Right: Hon-Lik, the inventor and 'father of vaping'.
Arguments for allowing the sale of e-cigarettes
1. E-cigarettes are preferable to tobacco cigarettes as they are less harmful Supporters of e-cigarettes argue they are preferable to tobacco smoking as they have a less damaging effect on the health of smokers and passive smokers. Without tobacco, tar, ash, or carbon monoxide, e-cigarettes are marketed as 'healthier' alternatives to cigarettes. In July, 2016, Harvard Health Publishing published an overview of the advantages and disadvantages of e-cigarettes written by contributing editor, John Ross. Ross stated, ' A burning cigarette gives off noxious gases, such as carbon monoxide and hydrogen cyanide. Cigarette smoke also contains an ultrafine suspension of gummy residue, known as tar. Most of the carcinogens in cigarette smoke are found in the tar. The major benefit of e-cigarettes, compared to regular cigarettes, is that they do not produce the tar or the toxic gases found in cigarette smoke.'  In July, 2014, a report surveying the findings of over 80 studies on e-cigarettes' safety and their effects on users found that based on the evidence, e-cigarettes are much less harmful to smokers and bystanders than conventional cigarettes. The researchers found that based on the evidence, e-cigs are much less harmful to smokers and bystanders than conventional cigarettes. In February, 2017, a study funded by Cancer Research UK stated, ' Our study shows that bodily level exposure to established and important smoking-related carcinogens and toxicants is reduced by between 56 percent to 97 percent in long-term e-cigarette users who have stopped smoking completely, compared with tobacco cigarette smokers.' In September, 2017, NHS Health Scotland, Scotland's national health education and promotion agency, issued a consensus statement claiming that e-cigarettes are 'definitely' less harmful than smoking tobacco. The statement was endorsed by more than 20 other organisations including health boards, academia and charities such as the British Lung Foundation and Cancer Research UK. Other research from Public Health England concluded that e-cigarettes were 95% less harmful than normal cigarettes. In January, 2017, Linda Bauld, Professor of Health Policy and CRUK/BUPA Chair in Behavioural Research for Cancer Prevention, University of Stirling, stated, 'I believe that e-cigarettes have huge potential to save lives by providing an alternative to smoking. Yet this can only be realised if we address negative harm perceptions and communicate honestly with the public. Ongoing research can help with this, and 2016 has seen the start of important studies, many commissioned by Cancer Research UK, which will tell us more in the future.' 2. E-cigarettes can help smokers quit tobacco-based cigarettes Some studies have suggested e-cigarettes can be effective in helping tobacco smokers give up the habit. Multiple studies and surveys have indicated that e-cigarettes have the potential to help tobacco smokers reduce their consumption or quit altogether. One New Zealand study showed e-cigarettes to be as effective as nicotine patches. An August 2014 study that surveyed over 20,000 Americans showed that among adults who used a product to help them quit smoking, 57% chose e-cigarettes. That was compared to the 39% who used prescription drugs like Chantix and the 39% who used other over-the-counter methods like patches or nicotine gum. Research findings published in the British Medical Journal in September, 2016, concluded that 'the increase in e-cigarette use has been associated with an increase in success of quit attempts.' The report suggested that in 2015 these devices helped at least 18,000 smokers to stop who would not otherwise have done so. On April 4, 2016,nThe Australian Medical Association's journal, Australian Medicine, published an opinion piece by Dr Colin Mendelsohn, an Australian tobacco treatment specialist, opposing the AMA's position statement against e-cigarettes. Dr Mendelsohn stated, ' Three meta-analyses and a systematic review suggest that e-cigarettes are effective for smoking cessation and reduction. The evidence indicates that using an e-cigarette in a quit attempt increases the probability of success on average by approximately 50% compared with using no aid or nicotine replacement therapy (NRT) purchased over-the-counter. ' The vaping promotion site, Vaporfi, outlines numerous reasons why vaping can be successfully substituted for conventional cigarette smoking. The site notes that a number of attendant satisfactions that smoking gives the smoker are replicated by vaping. Included among these are supporting 'muscle memory'. The site claims, ' Unlike [other] methods..., vaping helps simulate the psychological attachment you've developed to the act of smoking a cigarette. The act of smoking and the rituals that make it up, are a big part of what the smoker is actually addicted to. When you're vaping, you go through those familiar motions attached to smoking. In doing so, you maintain that muscle memory you've created from smoking over the years, but at the same time you eliminate actually taking in tobacco smoke.' Vaporfi also refers to the 'throat hit', the apparently pleasurable sensation smokers experience at the back of their throats when smoking. The site claims, ' The universal sentiment seems to be that vaping is the one and only non-smoking alternative that allows you to experience this sensation and yet still eliminate the intake of smoke.' Thus there are numerous justifications offered as to why e-cigarettes might make it easier for those smoking conventional cigarettes to give up the habit. (It should be noted that Vaporfi does not appear to envisage the new e-cigarette smokers giving up this habit.) 