OR07-4 E-CIGS (VAPORIZERS): A PUBLIC HEALTH OPPORTUNITY THAT WILL BE MISSED? Dr Robert Hämmig, MD Psychiatry & Psychotherapy FMH President SSAM Medical.

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OR07-4 E-CIGS (VAPORIZERS): A PUBLIC HEALTH OPPORTUNITY THAT WILL BE MISSED? Dr Robert Hämmig, MD Psychiatry & Psychotherapy FMH President SSAM Medical Director Addiction Department University Psychiatric Services Bern SSAM

Disclosure No conflict of interests

Tobacco Atlas (4th edition) Cigarettes account for 92% of the value of all tobacco products sold globally

WW II

Well deserved pause of our heroes with a mild stimulant /relaxant WW I WW II Dak To (Vietnam) 1967 Saipan 1944 Ryūkyū Islands 1945 Falluhjah (Iraq) 2004

Smoking cessation Jorenby et al. JAMA 2006;296:56 – 63Gonzales et al. JAMA 2006;296:47–55 from: Nides, The American Journal of Medicine (2008) Vol 121 (4A), S20–S31

Cigarette smoke vs. E-cig vapour From Tobacco Atlas, 4th edition Chemicals in E-cig Vapour Nicotine”Cockroach poison” Glycerol Food Additive E422

E-cigs: the public debate E-cigs: do they fall under tobacco laws or pharmaceutical law? Arguments against e-cigs: – Nicotine is lethal already in small amounts – E-cigs are a gateway to tobacco smoke

Good and bad nicotine from an 1980ies anti-smoke game

Nicotine: the “cockroach poison” *Mayer. Arch Toxicol (2014) 88:5–7 Lethal nicotine Historic case: Hippolyte Visart de Bocarmé was sentenced to death for murdering his brother in law with nicotine in mg of nicotine as a lethal dose stems from an error in the 19th century scientific literature. This error was copied ever since.* Lethal dose of nicotine is between 0.5g -1.0g or even more. from glossary of Tobacco Atlas, 4th edition

Gateway theory There is no observation that would confirm a gateway theory from e-cigs to tobacco cigarettes. There are observations for the other way round. Gateway theories are normally wrong. A temporal sequence is not a causality.

SwissVap Study Delphi study with tobacco experts Results: Yes to nicotine containing fluids for vaping But: – No advertising – Limitation of content – Youth protection measures QR code for download of report

Nutt et al. Eur Addict Res 2014;20: Marketing prohibited in Switzerland ENDS electronic nicotine delivery system products

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