Thank you very much, Mr. Chairman, and members of the committee. I thank you for allowing me to speak to you today. I'm grateful for the invitation.
I've been directing a smoking cessation clinic for quite a few years. My experience is dealing with ill and very ill smokers. This is more or less the sense of my intervention.
It is rather naive to think that all smokers want to stop smoking and are able to stop smoking. Nowadays even the best clinical studies usually have a success rate of less than 30% abstinence of one year. Approximately one in three smokers in the United Kingdom currently attempts to quit each year but only about one in six of those who try to quit remains abstinent for more than a few weeks or months. It is about 5.5% altogether. In Canada, 66% will attempt to quit in the next six months.
Cigarettes are the most addictive tobacco product. As it is well recognized, if it is the most addictive tobacco product, it might not be that easy to stop smoking. It takes more than just willpower.
We know very well that tobacco smoking has very dreadful consequences on health, both for the smoker and for the ones who are exposed to second-hand smoke. Smoking tobacco kills, but nicotine does not. Nicotine does not cause cancer, does not cause cardiovascular disease, and does not cause pulmonary disease—COPD, for example. But nicotine creates a dependence. As a chest physician, I've seen enough lung cancer and cases of COPD, asthma, and chronic bronchitis to know that this is a dreadful consequence of smoking. Lung cancer and COPD represent our daily bread in chest medicine. Fifty per cent of smokers will die from a tobacco-related disease. Smokers will die eight to 10 years earlier than non-smokers. Smokers who stop smoking before the age of 35 have a longevity similar to non-smokers. Smokers who quit by the age of 35 can live as long as non-smokers, both men and women. Very little attention is paid to this group of smokers.
I don't have the time to talk about all the illnesses related to tobacco smoking, so I'll concentrate on cancer. Smoking is involved in the etiology of at least 14 different cancers. For some of these it is the main cause, like lung cancer. E-cigarette vape might contain some carcinogenic substances but it is less than 1% of the threshold limit value in the workplace and up to 450 times lower than in cigarette smoke.
Swedish people have used snus for many years, since the beginning of the 20th century. They have the lowest lung cancer rate in the world. It is lower than the United States and lower than Norway. It represents an important fall in the number of deaths by cardiac attack, a fall of 22% in men between 1987 and 1995. It has a low rate of buccal cancer, which keeps on falling in spite of increased use of snus.
Despite controversy, it is clear that e-cigarettes are far less hazardous than tobacco—95% less. I hope that people had a chance to look at the fourth Public Health England report confirming this conclusion, which was issued last week. Smokers smoke primarily for the nicotine, but die primarily from the tar, the combustion of tobacco.
If you look at the number of illnesses related to tobacco smoking, and on the other side, at the addiction that might be created by nicotine, you see that the question becomes, for nicotine-addicted tobacco smokers, is it ethically and morally correct to discourage them from using a 95% less harmful nicotine delivery system?
In conclusion, e-cigarettes can save many thousands of lives. You have the numbers that have been figured out by Great Britain, U.S.A., and China, but they have to be regulated. They must not be advertised, like my predecessors have spoken about, but their availability must not be made more difficult than buying tobacco cigarettes.
Dr. Polosa just recently published a study showing that it is very important that the addicted smoker who wants to switch to electronic cigarettes be coached and shown how to use them. In my experience, when older people buy electronic cigarettes, they don't use them properly.
Thank you very much for your attention.