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8 November, 2019 00:00 00 AM
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Vaping: Alarmism isn’t wise, evidence- based approach is

It is important for Bangladesh to understand the issue clearly for implementing the prime minister’s stated goal of making Bangladesh tobacco free by 2040
Dr. Rajib Hossain Joarder
Vaping: Alarmism isn’t wise, evidence- based approach is

Prime Minister Sheikh Hasina’s vision of making Bangladesh a tobacco-free country by 2040 is not only an extremely important task at hand, but it is absolutely essential to make tobacco related health risks a priority area. Currently, the tobacco related health situation in Bangladesh is “alarming” according to the World Health Organization.

A disturbing 35% of the adult population are currently using tobacco either in smoked and/or in smokeless form. Furthermore, 43% and 39% of adults are exposed to secondhand smoke at their workplaces and in their homes, respectively. Seven per cent of youth aged 13 to 15 years use tobacco.

Tobacco control alone in the conventional way might prove just not powerful enough to achieve desired results. And that is why established practices of harm reduction must be considered. Vaping or e-cigarette happens to be a method that has been demonstrably effective as a quitting tool.

It is therefore, not only reactionary, but also dangerous to fall prey to the latest health scare regarding vaping. And it would be tremendously callous to simply not look at the evidence for the effectiveness of vaping as a cessation aid.

As the latest news on vape related illnesses in the US causes concerns the world over, Bangladesh needs to take special notice of what is going on in the UK, where no such outbreak took place and the British government’s health organisations continue to support the use of vaping as a safer alternative to traditional tobacco smoke.

It is important for Bangladesh to understand the issue clearly if it is really serious to implement the prime minister’s stated goal of making Bangladesh tobacco-free by 2040.

The reason the UK hasn’t had any serious vape related illnesses is simply because the use of vape is properly regulated and it is adopted by the government's public health agencies as a cessation tool for cigarette smoking. At the same time the real culprit behind the outbreak isn’t vaping, but illicit products used by the victims, as FDA now points out.

The Food and Drug Administration (FDA), the US agency responsible for protecting and promoting public health found that “...most of the patients impacted by these illnesses reported using THC-containing products, suggesting THC vaping products play a role in the outbreak.”

Despite the health scare the recent outbreak has caused, FDA is actually quite clear on the matter.  Its latest recommendations for the public include avoiding products containing THC, not buying any vaping product off the street or from other illicit or social sources, and to not modify or add any substances, such as THC or other oils, to vaping products.

FDA also explicitly urges the public to not quit vaping in order to go back to cigarette smoking. “If you are an adult who uses e-cigarettes instead of cigarette smoking, do not return to smoking cigarettes,” information released on FDA website earlier this month says.

As it becomes obvious that the vape-panic is a result of misinformation, Bangladesh needs to act diligently on the matter instead of jumping to conclusions.  There is no reason why Bangladesh shouldn’t follow the UK’s example, which has officially adopted use of e-cigarette or vaping as a quit-smoking tool.

Public Health of England in, what it calls a “landmark review,” found that e-cigarettes are around 95% less harmful than combustible cigarettes. As a result of this finding the widely respected NHS (National Health Service) now recommends e-cigarette to help quit smoking. Vape products are now also sold in shops in British hospitals.

“Many thousands of people in the UK have already stopped smoking with the help of an e-cigarette. There's growing evidence that they can be effective,” says  NHS.

With over 21.9 million cigarette smokers, Bangladeshi policymakers need to seriously consider adopting cessation and harm reduction programs like the UK has done. Evidence shows that vape is an effective quitting aid. In the year up to April 2015, 2 out of 3 people who used e-cigarettes in combination with the NHS’s ‘stop smoking service’ quit smoking successfully.

The e-cigarette is not meant to fulfill a luxury. Respected organisations like the UK’s NHS do not recommend vaping to help people with being ‘cool.’  The policymakers in Bangladesh must take into account the widely recognized role of vaping. It is not for underage individuals, and it is not to be recommended to people who do not smoke.

It is meant as a harm reduction tool, so that people can use vaping as an aid to quit the significantly more harmful cigarette smoking. The recent move toward a ban shows that lawmakers are not considering crucial facts. Vaping has already been tried and tested as a cigarette quitting aid and it achieved tremendous results. It continues to be recommended by experts as quitting aid, with a recent study finding that e-cigarette may help 70 thousand smokers quit each year.

A major UK clinical trial published in 2019 found that, when combined with expert face-to-face support, people who used e-cigarettes to quit smoking were twice as likely to succeed as people who used other nicotine replacement products, such as patches or gum, NHS informs the British public in its website.

Without a clear strategic path -- similar to that of the UK -- reducing cigarette smoking will not be easy or even possible for Bangladesh. And it makes all the more sense to adopt the UK model given that Bangladesh has traditionally followed the standards of the UK in medical practices, including gaining specialisation degrees for doctors from UK accredited organisations.

If, like the UK, 2 out of 3 cigarette smokers in Bangladesh can quit through the use of vape, which is 95% less harmful according to Public Health England, then it makes no sense to ban vape products based on misinformation and simply on a whim.

The writer is Assistant  Registrar, Dept. of Surgery, Dhaka Medical

College Hospital

 

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Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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