translated from Spanish: Regulation of electronic cigarette: a public health dilemma

one of the dilemmas faced by contemporary societies where there is State of Derec Ho and democratic procedures of conflict resolution is to reconcile personal freedom with the goals of public health. Therefore, the free and democratic States have understood that a person can assume behaviors that go against their own well-being. In this context, the consumption of tobacco and the possibility of reducing damage by avoiding toxins produced by the combustion of the tobacco, is one of the dilemmas to solve the public health.
In 2003, nearly half of the adult population (43.5%) consuming cigarettes in our country. According to the latest national survey of health asks “do now you smoke cigarettes?”, 33% of Chileans responded positively. This represents a decline of 9.8 points in relation to 2003 and 6.5 compared to 2010. Although progress has been evident with respect to the reduction of tobacco use, this is still the main cause of preventable morbidity and mortality in our country.
The legislative efforts of the last few decades have been directed to eliminate the sale of tobacco to minors, education to the population about the risks to their health, an increase in taxes, the ban on advertising, the regulation of additives and the limitation of the consumption in public spaces. Currently, is transacted in the Congress a new initiative aimed to deepen this positive process, under the premise of improving the protection and prevention of tobacco use in the under age, as for example the obligation of the flat pack.

In this context, new regulatory efforts should aim, on the one hand, to the reduction of combustion as a mechanism of nicotine and tobacco consumption, and on the other the limitation of nicotine as an addictive substance par excellence.
The combustion of tobacco, more than 1,000 celsius degrees emits more than 4,000 substances and gases, most of them highly toxic. Nicotine and combustion must be in the sights of the authorities in the next regulatory efforts.
Nicotine is a stimulant that produces damage to health, is not directly responsible for lung cancer and respiratory and heart diseases. The greatest burden of disease related cause obviously are toxic compounds produced by the tobacco combustionado. For this reason, for example, in the United States, the Agency health regulatory (FDA) extended its authority to regulate all tobacco products, including electronic cigarettes – also called vaporizers or electronic management systems nicotine (SEANs). These are devices to battery used to inhale a vapor that commonly – though not always – they contain nicotine.
In Chile, the electronic cigarettes may or may not contain nicotine, are subject to government regulation, where liquids containing nicotine should be authorized by the ISP after going through the same process of approval of a drug and the they do not contain the compound, they can be freely marketed. This is, in practice, been implicated in Chile, an indirect prohibition for SEANs with nicotine.
The FDA has declared that this new technology of SEANs, presents both advantages and potential risks. For example, if certain products, such as electronic cigarettes, have one toxicity lower in comparison with the conventional to combust, encourage current smokers to switch to them completely, they would have the potential effect of reduce the number of illnesses and deaths.
Likewise, conversely if some of these products generate nicotine addiction in young or not redujeren the interest of the person by quitting smoking, public health effect would be negative.
On the other hand, the authorities and the Medical College of the United Kingdom have focused on the concept of harm reduction. Under this look if a product without combustion, albeit with nicotine (strictly regulated) is transformed into a real alternative for consumers of conventional cigarettes, would be an important contribution to public health policies.
The FDA has encouraged manufacturers of SEANs go in search of innovations in products that can maximize the benefits and minimize the risks.
From the above, a public debate, based on scientific evidence, will allow us to assess the effects of these products on public health.
In our country today, indirectly, prohibited the marketing of electronic cigarettes with nicotine, however, their use is increasing unregulated with respect to the content of the substances that vaporize. Dubious quality products are marketed by tens of thousands every year and are purchased by people seeking alternatives to the burning of cigarettes.
In Chile it is absolutely necessary to discuss a new regulation of the market of electronic cigarettes, especially their content of nicotine and its techniques promotional (including designs to prevent the use on young people).
The scientific evidence on the safety of electronic cigarettes is still under discussion. In any case, a plausible hypothesis is that they are less toxic than conventional cigarettes because not combust.
If scientific evidence ended showing that these new mechanisms of dispensation of nicotine may be helpful as an alternative to smoking cessation with combustion, or to quit cigarette smoking, probably would be useful to establish the same regulation for example of the European Union.
Worldwide scientific debate among experts regarding the benefits and risks of the SEANs in the context of health for tobacco harm reduction is already installed. Under this point of view, it is important to maintain a proper balance between the protection of public health and the development of innovative products that will reduce the damage caused by tobacco.
In Chile, it is necessary to discuss about our current regulatory framework for the SEANS, the perspective that opens to consider this new alternative of reducing the risk of the addictive effects of nicotine and the lethal impact of combustion.
In addition to developing a strict regulation of the use of SEANs in Chile in order to implement measures for gradual elimination of the combustion of tobacco, this could be a public oriented health policy decision to reduce morbidity and mortality related directly and indirectly with the consumption of tobacco and thus save millions of lives in the near future.

Poured in this op-ed content is the sole responsibility of the author and do not necessarily reflect the editorial line nor the counter position.

Original source in Spanish

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