or07-4 e-cigs (vaporizers): a public health opportunity that will be missed?

OR07-4E-CIGS (VAPORIZERS): A PUBLIC HEALTHOPPORTUNITY THAT WILL BE MISSED?

Dr Robert Hämmig, MDPsychiatry & Psychotherapy FMH

President SSAMMedical Director Addiction Department

University Psychiatric Services Bern

•S•S•A•M•

Disclosure

• No conflict of interests

Tobacco Atlas (4th edition)

Cigarettes account for 92% of thevalue of all tobacco products sold globally

WW II

Well deserved pause of our heroes with a mild stimulant /relaxant

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Saipan 1944

Ryūkyū Islands 1945

Falluhjah (Iraq) 2004

Smoking cessation

Jorenby et al. JAMA 2006;296:56 – 63 Gonzales et al. JAMA 2006;296:47–55

from: Nides, The American Journal of Medicine (2008) Vol 121 (4A), S20–S31

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Chemicals in E-cig Vapour

Nicotine ”Cockroach poison”Glycerol Food Additive E422

E-cigs: the public debate

• E-cigs: do they fall under tobacco laws or pharmaceutical law?

• Arguments against e-cigs:–Nicotine is lethal already in small amounts– E-cigs are a gateway to tobacco smoke

Good and bad nicotine

from an 1980ies anti-smoke game

Nicotine: the “cockroach poison”

*Mayer. Arch Toxicol (2014) 88:5–7

Lethal nicotine• Historic case:

Hippolyte Visart de Bocarmé was sentenced to death for murdering his brother in law with nicotine in 1851.

• 60mg of nicotine as a lethal dose stems from an error in the 19th century scientific literature. This error was copied ever since.*

• Lethal dose of nicotine is between 0.5g -1.0g or even more. from glossary of Tobacco

Atlas, 4th edition

Gateway theory

• There is no observation that would confirm a gateway theory from e-cigs to tobacco cigarettes.

• There are observations for the other way round.

• Gateway theories are normally wrong. A temporal sequence is not a causality.

SwissVap Study

• Delphi study with tobacco expertsResults:• Yes to nicotine containing fluids for vaping• But:–No advertising– Limitation of content– Youth protection measures

QR code for download of report

Nutt et al. Eur Addict Res 2014;20:218-225

Marketing prohibited in Switzerland

ENDS electronic nicotine delivery system products

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