Regulatory authorities focus on e-cigarettes as if the smoking problem has been solved…

Regulatory authorities focus on e-cigarettes instead of

dealing with the tobacco epidemic


By Dr Farsalinos

It is really surprising to realize how much time, effort and resources are spent by public health authorities in order to “regulate” e-cigarettes. In most cases, their purpose is to restrict availability and accessibility of e-cigarettes to consumers (smokers); they are also trying to limit variability of products and their evolution potential. The main reason for such “regulation” (according to their own statements) is the unknown long-term effects of e-cigarette use; their goal is to protect public health. Interestingly, discussion about e-cigarettes has almost overshadowed the discussions about smoking and how this epidemic is progressing.


Where the truth lies

Such regulatory attempts and decisions are, to say the least, a complete paradox. The behavior and stance of such regulatory agencies makes you believe that they have solved the smoking epidemic and they are now concentrated on a new threat for society (that is, e-cigarettes). WHO predicts that 1 billion deaths due to smoking are expected during the 21st century.  The annual death toll due to smoking is expected to increase from 6 million today to 8 million in 2030. There is no smoker who does not know that this habit is a killer, yet they continue to smoke. Despite the smoking bans, despite the significant increase in price, despite the proper information and education about the harmful effects. Therefore, it seems odd that public health authorities concentrate all their efforts to e-cigarettes, which may represent a historical opportunity to decrease smoking-related health damage. Every day we hear of a local health board in a small US town getting ready to implement ban or restriction to e-cigarettes. It is the new trend in politics…

In my opinion, we should not blame the regulatory boards but the scientists who advice them. E-cigarettes are a field where mis-information, scientific mis-presentation, intimidation and fear-mongering have become the main agenda, even inside the scientific community. Perhaps they do it because of ideology or fear of history repeating itself (development of the tobacco industry during the 20th century). However, the ethical obligation of the scientific community is to provide proper and reliable information based on facts. Of course, they should warn about theoretical dangers, but in no way should they ignore the facts.

I am going to present a characteristic case where scientists fail to realize the true implications of their research and make some paradoxical conclusions about their own findings. Last year, during the annual meeting of the Society for Research on Nicotine and Tobacco Europe (SRNT-Europe), a study performed in South Korea was presented in poster format. It was a survey of 1872 students of middle and high schools in a city near Seoul. Obviously, the main purpose was to evaluate e-cigarette awareness and use (together with smoking experience) in this population of adolescents. The authors reported that 6.3% of the sample (117 adolescents) had experience with e-cigarettes. Smoking experience was reported by 17% (318 adolescents). Even more interestingly, 101 out of 117 adolescents who reported e-cigarette experience were smokers (86%). Using statistical analysis the authors mentioned that smokers were 33 times more likely to try e-cigarettes compared to non-smokers.

Obviously, the main conclusion of the study is that smoking prevalenve is quite high in South Korean adolescents, and e-cigarettes are mainly used by smokers and may represent a gateway from smoking (since 86% of e-cigarette users were smokers). Shockingly however, the authors’ conclusion was: “E-cigarette use among South Korean adolescents was relatively common. Continuous monitoring and measures to prevent e-cigarette use is needed.” Obviously, the authors believe that the 17% smoking rate (or smoking experience, as it is mentioned) in this group is not important and should not alarm the authorities (?) How can anyone really make such a conclusion from analyzing these data? Is this the kind of advice that these scientists will provide to the regulatory agencies in order to make proper decisions for the benefit of public health? How can we expect regulation to meet the real need of the population when scientists cannot understand their findings or mis-present them in such a ridiculous way?

The poster is available here for everyone to see it



Dr Farsalinos is a researcher at Onassis Cardiac Surgery Center in Athens-Greece and at Medical Imaging Research Center, University Hospital Gathuisberg in Leuven-Belgium. He is actively involved in research on e-cigarettes’ safety and risk profile.

Background Image

Header Color


Content Color