On this world tobacco-free day (31 May), those who are in favour of the development of vaping as a way to gradually wean people off smoking and those who are against it will once again be highlighting their differences. In support of their claims, opponents to vaping will be brandishing a number of studies – all from the United States. And that’s where the problem lies. It is the same for the fight against tobacco as for other major subjects: America – a country we love for so many other things – is always keen to impose its point of view on the entire planet, starting with its best enemy, Europe.
Vaping - a tool for weaning people off tobacco
On the subject of vaping and whether or not it is capable of serving as an effective tool in weaning people off tobacco gradually, the USA has had the merit of being in the forefront for launching studies that attempt to measure the real effects on the basis of the broadest possible experimentation base, and mainly human at that. Europe held back on following suit, and the only European study worthy of the name, carried out by the British – before there was any mention of Brexit -, was carried out on the basis of samples that were more limited than on the other side of the Atlantic.
But it’s the same with studies as with everything else, and scientists, particularly since Rosenthal, are well aware of the bias of the experimenter effect, according to which the framework within which you carry out your work is bound to influence the results you obtain, and above all their analysis.
So when it comes to vaping, the USA is profoundly different from Europe, particularly France. In France there are no observations of passive vaping or of a gateway effect, or cardiovascular problems, or dangers for pregnant women.
Europe protects consumers
We may note in passing that these fashions regarding vaping, encouraged by the big tobacco companies, also provide an opportunity to promote the additives included in e‑liquids, including those based on cannabis, within a legislative and regulatory framework that we consider far too vague. Here again, Europe has the virtue of providing better protection for its consumers – the THC molecule is banned in France – although it is legitimate to discuss the evolution of our regulations.
It therefore comes as no surprise that the American studies applied to these very different vaping habits, which it has to be said are less virtuous than ours, have produced serious warnings about the use of e-cigarettes in getting people weaned off tobacco. Their summary and indeed their caricatures as put about on the Internet have added further to their case, popularising a whole raft of counter-truths and fake news.
We can be sure that if these studies were carried out in Europe the conclusions reached would be very different. This work has now been started, and mobilisation is gaining ground. The independent scientific community, particularly in France with the participation of the Paris hospital authority APHP, but also that of a number of university hospitals and Swiss parties, has taken up the subject. In several major university medical centres in France (no fewer than eighteen, in fact), work is in hand to measure the role vaping can play in weaning people off tobacco and the real effects of nicotine on the human body. It will take some time to reach results; we will have to be patient before we can consolidate the data, and above all we must not stop there.
In the next few years, it will be necessary for these forces to group together and become federated in order to reach, from the French and European point of view, an incontrovertible conclusion and a true evidence-based discourse in the service of this real challenge to public health: vaping as a key means of weaning people first off tobacco and then off nicotine.
by SÉBASTIEN ROUX