Public Health: Similarities of e-cigarettes and COVID vaccination? Now or never

In one case, 250,000 deaths in the last few months. On the other, this year only 480,000 deaths. In both cases, regrettable and preventable deaths. Also, both are public health emergencies, one that has been in the news every day since January, the other no longer on the radar.

Covid-19 has proven to be the most acute public health crisis since 1918 in terms of a deadly infection. In January, its genome was sequenced, in march, a first mRNA vaccine was starting clinical trials and now in November of the same year, two vaccines have hinted very positive results, either the Pfizer one at 90% or the Moderna one with 94.5% efficacy. While encouraging results, many questions still lie ahead: what could be the durability of the immune response that such vaccines do elicit, how safe will these be, on both mid and long term, and would these reduce the risk and severity of infection if such happens in an individual?

In the case of e-cigarettes, the exposure data to toxic compounds do show a reduction of 95% of such. The initial data, when compared to existing smoking cessation options such as nicotine replacement therapy, or counselling, have shown that efficacy-wise one sees double the response rates, either short or long term. And a Cochrane review recently pointed to such an option as one that now gathers more evidence in supporting its usage.

In both cases, either regarding the COVID vaccine or e-cigarettes, similar gaps in scientific knowledge are seen. Long term effects in protection do remain to be assessed, any potential in reducing the risk of progressing towards diseases is under assessment, the issue of long term side effects remains unknown. But in both cases, the potential gains outweigh the risk from a public health perspective. While vaccination may later change COVID forever, in eradicating it, moving from traditional cigarettes toward electronic versions of it has been claimed as the Holy Grail in public health for smokers. We should not block vaccination campaigns in light of such missing information, but why should we do such limitation in light of the impact of electronic cigarettes?

In both cases, the general public needs to be informed as the political implication rather than science have driven the discussion around these options. Like one saw reductions in trust towards vaccination for COVID with the White House's lack of a clear message on this disease, similar disinformation was seen around e-cigarettes. Clear messages are warranted to boost levels of both knowledge and confidence in either vaccination or harm reduction strategies for smoking reduction and cessation. On that front, it is now clear that wearing a mask constitutes a very effective harm reduction strategy in preventing COVID infection. Therefore both these topics may share more similarities than differences. One where science should be driving our vision and not some political clouding rhetoric. In countries where science was and is the driving force in public health decision processes, we are seeing very positive results in reducing the smokers of users of cigarettes, and the number of COVID-19 cases...