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OR07-4 E-CIGS (VAPORIZERS): A PUBLIC HEALTH OPPORTUNITY THAT WILL BE MISSED? Dr Robert Hmmig, MD Psychiatry & Psychotherapy FMH President SSAM Medical Director Addiction Department University Psychiatric Services Bern SSAM

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Disclosure No conflict of interests

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Tobacco Atlas (4th edition) Cigarettes account for 92% of the value of all tobacco products sold globally

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WW II

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Well deserved pause of our heroes with a mild stimulant /relaxant WW I WW II Dak To (Vietnam) 1967 Saipan 1944 Ryky Islands 1945 Falluhjah (Iraq) 2004

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Smoking cessation Jorenby et al. JAMA 2006;296:56 63Gonzales et al. JAMA 2006;296:4755 from: Nides, The American Journal of Medicine (2008) Vol 121 (4A), S20S31

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Cigarette smoke vs. E-cig vapour From Tobacco Atlas, 4th edition Chemicals in E-cig Vapour NicotineCockroach poison Glycerol Food Additive E422

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E-cigs: the public debate E-cigs: do they fall under tobacco laws or pharmaceutical law? Arguments against e-cigs: Nicotine is lethal already in small amounts E-cigs are a gateway to tobacco smoke

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Good and bad nicotine from an 1980ies anti-smoke game

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Nicotine: the cockroach poison *Mayer. Arch Toxicol (2014) 88:57 Lethal nicotine Historic case: Hippolyte Visart de Bocarm was sentenced to death for murdering his brother in law with nicotine in 1851. 60mg of nicotine as a lethal dose stems from an error in the 19th century scientific literature. This error was copied ever since.* Lethal dose of nicotine is between 0.5g -1.0g or even more. from glossary of Tobacco Atlas, 4th edition

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Gateway theory There is no observation that would confirm a gateway theory from e-cigs to tobacco cigarettes. There are observations for the other way round. Gateway theories are normally wrong. A temporal sequence is not a causality.

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SwissVap Study Delphi study with tobacco experts Results: Yes to nicotine containing fluids for vaping But: No advertising Limitation of content Youth protection measures QR code for download of report

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Nutt et al. Eur Addict Res 2014;20:218-225 Marketing prohibited in Switzerland ENDS electronic nicotine delivery system products

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