Can electronic cigarettes save your life?
It is a challenging task for all family doctors to have an interview with patients and to persuade those who smoke for years to quit the habit. It's not because we don't realize how harmful smoking can be - doctors and patients both know it's a deadly habit. But no matter how hard our doctors say it, or what kind of panacea they come up with, it's really hard for patients to quit smoking. We'll try this method and try that again. The patients first gnash their teeth and quit smoking, but soon they relapse and the addiction continues. That's why any treatment that really helps smokers around the world, more than half of men in China, quit smoking is a medical miracle.
So electronic cigarette powder, a battery-powered device that does not contain tobacco, comes on the scene, volatilizing liquid nicotine and other addicts as people smoke it. Although e-cigarettes still account for a small share of the market in most countries, they have become increasingly popular in the past two years, including China, where most of the e-cigarettes are now assembled. The controversy surrounding this product also follows. Is electronic cigarette a miracle or a strange story? As long as you pay a little attention to the news, doctors and public health experts around the world are having a huge controversy over e-cigarettes. Many experts enthusiastically appeal that electronic cigarettes should be widely used, while others believe that the potential health risks of electronic cigarettes are not yet fully understood, so it should be regarded as ordinary cigarettes and that electronic cigarettes need to be controlled or even banned before further research is available. I am on the side that supports e-cigarettes, at least for the time being, provided that the production, distribution and promotion of such products are properly regulated.
Doctors'first duty is not to do evil, but can we now guarantee that electronic cigarettes will not do evil? There has been no consensus in the medical community, and the World Health Organization (WHO) finally added a point to its latest report this month (September) that electronic cigarettes are "a growing front that promises but also threatens tobacco control. They found that "there is not enough evidence that electronic cigarettes can help users quit smoking." They also strongly appealed for regulatory policies to protect children, including strict restrictions on advertising and any taste and packaging that proves attractive to children.
I agree with this point: there is reason to express concern about electronic cigarettes. Children may be drinking liquid nicotine in electronic cigarettes by mistake, causing serious stomach problems, but responsible parents should have known for a long time that any chemicals that might cause harm need to be kept away from children and locked up. I am also worried about the growing number of teenagers who find e-cigarettes cool, fueled by advertising. More than 260,000 young Americans who had never smoked before tried electronic cigarettes in 2015, more than twice as many as 79,000 in 2013, according to a study published in August by the Centers for Disease Control and Prevention. But a new study by the Action on Smoking and Health (ASH) charity shows that while the proportion of teenagers who try to smoke e e-cigarettes has risen from 7% in 2015 to about 10% in 2016, 90% of them have smoked regularly before and never smoked. 98% of children never smoke an electronic cigarette.
Many critics of e-cigarettes have focused on the possible link between e-cigarettes and ordinary cigarettes, especially the potential impact on teenagers, but the fact remains that tens of millions of long-term smokers around the world face serious and immediate health problems. I worked as a family doctor, and when I saw a 30-year-old patient who smoked a pack of cigarettes a day, I immediately realized that he had crossed a fairly serious medical milestone. Because such smokers are at higher risk of cancer, heart disease and all-cause death, the Preventive Service Task Force now recommends that they all undergo an annual chest CT screening for lung cancer. Professional and ethical obligations required me to try every means to save the patient's life, and I would advise him that he should try any means that might help him quit smoking, including electronic cigarettes.
Anti-e-cigarette campaigners often say that data on the health effects of e-cigarettes are scarce, and that's true. Until recently, very few well-designed studies have been seen. But now that several good studies have emerged, which can be called randomized controlled trials, we should re-examine our position on e-cigarettes on the basis of these more solid new evidence.
The first study, called ECLAT, was published in early 2013 in the PLOS ONE. The one-year study tracked 300 Italian smokers and gave them all kinds of nicotine doses of electronic cigarettes for a total of three months. At first, these smokers did not plan to quit smoking. But at the end of the study, 13% of the high nicotine group quit smoking, 9% of the low nicotine group quit smoking and 4% of the placebo group quit smoking. In addition, a considerable percentage (73%) of smokers who quit smoking no longer use electronic cigarettes, if someone is worried that smokers will take one
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