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HR - June 19/3: Do not equate big risks, small risks and hypothetical risks under one umbrella as unsafe

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Dr KK Aggarwal    17 June 2019

When the government warns us about the risks of fats, salt, sugar, alcohol or electronic cigarettes, they equate big risks, small risks and hypothetical risks under one umbrella as “unsafe.” No one talks about potential risks against potential benefits.

Cigarettes contain nicotine, tar and carbon monoxide. Of these tar and carbon monoxide are known carcinogens.

Electronic cigarette devices create a vapor (aerosol) people inhale, providing nicotine without the carcinogenic tar.   

They are very unlikely to be anywhere near as harmful as cigarettes. People who switch from smoking to “vaping” may be prolonging their lives and the lives of people around them.

While some studies have shown that electronic cigarettes contain carcinogenic compounds, and that the nicotine itself, while not a cause of lung disease, might be harmful, these are minor risks compared with smoking.

Vaping should be considered dangerous if it functions as a gateway drug, leading more people to smoke. Likewise, it should be considered beneficial if it acts as a substitute for smoking, giving people a safer alternative.

The public health approach known as harm reduction is associated with safe injection site programs. Sure, it would be better if nobody injected drugs, but in our imperfect world, clean needles save lives.

The public health community in the United Kingdom has embraced them, based on the estimate that they are 95% less harmful than smoking.

Teens would be much better off not using any nicotine products, as they run a high risk of addiction, but we need to be concerned only if vaping is leading to increase in cigarettes consumption in them. If smoking rate is reducing, at the cost of vaping, this is harm reduction.

Interpreters tend to err on the side of exaggeration over exoneration, but that is not always in the best public interest.

Exaggerating the risks of vaping might seem harmless, but it’s harmful if it gives people the impression that it’s so dangerous they might as well smoke.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

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