A top Israeli cardiologist said nicotine is not carcinogenic and does not cause hearth diseases
“Nicotine is addictive, but it doesn’t harm the body. It’s not carcinogenic, and it doesn’t cause heart disease or blood vessel disease. If there is an alternative way to satisfy the nicotine craving of smokers without burning tobacco, this is clearly an option worth considering,” said Prof. Reuven Zimlichman, director of The Brunner Cardiovascular Research Institute at Tel Aviv University, said.
Zimlichman made the statement during the 46th Philippine Neurological Association (PNA) annual convention held from Nov. 26 to 29, 2024 at the Conrad Manila in Pasay City.
Zimlichman advised hardened Filipino smokers to consider switching to a heated tobacco or vape product if they are unable to quit cigarettes.
“Ask your patient to consider switching to a heated tobacco product or vape. The more severe the patient’s cardiovascular disease is, the more benefits they can derive from switching,” Zimlichman told Filipino doctors who attended the event.
Smoke-free products such as vapes and heated tobacco products that deliver nicotine without burning tobacco can save the lives of millions of hardened smokers who are unable to quit smoking, he said.
“Quitting smoking is very difficult because tobacco contains nicotine, which is highly addictive. But it’s not nicotine that causes the serious health effects of tobacco use. It’s the thousands of chemicals produced by the burning of tobacco that make smoking so deadly,” said Zimlichman.
Zimlichman said nearly half, or 49 percent, of smokers diagnosed with coronary artery disease continue to smoke, 57 percent of smokers continue to smoke after a stroke, and 72 percent of smokers diagnosed with peripheral artery disease (narrowing of the arteries that supply blood to the arms and legs) continue to smoke.
Previously a non-believer in tobacco harm reduction, Zimlichman changed his position after reviewing the emerging scientific evidence supporting the novel public health strategy.
He said heated tobacco products and vapes, which are forms of tobacco harm reduction, are technological innovations that have the potential to save millions of lives.
Tobacco harm reduction is a public health strategy that aims to provide less harmful alternatives to people who do not want to quit smoking by themselves or with currently approved methods.
Heated tobacco products are lithium battery-powered devices that heat the tobacco just enough to release a nicotine-containing tobacco aerosol but without burning the tobacco. Because tobacco is heated and not burned, there is no smoke, and the levels of harmful and potentially harmful chemicals in the generated aerosols can be significantly reduced compared to cigarette smoke.
“Heated tobacco products offer the best chance for hardened smokers to quit smoking,” Zimlichman said.
Vapes or e-cigarettes are lithium battery-powered devices that heat a liquid (called an e-liquid) that typically contains nicotine, propylene glycol, vegetable glycerin, and flavorings. The e-cigarette converts the e-liquid into a mist or vapor that the user inhales. This is why using an e-cigarette is known as vaping. E-cigarettes do not burn tobacco and do not produce tar or carbon monoxide, two of the most damaging elements in tobacco smoke.
He cited the results of a 2021 South Korea study, which showed that switching to smoke-free products was associated with a 23 percent lower risk of cardiovascular disease among both recent and long-term switchers. The reduction in cardiovascular disease risk among switchers was mostly attributed to heated tobacco products.
He also cited Sweden, a country internationally recognized for its successful tobacco harm reduction strategy through the widespread use of snus and nicotine pouches. As a result, the country has achieved a significant decline in smoking rates. According to Smoke-Free Sweden, a campaign advocating for Sweden’s approach to tobacco harm reduction, the nation’s cancer incidence is 41% lower than the European average, and it has the lowest rate of tobacco-related diseases in the EU.
Zimlichman said that after over 50 years of implementing essentially the same tobacco control strategies, nothing has changed.
“There are currently an estimated 1 billion smokers globally, with 8 million people dying of smoking-related diseases every year. We need to try something new. Governments, regulatory agencies, and the medical community need to be open to new ideas such as tobacco harm reduction,” he said.
