Professor Riccardo Polosa, an international asthma specialist, was responding to concern expressed last week by the Asthma and Respiratory Foundation that there was no good evidence that e-cigarettes reduced the number of cigarette smokers. It also didn’t want the younger generation taking up vaping and called for e-cigarette sales to be restricted to smokers.

New Zealand is proposing to change the law next year to allow local sales of nicotine e-cigarettes and nicotine e-liquid (see below) in normal retail outlets as a move to help people quit cigarettes.

Polosa agreed with the Foundation that at present there was equal published evidence for and against e-cigarettes helping people quit smoking tobacco and likewise researchers were unable to prove whether e-cigarettes were safe or unsafe.

But his own lung research in Italy is indicating that switching from smoking to vaping e-cigarettes can reverse the harm done from inhaling the toxins in tobacco smoke. Polosa’s most recent study, just published in November in Nature, compared the lung health of regular vapers (who have never smoked tobacco cigarettes) with people who didn’t smoke or vape. That study found no significant change in health outcomes or pathology between the two groups after three and a half years of monitoring.

Polosa said the United Kingdom was currently proving that easy access to nicotine vaping – combined with high taxation on cigarettes and other tobacco control policies – can see a major shift from smoking tobacco to much less harmful nicotine e-cigarettes. Polosa said the liberal approach to vaping in the UK had contributed to the largest acceleration in the numbers of smokers quitting ever recorded in the country.

He said he really hoped New Zealand would follow as allowing vaping was a “fantastic public health opportunity” and if it was implemented and integrated with existing tobacco control policies it would get results – particular in communities where smoking rates were still very high – like the Māori and Pacific communities. “I see this as a beacon for public health coming from New Zealand and as an international leading expert in the field I can tell you that New Zealand has been inspirational to my work many times.”

Polosa said while he could empathise with those concerned at the risk of young people taking up vaping, there was a bigger public health issue at stake.
“Let me remind you that the big problem at this very moment is to prevent deaths (from smoking) – so we really need to act now on the adults,” said Polosa. He said public health was always a trade-off. “And if the (trade-off) compromise is a few kids initiating vaping well so-be-it at least we will have many others who will be quitting combustibles (tobacco cigarettes).”

“I’m not saying electronic cigarettes are the silver bullet,” said Polosa. “But neither are the tobacco control policies we have now a silver bullet. I think the integration of two ‘good bullets’ (i.e. electronic cigarettes and tobacco control policies) – will make a ‘silverish’ bullet.”

The Italian professor of internal medicine at the University of Catania in Italy, was in New Zealand last week as a guest Marewa Glover, fellow vaping research and Massey University Associate Professor, and he spoke in Auckland and Wellington on his research.

Polosa, an asthma specialist, said the focus of his research was “on answering the question whether e-cigarettes are safe in the long-term – yes or no?”

He said it was a very difficult question to answer but there was now a number of research papers, including his own, suggesting that e-cigarettes are not raising health concerns. A problem faced by researchers was that a very large majority of e-cigarette users (95-98%) are either smokers or ex-smokers. “So it is going to be extremely difficult to prove anything because of the background damage already caused by their previous smoking history.”

But he said you can examine whether there was evidence that switching to e-cigarettes can cause a reversal of the lung harm done from inhaling the toxins in tobacco smoke – which had been the focus of his research for the past five years.

Polosa said his findings were indicating that switching to nicotine e-cigarettes was reversing the harm in a similar way that quitting smoking did – particularly when smokers switch at a younger age. “If you switch when you are 70 – after 50 years of smoking history it is very difficult to show any reversal of the chronic damage done but however most of the people switch (to vaping) in the age range of 25-55 when you can still show reversal of damage.”

Based on his research to date he believed electronic cigarettes were unlike to raise significant health concerns for the respiratory tract and that promoting further access to vaping may reduce risk and reverse the harm from smoking tobacco.

Background on New Zealand plans to legalise e-cigarettes

The previous Government announced in late March that it was planning to change legislation to allow the legal sale of nicotine and non-nicotine e-cigarettes and e-liquid (to people aged 18 years and over) in normal retail outlets. At the time it said the changes were unlikely to come into effect until the middle of 2018 as the legislation would first need to go through Parliament.

The new Minister of Health David Clark, was quoted at the time (in his role as opposition health spokesperson) that it made sense to regulate nicotine e-cigarettes because they were already in use in New Zealand (despite local sales of nicotine e-liquid currently being illegal) . But he did not see e-cigarettes as the “silver bullet” for smoking cessation and he called for proper funding for smoking cessation programmes and for the government to be ready to review evidence if e-cigarettes were shown to be a path into smoking rather than away from it.
Clark has made Associate Minister of Health Jenny Salesa responsible for tobacco control policy and services.

The Ministry of Health on its Vaping (e-cigarettes) page says it believes e-cigarettes have the “potential to make a contribution to the Smokefree 2025 goal” and could ”disrupt the significant inequities” there are at present (i.e. the smoking rate for Māori women being more than double the smoking rate for all New Zealand adults.)

The latest 2016/17 New Zealand Health Survey statistics show that 15.7 per cent of all Kiwi adults are still smokers – just 0.6 per cent lower than the previous year and the rate has dropped just two per cent in the last four years. The smoking rate for Māori women remains high 38.2 per cent – down from just under 40 per cent the year before.


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