It is the tar and other toxins in tobacco smoke, rather than nicotine, that are responsible for most of the harm associated with smoking…BMA December 2017
It’s Lukewarm Support But Any Support is Good Support Right?
The British Medical Association is the latest lofty and influential group to recognize e-cigarettes as the most effective way to help smokers quit.
I say recognize – this is not a spectacular U-turn on their part – it’s fair to say the BMA has hardly been the champion of e-cigarettes choosing a more cautious approach to their value particularly as a smoking cessation tool – but it’s a yet another nail in the coffin of the anti vape brigade.
Indeed their latest paper laying out their position on e-cigs is certainly supportive but hardly what you might call glowing.
It’s more of a nod to what they see as the ‘effectiveness’ of e-cigarettes and general advice to doctors.
But hey as the dam of anti vaping fervour seems to be breaking the more of these powerful groups that come aboard the better.
Who Exactly ARE the BMA?
In a nutshell the BMA is the trades union of all British doctors and GPs and currently has around 156,000 members [about 70% of all doctors in the UK] and 19,000 medical students – fully qualified members pay over £450 per year in membership fees.
They also play a pivotal role in how doctors perform and say they can ‘… influence the advancement of health and the profession’ and offer various charitable and research grants.
To that end the main thrust of this new paper is aimed at advice for doctors – particularly GPs – on how best to discuss e-cigarettes and vaping with their patients.
However they do tackle the tricky subjects of e-liquid flavourings – so called passive vaping and of course the kids and e-cigs angle.
What the BMA Has to Say About Vaping
On e-liquid flavourings the BMA says:
…given the large numbers of people using flavoured e-liquids without reporting problems, it is unlikely they are having a significant acute impact on the health of users.
Let’s hope advocacy groups around the world – particularly the USA – take note of that!
On the old chestnut that vaping is a ‘gateway to smoking for young people’ the BMA says:
The WHO (World Health Organization) have also highlighted concern that the use of e-cigarettes among children and young people may promote tobacco use. 37 To date, however, evidence indicates that this is not occurring to any significant extent in the UK.
I respectfully suggest governments around the world let this sink in because study after study that I read suggest this is true across the globe – so your arguments are void!
The BMA on vaping whilst pregnant:
…if a pregnant woman chooses to use an e-cigarette to stay smoke free, she should not be discouraged from doing so.
Can’t argue with that and you can read our full article on vaping whilst pregnant HERE.
Sadly the BMA’s stance on vaping in public places is where they let themselves down somewhat – at least in my humble opinion.
In the past they had a hard-line on this subject and whilst their opinion has shifted slightly – they are still NOT 100% behind the idea that there’s no risk to ‘bystanders’ from e-cig vapour – so called ‘passive vaping’.
And this DESPITE agreeing that all the research shows passive vaping is a myth – though to be fair they do acknowledge the findings saying:
Current evidence indicates that exposure to e-cigarette vapour does not pose specific health risks – unlike exposure to second hand smoke – and that their widespread use in public places has not had unintended consequences on re-normalising smoking or on compliance with smoke-free laws.
It would therefore be reasonable to support a softer regulatory approach than exists for smoking in public. While such an approach would not restrict e-cigarette use in public places outright, it would also recognize that there are a wide range of public places (for example on public transport or in schools and nurseries) in which it would be entirely legitimate for their use to be restricted.
Ummm the BMA might need a few doctors getting the splinters out of their bums given the fence sitting on this extremely important issue.
BTW I’ll have an article soon about a campaign for vaping to be accepted in public spaces – so stay tuned!
BMA’s Advice to Doctors on Vaping
I’ve never actually spoken to a doctor about quitting smoking since I packed up the fags – indeed I don’t think I’ve ever mentioned vaping with my doctor.
I think I got a packet of free patches 6 or 7 years ago but to be honest I reckon most of us who’ve successfully quit by vaping cut the middle man out and just bought a starter kit.
However as e-cigarettes are now firmly in the mainstream and even sold in chemist shops – I guess the GPs in particular needed some kind of guidance on their potential.
The BMA says:
We’ve tried to answer some common questions about these devices, to support doctors when discussing their use with patients. It is not intended to be prescriptive, or to provide clinical advice, but to provide guidance highlighting some of the key factors to consider.
OK so here’s a selection of key points given to doctors by the BMA – I’ll give you a link at the end to see all of them and to download the full paper:
- While the safest option is to use neither tobacco nor e-cigarettes, there is no situation in which it is safer to continue smoking than to use an e-cigarette.
- E-cigarettes are now the most popular aid used in attempts to quit smoking. Many individuals who have attempted and failed to quit smoking using other methods have reported finding e-cigarettes useful in quitting or cutting down.
- The evidence-base in this area remains weak, though most studies demonstrate a positive relationship between the use of e-cigarettes and smoking cessation.
- Combining e-cigarettes with behavioural support is likely to increase the chance of successfully quitting tobacco use.
- In the absence of long-term studies it is not possible to be certain about the long-term health risks, but there is growing consensus that use of e-cigarettes is significantly safer than smoking.
- Unlike cigarette smoking, e-cigarette use does not expose users to the products of combustion, and most of the toxicants causing smoking-related disease are absent or significantly reduced in e-cigarette vapour.
- Indications to date are that complete switching can lead to improvements in the levels of toxins and carcinogens in urine similar to that in smokers who switch completely to NRT (nicotine replacement therapies)
All valid points except perhaps that last one.
I’m not sure where that evidence comes from but as you can see from my article Nicotine Patches and Gums Don’t Work – I’m no scientist but I suggest vaping is not only pumping less toxins into your body but doing it far more effectively than over the counter NRTs – but that’s just me 😉
Final Thoughts on the BMA E-Cig Paper
The title of the paper is E-cigarettes: Balancing risks and opportunities – for me they’ve missed a word out – as in “missed” opportunities!
Whilst any support of e-cigs has to be welcomed the BMA has indeed missed a golden opportunity to fully support vaping as a potential life saver – especially on the subject of passive vaping or as they put it ‘harm to bystanders‘.
Let’s get this straight – there is NO harm to bystanders from vaping!
The BMA has once again ducked and dodged this important issue by calling for a vape ban in some public spaces but not others – like I said a missed opportunity and a confusing one to say the least!
It’s fair to say GPs in particular now have some kind of guidance on how to deal with e-cigarettes – but I read the whole thing through three times and came away with the feeling the BMA was hedging its bets or at least taking only tentative steps towards total support.
A feeling voiced by the New Nicotine Alliance who told me the report was:
Better late than never. At last some considered but cautious support for e-cigarettes from the BMA, the doctors’ trade union. We’ve seen negative statements on e-cigarettes from BMA spokespeople. But this position paper can now leave the UK’s GPs in no doubt about the advice they should give to patients – that e-cigarettes are the safer alternative to smoking.
Better late than never indeed – I just wish they’d been a little more forceful in their support especially on the subject of vaping in public.
So as Christmas presents from the BMA to the vaping world go – this paper is more of a £5 book token from your Great Aunt than a shiny new bicycle – but hey it’s the thought that counts…right?
You can download the full paper HERE