Scheer Report - Was steckt dahinter Teil 14

 Hallo Liebe Leser, 


Heute kommt vierzehnten und somit letzen Teil der Anmerkungen zum Scheer Report. Also die Dinge die mir zum Scheer Report aufgefallen ist und welche man als Anregung für eine Mail an die Abgeordneten mitnehmen kann. Dieses mal werde ich das Fazit aufteilen einmal zu diesem Teil und dann einmal zum gesamten Scheer Report.
 
Vorab liste ich Euch wie schon im vorigen Teil alle Artikel dieser Serie auf:
 

Wie auch im Teil vorher werde ich mich nur auf die Bereiche im Scheer Report beschränken, welche nicht explicit in den vorigen Artikeln behandelt wurden, es sei denn ich habe neue Anmerkungen dazu gefunden. Daher fangen wir auch mit Seite 70 des Scheer Reportes an. 

6.7
Role of electronic cigarettes in the cessation of traditional tobacco smoking and dual use


Smoking cessation has additionally been recognised as an essential component of the WHO’s MPOWER package for tobacco control and the WHO Framework Convention for Tobacco Control (FCTC) (WHO, 2008). WHO has selected a 30% reduction in tobacco use as one of the 25 by 2025 goals, and the WHO Regional Office for Europe has professed their ultimate goal to have a European region free of tobacco use (WHO, 2015).

Due to the large health benefits of smoking cessation for both the individual and public health overall, it is essential to implement strategies to assist smokers in quitting. Using the Eurobarometer datasets, research has indicated that in the EU and among current and former smokers, those who had ever attempted to quit without assistance increased from 70.3% in 2012 to 74.8% in 2017. During this timeframe, experimentation with the use of electronic cigarettes for smoking cessation increased (3.7% to 9.7%), while on the contrary the use of pharmacotherapy (14.6% to 11.1%) and smoking cessation services (7.5% to 33 5.0%) declined across the EU (Filippidis, et al.,2019). Notably, the differences in cessation methods across European Member states were associated with the existence of comprehensive national smoking cessation policies. Recent data on quitting activity, including quit attempts and intention to quit, and use of cessation assistance among a cohort of smokers from eight European countries indicated that experimentation with electronic cigarettes as a smoking cessation device in the last quit attempt differed substantially across different European Member states, ranging from 5% in Spain to 51.6% in England – highlighting the differences across the EU (Hummel et al., 2018).

In light of the above population experimentation with electronic cigarettes, it is important to assess through reviews of existing evidence, cohort studies and randomised control trials to assess the weight of evidence available. To this extent, a Cochrane Review (Hartmann-Boyce, 2016) included 24 studies (three RCTs, two of which were eligible for meta-analysis, and 21 cohort studies)- up to 2015, in which the authors noted that there is evidence from two trials that electronic cigarettes help smokers to stop smoking in the long term compared with placebo electronic cigarettes. However, the small number of trials, low event rates and wide confidence intervals around the estimates mean that our confidence in the result is rated 'low' by GRADE standards. Malas et al., (2016) identified 62 relevant references appraised in accordance with the GRADE system, in which the quality of the evidence in support of electronic cigarettes' effectiveness in helping smokers quit was assessed as very low to low, and the evidence on smoking reduction was assessed as very weak to moderate.
In 2019, a new RCT was published (Hajek, et al., 2019). In this study motivated smokers attempting to quit and who were not current users of either product were randomised to either electronic cigarettes or nicotine replacement therapy (NRT) for 52 weeks (n=886). At 1year, the abstinence rate was 17.7% in the electronic cigarette group and 8% in the NRT 4 group. Notably, participants who did not achieve abstinence and used electronic cigarettes showed a significant reduction in their exhaled carbon monoxide, suggesting decreased tobacco consumption. The study concluded that use of electronic cigarettes was more effective than use of NRT for smoking cessation in the trial when both were accompanied by behavioural support.

In 2019 another RCT was published (conducted in 2016–2017 in New Zealand) comparing electronic cigarettes, with and without nicotine, as an adjunct to NRT in the form of a nicotine patch (Walker et al., 2020). The study randomized smokers motivated to quit. In this study smokers using nicotine-containing electronic cigarettes were more likely to have  biochemically verified, continuous cigarette abstinence at 6-month follow-up than those randomized to patch plus nicotine-free electronic cigarettes or to nicotine patch alone (7%, 16 4%, and 2%, respectively).

Taking the above RCTs into account and the information available through systematic reviews that have synthesized the observational literature on the impact of electronic cigarette use the most recent 2020 Surgeon general’s report on Smoking Cessation (Surgeon General 2020) concluded that “The evidence is inadequate to infer that e-cigarettes, in general, increase smoking cessation”. Moreover the report also concluded that  “the evidence is suggestive but not sufficient to infer that the use of e-cigarettes containing nicotine is associated with increased smoking cessation compared with the use of e-cigarettes not containing nicotine, and the evidence is suggestive but not sufficient to infer that ore frequent use of e-cigarettes is associated with increased smoking cessation compared with less frequent use of e-cigarettes.”

In addition, the European Heart Network reported that there is not sufficient evidence until now that electronic cigarettes’ use is an effective mean for smoking cessation.

