Tobacco: new uses, real dangers

the essential
Smoking has decreased in France. But the new uses around electronic cigarettes are not without danger. Young people are the targets. The point a few days before World No Tobacco Day (May 31).

As World No Tobacco Day approaches on May 31, France is still a country of smokers with more than three out of ten adults affected in 2020 according to data from Public Health France. But consumption has fallen in recent years, especially between 2016 and 2019 when nearly 1.6 million smokers quit smoking.

In 2021, the French observatory for drugs and addictive tendencies, however, notes a shift towards other tobacco products such as heated tobacco and chicha, which benefit from a positive image among adolescents and young adults. “You would think that young people smoke less than previous generations and that the classic cigarette has become outdated. But the strategy of the tobacco industry is always to seduce a new generation since its traditional product kills 63% of its customers before the age of 69, ”underlines Dr Olivier Galera, tobacco specialist at the Saint-Orens clinic in Haute-Garonne. (1).

“Puff”, shisha, heated tobacco

Doctors are thus observing with fear the rise of the “puff”, a disposable electronic cigarette, allowing between 300 and 600 puffs for a price of less than 10 €. “They are prohibited for sale to minors, but teenagers are snapping them up, especially via social networks. These products with sweet aromas of spread, cotton candy, strawberry, are made to attract them but they contain in most cases around 0.7 to 0.9mg of nicotine. Nicotine is the most addictive drug available on the legal or illegal market when it is delivered rapidly to the brain as is the case with these electronic cigarettes. This generation of consumers may never have touched a classic cigarette but will become addicted to nicotine. And we do not know the long-term effects of these products which seem less harmful (no carcinogenic tars, no carbon monoxide, less fine particles)”, adds Dr Olivier Galera.

Another generational product, chicha, which conveys the false idea that smoke filtered by water is less toxic. “It is an aberration! During a shisha session, we inhale 30 to 100 times more carbon monoxide (toxic for the heart) than with a conventional cigarette”, argues the tobacco specialist who also recalls that smoking cannabis, in addition to the dangers of combustion (like the traditional cigarette), “increases the effect of nicotine and therefore makes you even more dependent”.

With a look close to the electronic cigarette, heated tobacco products (IQOS, Ploom…) are not harmless either. “In the electronic cigarette, you heat a liquid to 60-80°, there you vaporize a small bar of tobacco. It is pyrolysis at 300° which brings out acenaphthene, a powerful carcinogen three times more present than in a traditional cigarette, ”explains the doctor again.

For weaning, prefer nicotine substitutes

At the Toulouse University Hospital’s smoking cessation aid coordination unit, Dr Audrey Rabeau, pulmonologist and oncologist also confirms that all “these products are not without risk to health due to the inhalation of carcinogenic substances and unknown long-term effects of inhaling flavorings and additives. These are not drugs but consumer products so when they are mentioned for weaning we prefer to direct our patients to nicotine substitutes (patches) at a sufficient dose. They are now reimbursed without notion of duration and can be prescribed by doctors, nurses, physiotherapists, midwives”.

(1) Author of “Tobacco Libris, how to free yourself easily from tobacco”, HD edition

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Tobacco: new uses, real dangers

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