English translation from Press Release, October 2021
Original version in french

THIS CALL IS ORGANIZED BY THE ASSOCIATION SOVAPE – www.sovape.fr

Call for doctors to better use the opportunity by vaping in the fight against cancer – More than 117 French doctors support this Call

Press Release | Since 2019, the SOVAPE association, that advocates for tobacco harm reduction has commissioned an annual survey from the BVA institute on public perceptions of the relative risks of vaping, smoking and nicotine, in relation to the risk of cancer. Following the results of the 2021 survey (see below), SOVAPE is asking doctors to support their call to better use the opportunities offered by vaping in the fight against cancer.

Vaping and the fight against cancer

SOVAPE’s call to public authorities and health authorities: vaping presents an opportunity that must be integrated into plans to fight cancer. Vaping combats the primary risk factor for cancer – smoking. .

We know that quitting smoking greatly reduces the risk of developing cancer over the years. In addition, when cancer is diagnosed, quitting smoking improves the effectiveness of cancer treatments and prolongs life expectancy.

Nicotine replacement therapy is an approved treatment, which uses nicotine to facilitate smoking cessation by lessening the negative effects of withdrawal. Similarly, vaping makes it possible for smokers to substitute their harmful smoking habit with an alternative, which is free from the toxins of combustion, which are responsible for smoking related disease. Nicotine does not cause cancer.

After 10 years of widespread use of vaping products there is now a substantial body of scientific research, to be continued, which has established the consensus that:

  • vaping is an effective aid for stopping smoking,
  • vaping is far less harmful to health than smoking.
    .

Vaping suffers from a poor image and is hindered by regulations that reduce its effectiveness and deter smokers

This third annual BVA survey for SOVAPE [2] finds that: 80% of French people believe that nicotine is carcinogenic (up 2 points compared to 2020), and 77% do not know that vaping is much less risky than smoking (also up 2 points). These misperception trends persist year after year.

Over 99% of vapers use vaping to reduce or quit smoking. Despite this, regulations focus on the fear of use by non-smokers, particularly young people. After over a decade of widespread use, vaping is clearly an exit from smoking, and not an entry into it. Wherever vaping is growing, youth smoking is declining.

However, regulations do not reflect this. In France, advertising and ‘propaganda’ for vaping products are banned. The European limit of 10 ml for refill bottles increases the cost for users and the 20 mg/ml limit on nicotine strength reduces its effectiveness for smoking cessation. The impact of these supposedly protective measures has never been evaluated. Nor have the potential consequences of current European plans to limit flavours and impose additional taxes (in addition to the 20% VAT) been evaluated, although these measures will penalise vapers and smokers wishing to quit.

An unprecedented public health disruption

In the fight against Covid19, public authorities and health authorities established a benefit/risk balance for vaccinations based on scientific evidence. Clear official incentives and effective mobilisation of health professionals have pushed the population to act in order to protect themselves.

With regard to vaping, the lack of commitment from public authorities and health authorities is no longer acceptable. It is essential for public health that they seize this unprecedented and historic opportunity to accelerate the decline of smoking and the harm it causes each year: in France, that is 75,000 preventable deaths, as well as cancers, respiratory diseases, cardiovascular diseases…

Call for a paradigm shift on vaping

Faced with the ravages of cancer, national and supranational (European Union) plans to beat it must include vaping. Authorities should be promoting conditions for its effectiveness and regulation must be evidence based, with an accurate assessment of the risks.

We call on all health professionals who are in direct contact with patients trapped by smoking to demand a change in the attitude of the public authorities and the health authorities towards vaping, at this time, while cancer control plans are being discussed.

According to the INCa, 20% of the 382,000 cases of cancer that occur each year are linked to smoking, including 80% of lung cancers [2].

With 14 million smokers in France, vaping is not a problem. It is a solution.

 

NOTES ET RÉFÉRENCES

[1] – Sondage BVA pour SOVAPE 2021 : à consulter ici.

[2] – INCa : Panorama des cancers en France, édition 2021 : https://www.e-cancer.fr/pdf_inca/preview/303372/4327939/file/Panorama%20des%20cancers%20en%20France_2021.pdf

Questions, réponses et ressources à propos des arguments développés dans cet appel : à consulter ici.

Liste des soutiens à ce jour : à consulter ici.

