“cigarette smoking remains a serious global public health problem.In 2019,15% of deaths in the over 35s in England were attributable to smoking adn in the same year,due to the damage of smoking,the country’s finances lost 13.5 billion pounds. E-cigarettes are currently one of the best ways to help people quit smoking, bringing a gain in individual and public health. according to 2024 data from the Cochrane Review, the smoking cessation rate at 6 months is better among those who choose to replace traditional cigarettes wiht e-cigarettes containing nicotine rather than nicotine substitutes. None of the studies considered by the Cochrane Review highlighted serious short-term adverse effects resulting from the use of e-cigarettes. Thus Alan Boobis, emeritus professor of Toxicology and president of the Committee on Toxicity of the United Kingdom of Imperial College London, on the occasion of the 2024 edition of ‘E-cigarette summit UK – Science, Regulation and Public health’, a conference born with the The objective is to facilitate dialog and thoughtful analysis of the scientific evidence regarding the use of electronic cigarettes (e-cigs) as an option to traditional cigarettes and as a possible useful tool for quitting smoking.
In his speech ‘Effective public health protection requires solid scientific evidence: avoiding unintended consequences’, the expert explained that, “in the regulation relating to e-cigarettes, what has caused concern in recent years has been the flavorings used in the formulation of e-cig liquids, on the one hand considered an attractive factor for those young people who would not need to use electronic cigarettes because they are not already smokers of traditional ones, and on the other considered a possible health risk”.
However, “the data show that aromas - continues Boobis – have a different role depending on the age groups and I believe we should focus on the most impactful problems, ensuring that accurate data is provided. I believe that the attractiveness of aromas is problably a greater problem than the potential health risk. In fact, many of the flavorings contained in e-cigarette liquids are also used in food and in some traditional cigarettes – he clarifies – they have the same effects, naturally based on the concentration, which if they were ingested orally with food highlight only some exceptions for what are the local effects on the lungs. For example, cinnamaldehyde (contained in cinnamon essential oil, ed.) can have a sensitizing effect which though does not. has been identified in those who use e-cigs. The data available so far do not raise particular concerns about the presence of flavorings in e-cigarettes, but having more information would certainly be useful.”
Then speaking about the effects of heat on the aromas present in electronic cigarette liquids, the professor states: “When they heat up, they can have a degradation due to heat, which however is low at the normal temperatures reached by electronic cigarettes. The same degradation due to heat It also occurs when foods containing these same flavors are cooked or reheated and no side effects have been observed.” Also at the center of Boobis’ intervention were pathologies that were hypothesized to be linked to flavourings, such as the so-called ‘Evali epidemic’ which though was linked to the “improper reuse of products for vaping with self-produced liquids containing THC”, recalls the expert , and the ‘popcorn lungs’ syndrome linked to the use of diacetyl, a component banned from e-cig liquids as 2016 in the european Union and the United Kingdom.
Clive Bates, director of Counterfactual consulting Ltd.also presented his point of view in the speech ‘When unwanted consequences are the main result: rethinking regulation’. “Electronic cigarettes – he explains – have so far proven to be less harmful than traditional cigarettes and a valid aid in quitting smoking completely. In the United Kingdom, adult smokers of both traditional and electronic cigarettes are 20 times more numerous than smokers under 18. We must therefore reflect and understand the main consequences of the regulation imposed on products containing them. nicotine substitutes for traditional cigarettes. The unexpected consequences of rules and restrictions that limit access to alternatives to traditional cigarettes are that people will return to smoking traditional ones people try to make flavored liquids at home, increasing the risks and not actually reducing smokers and the risks associated with smoking.”
“Banning flavors will only lead to the creation of an underground market and not to the end of their use,increasing the risks for consumers - underlines Bates – By then increasing the price of electronic cigarettes,people will return to smoking traditional ones. The ban of single-use e-cigarettes would impact over 2.6 million people in Great Britain, one in every 20 adults. Furthermore, the effects of the ‘generation ban’ will be null and void until 2044 and limited thereafter to 2056.We must focus on those who smoke now and must be helped to quit in the most effective way.Summing up my position, I believe we must give a realistic model of the risky behavior of young people, offer a legal market for adult smokers who want to quit. smoking traditional cigarettes, implementing regulation proportionate to the risk and having a responsible market, with a description of the brand and flavours”.
