Abrams and Niaura work for the Legacy organization, a body committed “committed to empowering young people to reject tobacco and create ‘Generation Free’, the first generation for whom tobacco use is a thing of the past.”
The report advocates a two-pronged “harm minimisation” approach within which they call for proven tobacco control policies (such as raising prices) to be balanced by a prudently controlled emerging electronic cigarette market. The key aim, so they say, should be to boost the difference between any vaping-related harm and lethal cigarettes.
Abrams and Niaura point out that confusion is arising from conflicting interests and is resulting in policy-making errors. “When the stakes are high, as they are in the currently shifting tobacco control landscape, fears of unknown and hypothetical consequences can fuel strong emotion,” state the authors. “Can such fears cloud a rational, scientific approach to health policy and mislead policymakers and the public?”
The pair positively welcome the use of the inclusion of vaping from the outset. “Our view is that [ecigs] represent a new set of tools with the potential to minimize harm related to combustible tobacco use,” they continue. But they also caution how this should be done: “only if [ecigs] are prudently managed and marketed to adult smokers and only if the public is accurately and truthfully informed about them and how best to use them to eliminate combustible cigarette use.”
Scorn is placed on the manner gateway evidence has been collected. The report highlights the inherent flaws due to impacting the quality of design resulting in too many recommending that ecigs are “a pathway into lethal cigarettes” and consequently “undermine efforts to quit smoking”.
Similar criticism is given to the design of all research disproving the effectiveness of vaping as a method of quitting. “The evidence to date does not support this simple negative interpretation of their data,” they write. “Several observational studies, for example, reported that any use of e-cigarettes is correlated with reduced cessation,” Abrams and Niaura added before referring to work by the likes of Professor West.
The pair conclude: “If properly regulated and responsibly made and marketed, especially by independent manufacturers who have less conflict as Big tobacco does by also selling lethal cigarettes, [ecigs] have the potential to improve the public health.”