As the US struggles with vaping, the UK sees e-cigarettes as a powerful tool to help smokers quit.
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The Royal College of Physicians explicitly tells doctors to promote e-cigarettes "as widely as possible" to people trying to quit. Public Health England's advice is that vaping carries a small fraction of the risk of smoking.
U.S. Public health officials have taken a more cautious approach and are slowly regulating e-cigarettes. This caution has become an alarm, but with the explosion of teenage vaping, prompting the federal government and some states to take steps to ban the fruity and mint flavors that appeal to young people.
And now, with hundreds of cases of mystery pulmonary disease in the United States, the Centers for Disease Control and Prevention in the United States recommends that people consider not using electronic cigarettes, especially those with THC, the compound that gives their back high level.
The US response is "utter madness," said Dr. John Britton, director of the British Center for Tobacco and Alcohol Research at the University of Nottingham. "The reality with smoking is that if you tell people to stop vaping, they will go back to tobacco and the tobacco killings."
E-cigarette regulations vary by state, which makes a multifaceted policy. More than 30 countries ban e-cigarettes directly; India stopped selling this month. Many European countries, including Austria, Belgium, Germany and Italy, classify e-cigarettes as tobacco products and are subject to strict controls. They are mostly marketed as consumer products in the UK and France under more loose rules.
Following their arrival in the United States in 2007, e-cigarettes are largely unregulated. The US Food and Drug Administration failed to do so three years ago and is still working out details. Meanwhile, black market versions flourished.
Appearing before Congress last week, the FDA acting commissioner was pressured to explain the agency's position. Several lawmakers have proposed that e-cigarettes be completely removed from the market.
"We do not consider these products safe, we believe they are harmful," said Dr. Ned Sharples. "We don't really think anyone should use them except people who use them in the place of combustible tobacco."
In Britain, a review by Public Health England, a CDC-like agency, concluded that vaping was about 95% less dangerous than smoking. A leading British anti-smoking organization, Ash has even called for electronic cigarettes to be licensed as medicines and to be provided free of charge to smokers trying to quit a government-funded British health system.
"We need radical solutions to stop smoking, and one option is to provide smokers with electronic cigarettes to get the necessary nicotine without tobacco smoke," Britton said. "We have a much more relaxed attitude towards people. nicotine addicts on the grounds that nicotine itself is not particularly dangerous. "
Electronic cigarettes and other vaping devices usually heat a solution containing nicotine in inhaled vapors. The amount of nicotine varies widely: Some countries set limits on call counts There is no hat in the US, and the leap in American teens has drawn warnings from health officials that nicotine can harm the still-developing brain of a teenager
"What is right for England may not be right for the US," says Ryan Kennedy Institute for Global Control on Tobacco at the Johns Hopkins Bloomberg School of Public Health
Compared to the United States, England has historically higher levels of tobacco use and "deeper comfort" with the idea of replacing it less of a bad habit to fear one said Kennedy. British health officials have succeeded and are keen to regulate e-cigarettes strictly while promoting them as a means of stopping smoking.
"It's not very surprising that a place like England has embraced e-cigarettes," Kennedy said. "Many things are arranged to make sense of using these devices to help people switch from cigarettes."
Meanwhile, in the United States, the rapid rise in popularity of e-cigarettes among teenagers is a thriving black market.
"There are obviously a lot of moving parts with this," he said.
Another key difference is advertising. Unlike in the US, the UK has strict regulations on vaping advertising; all television, online and radio marketing is prohibited, explained Linda Bould, a public health teacher at the University of Edinburgh.
"E-cigarettes are being promoted to middle-aged smokers as a way to quit and the images of our annual quit campaign are usually all men with beards, so it looks pretty boring," she said.
On Friday, the CDC said. THC vaping products appear to play a role in the puzzling outbreak of the United States and lung deaths in the U.S. The agency said many of the 800 people who became ill reported THC vaping, saying it needed more information about whether a product, substance, or brand fits. Some researchers suspect an ingredient used as a thickener in vaping oils, especially in black market products.
"It is inconceivable that any legitimate vaping product would cause this degree of damage," Britton says.
Some British electronic users
"There seems to be some panic out there, but it has nothing to do with us," says Lewis Niall, a personal trainer outside the London-based vaping shop.
Niall said that vaping as a whole should not be tarnished if the problem is illegal marijuana products.
"I feel so much better after switching to cigarettes that I don't think anything will change your mind," he said.
AP Medical Medical Mike Mike Stobbe in New York, Carla K. Johnson in Seattle and Matthew Peron in Washington contributed to this report.