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117 supports (october 29, 2021) :

Marion ADLER | Docteur | Tabacologue, addictologue, généraliste | Xavier AKNINE | Médecin | Médecin généraliste | Philippe ARVERS | Md, PhD | Addictologue et tabacologue | Martin ASSAYAG | Docteur | Psychiatrie | Sylvain BALESTER MOURET | Docteur en médecine | Addictologie clinique | Arnaud BALZAC | Docteur | Médecin addictologue | Vianney BASTIT | Docteur | ORL | Marie BÉJOT | Docteur | Tabacologue | Catherine BENNER | Médecin | Addictologue, tabacologue | Jacques BERTROU | Médecin | Addictologue | Frédérique BISIAUX | Médecin | Généraliste, douleur | Pascale BLOUET | Médecin | Psychiatre | Michel BOLOPION | Médecin généraliste | Addictologie | Anne BORGNE | Docteur | Addictologue | Harmony BOUCHEZ | Docteur | Médecin généraliste addictologue | Jean-Paul BOYES | Médecin généraliste | Addictologue | Camille BRAND | Médecin | Addictologue, tabacologue | Maxime BREBAN | Professeur en médecine, Chef de service, Directeur d’équipe de recherche Inserm / UVSQ Paris Saclay | Rhumatologie | Anne BRETEL | Docteur psychiatre | Psychiatre addictologue | Sylvie BOULANGER | Médecin | Nutritionniste Addictologie | Catherine BREUILLY-LEVEAU | Médecin | Médecine générale, service de tabacologie et addictologie | Barbara BROERS | Professeur | Médecine de l’addiction | Michel CADART | Docteur en médecine | Géneraliste coordinateur médical RESAD Vaucluse | Gérard CAMPAGNE | Médecin | Addictologue | Sophie CAPTIER | Médecin addictologue | Addictologie | Bernard CAULE | Docteur | Médecine générale | Roland CAZALIS | Docteur en médecine | Médecine générale | Hugues CHABRIAT | Professeur en neurologie | Neurologie vasculaire | Mattéeo CHIARETTI | Médecin | Addictologue | Pascal CLEMENSON | Docteur en médecine | Addictologue | Arnaud COCAUL | Docteur | Nutritionniste | Élodie COQUAN | Docteur | Oncologie | Stéphane CORBINAIS | Docteur | Gastro entérologue | François CORDONNIER | Docteur | Médecine générale | Alain CORNEN | Docteur en médecine | Cardiologie, réanimation médicale | Jean-Pierre COUTERON | Psychologue | Addictologie | Anne-Sophie COUTIN | Docteur | Gynécologie obstétrique | Sylvie DARSOUZE | Docteur | Tabacologue | Pascal DEBOVE | Médecin | Pneumologue | Michel DELAUNAY | Docteur | Ophtalmologie | Valentine DELAUNAY | Médecin | Addicto | Isabelle DELAUNAY LELIEVRE | Médecin | Pneumologue | Claire DELORME | Médecin | Soins oncologiques de support | Pierre DEMONTROND | Docteur | Pneumologue, oncologue thoracique | Corinne DEPAGNE | Docteur | Pneumologie | Hervé DOUARD | Médecin | Gastro-enétrologue | Gérard DUBOIS | Professeur honoraire de santé publique | Santé publique | Catherine DUBOS ARVIS | Médecin | Pneumo-oncologue | Dominique DUPAGNE | Docteur | Médecine générale | Olivier DURET | Médecin | Généraliste | Martine ENGERRAND | Docteur | Médecine générale | Françoise ETCHEBAR | Médecin généraliste | Addictologue | Jean-François ETTER | Professeur | Santé publique | Philippe EVENOU | Docteur en médecine | Dermatologue | Audrey FAVEYRIAL | Docteur, directrice des affaires médicales de centre François Baclesse | Oncologie médicale | Marie-Josée FERRO-COLLADOS | Médecin | Addictologue | Anaenza FREIRE MARESCA | Docteur de médecine | Infectiologie, addictologie | Marie-Pierre GALAIS | Médecin | Hépatogastroentérologue | Florent GASCOUGNOLLE | Docteur | Médecine générale | Benjamin GOUACHE | Docteur | Psychiatre | Philippe GRUNBERG | Médecin et enseignant | Généraliste | Renaud GUIU | Médecin | Médecin du sport | Jean-Marie HEID | Docteur | Médecin addictologue | Eliane HERRAN | Médecin addictologue | Addictologie | Bernard GÉRY | Médecin | Oncologue radiothérapeute | Sylvianne JACQUEMIN | Docteur en médecine | Psychiatrie | Bruno JOURNE | Médecin Addictologue | Addictologue | Jacques LACROIX | Médecin | Médecine générale | Marion LAFOSSE | Docteure | Anesthésiste-réanimateur | Christophe LAMARRE | Docteur en médecine | Spécialiste en médecine générale | Audrey LASNE-CARDON | Docteur | ORL et chirurgie cervico-faciale | Didier LAURENT | Médecin | Gastro-entérologue | Franck LE CAER | Docteur en médecine | Douleur soins palliatifs | Mathilde LECHEVREL | Enseignant – Chercheur | Toxicologie | Jacques LE HOUEZEC | Docteur en science de la vie et de la santé | Dépendance au tabac, tabacologue | Jacques LELOUTRE | Médecin | Addictologue | Brigitte MALNOURY | Médecin | Généraliste | Béatrice LE MAITRE | Médecin | Tabacologue | Thibault LE MEHAUTE | Docteur | Médecine générale | Annaïg LE PENNEC | Médecin | Addictologie | Delphine LEROUGE | Docteur | Onco radiothérapeute | Marie-Thérèse LETERTRE DELAUNAY | Docteur | Ophtalmologie | William LOWENSTEIN | Médecin interniste et addictologue, président SOS Addiction | Addictologie | Loredana MARTES | Médecin | Chirurgie thoracique | Gérard MATHERN | Docteur en médecine | Penumologue, tabacologue | Damien MAUILLON | Médecin | Addictologue | Astrid MAURAY CAPLANNE | Médecin | Addictologue | Marie-Line MAZURKIEWICZ LINE | Praticien hospitalier | Addictologue | Wajdi MEHTELLI | Docteur | Psychiatre, Addictologue, Tabacologue | François MEURET | Docteur en médecine | Médecin généraliste | Xavier MIRABEL | Médecin hospitalier, chef de pôle | Oncologue radiothérapeute | Pascale MODAI | Docteur | Médecin du travail | Jean-Pierre MOIROUD | Docteur en chirurgie dentaire | Orthodontie | Arnaud MUYSSEN | Médecin | Addictologue et biologiste | Saadia NAHLI | Médecin | Addictologie | Phuc NGUYEN | Médecin | Addictologie | Caroline PAPEIX | Médecin | Neurologue | Aurélie PARZY | Docteur | Gastroentérologie | Dominique PASQUET-MOULIN | Médecin | Généraliste | Etienne PATRICOT | Médecin | Addictologue | Antoine PELISSOLO | Professeur de médecine, chef de service | Psychiatrie | Annie PEYTIER | Docteur | Gastroentérologue, oncologue | Laurence PICARD | Docteur | Pharmacie | Aline PICON | Médecin | Addictologie | Estelle PIROLLO | Docteur | Addictologue | Philippe PRESLES | Docteur | Tabacologie, psychothérapie | Audrey RAMBEAU | Docteur | Oncologie | Gérard REGINE | Médecin | Généraliste | Thierry RENAUX | Médecin | Addictologie | Rose-Marie ROUQUET | Docteur en médecine | Pneumologie, tabacologie | Christelle ROUSSEAU | Médecin | Médecine du travail | Pierre ROUZAUD | Médecine du travail, Toxicologie et médecine légale, réparation juridique du dommage corporel, médecine aéronautique | Kenneth SHERWIN | Docteur | Médecin généraliste | Jean-Baptiste TRABUT | Docteur | Addictologie | Marie VAN DER SCHUREN | Médecin | Tabacologue, addictologue | Nadine VIDÉ | Médecin | Tabacologue | Johanna WAEERMANN | Docteur | Oncologie | Alexandre ZAKINE | Psychologue | Addictologie

