On Thursday, July 7, the first meeting of the working group requested by the Directorate General of Health on electronic cigarettes took place. Prof. Benoit Vallet hosted the working group at the Ministry of Health. AIDUCE participated in this meeting alongside other actors invested in the fields of vaping, addiction and risk reduction, or the fight against smoking: HCSP, HAS, INSP, ANSM, INC, CNCT, DNF, SOS Addictions, RESPADD, Federation Addiction, MILDECA, SFT, Fivape, Sovape.
The main objective given to this group is to define the role of vaping in tobacco control and harm reduction.
The session opened with the presentations of the recommendations of the High Council of Public Health (HCSP) (1)
The HCSP recommends :
- to continue and intensify policies to combat tobacco consumption;
- to inform, without publicity, health professionals and smokers that the electronic cigarette:
- is a tool to help stop smoking among people wishing to quit smoking;
- appears to be a way of reducing the risks of smoking exclusively. The advantages and disadvantages must be emphasized.
- To maintain the terms and conditions of the sale and advertising prohibitions provided for by the law of modernization of our health system and to extend the prohibition of use to all places assigned to collective use.
The HCSP invites :
- strengthening the French observational system for smoking, conducting robust epidemiological and clinical studies on e-cigarettes, and launching
research in human and social sciences on this question; - clarify the status of the electronic cigarette and refill bottles;
- to continue labeling and marking efforts to ensure maximum information for consumers and ensure their safety;
- to engage relevant stakeholders, in particular the pharmaceutical industry, in thinking about the creation of a "medicalized" electronic cigarette;
- increased responsiveness of public authorities to "technological innovations implying a benefit for public health" proposed by the market and not benefiting from prior regulation;
- the World Health Organization to make general recommendations on e-cigarettes that would enrich a future version of the Framework Convention on Tobacco Control.
And the HAS High Authority for Health (2)
HAS recommends in its opinion of 2014 that it has not seen fit to review since :
- Due to insufficient data on evidence of efficacy and safety, it is not currently possible to recommend e-cigarettes in smoking cessation or tobacco reduction.
- It is recommended that smokers who use e-cigarettes be informed of the current lack of data on the risks associated with their use.
- Due to the substances contained in e-cigarettes compared to those contained in tobacco, e-cigarettes are supposed to be less dangerous than tobacco. If a smoker refuses the recommended means of nicotine replacement, their use should not be discouraged but must be part of a strategy of stopping with accompaniment.
- Clinical studies and observational public health studies on the effects of e-cigarettes are recommended, including the following:
- toxicity / safety and effects of long-term exposure;
- efficacy comparison with TNS in smoking cessation;
- interest in a risk reduction perspective;
- impact on trivialization, normalization and the social image of smoking;
- composition of liquid refills and steam;
- product quality, description of product diversity and change of products over time;
- pharmacodynamics, pharmacokinetics, toxicology, carcinogenicity;
- effects of exhaled vapor, fire and burns due to smoking;
- addictive potential, risks of addiction;
- risks associated with nicotine refills;
- etc.
- It is recommended that the new forms of tobacco or nicotine that may appear on the market, be they drugs or consumer products, should be monitored in the same way.
The meeting continued with a tour de table of the speakers present.
We particularly appreciated the interventions of Dr. Lowenstein (SOS addiction) and Dr. Couteron (Federation addiction) who recalled the importance of the vape as a risk reduction tool by comparing it with opiate substitutes and reminding that happy time, the treatments were able to make their entry in France in spite of the too cautious opinions of the HCSP and the HAS. They also emphasized the richness that this working group can bring to the very different worlds and visions of the participants.
The AIDUCE insisted that we were in the presence ofan anxiogenic speech and disproportionate laws that were important to revise, the HCSP having put their finger on a problem: we no longer know what an electronic cigarette is, initially a common consumer product that has diverted millions of smokers from smoking, some would like to turn it into an industrialized drug, of others categorize it as if it were tobacco and make it as unattractive as possible, while its users and manufacturers would like to improve and distribute it.
The AIDUCE denounced the participants' reluctance, and recalled that every day lost to hiding behind non-existent fears, people would die of smoking. The anxiety-provoking discourse must stop as soon as possible to preserve public health.
Sovape and AIDUCE insisted on the deleterious effect of bans on communication, promotion and information about the vape, for individuals, health professionals but also by the consequences on that of professionals. These prohibitions call into question both freedom of expression and information on little or no basis and not proportionate.
Anne Borgne, addictologist (RESPADD) also emphasized that risk reduction is not about not seeing any risk at all, and that HAS recommendations were problematic for health professionals who want to give advice to smokers.
Some stakeholders wish that the vape be a medicine, to be able to prescribe it and regret the lack of a study on efficacy as a smoking cessation method.
The ANSP that animates the page Tobacco Info Service recognize in the vape a « great hope » as a help to stop smokingbut remains cautious in his advice because must follow the advice of the health authorities. The agency wants a true open dialogue with the population.
The representative of DNF also emphasized the application of the rules and wish the vape is not considered a festive object.
The representatives of Fivape insisted on the independence of the vape actors from the tobacco industry, and the disastrous consequences for the ban on advertising and propaganda sector. They also recalled that the vape did not include combustion, thatit had to be differentiated from tobacco.
The working group will continue to discuss the various issues pending the next meeting scheduled for September. In the meantime, we will have to establish the issues that the group will have to deal with more specifically (communication in the context of a ban on advertising and propaganda, vaping in public places, etc.).
The Aiduce sincerely hopes that this working group will succeed in finding a consensus in order to preserve a free and responsible vape. The freedom of choice, use and massive availability, a speech made, a support network of users have so far allowed mass adherence of smokers reducing their risks related to tobacco.
Source : Aiduce.org
