“The Debate on Restricting Electronic Cigarettes to Medical Prescriptions: Expert Opinions and Insights”

Electronic cigarettes are once again in the hot seat. More and more voices are being raised to demand a ban on “puffs”, these single-use products developed to target teenagers, with their Nutella, Milka or Red Bull flavors. The Minister of Health François Braun himself declared himself in favor of it this Wednesday, May 3 during an intervention on France Inter. Other states have already taken action. And in particular Australia, whose government has also announced its intention to very strongly limit access to all vaping products: in this country, they must be prescribed by a doctor, with the sole objective of smoking cessation. While many are worried about seeing the vape become a way of entering cigarettes for the youngest, would this measure be relevant in our country? Two experts discuss it.

YES / “Provided that we also strengthen the fight against tobacco”

By Prof. Loïc JosseranPresident of the Alliance Against Tobacco

The electronic cigarette can be useful for quitting smoking, allowing some to cross a course. Used over the long term, however, it risks becoming a tool for maintaining nicotine addiction, but also for the gesture of smoking, which is very difficult to pass. In addition, those who have never smoked can learn about nicotine through vaping. So the idea of ​​restricting the use of e-cigarettes to a medical prescription, in a strict logic of weaning, seems to me to be going in the right direction.

In France, vapers represent only 5 to 6% of the adult population, according to a survey by Public Health France. On the other hand, a study conducted by BVA shows that 13% of 13-16 year olds have already used e-cigarettes and puffs, while the sale to those under 18 is normally prohibited. Reserving access to prescription holders would be a real development and would help to eliminate this consumption among the youngest. This seems important to me because the High Council for Public Health has very clearly shown in its latest report that there is a gateway effect from vaping to tobacco products.

At the same time, the fight against smoking should of course be strengthened. This requires continued price increases, and a policy of “denormalization” which has proven itself in the United States, the United Kingdom and Canada. In these countries, communication campaigns have reminded us of what the tobacco industry really is: a very polluting activity, which contributes to deforestation, which makes people addicted, impoverishes and kills smokers. And above all, they strictly enforced the ban on sales to minors. By doing the same in France, we would solve the tobacco problem in a generation.

NO / “In France, it would be a public health error”

Par le Pr Bertrand Dautzenbergtobacco specialist and professor emeritus of pneumology

Reserving the use of the electronic cigarette to a medical prescription would amount to prohibiting it completely. It would be a form of prohibition, and we know that doesn’t work. France is the European country that most strongly regulates cannabis, and it is also the country where it is smoked the most…

Australia is a special case: in populations of European descent, there are hardly any smokers. In this context, vaping may play a debatable role, with the theoretical risk of helping some e-cigarette users return to smoking. But so far, this fear of the Australian government has not materialized. Under these conditions, is it really appropriate to ban electronic cigarettes, which are 95% less toxic than tobacco?

In a country like France, where there are still 25% to 30% of smokers, restricting access to vaping would be a major public health error. I am not talking about puffs, which are very polluting and which often do not comply with the legislation on mandatory safety information. But by dint of demonizing the electronic cigarette too much, we push consumers to go or come back to tobacco, which is an aberration. Even if it is always better not to smoke at all, long-term vaping poses infinitely fewer problems than tobacco. The potential role of vaping as a gateway to cigarette smoking is suggested in some studies, but is contradicted by others and by epidemiology. I am currently working to disentangle these contradictory studies and the e-cigarette may appear more as a competitor than as a gateway at the end of the analysis. If this is confirmed, why should we fight against a potential alternative to tobacco, whose usefulness and harmlessness is demonstrated for smokers?