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Ressources

Nicotine and cancer

Does nicotine cause cancer? According to the WHO: NO. Link: https://cancer-code-europe.iarc.fr/index.php/fr/12-facons/tabac/1164-la-nicotine-provoque-t-elle-le-cancer

Also see this recent publication from Cancer Research UK: E-cigarettes: what we know and what we don’t – Link: https://news.cancerresearchuk.org/2021/04/26/e-cigarettes-what-we-know-and-what-we-dont/

Vaping and cancer

Among other references, we can quote the INCa which states: « Unlike cigarettes, they do not contain tobacco, nor do they create smoke or combustion. Although nicotine is addictive and, in very high doses, harmful to health, e-cigarettes do not contain the vast cocktail of carcinogenic chemicals found in combustible tobacco » (our translation) in « Electronic Cigarettes: An Opportunity to Reduce Tobacco-Related Cancers?

Downloadable PDF: https://www.e-cancer.fr/content/download/198962/2674935/file/Ciigarette_electronique_Extrait_de_la_synthese_des_cancers_en_France_2016_20170530.pdf

Article from 2016 by Pr Bertrand Dautzenberg and Dr Daniel Garelik: Patients with lung cancer: Are electronic cigarettes harmful or useful?

Vaping is an effective aid to stop smoking

In France, according to the 2017 Health barometer published by Santé Publique France, 870,000 ex-smokers say that vaping helped them to stop smoking (including 700,000 people who had stopped smoking for at least 6 months). The main aids used were electronic cigarettes (26.9%) and nicotine substitutes (18.3%)

Ref: Barometer of Public Health France 2017. Electronic cigarette use, smoking and opinions of 18-75 year olds – Pasquereau A, Quatremère G, Guignard R, Andler R, Verrier F, Pourchez J, Richard JB, Nguyen-Thanh V – 2019 – https://www.santepubliquefrance.fr/determinants-de- sante/tabac/documents/enquetes-etudes/barometre-de-sante-publique-france-2017.-usage-de-la-cigarette-electronique-tabagisme-et-opinions-des-18-75- ans

Ref: Smoking cessation attempts in the last quarter of 2016 and the link with the Month without Tobacco: first results observed in the 2017 Health Barometer – Romain Guignard (romain.guignard@santepubliquefrance.fr), Jean-Baptiste Richard, Anne Pasquereau, Raphaël Andler, Pierre Arwidson, Olivier Smadja, Viêt Nguyen-Thanh; the 2017 Health Barometer group* Santé publique France, Saint-Maurice, France – –
Link: http://beh.santepubliquefrance.fr/beh/2018/14-15/2018_14-15_6.html

Vaping is far less harmful than smoking

Public Health England, in the UK, estimates that vaping is 95% less harmful than smoking.

A study by the Pasteur Institute shows that vaping reduces carbonyls by 99.8% and polycyclic aromatic hydrocarbons by up to 99.2% compared to tobacco smoke, which is a bigger reduction than from heated tobacco. The Institute nevertheless urges caution before extrapolating a reduction in harm proportional to the reduction in emissions.

Ref: Comparison of the chemical composition of aerosols from heated tobacco products, electronic cigarettes and tobacco cigarettes and their toxic impacts on the human bronchial epithelial BEAS-2B cells – Link: https://www.sciencedirect.com/science/article/abs/pii/S0304389420314060?via%3Dihub

Entry point for non-smokers, and in particular young people, into smoking

Research carried out by the OFDT and INSERM not only indicates the absence of a gateway effect, but also suggests a diversion effect of vaping against adolescent smoking. Young people who have tried vaping at least once have about a 40% lower risk of becoming a smoker by the time they are 18 than those who have never tried.

Ref: Sandra Chyderiotis, Tarik Benmarhnia, François Beck, Stanislas Spilka, Stéphane Legleye, Does e-cigarette experimentation increase the transition to daily smoking among young ever-smokers in France?, Drug and Alcohol Dependence, Volume 208, 2020 – Link: https://doi.org/10.1016/j.drugalcdep.2020.107853.

Ref: Legleye, S., Aubin, H.‐J., Falissard, B., Beck, F., and Spilka, S. (2020) Experimenting first with e‐cigarettes versus first with cigarettes and transition to daily cigarette use among adolescents: the crucial effect of age at first experiment. Addiction – Link: https://doi.org/10.1111/add.15330.

The value and impact of these supposedly protective measures have never been evaluated, but evidence of negative effects from flavour bans is mounting. A publication in JAMA pediatrics is based on data collected from more than 100,000 California high school students as part of the biennial Youth Risk Behavior Surveillance System (YRBSS). It found that San Francisco’s ban on the sale of flavoured vaping products was associated with an increase in smoking among high school minors compared to other school districts. – Link: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2780248

Another US cohort study, involving nearly 18,000 adult participants, reached the same conclusion: those who started using products with non-tobacco flavours were more likely to quit smoking than those who used tobacco flavours. – Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766787

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