismissed the argument that the SCHEER committee had not relied on scientific data.
“The SCHEER committee takes into consideration the most recent and up-to-date scientific evidence and technical developments and, as appropriate, the existing provisions concerning e-cigarettes under the TPD (in particular Article 20(3)), and the evolution of new products on the market,” an EU spokesperson told EURACTIV.
“The scientific opinion addresses considerations relevant both at individual level and at population level, from a public health perspective and reply to specific questions from mandating DG only (cf. mandate),” the spokesperson said.
EURACTIV was informed that SCHEER working group in e-cigarettes is now addressing the specific comments, suggestions, explanations or contributions on the scientific basis of the Opinion received by 26 October by all relevant stakeholders.
“These comments will be taken into consideration if they are found relevant,” the spokesperson said.
EURACTIV also contacted Italian professor Riccardo Polosa, who is also the director of the Center of Excellence for the acceleration of Harm Reduction (CoEHAR), who said that the “Opinion did not take much time to evaluate cessation – less than two pages in the report”.
Just after the report was posted, he added, the “well-respected Cochrane review” came out with their update that found moderate evidence of effectiveness.
“Science has a high bar for proof, which is right. At the same time, any way a person can stop smoking is good – chewing gum, sucking lollipops. It is well known in harm reduction that substitution is easier to achieve than abstinence, so that is why e-cigarettes have worked for many people to stop smoking,” he explained.
[Edited by Zoran Radosavljevic]