The future anti-smoking law should put 'barriers' to the sale, advertising and consumption of electronic cigarettes and 'Iqos'

• Draft The Spanish anti-smoking law is outdated 10 years after its last reform

• Smoking US authorizes the sale of an electronic cigarette for the first time

The eternal struggle between smoking and public health. A clear conflict of interest involved in tricks and tricks that the tobacco lobby knows how to handle perfectly. After 10 years of the anti-smoking law in Spain, experts ask "as soon as possible" for the legislative amendment. "We are having too much laxity", affirms Carlos A. Jiménez Ruiz, president of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR); especially with alternative products like e-cigarettes or heated tobacco.

The new law should equate everything related to the sale, consumption and advertising of this type of device to the regulation of conventional tobacco. Otherwise, they will continue to open specialized and design stores located in the best streets of large cities, "where people of any age enter and

that addictive substances are being sold whose consumption is associated with different diseases ", argues the pulmonologist.

They 'play' with the idea that they are products of reduced risk, to stop smoking, and some facts, far from clearing up such confusion, add fuel to the fire. Just a month ago, the United States authorized for the first time in history the sale of the Vuse vaping device manufactured by the tobacco giant RJ Reynolds, owned by British American Tobacco. According to the American Drug Administration (FDA), data provided by the manufacturer showed that their tobacco-flavored products (not other flavors) can help smokers to "significantly reduce" their consumption of tobacco. conventional cigarettes.

The experts put their hands to their heads.

"We believe that it has been a very unfortunate decision and that is why from Separ and other national and international scientific institutions we have spoken out against it," says the president of the pulmonologists.

Precisely, a later article published in the magazine 'JAMA Network Open' indicated just the opposite to the FDA.

The authors found that "individuals who quit smoking and switched to e-cigarettes or other tobacco products actually increased their risk of relapsing to smoking over the next year by 8.5 percentage points compared to those who they stopped using all tobacco products. "

Clearly, says Francisco Rodríguez Lozano, president of the European Network for Smoking and Tobacco Prevention in Brussels (ENSP), "[the FDA's decision] is a mistake."

However, he adds, "it should be noted that the FDA allows its sale, but not for therapeutic use. In Spain it can also be purchased."

Harmful effects on health

Beyond the controversy that the step taken by the FDA has caused, the truth is that there are no gaps in the eyes of the medical and scientific community.

For the World Health Organization (WHO), electronic cigarettes are not safe and it is better not to use them.

It is not marketing campaigns but science that can provide reliable answers.

To date, the evidence shows that these devices are associated with an increased risk of cardiovascular diseases and lung disorders (the disease described as EVALI -Vaping-Associated Lung Injuries-) and adverse effects on the development of the fetus during pregnancy.

"It may be that heated tobacco has fewer toxic substances, but the concentrations it contains are capable of causing cancer, not only in the lungs but also in other organs, according

" explains Jiménez Ruiz. Regarding e-cigars that claim not to include nicotine, "some of them do carry certain amounts, but also other carcinogenic substances. It has also been shown that flavorings can cause precancerous lesions."

Science says it loud and clear, but on the other side is the tobacco lobby.

It remains to be seen if this time it is threatening enough to avoid the regulation of these types of products.

From the outset, in 2020, the Ministry of Health published a report stating that the electronic cigarette aerosol contains carcinogenic substances.

In other words, it is aware of the long-term risk of its consumption and exposure.

The five essential measures

Experts trust that the modification of the anti-smoking law will be ready before 2023 and hope that the regulation of this type of devices will be a reality. In fact, it is one of the five "essential" measures that Separ has presented to the Ministry to make them effective in the new law. The other four are:

, introducing plain packaging, and increasing and promoting health care for smokers to stop tobacco use.

The inclusion of these five points "would represent a great help to smokers to stop smoking, ease so that young people do not start using and protect non-smokers from polluted air [...] It should be remembered that tobacco is responsible for more than 1,000 deaths a week, "concludes the president of Separ.

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