Many questions, few answers — Ahmad Syamsul

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FEBRUARY 17 — I read with great interest the recent Q&A issued by the World Health Organisation (WHO) on e-cigarettes. As a consumer, i find that this document is commendable and timely, especially given the heated discussion over the health implications of such devices as well as the high youth uptake. Governments globally are grappling with this vaping phenomenon given its increased in popularity in recent years.

However, I can’t help but feel that the WHO’s approach to this issue is repeating the same mistakes that it made when it came to tobacco control — namely the outright demonisation of the product altogether, without providing viable solutions to the real problem at hand.

The Q&A — which contains no disclaimers — posits that e-cigarettes and vaping are just as bad as smoking cigarettes. It rejects wholesale the increasing scientific evidence that electronic nicotine delivery systems (ENDS) are less harmful than smoking combustible cigarettes. Furthermore, the WHO asserts that these electronic products are addictive, again without any substantiated proof.

The WHO is completely within its rights to embark on anti-vaping activism in the name of public health advocacy. However, the inconsistencies in its arguments, its cherry-picking of facts and lack of science-based evidence to support its stance have raised serious questions about its credibility and integrity.

To an extent, I couldn’t agree more with Professor Peter Hajek, the Director of the Tobacco Dependence Research Unit at the Queen Mary University of London (QMUL) who lambasted the WHO Q and A on e-cigarettes and rightly pointed out that the WHO has a history of anti-vaping activism that is damaging their reputation. He labelled the document as particularly maligned and highlighted that practically all the factual statements in it are wrong.

There is no evidence that vaping is ‘highly addictive’ as less than 1% of non-smokers become regular vapers nor does it increase risk of heart disease or that it could have any effect at all on bystanders’ health.

While many were quick to blame the US outbreak of lung injuries for example to vaping, it has been proven now it is due to contaminants in illegal marijuana cartridges and has nothing to do with nicotine vaping. There is clear evidence that e-cigarettes help smokers quit.

If it gets its way and brings about the extinction of e-cigarettes and vaping, the WHO may ironically, inadvertently cause the one outcome it has tried to battle for decades: An increase in cigarette smoking. This may yet be one of WHO’s biggest errors in the 21st Century — adding to a growing list of failures that can be laid at its door since its establishment in 1948.

We all still remember its slow response to the emergence of Ebola in 2014, the outbreak of tuberculosis in Papua New Guinea and the H1N1 epidemic.

The WHO — whether consciously or not — is turning into an ideologically-driven propaganda machine instead of a disinterested and competent global public health authority. It is increasingly choosing to spread fear, rather than knowledge and an objective assessment of the scientific evidence. Its influence — whether deliberate or not — has become pernicious.

In 2015, for instance, one of its France-based agencies, the International Agency for Research on Cancer (IARC) published a list of no fewer than 989 items that it claimed were likely to cause cancer, including cell phones, meat, plutonium, mustard gas and glyphosate.

Much like the current Q&A, that report was greeted with much scepticism. However, there are people today who are still unsure of whether meat, charred food or polyester can increase their chances of getting cancer.

Global health governance needs to be more objective, and transparent. It must not be constrained by a paternalistic desire to police habits and lifestyles. Rather, the focus should be on finding solutions. That can only happen if there is an understanding of the issues at hand rather than simply adopting knee-jerk reactions to every issue.

In this case, the key is to reduce the harm that people do to themselves by exposing their bodies and those of others to cigarette smoke. Even Dr Nick Hopkinson, from the National Heart and Lung Institute of the Imperial College London acknowledged that   e-cigarettes are substantially safer than smoking, because the toxic substances present in e-cigarette vapour are nil or at very minimal levels.

Rightly so, this position adopted by WHO has been criticised by many doctors and experts on tobacco control, because there are many independent studies that indicate a much lower level of harm from electronic cigarettes compared to smoking regular cigarettes. 

Of course, it would be better if people stopped smoking in general. But less harmful alternatives, like e-cigarettes, shouldn’t be dismissed or worse yet, subject to scaremongering. No one is advocating a free-for-all when it comes to such devices. Governments should strictly regulate their manufacture and use — including category differentiation and strict age controls.

The “enemy” in this sense is clearly cigarette smoke.

But does the WHO realise this? Is it listening? Does it care? If doctors and health experts are doubting WHO and its lack of objectivity, how about us the masses? What if WHO is wrong?

This really begs the question — Who watches the WHO?

*This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.

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