Nearly 700 people participated online when the THR Summit Spain 2023 was broadcast live on Thursday evening. Doctors met with researchers, activists and health scientists in a discussion about e-cigarettes and the role of technology in smoking cessation and harm reduction.
THR SUMMIT SPAIN. "You don't need to be a doctor to understand the difference between smoking and using an electronic cigarette. Smoke is smoke, vapor is vapor. It's all about temperatures and heating. There is no doubt that vejpning is a safer way to use nicotine. The question is rather HOW much safer? We can't answer that until we have epidemiological studies" said the cardiologist Konstantinos Farsalinos, during the discussion at THR Summit Spain.
Worrying developments for smokers
The theme of the conference revolved around e-cigarettes and the relative risks of harm, but also how doctors can use the technology to help smokers quit. The debate on vejpning has been ongoing for a long time across the EU, not least in Spain where smoking rates are among the highest in Europe. At the same time, few official institutions have highlighted harm reduction as a strategy to reduce the harms of smoking.
"This is very worrying. Smoking claims many lives every year. And despite the introduction of strict anti-smoking laws almost 20 years ago, there has been no significant reduction in smoking in Spain. It is therefore of utmost importance that we discuss alternative ways to break this pattern. E-cigarettes are one of several methods we need to discuss." stated Dr. Fernández Bueno, surgeon at the University Hospital of Madrid in his opening speech.
Unacceptable to stifle discussion
At the same time, there is huge opposition to the technology, especially from anti-tobacco groups and pharmaceutical companies, but also from the World Health Organization (WHO). The conference was originally scheduled to take place in the Juan Carlo University auditorium in Madrid. However, the Spanish Public Health Agency and representatives from WHO called on universities to withdraw from the collaboration at the last minute. The Tobacco Harm Reduction Summit Spain became an online meeting instead. Despite the uproar, almost 700 people participated via the web. Far more than had registered their interest earlier.
"We have seen completely unacceptable behavior from our authorities. Just because their officials think differently on a factual issue, it is not ok to try to stop a scientific debate. Ironically, this has led to the fact that we have more people in attendance today than we would have had if the conference had taken place physically", Dr. Fernández Bueno stated.
Anti-tobacco movement attacks e-cigs
Clive Bates, a consultant in the field of harm reduction and sustainability, said that the debate on e-cigarettes is really about something other than public health.
"There is no doubt that e-cigarettes have the potential to replace cigarettes in the market. We also know that harm reduction works, a proof of concept is Sweden where snus has displaced smoking in large parts of the population. The result is significantly fewer deaths from smoking-related harm. But this challenges the fundamental ideas that have guided the anti-tobacco movement since its inception. A consumer-driven revolution benefits neither them nor their funders. So we see their gun towers now targeting e-cigarettes and nicotine instead of the real problem: smoking." said Clive Bates, who chaired one of the seminars during the conference.
"Must look out for the best interests of the patient"
Josep María Ramón Torrell, a doctor and professor of medicine, noted that the open battle over e-cigarettes affects both smokers and doctors in Spain. Currently, as a doctor, he is not allowed to recommend the products as a smoking cessation tool.
"As a doctor, I have to look after the patient's best interests. If the patient smokes, it is my job to convince him or her to quit. Today we have access to nicotine medicines, which work for some but far from all. Hardcore smokers won't quit just because they are prescribed a pill and some talk therapy. Smoking is part of people's everyday lives, their social lives. That's where e-cigarettes come in. I have seen first-hand how hopeless cases, heavy smokers switch to vejpning and stay smoke-free, without major problems. Therefore, it is of utmost importance that our politicians regulate these products wisely, in the same way they regulate nicotine medicines. Josep María Ramón Torrell, during a discussion with Spanish doctors and health scientists.
More smokers in Spain
At present, between 29 and 32 percent of the population in Spain. The EU average is 20%. In Sweden, the percentage of smokers is closer to 6% - according to EU Barometer this is probably due to snus replacing smoking in the group of men aged 26-46 in Sweden.
The proportion of vejp users in Spain, as in the rest of the EU, is 1-2% of the population. In the UK, where vejp smoking is recommended as a substitute for cigarettes, the proportion of vejp users is just over 7% (smoking has declined from 20 to 13 percent since 2011).
The same trend we see in Sweden although, thanks to snus, we started at a much lower level.
The last % smokers are incredibly difficult to get rid of if you only use restrictions, punitive taxes and threats / scare propaganda as weapons.
Over the past 10 years, the number of smokers in Sweden has decreased by almost exactly the number of e-cigarette users we have today. It can be said that harm reduction has, despite the reluctance of the authorities, accounted for all the reduction in the last 10 years.
Time for politicians to wake up from their hard core denial strategy and realize that e-cigs, snus and nicotine pouches are the only way to eradicate tobacco smoking from our society.