e-cigarette impact on Public Health

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e-cigarette impact on Public Health Jacques Le Houezec Consultant in Public Health and Tobacco Dependence Amzer Glas, Rennes & Special lecturer, UK Centre for Tobacco Control Studies, University of Nottingham, England Manager, www.treatobacco.net jacques.lehouezec@amzer-glas.com http://jlhamzer.over-blog.com/ Milano - 11/06/14 1

Disclosure Consultant for public sector : EC SCENIHR, INSERM (France), Ministry of Health, writer of a Newsletter for smoking cessation specialists (SFT) Consulting for pharmaceutical industry : J&J, Pfizer, Novartis, Pierre Fabre Consulting for tobacco industry : never Consulting for e-cigarette industry : never http://jlhamzer.over-blog.com/ Milano - 11/06/14 2

e-cigarettes a consumer led revolution For the 1 st time in tobacco control, smokers talk to each other... Monthly users on the vapers' French forum (61 000 members) http://jlhamzer.over-blog.com/ Milano - 11/06/14 3

Tobacco sales are decreasing in France In France (OFDT data), cigarette sales - 4.6% in 04 2014/04 2013, - 7.8% for Jan-Apr 2014 roll-your-own tobacco, - 8.2% in 04/14 (-7.7% for Jan-Apr) cessation treatments, -23.2% in 04/14 (-30.2% for Jan-Apr, patches most affected (-57.8%). http://jlhamzer.over-blog.com/ Milano - 11/06/14 4

Tobacco sales are decreasing in Italy http://jlhamzer.over-blog.com/ Milano - 11/06/14 5

Experimentation rates, recent use and daily use of e-cigarette in France. ETINCEL-OFDT (telephone survey) realised 12 to 18 November 2013 on 2,052 individuals representative of French population (15 to 75 years). 18% [16,7-20,1] have used at least once an e-cigarette, 2.5 folds more than in March 2012. Over 3% of daily use: 54% of recent e-cigarette users use it daily, representing 3.3% [2.5-4.1] of French people. 1.3% use exclusively e-cigarettes, and have quit smoking, 500,000 new quitters. http://jlhamzer.over-blog.com/ Milano - 11/06/14 6

Prevalence of e-cigarette use in England An estimated 2.1 million adults in Great Britain currently use e-cigarettes. About 1/3 of users are ex-smokers (700,000) and 2/3 are current smokers. Prevalence of e-cigarette use has plateaued at 16% of current and recent smokers N=11,318 adults who smoke or who stopped in the past year; increase p<0.001 http://jlhamzer.over-blog.com/ Milano - 11/06/14 7

Aids used in most recent quit attempt Increase in use of e-cigarettes for quitting has been accompanied by a smaller reduction in use of other aids except behavioural support N=4,810 adults who smoke and tried to stop or who stopped in the past year http://jlhamzer.over-blog.com/ Milano - 11/06/14 8

e-cig use in former and never smokers http://jlhamzer.over-blog.com/ Milano - 11/06/14 9

e-cigarettes use in children in Britain http://jlhamzer.over-blog.com/ Milano - 11/06/14 10

e-cigarettes use in children in France http://jlhamzer.over-blog.com/ Milano - 11/06/14 11

Cigarette smoking prevalence in England Prevalence is declining faster than in previous years since 2008 Base: All adults Graph shows prevalence estimate and upper and lower 95% confidence intervals http://jlhamzer.over-blog.com/ Milano - 11/06/14 12

Cigarette smoking prevalence in Italy http://jlhamzer.over-blog.com/ Milano - 11/06/14 13

e-cigarettes impact on Public Health Electronic cigarettes Tobacco cigarettes How harmful are e-cigarettes? ( 99%?) Cigarettes kill half of their users! What about secondhand vapour? (no known risk so far) Will they lead to smoking cessation? (some data showing it is the case) Will they undermine tobacco control efforts? (data show decrease in cigarettes sales and prevalence when e- cig use increase) Secondhand smoke kills too! Prevalence of smoking is plateauing in many countries Tobacco control efforts should be sustained http://jlhamzer.over-blog.com/ Milano - 11/06/14 14

Recent conclusions by ASH London According to Action on Smoking and Health (London) Electronic cigarettes are not cigarettes. They contain no tobacco and using them is not smoking. e-cigarettes are more attractive to smokers than NRT while providing them with a safer alternative to cigarettes. There is evidence that they can be effective in helping smokers quit, and little evidence that they are being used by never smokers. The number of children and young people regularly using electronic cigarettes remains very low and their use is almost entirely amongst those who are current or ex-smokers. This is a similar pattern to that found in jurisdictions such as the USA. In the absence of evidence of significant harm to bystanders, ASH does not support the inclusion of electronic cigarettes in smokefree laws which would completely prohibit their use in enclosed public places. http://jlhamzer.over-blog.com/ Milano - 11/06/14 15

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