Reading it is like taking a step back in time, or being in Australia.
The authors of the SCHEER report appear to be biased against e-cigarettes and harm reduction. The report reheats several arguments, such as the ‘gateway effect’ and the ‘renormalisation’ hypothesis, which are now a decade old and have been contradicted by real world evidence. While it downplays strong evidence showing that e-cigarettes have been a gateway from smoking for millions of people, it amplifies speculation about hypothetical risks. When the authors are unable to find adequate evidence for anti-vaping claims, they quote from organisations which share the same prejudice. Much of the evidence is treated selectively and some of the conclusions made about the strength of evidence are baffling.
This is a worry for consumers because the SCHEER report is designed to alert the European Commission to the ‘potential need for legislative amendments’ to the Tobacco Products Directive.
It wanted to regulate e-cigarettes as medical devices in the last Tobacco Products Directive, which came into force in 2016. Its plans were derailed by the European Parliament, but it may soon try again. The European Commission seems particularly interested in banning flavours in e-cigarette products, a policy copied from American prohibitionists which would make vaping much less appealing to smokers who are thinking of switching to a product that could save their lives.
In reality, the SCHEER report does not compel the Commission to do anything. The only evidence for health risks which the SCHEER report rates as ‘strong’ in the final opinion relates to poisoning and injuries due to burns and explosions. These hazards have already been dealt with in the existing Tobacco Products Directive and do not require further legislation.
However, while the report does not explicitly call for any new laws, it gives the European Commission ammunition if it wishes to table some. As the evidence that e-cigarettes are relatively harmless and effective smoking cessation devices continues to grow, the SCHEER report will be used as a crutch for those who continue to lobby against them.
The tobacco industry has continuously attempted to subvert these life-saving public health measures. Over the last decade, the tobacco industry has promoted e-cigarettes as cessation aids under the guises of contributing to global tobacco control. Meanwhile, they have employed strategic marketing tactics to hook children on this same portfolio of products, making them available in over 15,000 attractive flavours.
The scientific evidence on e-cigarettes as cessation aids is inconclusive and there is a lack of clarity as to whether these products have any role to play in smoking cessation. Switching from conventional tobacco products to e-cigarettes is not quitting.
"We must be guided by science and evidence, not the marketing campaigns of the tobacco industry – the same industry that has engaged in decades of lies and deceit to sell products that have killed hundreds of millions of people”, said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “E-cigarettes generate toxic chemicals, which have been linked to harmful health effects such as cardiovascular disease & lung disorders."
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