Electronic cigarettes offer “the best hope ever” of eliminating harmful smoking, according to a London-based psychologist who specialises in tobacco-dependence research.
A major switch by smokers to e-cigarettes would decrease death and disease, Prof Peter Hajek, professor of clinical psychology and director of the Wolfson Institute of Preventive Medicine's tobacco dependence research unit, believes.
Hajek, who has been invited to Galway later this month by Croí, the west of Ireland heart and stroke charity, has developed treatments for dependent smokers and people with weight problems and contributed to the establishment of a specialist stop-smoking service in Britain.
“Because e-cigarettes resemble real cigarettes, our gut reaction is negative, but once you look into the implications there is great potential,” Hajek says.
E-cigarettes, which are battery-powered and contain a cartridge filled with nicotine that has been dissolved in propylene glycol or vegetable glycerol and water, are not subject to the same regulatory controls as cigarettes.
The vapour emitted is free of harmful substances such as tar, but the Minister for Health, Dr James Reilly, has said he is reviewing the evidence before deciding on their wider regulation. He has indicated that he may ban their sale to under-18s.
"Statistics can be a bit misleading, but about one-third of smokers in Britain have tried them, while only 12 per cent of that group have actually made the change," says Hajek.
It's not the nicotine
"Sales of cigarettes went down by 6 per cent in Europe last year, so tobacco companies are watching the trend. Nicotine itself may be no more harmful to health than coffee, and it's the other substances in regular cigarettes that are dangerous."
Hajek smoked as a student – “mainly when my mates did” – but was never hooked, he says. He is aware of the battle involved in overcoming the addiction, and has worked on trials and clinical treatments to reduce dependence. He has contributed to the British National Institute for Health and Care Excellent (Nice) guidelines, which recommend nicotine replacement prior to quitting.
“Unfortunately, cigarettes are still seen as glamorous among young people, and good in helping to keep weight down,” he says. “Also, if your life is stressful, if you have mental health issues, if you are around people who smoke, or if your genes make you react to nicotine positively, it can be difficult to stop.”
Population data shows the most successful quitters are those “who do it on their own, with no assistance, and out of the blue”, he says.This is “probably because they were less dependent” in the first place.
“E-cigarettes need more time to develop and to out-compete deadly conventional cigarettes, but they have the potential to end the tobacco epidemic,” Hajek says. “So if regulators decide to ban them or submit them to stricter regulations than conventional cigarettes, this would be detrimental to public health.”
However, he agrees with a ban on sales to under-18 year olds, as “it is a good idea not to expose this age group to nicotine”.
He says it is only a matter of time before tobacco companies switch over to e-cigarette manufacture themselves, with some already buying into this new market. “Just think about the fact that it took 100 years for cigarettes to kill off tobacco pipes, snuff and cigars, and to become as successful as they are now,” he says.
Hajek, who is attached to the London School of Medicine and Dentistry, Queen Mary University of London, has written or co-authored over 250 publications. He will be in Ireland later this month to teach on the NUI Galway medical school's MSc in preventive cardiology.
He is also delivering a one-day workshop to healthcare workers at the Croí Heart and Stroke Centre (now called the National Academy of Preventive Cardiology).
