Vaping experts have slammed the Hong Kong Government for turning a deaf ear to the potential to improve health outcomes. A European doctor-researcher believes vaping can help many to reduce the harm of using cigarettes and even quit.
Consumers and business owners alike have been consistent in their calls urging the Hong Kong Government to adopt a more open attitude towards vaping products, also known as e-cigarettes. Last week, a European doctor and scientist, Professor Riccardo Polosa, arrived in Hong Kong making the argument that is can be a boon to public health and even reduce smoking rates.
Professor Riccardo Polosa is a doctor turned scientist supporting the liberalisation of vaping products in order to lower the incidence of smoking and help people quit. He is the former president of the Italian Anti Smoking League (from 2003 to 2008) and founded the University of Catania’s Centre for Tobacco Research in 2003, making him an active member contributor to the European debate on vaping regulatory issues.
In his recent visit to Hong Kong, the smoking cessation expert stressed that vaping, given proper monitoring and regulation, can be a “gateway away from the harmful effects of smoking”, citing a widely endorsed report by Public Health England which concluded that e-cigarette is 95% less harmful than combustible cigarettes in terms of harmful constituents produced.
“By definition, smokers are already polluting themselves with more than 7,000 chemicals. What causes disease… is a synergistic action of these many thousands of chemicals. If you look at the component…of what is emitted by electronic cigarettes, it’s not thousands of chemicals, but a few, 95% less chemicals,” Professor Polosa explained.
Commenting on the Hong Kong Government’s cool, if not dismissive, response towards market liberalisation of vaping products, the professor criticised it for being “brainwashed by ideological information.” “It seems to me that [the] Hong Kong [Government]…is trying to mimic what’s happening in Singapore..to follow steps without any scientific reason,” he said, calling it “nonsensical” and “irresponsible” for the Hong Kong Government, or any government, to deprive smokers of a lower risk alternative which can generate a “public health revolution.”
For Professor Polosa, what matters at the end of the day is the smoking prevalence. He draws upon findings of studies conducted by his team in the past three years over switching from smoking to vaping and its impact on tobacco-related diseases (here, here and here). “All people exclusively adopting the vaping lifestyle are improving all objective and subjective outcomes for all diseases under examination. So it’s a great public health gain that we are going to see if we embrace electronic cigarettes,” the professor said. “I would like to caution the Hong Kong Government to follow more beneficial examples, say in England, where e-cigarette [usage] has been very popular for the past five years and they have seen the largest decrease in smoking prevalence.”
“I understand [Hong Kong] has a flat rate for smoking for the last seven or eight years, so it is time for a change…We see in other countries where [vaping] had been liberalised, there were big changes in smoking prevalence and I don’t see why this is not going to happen in Hong Kong too,” the professor added.
Crusade for health
As such data is not yet available in Hong Kong, Professor Polosa urged the Hong Kong Government to build up its own smoking prevalence data, monitor it and formulate vaping policies accordingly. In his short trip to Hong Kong, he met with lawmakers Joseph Lee Kok-long (李國麟), representative of the Health Services functional constituency, and Aron Kwok Wai-keung (郭偉强) for the Labour constituency and offered his expertise in designing a monitoring system and designing experimental protocol.
Speaking to HT, Lee was open to Professor Polosa’s ideas. “I think this is a good perspective that would allow Hong Kong smokers to have a better informed choice,” Lee says. “Right now there is no regulation over e-cigarettes in Hong Kong, so the Government should look into the regulatory lines drawn by other countries that have already legalised the product.”
The Federation of Trade Union lawmaker and social worker, meanwhile, is less open. “Whether examples in other places can be applied to Hong Kong remains unclear. It can be due to cultural difference, or difference in the perspectives over what e-cigarette can deliver. Indeed, the Baptist University of Hong Kong was commissioned to conduct a research and found that, used improperly, there are harmful chemicals in e-cigarette that can lead to cancer. If you can’t prove that the substances in e-cigarette are 100% safe, it is hard for us to be convinced that there are other, positive functions of the product,” Kwok says. “That being said, I have always urged the Government to provide more scientific evidence to support their proposition. Given current findings, I am leaning towards stricter regulations [on e-cigarette], but it is still too early to conclude whether we should ban it completely. The Government should strive to provide a regulatory framework first, but if it insists that they don’t have the resources to provide such a supplement, banning the product may be the only way to go.”
As a general response, Professor Polosa slammed the papers generally embraced by the Hong Kong Government for not reflecting normal use, while noting a general misunderstanding in the general public towards nicotine.
“You stress the product so that it produces a much higher level of toxicants. This does not appear under regular use,” he said. “The dosage of nicotine normally absorbed by smokers is just a transmitter, or a psycho-stimulant. Nicotine doesn’t cause cancer. Nicotine doesn’t cause lung disease. Nicotine doesn’t cause serious cardiovascular problem. What causes these problems is the [chemicals arising from] combustion. So you need to quit combustion, not to quit tobacco nicotine.”
“E-cigarette should not be categorised as a drug, and in principle not as a tobacco product. In essence, it is currently included as a separate chapter under the tobacco category in Europe. Hong Kong may want to follow [Europe],” he says, suggesting an increase in tobacco tax in addition to other regulatory initiatives.
The ‘kids’ card
The two lawmakers also express concerns over teenagers picking up smoking habits if vaping is made available to them. In response, Professor Polosa drew upon a recent study by the Centers for Disease Control and Prevention (CDC), a leading national public health institute of the United States, which found that e-cigarette use among middle and high school students in the US is skyrocketing.
“Data in CDC shows clearly that even though there is a high adoption rate in experimentation of e-cigarette, smoking prevalence in the same age group is going down for the first time in ten years,” he said, “In fact, the CDC lied as it released the two sets of data months apart, making people think that the two are unconnected.” In other words, teenagers may be smoking less because they are vaping instead.
“It’s never been shown that this is going to cause an increase in smoking prevalence…30-50% of kids have a risk-seeking profile. That’s normal. But the large picture is not the few kids that are trying e-cigarettes, the large picture is billion of smokers that need a safer alternative,” the professor added. “I find it very irritating to use kids for their campaigns.”
Train the shoppers!
Back in his country, Professor Polosa has launched a collaborative project to provide training for vape shop owners and salespersons on smoking cessation counselling.
“I prefer to have professionals in vape shops. Probably in the future we need to regulate vape shop owners and salespersons in the way we regulate pharmacists. They should have a minimal training, because after all they are helping people to quit smoking,” he says. “I don’t see anyone in Hong Kong who is in charge of smoking cessation.” There is much to be done Expect the professor to be in Hong Kong more often as part of his lifelong mission to help people quit smoking.