Harm reduction experts across the country were shocked when the New York State Department of Health (DOH) recently issued a letter instructing physicians to discourage vaping as a smoking cessation method for their patients. Commissioner Howard A. Zucker does, however, encourage physicians to promote more traditional Big Pharma therapies that are FDA-approved, such as nicotine patches, gums and lozenges.
New York smoking rates in decline as vaping gains in popularity
These alternative products are each manufactured by major pharmaceutical companies with names like Johnson & Johnson or GlaxoSmithKline – companies that have witnessed the sales of their nicotine replacement therapies plummet in recent years largely due to the increase in popularity of vaping. And even though Zucker makes claims in the letter that e-cigarette use is on the rise, he also boasts about a “historic low” in high school smoking rates over the past two years.
“The good news is that the smoking rate among New York’s high school students declined to a historic low of 4.3 percent in 2016. The bad news is that during the last two years, the use of e-cigarettes among youth nearly doubled from 10.5 percent in 2014 to 20.6 percent in 2016. Many young people are lured by the intentionally sweet flavors and the mistaken belief that e-cigarettes are safe to use. But e-cigarettes are not safe. Both cigarettes and e-cigarettes contain nicotine, which is highly addictive and can cause permanent changes in young, developing brains.”
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That last sentence is pure fiction. Zucker’s statement that the nicotine in e-cigs leads to brain damage in “young, developing brains” lacks any basis in scientific fact. Furthermore, the nicotine concentrations of e-liquids are substantially lower than the levels associated with combustible cigarettes. And they are certainly comparable to those of Big Pharma products. Zucker also glosses over the fact that the majority of teen vapers tend to vape e-liquids with zero-nicotine.
“I encourage all health care providers to talk to their patients – young and old alike -- about the dangers of e-cigarettes and to discourage their use. For patients who are already using traditional cigarettes or e-cigarettes, there are currently seven FDA-approved medications for smoking cessation, including five nicotine replacement therapies. Medicaid and most insurance plans will cover a portion of the cost of smoking cessation products.”
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Zucker even instructs patients currently finding success with e-cigarettes as a smoking cessation method to make the switch to one of the seven FDA-approved alternatives. This is risky business, especially to the health of the patient. Even though there are reams of scientific research studies indicating that e-cigs are 95 percent safer and healthier than smoking, Zucker still demonizes the entire industry at the health risks of millions of New Yorkers.
Dr. Michael Siegel takes issue with New York DOH letter
When the letter was first published, many in the medical community were outraged, including Dr. Michael Siegel from the Boston University School of Public Health. Siegel believes that doctors who ask their patients to give up vaping and try another smoking cessation product are essentially being highly irresponsible.
“This advice to physicians to discourage quit attempts using e-cigarettes is unqualified. It does not say: ‘Encourage smokers to try an FDA-approved medication first, and recommend e-cigarettes only if that fails.’ It advises physicians to discourage e-cigarettes under all circumstances. Obviously, this includes the circumstance where the patient tells the physician that she has no interest in using Big Pharma products and instead, wants to try vaping.”
“This blanket recommendation is inappropriate and in my view, damaging.”
Hopefully, physicians in New York State will see right through the anti-vaping propaganda of the New York State DOH and draw their own conclusions. If “the patch” and Nicorette gum are safe (but less effective), then e-liquids with comparatively lower levels of nicotine concentrations – or perhaps even zero nicotine- should be safe, as well. It’s only basic, common sense.
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