In March, the BMA issued an opinion piece on e-cigarettes. This is probably intended as guidance for doctors.
E-cigarettes in public places and work places - The British Medical Association
What is becoming increasingly obvious is how incompetent the department responsible for these proclamations is: following the invented statistics regarding the strength of cigarette smoke in cars, and the lies regarding the effectiveness of simply opening the windows, they have now issued an opinion that will directly result in loss of life if followed. It is hard not to rename the BMA Board of Science as the Board of Incompetent Fools and Liars.
The 'E-cigarettes in public places and work places' shortform intro states:
"Although they have been promoted as cigarette substitutes" and later "...not to recommend the use of e-cigarettes as aids to smoking cessation" are contradictory statements. E-cigarettes - rightly - are indeed 'cigarette substitutes'. This is called Harm Reduction. Harm Reduction has nothing to do with cessation.Electronic cigarettes (e-cigarettes) are battery-powered products that often look like real cigarettes. Although they have been promoted as cigarette substitutes, they are not properly regulated and there has been little research into whether they are safe or effective as aids to stop smoking.
This joint briefing from the BMA Occupational Medicine Committee and the BMA Board of Science looks at the available evidence on e-cigarettes and their use in public places and work places.
It advises doctors not to recommend the use of e-cigarettes as aids to smoking cessation or as a lower risk option than continuing to smoke.
"[We] advise doctors not to recommend the use of e-cigarettes ..... as a lower risk option than continuing to smoke." To not do so contradicts expert medical opinion at this time, since the experts are not fools. Even the MHRA is not stupid enough to go up against expert medical opinion here, and now allows the statement, "E-Cigarettes are less harmful than smoking", since that is what the experts say. The BMA therefore contradicts expert medical opinion and the MHRA.
".....they are not properly regulated....." - another clanger. They are regulated enough that there are no toxins or contaminants, and this would satisfy most consumers as to their safety. If the BMA is saying more regulation is needed, such as dosage for example, it will be interesting to see how they want to see this introduced for other consumer products of the same class such as sherry, pipe tobacco, coffee and so on.
".....there has been little research into whether they are safe or effective as aids to stop smoking." Not surprising really, as e-cigarettes are not intended, designed, made or sold for quitting - they are a replacement that is acknowledged as being safer and phenomenally popular.
The summary says:
"E-cigarettes are not regulated as a tobacco product or as a medicine in the UK and there is no peer-reviewed evidence that they are a safe and effective nicotine replacement therapy"Summary
• E-cigarettes are not regulated as a tobacco product or as a medicine in the UK and there is no peer-
reviewed evidence that they are a safe and effective nicotine replacement therapy
• The use of e-cigarettes may undermine smoking prevention and cessation by reinforcing the
normalcy of cigarette use in public and workplaces
• Health professionals should not recommend the use of e-cigarettes as smoking cessation aid or a
lower risk option than continuing to smoke due to a lack of evidence of their safety and efficacy
One cannot argue with this, as both statements are entirely true. They are also completely irrelevant. E-cigarettes are not an NRT. This is rather lucky as well, since NRTs have about a 98% failure rate. If the BMA is saying that the Trading Standards authorities are not doing their job, and are not inspecting and analysing ecig refills for toxins and contaminants, then say so.
If a government regulation and inspection agency is not doing their job - just say so, and stop all this childish innuendo. If, on the other hand, this BMA department is unaware that there is a government agency that regulates, inspects, tests, analyses, and passes or prohibits specific consumer products (and which pays special attention to ecig products due to the noise) - then perhaps they should get out of the proclamation business until they know their job.
"The use of e-cigarettes may undermine smoking prevention and cessation by reinforcing the normalcy of cigarette use in public and workplaces"
It is not clear how not smoking reinforces smoking. If electronic cigarettes do not have a significant effect on health, as is likely, then promoting their use is hardly detrimental to public health.
"Health professionals should not recommend the use of e-cigarettes as smoking cessation aid or a lower risk option than continuing to smoke due to a lack of evidence of their safety and efficacy"
True, e-cigarettes should not be recommended as a quit-smoking aid, since they are a permanent replacement. However they can be recommended as a lower risk option because that is what all the experts say, and because we know exactly what is in them.
Quotes from the experts
Unless some new and hitherto unknown disease vector is discovered, there is no known potential for harm in the materials. As far as evidence as to their safety goes, we could have 200 clinical trials over 30 years showing beyond doubt that their use is safe, but the financially conflicted will still find ways to deny the evidence exists (as is the case with Snus). As for efficacy, if effectiveness as a replacement for smoking is being discussed, it might help to consider the many millions worldwide who use them successfully and no longer smoke cigarettes; and the growth of ~50% per year in their use. One might consider them phenomenally successful for something that has 'questionable efficacy' as a smoking replacement.
If we are instead talking about efficacy for quitting, then indeed nobody knows - or cares.
Another fine proclamation by the BMA Board of Incompetent Fools and Liars. And yes, take me to court for libel on that one: not much chance of succeeding when this Board published ridiculous made-up statistics such as the famous "Cigarette smoke in cars is 23 times stronger than.....", which had to be rapidly retracted when it was found to have been made up by a Sunday Sport journalist on April Fool's Day, or similar; and the patently wrong "Doctors should not recommend e-cigarettes as a lower-risk option than continuing to smoke", when all the professors of medicine who have researched ecigs, the world's most renowned epidemiologists and experts in this field, several doctors' groups, and even the MHRA are saying exactly the opposite: e-cigarettes are a safer option than smoking.
It is difficult to decide whether these people are as stupid as they appear, or if there is some kind of financial motive. If doctors are getting advice from the financially conflicted here, it might be worth looking at the oath they take. A doctor who prescribes pharmaceutical interventions for smoking cessation may be assigning several times the risk to the patient compared to informally advising them to research e-cigarettes. Around a 95% failure rate with pharmacotherapy, versus an anecdotal 20% failure rate with e-cigarettes in a fully-mentored environment.
A risk of death for all the failed patients returning to smoking (which is almost all pharma-assisted patients) of somewhere probably around 33%. A very low risk of death for e-cigarette users, unless chocolate flavour is going to kill vapers by the thousand.
Probably, the most charitable statement that can be made about these doddering old fogeys is that they must take two or three decades to catch up with the facts. Hopefully, not too many doctors will take any notice of the misinformation the BMA publish. It is difficult to decide whether the sort of materials they have published here can be dismissed simply as institutionalised stupidity, or lies promoted by the financially-conflicted.
This BMA department is acting suspiciously like pharma shills - and pharma's agenda is to protect the status quo at all costs. The last thing pharma wants is less smokers, and especially significantly less smokers. The Swedish scenario is pharma's worst nightmare: 40% less smokers and therefore vastly less sick smokers needing the hugely profitable chemotherapy drugs, COPD drugs and cardiac drugs that make up so much of pharma's income. Sweden is pharma's worst nightmare and they will do anything to stop that situation spreading elsewhere.
Pharma needs smokers; and the more of them, and the sicker they are, the better for pharma (and their good friends and beneficiaries).
It's nice to see a doctor's association working so hard to keep sickness levels up. Perhaps we should ask why?