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More sowers of doubt about vape

Written by Monsieur Vapoteur

Source journalduvapoteur.com

vape prohibited

The opinion (more than nuanced ...) of the High Council of Public Health / HCSP on the electronic cigarette continues to make much noise ...

Afterthe position of tobaccologists and addictologists encouraging vapotage, three members of the High Council of Public Health state in Le Monde.fr that "if it is plausible that vapotage may be in some an aid to the cessation of cigarette consumption, there is no sufficient evidence that it provides a benefit in comparison to other validated treatments, drug or not.

Unfortunately, the puff phenomenon is not helping to move in the right direction, as you will see from their arguments below.

All three members of the working group on this opinion very relative to the benefits-risks of the electronic cigarette of the HCSP: Ivan Berlin (senior lecturer, hospital practitioner, Pitié-Salpêtrière Hospital, Paris); Anne-Laurence Le Faou (senior lecturer, hospital practitioner, Georges-Pompidou European Hospital, Paris) and François Alla (professor of public health at the University of Bordeaux and hospital practitioner at the University Hospital of Bordeaux).

Here is what they tell us:

Individual and collective health decisions must meet ethical requirements. In particular, this requirement involves an evidence-based approach, according to well-established rules used internationally, in order to deliver care whose effectiveness has been demonstrated, whose level of risk is known and whose benefits exceed the risks. It is this benefit-risk ratio that is at the heart of decisions, in all countries and for all independent health institutions.

The opinion of the High Council for Public Health (HCSP) on the use of electronic cigarettes follows these rules.


Common consumer products

The majority of knowledge on "vaping products" (consisting of a battery, a tank filled with eliquid, heated by a resistor and producing an aerosol), the name used by the 2016 law on the modernisation of our health system, reminds us that these are not health products, but products of everyday consumption.

In France, more than half of vapers also smoke tobacco. Reducing tobacco consumption (e.g. from 15 to 5 cigarettes a day) does not reduce the risk of tobacco related diseases or death.

Some vapers use this argument to use vaping products to reduce the undoubted risk associated with tobacco use. It is therefore important that the message of support for complete cessation of tobacco use is heard by health professionals, the social sector and smokers.

However, the data from currently available sources do not provide a sufficient level of evidence regarding the benefit of vaping products as a smoking cessation aid compared to other validated treatments, whether or not they are medicinal. Furthermore, these data do not allow for an assessment of the potential risk associated with their use.

A risk of becoming a smoker

Consequently, due to the insufficient level of evidence compared to the level of evidence required for health products, the HCSP working group could not recommend to health professionals the "prescription" of vaping products in this indication. These recommendations are in line with those of health authorities in several countries and international health bodies (...)

The HCSP working group was well aware of the wide use of these consumer products, recognised that it is plausible that these products may be an aid to smoking cessation for some people, and thus left the way open for their use by smokers as consumer products if they choose them, duly informed, instead of or in addition to validated treatments. Vaping products are available to all, including young non-smokers. Current evidence suggests that the use of vaping products by male and female non-smokers may induce a risk of becoming a smoker. According to the most recent French data, the use of vaping products has increased among nonsmokers in secondary schools.

If we do not want to increase the number of future smokers, these products should be discouraged for non-smokers, especially young people. Moreover, vaping products are easily misused: the tank can be filled with liquids containing highly addictive nicotine, but also with substances such as cocaine, opiates or cannabis.

The urgent need for evidence

The HCSP working group drew the attention of health authorities to the need to set up a surveillance system to collect signs and symptoms potentially related to the use of vaping products that vapers or health professionals could report. This surveillance system would make it possible to assess whether their use is associated with a risk, what type of risk it is, and what the intensity of this risk might be.

For the population, any intervention that eliminates tobacco use is welcome. However, the level of health risk from using vaping products must be compared to the significantly reduced risk from quitting smoking and the risk from continuing to smoke. It may be thought that the exclusive use of vaping products is associated with a reduction in health risk compared to smoking, but that these products may also induce a risk compared to no smoking and no vaping products. The question is: Can we quantify the risks in these three situations?

The debate on vaping products is only relevant if it is based on thorough knowledge and free of conflicts of interest. The HCSP working group stressed the urgency of acquiring evidence-based knowledge to enable responsible decisions on the use of vaping products, both in everyday life and within the health care system.