The Royal College of Physicians in the UK has aligned with the position of Public Health England, deciding that vaping should be promoted to smokers as an option to help quitting and that there is no evidence it moves people in the other direction.

Hong Kong’s largely British trained medical community are again at odds with their mentors in Britain.

The Royal College of Physicians (RCP) released a report on Thursday acknowledging the positive impact e-cigarettes could have on public health. The Hong Kong Academy of Medicine proudly lists the Royal College of Physicians among its international partners in President Dr Donald Li’s welcome message. The current Secretary for Food and Health Dr Ko Wing-man was made Fellow of the Faculty of Public Health Medicine of RCP in 2002. Many Hong Kong doctors carry the Fellow of RCP designation. HT was still waiting for a response from the secretary’s office when this story went to press.

Better than smoking, should be promoted

In the 206-page report, entitled ‘Nicotine without smoke’, the RCP argued that while not as healthy as nicotine replacement therapy (NRT), e-cigarettes are effective in helping smokers to quit traditional tobacco and are likely to be 95% less harmful than combustible cigarettes, again citing the ‘biblical’ Public Health England report endorsed by e-cigarette supporters. It went as far as to associate a vaping device to an “ideal harm-reduction device” which can “ deliver nicotine in a manner as similar as possible to cigarettes, while at the same time maximising palatability and nicotine delivery to approximate the experience of cigarette smoking more closely.”

“[E]-cigarettes are likely to be beneficial to UK public health. Smokers can therefore be reassured and encouraged to use them, and the public can be reassured that e-cigarettes are much safer than smoking,” the report read.

The report also dismissed the “controversies and misunderstandings” that e-cigarettes can become a gateway to smoking, especially among teenagers: “E-cigarettes are not a gateway to smoking – in the UK, use of e-cigarettes is limited almost entirely to those who are already using, or have used, tobacco…E-cigarettes do not result in normalisation of smoking…is likely to lead to quit attempts that would not otherwise have happened, and in a proportion of these to successful cessation. In this way, e-cigarettes can act as a gateway from smoking.”

Dr Konstantinos Farsalinos, a Greek cardiologist who is outspoken in support of e-cigarettes, said the report is “extremely important and is expected to be highly influential”, and that it provides “a valid and unbiased approach to currently-available evidence, presents any uncertainties about long-term risk without hysteria and intimidation.”

Debate will continue

It is unlikely the report will end the debate in favour of the pro-vaping camp. It may just add fuel to the fire. It was soon picked up across the Atlantic, generating bouquets and brickbats from American commentators.



In Hong Kong, a recent Baptist University study commissioned by the Hong Kong Council on Smoking and Health (COSH) found that the level of polycyclic aromatic hydrocarbons (PAHs), by-product of burning petroleum, released from the devices is “at least one million times more than roadside air in Hong Kong.” COSH has been advocating for a total ban on e-cigarettes in Hong Kong, and the Hong Kong Government is holding a similar stance. Dr Farsalinos disagrees, arguing that it is a “disgrace” to compare the level of PAHs of e-liquid with that of breathing air.