3. Vaping may be a valuable option for hard-core smokers who cannot give up It has been suggested that rather than seeing e-cigarettes as a product to be taken up by novice smokers, they should be seen as a less harmful alternative for those already addicted to conventional cigarettes and unable to quit. Researchers from the Queen Mary University of London, in a study published in the journal Addiction, have stated, 'Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to [e-cigarettes] as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use.' A study published in the British Medical Journal's Tobacco Control Journal on October 2, 2017, found that 'a strategy of replacing cigarette smoking with vaping would yield substantial life year gains, even under pessimistic assumptions regarding cessation, initiation and relative harm'. In other words, switching from cigarettes to e-cigarettes could extend the lives of smokers, compared with if they were to continue smoking traditional tobacco cigarettes. The report concluded, ' Even the gloomiest analysis [the pessimistic model] shows a significant gain in years of life if nicotine is obtained from vaping instead of much more deadly amounts of toxicants inhaled with cigarette smoke.' In addition to living longer, the study also concluded that incorrigible smokers who switched to vaping might see other health benefits, 'including reduced disease disability to smokers, [and] reduced pain and suffering...' 4. E-cigarettes are not encouraging young people to take up smoking It has been claimed that recent studies suggest that e-cigarettes are not encouraging young people to smoke. In a comment published on his Internet site on August 29, 2017, Dr Colin Mendelsohn, an Australian tobacco treatment specialist, noted that a recent analysis of five studies in the United Kingdom strongly suggested that e-cigarettes are not leading young people to smoke. The study analysed five separate surveys in the United Kingdom between 2015-2017 of 60,000 young people aged 11-16 years. The study published in the International Journal of Environmental Research and Public Health, found that although young people are experimenting with e-cigarettes, regular use (weekly or more) is rare. A tenth to a fifth of 11-16 year olds had tried e-cigarettes, but only 3% or less used them regularly and most of those were already tobacco smokers. In the United Kingdom, e-cigarettes are available to adult smokers to help them quit; however, they cannot be sold or promoted to young people. Sale to under 18 year olds is prohibited and there are restrictions on marketing which may appeal to children or youth. Dr Mendelsohn claims, 'The UK has showed that it is possible to get this balance right and that the net benefits of e-cigarettes are strongly positive for public health.' This observation regarding the low incidence of e-cigarette use among British children and teenagers and their failure to act as a gateway habit, encouraging addiction to other forms of smoking, has been endorsed by a number of British researchers. Linda Bauld, Professor of Health Policy and CRUK/BUPA Chair in Behavioural Research for Cancer Prevention, University of Stirling, has stated, 'While young people are experimenting with e-cigarettes and the proportion who say they've tried them is rising, only very small numbers of young non-smokers are attracted to these products on any regular basis. This, it's worth remembering, is during a period when smoking rates among young people are continuing to fall, suggesting that - in the UK at least - there is no evidence yet that more young people are starting to smoke because of e-cigarettes.' 5. Other nations have allowed e-cigarettes Supporters of e-cigarettes have criticised the Australian government for its virtual prohibition of e-cigarettes. Those who hold this view note the more liberal approach adopted in a number of comparable nations. In the United Kingdom, the use, sale and advertising of e-cigarettes are legal and e-cigarettes are not covered by laws restricting smoking in public places. However, businesses may choose to ban e-cigarettes as well. A notable example is Transport for London, banning smoking and vaping as their Conditions of Carriage. Effective 1 October 2015, it is illegal to sell e-cigarettes or e-liquids to minors. In 2014 the government announced legislation would be brought forward to outlaw the purchase of e-cigarettes by people under the age of 18. In the United Kingdom, the Royal College of Physicians publicly endorses e-cigarettes for their public health benefits. It has stated, ' [R]egulation should not be allowed significantly to inhibit the development and use of harm-reduction products by smokers. .. in the interests of public health it is important to promote the use of e-cigarettes, NRT (nicotine replacement therapy) and other non-tobacco nicotine products as widely as possible as a substitute for smoking. Similarly, in the United States, the sale of e-cigarettes is also legal, though there is variation between states as to whether e-cigarettes can be smoked in certain public places. As in the United Kingdom, the sale of e-cigarettes to minors is prohibited. In Canada, though e-cigarettes were until recently technically illegal to sell, as no nicotine-containing e-fluid is approved by Health Canada, this is generally unenforced and they are commonly available for sale throughout the country. In November 2016, the Canadian government amended the existing Tobacco Act and renamed it the Tobacco and Vaping Products Act, in order to regulate the manufacturing, sale, labelling and promotion of the devices. In an opinion piece published in The Conversation of February 13, 2017, Dr Colin Mendelsohn, conjoint Associate Professor in the School of Public Health and Community Medicine at the University of New South Wales, stated that if the Australian government did not lift its ban on e-cigarettes ' Australian smokers will be denied access to life-saving technology estimated to have helped millions of smokers to quit overseas.' |
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