In advance of the Framework Convention on Tobacco Control (FCTC) held in Moscow in October 2014, there were a number of groups jockeying for position. First, a leaked document suggested the World Health Organization (WHO) was gearing up to take a negative stance against e-cigarettes at the FCTC meeting, concluding they were as dangerous as tobacco cigarettes. Second, a group of 53 researchers from 18 countries wrote a letter to Dr Margaret Chan, director-general of WHO, arguing there was “no evidence at present of material risk to health from vapour emitted from e-cigarettes,” and urging the WHO to be “in the vanguard of science-based, effective and ethical tobacco policy, embracing harm reduction.”
Finally, there was another group of 129 researchers and clinical experts, headed by Stanton Glantz of San Francisco, who wrote to Chan: they were adamant that e-cigarettes were nothing more than a Trojan horse designed by a predatory industry that was hell-bent on increasing profits. Following the FCTC meeting, advocates of harm-reduction were bitterly disappointed, although not surprised, when the WHO called on nation states to consider prohibiting e-cigarettes and banning advertisements.
On 17 December 2014, the first Cochrane Review on e-cigarettes was published, in which the authors sought to answer the question: How effective are e-cigarettes in helping people to stop smoking tobacco cigarettes? Although the data were limited – just two randomized trials and 11 observational studies – the results were encouraging: smokers who used e-cigarettes were able to stop or reduce their tobacco smoking, and there were no adverse effects resulting from e-cigarette use.
David Tovey, editor-in-chief of the Cochrane Collaboration, said: “This review provides a timely reminder of the challenges faced by smokers who find it hard to stop smoking. The results need to be strengthened with further comparisons between e-cigarettes and traditional cessation methods, and evidence on long-term safety.” For now, though, the jury would still appear to be out.