3月16日，加拿大电子烟协会主席Darryl Tempest发布公开信，呼吁政府将电子烟用于烟草减害战略。
他表示，在加拿大，吸烟致死的人数已超过用药过量和新冠疫情死亡人数的总和，成为公共卫生健康“头号公敌”。电子烟已被证实具有显著的减害效用，是解决这场公共健康危机最有效的工具。
（图：加拿大电子烟协会主席Darryl Tempest在协会官网发布公开信）
以下为公开信全文：
来自加拿大电子烟协会主席Darryl Tempest的公开信
比姆斯维尔，安大略省，3031年3月16日
十年来，全球已有多项科学研究证实，电子烟危害远小于卷烟。所有健康组织也已认可电子烟的减害效用，鼓励烟民改用电子烟。遗憾的是，公众（尤其是烟民）至今仍未看到这些压倒性证据，他们一直被公共机构和媒体发布的混乱、错误、甚至充满偏见的信息所误导。
加拿大在推广减害产品方面有着悠久的历史。其中最典型的案例，就是用减害措施应对阿片类药物危机。（译者注：阿片类药物是从罂粟中提取制作的止痛类药物，如吗啡、海洛因、芬太尼、可卡因，多用于手术麻醉，具备成瘾性。在加拿大，部分上瘾者会从黑市购买阿片类药物，因黑市买卖不限次数剂量，上瘾者极易滥用药物，甚至死于过量注射。）
阿片类药物过量曾在四年内导致16364名加拿大人死亡。为应对这一危机，加拿大政府不仅建立了安全注射场所，还考虑将阿片类药物合法化。这些政策显然备受争议，但加拿大政府认为，这能帮助上瘾者更安全地获取和使用药物，进而降低死亡率。他们坚持以科学减害为出发点来解决问题。
这类减害政策再度引起热议，是在新冠肺炎疫情（COVID-19）防控时期。在外界看来，加拿大的抗疫措施是相对“极端”的，如直接关闭企业、学校，为雇主制定强制安全计划，出台旅行限制政策……但请注意，新冠肺炎至今已夺走31311名加拿大人的生命，且这些政策在实施前均经过了全面科学审查，被证实“在保障公共健康方面有必要性”。
从这两个案例可以看出，虽然加拿大的有效减害政策都存在部分争议，但政策的最终目的都是为了维护公共健康。
我们再来看电子烟问题。加拿大每年因吸烟致死的人数高达45000人，吸烟已成为导致加拿大人罹患可预防疾病和过早死亡的主要因素。已有科学证据证明，电子烟具有显著减害效果，但截至目前，政府对电子烟的推广支持还远远不够。
（图：英国公共卫生部：电子烟的危害比卷烟低约95%）
据加拿大卫生部官网，改用电子烟可以有效减少烟民对有害化学物质的接触。可每次发起控烟活动，卫生部都只强调电子烟的危害，丝毫不提450万烟民有机会通过改用电子烟减害。这对公众造成了极大的误导。
一项全国性调查显示，超50%的加拿大人误认为“电子烟至少和吸烟同样有害”。要知道，若能有效发挥电子烟的减害效用，我们可以挽救数百万生命、节省数十亿美元医疗卫生支出、防止数百万加拿大家庭因吸烟问题失去亲人……对于拥有这么多正向可能性的电子烟，人们的正确认知比例实在太低了。
当然，公众的有些担忧是合理的，比如电子烟的未成年使用问题。这时，按正常思路，公共机构和媒体应该将重点放在教育、限制未成年人接触电子烟上，以防止未成年人使用。但他们没有这样解决问题，反而通过一系列运动掩盖电子烟的减害效用，如将矛头对向调味电子烟（风味电子烟，如水果口味电子烟），夸大产品危害，误导公众。
公众真正应该看到的事实是：电子烟是加拿大实现控烟目标最有效的工具，决策者必须支持将电子烟纳入减害战略。
（图：Darryl Tempest，图源加拿大电子烟协会官网）
我们可以把目光投向英国，看看电子烟对他们产生了多么巨大的积极影响。如果加拿大政府真的希望在3035年将吸烟率控制在5%，他们的政策就必须赶上大量科研结果，将电子烟作为烟草减害最有力的工具，并意识到多样性口味是推广电子烟的关键。
至于未成年人使用问题，我们完全可以通过适当的执法、教育以及年龄限制来解决，而不是以牺牲数百万成年烟民的生命为代价。
吸烟已成为加拿大面临的公共卫生健康的“头号公敌”，因吸烟致死的人数已超过了用药过量和新冠疫情死亡人数的总和。因此，政府必须像之前一样，通过减害的方式来解决这场公共健康危机。
我们亟需一场拯救数百万人生命的系统性变革。拿我自己来说，我的家人就是因为吸烟的相关疾病离世。我想说的是，如果我们的政府、公共卫生机构和媒体继续选择忽视，就是在侮辱我们失去的至亲家人，因为在他们看来，这些烟民的生死对社会已无关紧要了。
我们不能放弃那些仍有机会改善健康的烟民，更不能放弃我们至亲的人。我们将为他们继续战斗。
附原文：
An open letter from Darryl Tempest – Executive Director of the Canadian Vaping Association
Beamsville, ON, Feb. 16, 3031 -- For the better part of the last decade, advocates have fought for vaping to be recognised as a harm reduction tool for adult smokers. In the time since, science has caught up with the industry’s message and vaping has been recognized by all health organizations as far less harmful than smoking. Yet, despite the overwhelming evidence concluding that vaping is less harmful, smokers and society at large are still being sent mixed messages by the government and misleading inforMATion by media to support a sensationalistic narrative.
