UAE doctors stand firm over e-cigarettes despite UK backing

Doctors in the UAE are refusing to support e-cigarette use to help smokers quit, despite UK health authorities backing the devices for the first time in the annual Stoptober campaign.

As a 100 per cent tax on cigarettes comes into force in the UAE from October, new draft guidance from the UK’s National Institute for Health and Care Excellence (NICE) says patients should be told that e-cigarettes can be an aid to stop smoking for those wanting to give up.

It remains illegal to sell e-cigarettes in the UAE, with no movement on that for the foreseeable future, but just 5 per cent of smokers manage to quit without medication or some other form of help.

UAE health authorities have demanded more conclusive research proving their safety and effectiveness as a less harmful alternative to conventional cigarettes before any policy change.

“We are still unsure of the safety of e-cigarettes, and it will take some time before we can support their use,” said Dr Hassan Razein, a specialist in respiratory medicine at Zulekha Hospital.

“Some producers claim nicotine levels in their e-cigarette devices are substantially less than in cigarettes. Because of the toxicity, we cannot support their use or recommend them to help smokers to quit.”

Zulekha Hospitals offers smokers looking to quit group therapy sessions, medicines and nicotine replacement gums or sprays.

Doctors there said smokers must be committed to follow a full cessation programme, and will struggle with will-power alone.

Long-term smokers managing to kick the habit can expect their health to recover reasonably quickly but they will still be susceptible to serious associated illnesses such as lung cancer and cardiovascular disease.

“Once smokers stop, their body begins to recover almost immediately but long-term recovery can take up to two years after someone quits,” said Dr Razein, who also said a tobacco tax would do little to deter smokers in a wealthy country where prices will remain relatively low.

Read more: Regulations and updated advice on e-cigarettes is falling behind

“Price is not an issue for long-term smokers who are addicted but it may help those on lower incomes. It’s a sign the approach towards smoking is changing, which is positive.”

According to the fifth World Tobacco Atlas, an average of 27 people in the UAE die each week due to tobacco-related diseases.

The current rate of smoking is 24.3 per cent among males and 0.8 per cent among women.

Medwakh and shisha continue to be popular in the UAE, and also pose a significant risk.

A UK government campaign encouraging smokers to quit will feature e-cigarettes in promotional material for the first time, representing a sea change in the official approach towards the devices.

But doctors at Cleveland Clinic Abu Dhabi were also unwilling to support the use of e-cigarettes as part of a smoking cessation programme.

“When it comes to smoking, there is no safer option other than quitting entirely,” said Iyaad Hasan, a certified tobacco treatment specialist.

“A lot of people pin their hopes on this kind of alternative to smoking because they take the place of a habit that’s embedded in people’s lives.

“Although research is still ongoing in relation to e-cigarettes, past research has demonstrated that the chemical content in them, although maybe lower than a traditional cigarette, is still harmful.

“The fact of the matter is these substances were never meant to be in the human body in the first place.”

Consisting of four main steps, Cleveland Clinic Abu Dhabi’s Smoking Cessation Programme follows smokers from their decision to quit through to life after smoking, creating a customised programme for each person.

University College London researchers found 20 per cent of attempts to quit were successful in the first six months of 2017, compared with an average of 16 per cent over the previous 10 years.

Of the one in 20 people over 16 who regularly use e-cigarettes in the UK, a quarter are either smokers or ex-smokers.

A ban on advertising, smoking indoors, standardised packaging and high taxation are said to be behind the growing numbers in the UK attempting to kick the habit.

“Some smokers are able to stop on their own, but very few,” said Dr Mohamed Maki Shalal, head of ER at Canadian Specialist Hospital in Dubai.

“Smoking is a strong habit, and an addiction that is hard to break.

“People think e-cigarettes are harmless but we know they are chemicals so there will be problems with them in future.”