Hon Lik and Harm Reduction10.01.21
Hon Lik is famous for inventing the e-cigarette or vape in 2003, and commercializing it in 2004 but he wasn’t motivated by making money, his objective was harm reduction. In a recent interview he said:
“By 2002, I had tried to quit smoking several times. For health reasons, I wanted to quit smoking with the help of nicotine patches which were then available on the Chinese market. However, after using them for a while, I didn’t think this product was suitable for me. So I wondered if I could make a device which could atomize the dilute solution of nicotine into smoke-like condition, then inhale the nicotine vapor into the lungs and absorb it, like smoking a cigarette, to help alleviate the desire to smoke.”
From this spark of inspiration a whole industry has grown and it’s estimated that globally more than 40 million ex-smokers now vape. This is a source of pride for Hon Lik and he continues to bang the drum for tobacco harm reduction and the possibilities vaping brings to smokers that cannot or will not quit through a medical pathway (nicotine patches or gums) or willpower alone.
He has received recognition for his work, especially at the annual Global Forum on Nicotine, where he is a patron. The forum features both the tobacco and vaping industry participating alongside academics, medical and healthcare professionals who specialize in addiction, substance abuse and harm reduction.
In 2019 he featured in a Netflix documentary ‘Broken’, focused on the problem of teen vaping among affluent youth in the US, a brave move considering the show’s criticism of some participants in the vaping category. In his interview he gave a strong defence of tobacco harm reduction but is always unambiguous that these products, and any nicotine products, are for adults only.
The frustration for Hon Lik is that he believes the case for vaping as a harm reduction tool has been scientifically substantiated but the message has failed to get through to most adult smokers, journalists who cover health topics, and the wider public.
The data across the world shows a remorseless trend with trust in vaping actually lower now than in previous years, mainly due to inaccurate media coverage of events totally unconnected to regulated nicotine vaping like the EVALI lung disease outbreak in the US. Vaping products containing nicotine available commercially, based on Hon Lik’s basic e-liquid formula of propylene glycol, vegetable glycerin and flavourings, have never contained Vitamin E Acetate, the additive identified by the US Centers for Disease Control, as the trigger of the outbreak. This fact was never highlighted in media coverage, resulting in consumer confidence in products that had been used for nearly a decade without lung injuries, being severely impacted. Educating adult smokers on the relative risk of alternative nicotine products is difficult if the facts are not presented clearly.
The evidence is out there though and Hon Lik believes the inexorable progress of science will ultimately help the category be regulated and promoted properly to adult smokers. October 2020 saw the publication of the Cochrane review of evidence for and against Electronic Cigarettes as a smoking cessation tool. The review of more than 50 completed studies from all over the world was unambiguous in its conclusion; “The randomized evidence on smoking cessation has increased since the last version of the review and there is now evidence that electronic cigarettes with nicotine are likely to increase the chances of quitting successfully compared to nicotine gum or patches.”
It only received modest media coverage, which is understandable given the ongoing media focus on Coronavirus. Nevertheless where the academic world leads, the public health world will follow and even sceptical organisations like the World Health Organisation will surely be forced to positively engage in the vaping debate. If that happens it will be a testament to Hon Lik’s work in giving some agency back to adult smokers who have traditionally been offered only willpower or medical treatment to quit.
Hon Lik is a consultant to Fontem Ventures B.V., based in Beijing, China. You can find a recent interview with him on the Imperial Brands Science website.