Letter to her Majesty Queen Elizabeth on harms of E cigarette

Your Majesty Queen Elizabeth,

Subject – Your Excellency please inform your Health Ministry that less harm does not mean harmless

I am a cancer specialist in India and witness death, disease and devastation caused by tobacco every day in my clinic. I am writing this open letter to bring to your attention something that is not only harmful for 2.5 million vapers in UK but also misguided the public in India.

Recently Government of India banned E cigarettes or Electronic Nicotine Delivery System (ENDS) based on irrefutable scientific evidence. To date, over 20 countries have also banned the sale of ENDS. Government and Public health specialists in these countries are at logger heads with the tobacco lobby who are the prime investors in ENDS. The main argument of the ENDS lobby was that “Public Health England has said that E cigarette is 95% safer than cigarette”. Even Royal college of Physicians has been extensively quoted as supportive of ENDS. Such things are unimaginable from the land of Dorothy Hodgkin, Isaac Newton, Alexander Fleming, Rosalind Franklin etc.

This magic figure of 95% is being constantly exploited by ENDS lobby. The authors of this figure assumed that absence of harmful smoking- related chemicals makes ENDS safer. They ignored the fact that nicotine in pure form is a toxic chemical with a lethal dose of 30mg for an adult. This distorted evidence had contributors from the reputed institutions of London such as King’s College, Queen Mary University etc. It is shocking that this conclusion was derived from two grossly flimsy references and not a robust research. First reference was a briefing report to the UK All-Party Parliamentary Group on Pharmacy. The other reference was an article published in European Addiction Research. In 2013, the authors of this paper hosted a 2 day workshop of experts to discuss on “relative importance of different types of harm related to the use of nicotine-containing products”. The experts scored the products for their health effects, and weightings were given to the results. At the end, cigarettes were ranked as the most harmful with a score of 99·6 and E-cigarettes received a harm-score of 4%. Having said that, many experts in that workshop had serious conflict of interest that was not revealed in their publication. The entire narrative of safety of ENDS over traditional cigarette now stands shattered. The epidemic of adolescent vaping is an unprecedented phenomenon happening in USA. It has already caused 12 deaths and more than 1000 serious lung injuries in USA in just 3 months!

It is unfair to give entire credit to ENDS for the declining cigarette consumption in UK that would have happened regardless. The countries that have banned ENDS, including India, show steeper decline in cigarette consumption than UK. There is no conclusive evidence that ENDS is a superior form of quitting over currently approved ones. On the contrary, as per current evidence, one fourth use ENDS along with cigarettes and three fourth remain addicted to ENDS even after quitting cigarettes. This deprives the smokers of a nicotine free or risk free life. Ironically, to my knowledge, ENDS lobby themselves have never claimed quitting benefits and applied to drug regulators as a cessation tool. If ENDS could eliminate smoking, cigarette companies would not invest in their own death. ENDS industry isn’t interested in smokers but their main aim is to convert our innocent kids into Vapers by luring them with 1,500 flavours! As per Public Health England, around one in six children aged between 11 and 18 have tried e-cigarettes!

I sincerely request you to correct the monumental mistake before it causes further harm to your own population and world citizens.

Professor Pankaj Chaturvedi

Published by Prof Pankaj Chaturvedi

Deputy Director, Center for Cancer Epidemiology, Tata Memorial Center, Mumbai. Professor, Department of Head Neck Surgery, Tata Memorial Hospital, Mumbai

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