e-Cig Interview | Dr Jacques Le Houezec
Dr Jacques Le Houezec is a Consultant in Public Health, Tobacco dependency & he is a Special Lecturer in the Department of Epidemiology & Public Health at the University of Nottingham.
Vapour Magazine interviewed Dr Le Houezec to ask him about some of the misconceptions surrounding the use of e-cigarettes.
VM: E-cigarettes are promoted as a way to stop tobacco smoking. But would you advocate that people who do that successfully then also try to wean themselves off e-cigarettes?
JLH: E-cigarettes, or personal vaporisers (PV) as I prefer to name them, are first of all a harm-reduction product. Its intended to reduce the harm caused by smoking, motivated by nicotine addiction, to smokers by offering them a much less harmful alternative. For some smokers, even if they had not planned it, it is actually a way to quit smoking. Vaping is a much safer way of taking nicotine, which acts as a stimulant like caffeine, and is enjoyable for smokers. The fact that they find pleasure to use it, reinforced by the pleasure to discover various flavours – much more pleasurable than smoking a cigarette – its a great motivation to quit smoking.
VM: As research indicates, there are varying understandings of e-cigarettes and their uses. Many perceive them to be effective cessation tools and less harmful and addictive than cigarettes. What perceptions of e-cigarettes do you think are of the greatest concern for the public?
JLH: I think most vapers see them as a way to reduce or to stop tobacco smoking.
VM: When people switch to e-cigarettes do they suffer from any withdrawal symptoms?
JLH: No, if they use a nicotine concentration that suits their needs they don’t suffer from withdrawal. This is a key to success if one wants to quit smoking. They also have to use a good quality and effective vaporiser. Some products that are currently available to the consumer are not sufficiently powered to satisfy their needs.
VM: What impact do you feel e-cigarettes have had on public health & what are the health benefits of switching from tobacco smoking to e-cigarettes?
JLH: The impact is still low, but as the use of e-cigarettes spreads at a fast speed, roughly doubling the number of users each year, the impact will soon be detectable on smoking prevalence. Today, we already see tobacco sales declining (-7,6% in France last years on cigarettes, -11% in January 2014 compared to January 2013). The health benefits will also soon be detectable on health costs.
VM: How can we be sure that e-cigarettes are safe?
JLH: E-cigarettes are with no doubt much safer than smoking. We don’t know yet, and it will take decades to see, if some kind of risk is associated with long-term use. There is a need for some standardisation and control in their process, but certainly not the kind of medicinal regulation that is currently planned by the MHRA or the EU. The key of the success of vapourisers has been their innovation. The manufacturers have adapted the products to the needs of the users. In the case of a too strong regulation, and according to the text of the new Tobacco Products Directive voted recently, this innovation will be considerably slowed.
VM: Do e-cigarettes lead to more people becoming addicted to nicotine?
JLH: There is no evidence so far that this is happening. This is not what has been observed in Sweden or Norway with snus (a smoke-free tobacco product, banned in EU except in Sweden), there is to date no indication that it should be different with Personal Vapourisers (PV).
VM: On what basis do you think e-cigarettes can help people quit smoking?
JLH: Because if used correctly, they provide the smoker with the nicotine they need, as well as a new pleasure, which helps them to quit smoking more easily.
VM: How would you respond to critics who say that e-cigarettes should be banned?
JLH: It would be a disaster for Public health. This is a revolution, and Personal Vapourisers (PV) could eradicate smoking and its burdening costs and diseases in only a few decades if we offer it a place in the society. It is time to stop the quit or die status quo.
VM: Is nicotine dangerous & does it cause cancer?
JLH: Nicotine is not dangerous at the doses a smoker or a vaper use it. Nicotine does not cause cancer, and is not responsible of all the diseases due to tobacco smoking.
VM: Can you overdose on nicotine by using e-cigarettes?
JLH: No. Smokers know exactly the dose of nicotine they need, and they titrate it. They can control very precisely the dose of nicotine they absorb on a puff by puff basis. If they smoke too much, the first symptom is nausea, and they just stop taking it, and eventually it goes. Vapers do the same with their Personal Vaping (PV).
VM: Are there any side effects by using e-cigarettes?
JLH: A few, particularly at the beginning when they learn to use the product. The way to use a Personal Vapourisers (PV) is different from smoking. Vapers need to take slower, longer, and deeper puffs, and if they don’t they usually cough, it takes just a couple of days to adjust. The main long-term side effect is dehydration due to the propylene glycol (it is an humectant used for example in tobacco, to retain humidity). So, a vaper must drink more often (water of course) in order to avoid this problem.
VM: What about inhaling second hand vapour from using e-cigarettes, are there any dangers?
JLH: There is no evidence so far. First, the vapour disappears very fast in the air when exhaled by vapers (much faster than tobacco smoke), and there is no side-stream vapour (when a lit cigarette burns in the ashtray), there is only exhaled vapour from users. The vapour contains mostly vapour of PG/VG, nicotine, and some contaminants, similar to those from smoking, but at a very low dose, probably too low to cause any danger for bystanders.
VM: Do the contents of e-liquids contain any disease causing agents?
JLH: There are some traces of contaminants that comes with the nicotine (extracted from tobacco, like the one used for nicotine replacement therapy or NRT, usually a pharmaceutical grade nicotine is used), but at concentrations similar to what is found in NRT, so unlikely to cause substantial risk.
VM: What are the different health effects between burning nicotine & vapourising nicotine?
JLH: The combustion of any plant, not only tobacco, produces tar, carbon monoxide (due to incomplete combustion), and oxidant gases. Vapourising nicotine is not a combustion, and does not produce these dangerous substances. It is these products that cause tobacco smoking diseases, not nicotine.
VM: When people quit smoking they tend to put on weight, is this the case when people start using e-cigarettes?
JLH: I am not aware of any data on this, but as it is the case with NRT, using nicotine should reduce or abolish the weight gain seen in smokers stopping smoking.
VM: If a person is trying to stop smoking and thinking about e-cigarettes, what’s your advice?
JLH: Go for it ! It is by far the best way of stopping smoking I have witnessed around me. It is amazing to hear those smokers who did not intend to quit smoking and who just did it without noticing.
Source: Vapour Magazine UK