Vaping is a valuable aid in quitting smoking
Written by Monsieur Vapoteur
The electronic cigarette has found its place among the tools to stop smoking, say,
in a tribune in Le Monde, Bernard Basset (public health specialist, president of Addictions
France) and Amine Benyamina (psychiatrist addictologist, president of the French Federation of Addictology).
They deplore the intransigence of the High Council for Public Health on this subject.
The vapoteuse, improperly called electronic cigarette, has developed considerably
during the last decade.
Vape is used by many smokers who wish to end their addiction to tobacco,
and is often recommended by addictologists to their patients.
The relative youth of this device and the practices that accompany it have aroused enthusiasm, caution, and even mistrust, without any real progress being made,
caution, or even mistrust, without the debate being clearly settled, and the recent opinion of the High Council for Public Health (HCSP), on
(HCSP) on 4 January will not help.
The HCSP experts take a position on two completely different aspects of vaping:
on the one hand, the initiation of vaping for people, mainly young people, who have never smoked,
on the other hand, use as a tool for quitting smoking.
On the first point, there is a general consensus because no one has ever recommended recreational
But as far as helping people to stop smoking is concerned, the HCSP uses a reasoning that raises questions.
It states that the risks of vaping are not proven, but that caution is required, that doctors should not recommend it to their patients, and that it should be avoided.
that doctors should not recommend them to their patients to the detriment of proven treatments (patch, medication), but
(patch, medication), but it leaves the responsibility for their use to the individuals themselves.
The HCSP thus recommends turning a blind eye to a widespread practice out of a concern for extreme precaution.
widespread practice. Indeed, although the consequences of the fine particles contained in the vapour of vaporisers
are for the moment only a hypothesis or an avenue of research, the harmful effects of tobacco combustion
are well known and deadly.
However, weaning oneself off tobacco, which should be an objective for everyone, is very difficult because the product is so addictive.
For smokers, quitting is a long process, most often punctuated by relapses, and they
smokers try to make their journey easier by all possible means.
For a large number of them, smoking cessation has been a valuable, even decisive, aid. There can be no question of
There is no question of adorning it with all the attributes of a miracle cure. It is not, but in the real world
it has found its place among the ways to quit smoking. And no illness or death has so far been attributed to
attributed to the unabashed use of the vaporiser.
It is therefore difficult to understand why the HCSP is so intransigent in assessing the balance
between the serious and fatal risks of smoking and the still hypothetical risks of vaping.
One explanation can be found in the origins of the vapourizer. Invented on the fringes of science by an
by an unknown Chinese pharmacist, Hon Lik, it quickly grew exponentially in the commercial sector and took the
This commercial origin undoubtedly weighs heavily in the favour of the tobacco industry.
This commercial origin undoubtedly weighs on the representations of vape. It is all the more important
that a large number of its advocates are not free of links of interest with companies in the sector,
including in France.
Moreover, the tobacco industry has reacted by buying up many small vaping companies (devices and eliquids),
which is not reassuring when you know their unethical practices.
Finally, the economic deregulation environment in the United States has led to some highly questionable situations (promotion to young people who do not have the right to smoke).
(promotion to young people who have never smoked, high nicotine content to reinforce the addiction of
addiction to vaping, product design and marketing, etc.).
It is in this context of scientific caution and capital-intensive development that smokers wishing to
have to struggle, since the HCSP excludes vaping as a means of helping them to stop smoking, without however recommending its ban, which would have been
recommending a ban, which would have been the logical consequence of its reasoning. The HCSP opinion once again raises
The HCSP's opinion once again raises the ever-complex issue of risk and harm reduction. This has now been accepted as a concept, but has not been
This is now a consensus concept, but one that is not always reflected in people's use and in the practice of professionals;
without forgetting the view of society, which lends itself to all kinds of political positions.
We know the positive effects of harm reduction policy for intravenous drug users (and for crack cocaine), but we still find it difficult to offer this help.
intravenous drug users (and crack cocaine), but we still find it difficult to provide effective help to those who need it.
to those who need it.
The reflection on vaping is part of this duality of risk and harm reduction, between the certainty
of the dangers of tobacco and the fear of effects not yet known. Vaping, low-risk consumption rooms, risk and harm reduction
and harm reduction caused by alcohol are all subjects that merit a comprehensive reflection to make practices safer.
to make professionals' practices safer and, above all, to help users.
Pragmatism must be the only way forward, far from ideologies and the quest for profits. This is the current challenge
This is the current challenge for the public authorities, health professionals and users, but the HCSP's opinion does not help to address it.