Vaping policy: Science should prevail over prejudice

In a recent talk show, speakers urged the media to "play an active role to ban e-cigarettes in Bangladesh." Apart from a crucial misunderstanding of the media's role of being an advocate instead of a reporter of facts - the speakers appeared clearly clueless about the latest knowledge related to vaping which is alarming for several reasons.

As Bangladesh battles with an array of public health problems related to tobacco smoking, Prime Minister Sheikh Hasina's stated goal of making the country tobacco-free by 2040 seems more of an emergency than a grand vision. And it is only logical that in determining the ways through which this can be achieved, science will be given preference over preconceived ideas and conjectures.

The fact that vaping, also known as e-cigarette, has emerged as one of the most effective quit smoking tools, should be considered with diligence, not dismissed without investigation. There are a number of important factors that make vaping possibly a game-changer. Vaping now provides a technological solution for quitting cigarette smoking that was not available in the past.

Needless to say, just because something helps you quit smoking, that doesn't mean it should be pursued. The whole reason vaping is celebrated as a legitimate quitting tool is because it is significantly less harmful than conventional cigarettes. But how significant?

Public Health of England in what it calls a "landmark review," found that vaping is around 95% less harmful than combustible cigarette smoking. As a result of this finding the widely respected NHS (National Health Service) now recommends vaping to help quit smoking. Vape products are now also being sold in shops in British health facilities.

That's not all. A major UK clinical trial published in 2019 found that, when combined with expert face-to-face support, people who used e-cigarettes to quit smoking were twice as likely to succeed as people who used other nicotine replacement products, such as patches or gum, NHS informs the British public in its website.

A 2019 study found that an astounding 50 to 70 thousand people in England quit smoking in a year using e-cigarettes. Recently published in the scientific journal Addiction, the study found that 50,700 to 69,930 smokers in England stopped smoking in 2017 through the use of vaping. "The findings should be reassuring. They do help smokers quit, " said Jamie Brown, an author of the study and research fellow at University College London.
 
Even a cursory look at vaping, how a vaping machine works and what the user gets exposed to, reveal quite a lot. To state the very basics, vapes do not require combustion, and therefore, no fire needs to be lit and nothing needs to be burned. Consequently, there is no smoke, tar, carbon monoxide, etc in vapes.

There is also no risk of second-hand smoking, as there is no good evidence to suggest that second-hand vapour from vapes is dangerous to others. But in Bangladesh, far from reassuring, the success story of vaping as a cessation aid has not come to light. Despite the significant death toll, Bangladesh has not considered adopting any cessation program like that of the UK, where the country's National Health Service (NHS) has been able to help 2 out of 3 smokers quit smoking by use of vaping in combination with the NHS's 'stop smoking service.'
 
Vaping can make a difference, as evidence-based programs in the UK and elsewhere clearly suggest. And that is why misinformation about harm reduction, which is what vaping does, is outright dangerous. Given the gravity of the situation, it would be a disservice for regulators as well as policymakers to dismiss vaping as an effective quit smoking tool, which is being increasingly accepted as such around the world.
 
The speakers' demand for banning vaping is doubly disconcerting because it would force vapers to go back to cigarette smoking, which we already know to be more harmful considering the public health of Bangladesh.
 
The dichotomy in the whole vape discussion currently verges on an irrational misconception. When countries with much more experienced and robust health care structures are talking about how to ensure safe vape products, it seems naive at best and dangerously dogmatic at worst to talk only in terms of banning, instead of thinking about quality control in vaping products.
 
In reality, it is already late and talks about vaping product control should have started by now. By now we should have been talking about regulations to ensure that vendors are importing and selling quality vaping products. But it seems that we are once again behind the forward-thinking world.
 
Ultimately, the goal is to improve public health and harm reduction is an important pathway toward that goal. It is possible for Bangladesh, like the UK, to adopt vaping as a quit-smoking tool and help large numbers of smokers quit. And there is no reason to not take advantage of this solution which clearly exists and clearly works.

The writer is Professor, Head of Community Medicine, Enam Medical College, Savar