Health experts at an anti-tobacco conference defended e-cigarettes in Abu Dhabi, dismissing widespread concerns that the devices could lure adolescents into nicotine addiction.
Most experts agreed, however, that use of the devices, about which research warns that not enough is yet known, should be regulated.
Konstantinos Farsalinos, researcher from Onassis Cardiac Surgery Centre in Athens, said that in a study of nearly 19,500 people, mainly in the United States and Europe, 81 percent said they had stopped smoking by using e-cigarettes. "In fact, they quit smoking very easily within the first month of the e-cigarette use on average," he said. "That's something you don't see with any other method of smoking cessation."
But on Wednesday, WHO chief Margaret Chan backed governments that are "banning... regulating" e-cigarette use. She was speaking to reporters at the World Conference on Tobacco or Health, hosted by the capital of the UAE which has so far banned the devices.
"Non-smoking is the norm and e-cigarettes will derail that normality thinking, because it will attract especially young people to take up smoking," said Chan. "So I do not support that."
But for Jean-Francois Etter, associate professor at Geneva University, "e-cigarettes and nicotine and tobacco vapourisers should not be excessively regulated. This could decrease the numbers of smokers who switch to these new products", benefiting "only the big tobacco industry" whose leaders "will be able to survive in a tightly regulated environment".
Etter called the WHO stance on e-cigarettes "political". I think that the WHO people should know better than kill alternatives to smoking cigarettes," he said.
E-cigarettes were first produced in China in 2003, and have since spread globally. They have sparked what several participants at the gathering called a "very divisive debate".
Six million deaths annually
Dr.Alan Blum, a family doctor and director of The University of Alabama Center for the Study of Tobacco and Society, says he would usually recommend e-cigarettes to patients trying to quit, rather than "give a pharmaceutical product which has side effects and which have not worked very well".
But he also warned that e-cigarettes are being used by schoolchildren and that some people use cannabis and marijuana in the devices. Citing a yet unpublished study, Farsalinos insisted that "if three percent of smokers switch to e-cigarettes we are going to save about two million lives in the next 20 years".
The WHO says that tobacco kills nearly six million people a year and that unless urgent action is taken, the annual death toll could rise to eight million by 2030.
E-cigarette advocates argue that the device offers the smoker nicotine in a liquid, thus preventing the combustion of tobacco that releases most toxins. "Alternatives to smoking do not need to be 100 percent safe, they just need to be much safer than tobacco cigarettes," Etter said. "You choose the lesser of two evils."
A German delegate who requested anonymity argued that e-cigarettes will only lead to "dual use". Smokers will use e-cigarettes in places where they are not allowed to smoke while using traditional cigarettes when they can, she argued. "This increases nicotine addiction because they smoke and take nicotine all the time. This makes it much worse. In Germany, e-cigarettes can be bought everywhere by anyone. Children buy these and they initiate a smoking habit."
But Farsalinos insisted that "there is not a single case of a never-smoker who used e-cigarettes and then became a smoker of tobacco cigarettes". The German delegate still disagreed with a ban on e-cigarettes.
If they are proved to help smokers quit, then "e-cigarettes could easily be sold in pharmacies where you have a controlled product" and ensure they are only sold to adults. But she added: "We need regulation for this product."