In his report ‘Accelerating Smoking Cessation’,Robert Beaglehole,Emeritus Professor at the University of Auckland and Ash – Action for Smokefree 2025 New Zealand President,reiterates: “Smoking is still a major health problem and we would see huge benefits if we accelerate the total cessation of smoking. supporting my activity in the field of tobacco control for almost fifty years are two images: that of my father, who died at the age of 59 from the cardiovascular effects of smoking, and that of one of my young patient dying of lung cancer. Compared to the objectives set in 2010 for 2025,i.e. a 30% reduction in smoking globally, we are still behind, we have in fact achieved a 25% reduction of this delay, the deadline of the objective was in fact moved forward by 5 years. Women reached the target in 2020,while men should be able to reach it in 2030”.
“I am devoted to the WHO, but I believe that in this area it must do more and be more proactive. To help the WHO work better in this direction, I believe that countries should also think cooperatively and not as individuals and that there is also a need for more alliances and a voice from the public. I hope – he concludes – that the next general director will have a more open approach to these issues”.
How do e-cigarettes impact smoking cessation rates among different demographics?
Time.news Editor: Welcome to the Time.news channel. Today,we’re pleased to have professor Alan Boobis,an esteemed expert in Toxicology from Imperial College London,join us. professor Boobis, thank you for being here.
Alan Boobis: Thank you for having me. I’m glad to be part of this significant conversation.
Editor: Let’s dive right in. Smoking remains a major public health issue, responsible for significant mortality and economic loss. What role do you see e-cigarettes playing in addressing this crisis?
Boobis: E-cigarettes are emerging as one of the most effective tools for smoking cessation. Research,particularly a 2024 Cochrane Review,indicates that users of e-cigarettes containing nicotine have a higher likelihood of quitting compared to those who rely solely on conventional nicotine substitutes. This presents a significant opportunity to remedy the public health crisis associated with smoking.
Editor: it’s interesting that e-cigarettes could provide such benefits. Yet, I know there’s been concern about flavorings in e-liquids perhaps attracting non-smokers, especially youth. Can you elaborate on that?
Boobis: Absolutely. The flavorings in e-cigarettes can indeed appeal to young people who might not or else consider smoking.However, it’s important to differentiate the potential impact of these flavorings on different age groups. While they may attract non-smokers, they have not been shown to pose serious health risks—many flavorings are actually safe at the concentrations used, and some are even present in food and conventional cigarettes.
Editor: So, are you suggesting that the fear surrounding flavorings might be somewhat overstated?
boobis: I would argue that. The data we have indicates that the attractiveness of flavors may be a more pressing concern than the potential health risks. We need to gather more precise data to understand their effects better. For example, certain flavorings, like cinnamaldehyde, are safe in food but need careful consideration regarding their effects when inhaled.
Editor: that’s an important distinction. What about the safety of heating these e-liquids? Can you shed some light on that?
Boobis: Certainly. Heating can lead to some degradation of the flavorings, but at the normal temperatures produced by e-cigarettes, this degradation is minimal and comparable to what happens when we cook food with similar flavorings. So, while it’s good to keep an eye on this, current evidence does not show significant side effects linked to it.
Editor: Your insights are critical as we navigate this complex topic. For those who may be concerned about the long-term effects of e-cigarette use,what can you say about the ongoing research in this area?
Boobis: The current research landscape is evolving rapidly. While studies suggest no serious short-term adverse effects from e-cigarettes, long-term effects require more inquiry. It’s essential that we base our regulatory frameworks and public health policies on solid scientific evidence, ensuring we avoid unintended consequences while prioritizing public health.
Editor: A thoughtful and balanced outlook, Professor. Thank you for joining us and sharing your expertise on this vital topic. We look forward to following the developments in this field.
Boobis: Thank you for having me. It’s been a pleasure.