There is a lack of robust longitudinal data on the effect of electronic cigarettes on smoking cessation.
Smoking cessation has additionally been recognised as an essential component of the WHO’s MPOWER package for tobacco control and the WHO Framework Convention for Tobacco Control (FCTC) (WHO, 2008). WHO has selected a 30% reduction in tobacco use as one of the 25 by 2025 goals, and the WHO Regional Office for Europe has professed their ultimate goal to have a European region free of tobacco use (WHO, 2015). 
Wie schön hier wird einmal wieder mal mehr deutlich gemacht welches Ziel die WHO hat. In meinem Beitrag: Die Lügenpresse der WHO   habe ich ja schon aufgezeigt welcher Methoden sich diesbezüglich bedient wird. Heiligt der Zweck hier wirklich die Mittel? Ich denke nein.
 
 However, the small number of trials, low event rates and wide confidence intervals around the estimates mean that our confidence in the result is rated 'low' by GRADE standards. Malas et al., (2016) identified 62 relevant references appraised in accordance with the GRADE system, in which the quality of the evidence in support of electronic cigarettes' effectiveness in helping smokers quit was assessed as very low to low, and the evidence on smoking reduction was assessed as very weak to moderate.
 Ernsthaft die Beweiskraft das Dampfer mit dem Rauchen aufhören ist niedrig bis moderat? Na noch schallender könnte die Ohrfeige an die Dampfer, welche den kompletten Umstieg von der Pyro auf die E-Zigarette geschafft haben nicht sein. Als Gegenargument verweise ich hier mal auf die Quellen )21 )22 )23 )24 welche das Gegenteil belegen.

Fazit

Hier wird einmal sehr schön dargelegt, wessen Brot die die Schreiber dieses "Romanes" essen. Es ist eindeutig ein WHO-Papier zu Grunde gelegt. Dieses Dokument wurde bereits von mir im Artikel Was haben die geraucht- kann man das auch dampfen?   kommentiert. Wenn man beide Papiere nun nebeneinanderlegt, ist dieser Scheer Report nichts anderes als eine ausführlichere Kopie des Dokumentes der WHO. Und ja sollte dieses alles passieren, sehe ich schwarz für ein Dampfen wie wir es kennen, dann sehe ich schwarz für eine Aromenvielfalt wie wir sie kennen. Denn dann wird alles so streng regelementiert wie beim Tabak. Dazu habe ich mich bereits in den beiden Artikeln Aromenverbote in Liquids - da war doch mal was beim Tabak und Juhu - der Flavour Bann kommt (hoffentlich nicht) geäussert. Zumindest auf Bundesdeutscher Ebene können wir das hoffentlich nicht ja mittlerweile streichen. Mit dem Scheer Report wird das ganze nun aber auch auf EU-Ebene fest eingeplant. 
Was bleibt uns nun nach der erneuten Hetzjagd auf die E-Zigarette? Nun eigentlich nur eines das Ausbrechen aus der Komfortzone und damit das einstehen für den eigenen Genuss. Die Freiheit für sich entscheiden zu können, was ich wie dampfen möchte, wenn ich dampfen möchte. 

 
in diesem Sinne
Seid Achtsam 




Quellen
  1. Public Consultation on E-ciagrettes
    https://ec.europa.eu/health/scientific_committees/consultations/public_consultations/scheer_consultation_10_en
  2. Sheer Report
    https://ec.europa.eu/health/sites/health/files/scientific_committees/scheer/docs/scheer_o_017.pdf
  3. Annex (Anhang mit Regeln zur Erstellung des Reports)
    https://ec.europa.eu/health/sites/health/files/scientific_committees/docs/rules_procedure_2016_en.pdf 
  4.  https://de.wikipedia.org/wiki/Weltgesundheitsorganisation
  5. Sicherheitsdatenblatt pflanzliches Glycerin (Nachweis PH-Wert)  file:///C:/Temp/7301.pdf
  6. Sicherheitsdatenblatt Propylenglykol (Nachweis PH-Wert)  https://www.wigol.de/sites/default/files/download/datasheets/001526.PDF
  7.  https://de.wikipedia.org/wiki/PH-Wert
  8.  https://de.wikipedia.org/wiki/Stickoxide
  9.  https://www.cdc.gov/niosh/hhe/reports/pdfs/2015-0107-3279.pdf
  10.  https://de.wikipedia.org/wiki/Fagerstr%C3%B6m-Test#
  11.  http://www.openscienceonline.com/journal/archive2?journalId=718&paperId=4979
  12.  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177718
  13.  https://www.cdc.gov/niosh/hhe/reports/pdfs/2015-0107-3279.pdf
  14.  https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-019-0318-2
  15.  https://www.mdpi.com/1660-4601/14/9/973/htm
  16.  file:///C:/Temp/ijerph-14-00973-v2.pdf
  17.  https://www.mdpi.com/1660-4601/12/5/4889
  18.  https://onlinelibrary.wiley.com/doi/abs/10.1111/add.14013
  19.  https://www.eurekaselect.com/185534/article
  20.  https://tobaccocontrol.bmj.com/content/27/5/599
  21.  https://www.sciencedirect.com/science/article/abs/pii/S0376871614019863?via%3Dihub
  22.  https://tobaccocontrol.bmj.com/content/26/3/284
  23.  https://www.sciencedirect.com/science/article/abs/pii/S0306460317302915?via%3Dihub
  24.  https://journals.sagepub.com/doi/10.1177/1715163517723035

 

     Bildquelle: 

  1.  https://europa.eu/european-union/sites/europaeu/files/docs/body/flag_yellow_high.jpg

 

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