Thursday, March 27, 2014

Smoking Cessation Expert to Health Canada: Stop Killing Smokers



Health Canada has blocked sales of nicotine-containing e-cigarette sales, even though the devices are readily available in the U.S.  I previously commented on the agency’s unfounded opposition to tobacco harm reduction (here). 

This week, Dr. Gaston Ostiguy, medical director at the Montreal Chest Institute’s Smoking Cessation Clinic, told Health Canada, “It’s time to authorize the sale of electronic cigarettes.”  His stern admonition, published as an open letter in the Montreal Gazette (here), was co-authored by tobacco research and policy experts from Canada, Switzerland, Italy and the United Kingdom.

Dr. Ostiguy objected to the general obsession with tobacco prohibition: “Unfortunately, it is wishful thinking that one day we will completely eradicate nicotine use.”  He referenced a report that I have often cited in my lectures and blog posts: “In a landmark report published in 2007, the Royal College of Physicians makes a compelling case why harm reduction should no longer be ignored by health authorities to lower the death and disease caused by tobacco use.”

Dr. Ostiguy summarized the Royal College’s findings:  

·       Conventional prevention and cessation “will be ineffective for the millions of smokers who, despite best efforts to persuade and help them to quit, will carry on smoking.

·       “Tobacco-control policy needs to be radically extended to address the needs of these smokers with implementation of effective harm reduction strategies.
·       “Harm reduction in smoking can be achieved by providing smokers with safer sources of nicotine that are acceptable, and effective cigarette substitutes.
·       “There is a moral and ethical duty to provide these products to addicted smokers.”

The bottom line:

·       “Electronic cigarettes are such a substitute.”

Dr. Ostiguy noted e-cigarettes’ significant harm reduction benefits and their potential, but unproven, risks.  He called on Health Canada to establish appropriate regulation “so that good manufacturing practices are followed to protect consumers and that sales to minors are forbidden. However, any excessive regulations that could make it too difficult to communicate about the reduced risks of these products or to access them should be avoided.”

That is a message for FDA regulators, as well.

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