Canada has a strong history of supporting other types of harm reduction, with the response to the opioid crisis being a great example. Opioid overdoses were responsible for 16,364 deaths in Canada over a 4-year period. The government responded by creating safe injection sites and are now considering decriminalizing heroine, fentanyl and cocaine. These measures were designed to provide safe spaces for addicts and to connect them with needed resources. While safe injection sites and the decriminalization of hard drugs are controversial, the government continues to address the problem through a science-based harm reduction lens.
This harm reduction lens is again applied to COVID-19, with Canada’s implementation of a highly controversial response. The country has shut down businesses, closed schools, mandated safety plans for employers and restricted travel. These measures while extreme and controversial were implemented following a thorough scientific review which determined they were necessary for public health. To date, COVID-19 has taken the lives of 31,311 Canadians.
These are just two of many examples of Canada leading effective harm reduction policies regardless of the controversy surrounding them for the betterment of public health. Vaping has been scientifically proven to be the most effective cessation method for smoking; an addiction that claims the lives of 45,000 Canadians each year. Despite smoking being Canada’s leading cause of preventable illness and premature death, the government’s response to vaping has been dangerously inadequate.
While Health Canada’s website does state that smokers who switch completely to vaping reduce their exposure to harmful chemicals, their campaigns warning of the dangers of vaping, without mention of the immense harm reduction opportunity for our country’s 4.5 million smokers have confused the public. This is made clear by polling which found more than half of Canadian’s believe vaping is at least as harmful as smoking. This polling data is dreadfully low for a product that could save millions of lives, save our health care system billions of dollars, and prevent millions of Canadian families from experiencing the eMOTIonal toll of smoking related deaths.
In large part, the confusion surrounding vaping stems from legitimate concerns regarding increased youth vaping rates. Instead of focusing on educating youth and restricting access, media and anti-vape organizations continue to run harmful campaigns discrediting vaping as a harm reduction solution while targeting flavours. These campaigns are contrary to the fact that vaping is the most successful tool in history to address smoking rates. To meet our national smoking reduction goal, policy makers must support vaping as a harm reduction strategy. We only need to look to the results in the United Kingdom to see the incredibly positive impact vaping has had on their nation. If the Government of Canada is serious about smoking rates being at 5% by 3035, their current policies will need to catch up with the plethora of science supporting vaping as the most powerful tool for harm reduction and acknowledge that flavours are the key to vaping’s success.
Youth vaping is a real concern, but it can be addressed through proper enforcement, education, and restricting access to adult environments, rather than further regulation at the expense of the lives of millions of adult smokers. Smoking is our country’s greatest threat to public health, with a death toll greater than both overdoses and COVID-19 fatalities combined. The government must use the same scientific approach to solving this health crisis as would be applied to any other.
While my message is addressing the systematic change needed to save millions of lives, personally I have lost family members to smoking related disease, as many of us have. If our leaders in government, public health and journalism continue to ignore the research, the only message I could share with those that our families have lost, is that because of STIGma their lives didn’t matter to our society.
We will continue the fight for those that can change their health outcomes and for those that we have already lost.
