WHO report: Changing trends in global tobacco use but effects of e-cigarettes unclear
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WHO report: Changing trends in global tobacco use but effects of e-cigarettes unclear

Credit: Unsplash/Mathew MacQuarrie

The World Health Organization released today a report showing that the number of males using tobacco is on the decline for the first time. Europe is the region making the slowest progress in reducing tobacco use among females.

The WHO report covers the use of cigarettes, pipes, cigars, waterpipes, smokeless tobacco products and heated tobacco products. Electronic cigarettes, that do not constitute tobacco products because they do not contain tobacco (only nicotin), are not covered in the report.

However, they are still a serious public health concern according to WHO and the organisation intends to publish a report on the latest evidence concerning electronic cigarettes and vaping in February next year.

During nearly the past two decades, overall global tobacco use has fallen, from 1.4 billion in 2000 to 1.3 billion in 2018, or by approximately 60 million people. This has been largely driven by reductions in the number of females using these products (346 million in 2000 down to 244 million in 2018, or a fall over around 100 million).

Over the same period, male tobacco use had risen by around 40 million, from 1.050 billion in 2000 to 1.093 billion in 2018 (or 82% of the world’s current 1.3 billion tobacco users).

But positively, according to the WHO, the number of male tobacco users has stopped growing and is projected to decline by more than 1 million fewer male users by 2020.

“Reductions in global tobacco use demonstrate that when governments introduce and strengthen their comprehensive evidence-based actions, they can protect the well-being of their citizens and communities,” said Dr Ruediger Krech, Director of Health Promotion at WHO.

Despite such gains, progress in meeting the global target set by governments to cut tobacco use by 30% by 2025 remains off track. Based on current progress, a 23% reduction will be achieved by 2025. Only 32 countries are currently on track to reach the 30% reduction target.

But more countries are implementing effective tobacco control measures, which are having the desired effect of reducing tobacco use. Tobacco taxes not only help reduce tobacco consumption and health-care costs, but also represent a revenue stream for financing for development in many countries, according to WHO.

Every year, more than 8 million people die from tobacco use, approximately half of its users. More than 7 million of those deaths are from direct tobacco use while around 1.2 million are due to non-smokers being exposed to second-hand smoke.

According to another report released this week by The Standing Committee of European Doctors (CPME), the organisation is “highly concerned about the health risks of emerging novel tobacco and nicotine products”, such as electronic cigarettes.

Typical use of electronic cigarettes produces an aerosol that includes toxic substances that have known health effects, resulting in a range of significant pathological changes, writes CPME, and warns against e-cigarettes as a gateway to conventional cigarette smoking among children and teenagers.

As previously reported, out of the around 2 million smokers in Belgium, the proportion of those who use an electronic cigarette has been annually increasing by around 10%. Around 250,000 to 300,000 people in Belgium are estimated to be currently vaping.

Long-term health effects of electronic nicotine delivery systems (ENDS) are still unknown, and further research is required, writes WHO and refers to its forthcoming report. “There is substantial debate on the questions of whether ENDS are an effective cessation tool and whether they provide a gateway to smoking. For both questions, it is too early to tell.”

Asked by The Brussels Times about the dangers of e-cigarettes, Dr Krech replied that the specific level of risk associated with ENDS has not yet been conclusively estimated but that ENDS are undoubtedly harmful and should therefore be subject to regulation.

“There is insufficient evidence to back claims of their effectiveness in assisting smokers trying to quit conventional tobacco use. In most countries where they are available, the majority of e-cigarette users continue to use e-cigarettes and cigarettes concurrently, which has little to no beneficial impact on health risk and effects.”

M. Apelblat
The Brussels Times