In a letter addressed to WHO director general Margaret Chan, 129 health experts have warned the organisation and other public health authorities to be vigilant against tactics made by tobacco companies to promote e-cigarettes as a safer alternative to tobacco. According to them, these battery-operated devices that are designed to look and feel like regular cigarettes contain cartridges filled with a liquid that contains nicotine, as well as other chemicals that may be cancer-causing, and thus have the same addictive potential as a real cigarette.
The letter is a response to one from 53 scientists to Chan, sent on June 3, which said in no less direct language that treating e-cigarettes like tobacco would deprive smokers of a new and increasingly popular way to quit. While it is hard for a non-expert to know who to believe when the rhetoric is flying in both directions from very eminent people who all have a passionate commitment to public health, the timing of the debate is significant. In October, the WHO will meet to discuss whether to bring e-cigarettes into the framework convention on tobacco control, one of its proudest achievements.
The latest missive appears to swing the pendulum firmly back to the position of the opponents of a free market in e-cigarettes. It is signed by those who fear, based on decades of evidence of bad behaviour, that the tobacco companies are getting involved in the nicotine delivery devices in order to undermine bans on cigarette advertising and smoking in public places. A review of 84 e-cigarette studies published on a peer-reviewed journal of the American Heart Association seems to support this view. According to it, the chaotic marketplace of e-cigarettes is filled with unsubstantiated claims and quality control issues with the products themselves. This may not itself be decisive. But until we know, we should opt to be safe rather than sorry.