Right: Specialist vaping suppliers are proliferating and may soon be as familiar as tobacconists' shops once were.
Arguments for banning the sale of e-cigarettes
1. The safety of e-cigarettes has not been established Critics of e-cigarettes in all their forms, but especially those that contain nicotine, note that the products have been in use only since 2003 and that insufficient time has elapsed and insufficient research has been conducted to establish their safety. This point has been made by Dr Miranda Ween, a biologist and researcher with the University of Adelaide. Dr Ween has stated, ' The biggest issue is that we have no idea of what damage long-term use could do. It took decades to realise cigarettes caused cancer, and longer still to get that message to those using them. We don't want to repeat the same mistakes again. We need more research, and no one should be declaring them "harmless".'  The same point has been made by Becky Freeman, a tobacco control expert at the University of Sydney. Freeman has claimed that in the absence of evidence of their safety, it is irresponsible to allow e-cigarettes to be sold in Australia. Freeman has stated, 'We shouldn't treat smokers as guinea pigs.' It has further been noted that the products contain components that have not been taken into the human body in this manner before. Dr Ween has observed in relation to this point, ' Our work, and that of others around the globe, is starting to show that the flavours in e-cigarettes can be harmful as well as the nicotine. The flavours used are food-safe, but have not been tested once superheated and vaporised and inhaled into the lungs.' In June 2016, Australian Competition and Consumer Commission (ACCC) lodged a case in the Federal Court against Queensland-based companies Social-Lites and Elusion New Zealand, which each produce e-cigarettes. The ACCC maintains that claims the companies make about the safety of their products are inaccurate. The ACCC said its testing showed formaldehyde and acetaldehyde were present in both brands of e-cigarettes, among other toxins. Formaldehyde is classified by the World Health Organisation International Agency for Cancer Research as a Group 1A carcinogen, meaning there is sufficient evidence to show it is carcinogenic to humans. Acetaldehyde is classified as a Group 2B carcinogen by the IARC, which is classified as being possibly carcinogenic to humans. A laboratory study of 30 healthy individuals...who used an e-cigarette for just five minutes showed worsening in measures of airway and respiratory resistance, impedance, and exhaled nitric oxide. This response was deemed to be similar to that observed following tobacco cigarette exposure. Professor Matthew Peters, Head of Respiratory Medicine at Concord Hospital in Sydney, has stated, 'We just can't have a product available to the public on a hunch that it might be safer than smoking over the long run. Because it's no more than a hunch.' 2. E-cigarettes do not always encourage tobacco-smokers to relinquish their habit The effectiveness of e-cigarettes as a means of helping tobacco-smokers quit their habit has been questioned. A joint submission from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia to the federal government's Inquiry into the Use of Electronic Cigarettes and Personal Vaporisers in Australia observed that there are many means of using nicotine to help smokers quit and that e-cigarettes have not been shown to be a better alternative. The submission stated, 'There are many nicotine delivery systems already available for those who wish to quit smoking and there is a lack of evidence that e-cigarettes are superior to current best practice. The evidence of the efficacy of these devices in smoking cessation is weak. Furthermore, a Cochrane Collaboration review found there was no evidence that e-cigarettes were superior to nicotine replacement therapy.' A study published on April 21, 2015, in the leading journal Addiction concluded 'Daily use of e-cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non-daily use of e-cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking.' The study of 1,473 English smokers found those who did not use e-cigarettes were more likely to stop smoking after 12 months: 13.9% of non-vapers successfully quit, compared with 9.5% of occasional vapers and 8.1% of daily e-cigarette users. These findings have been replicated elsewhere. As of April, 2015, eleven published studies had investigated how people who vape compare with smokers who do not when trying to quit tobacco smoking. Stanton Glantz from the University of California has meta-analysed these studies and found that smokers who vape are 30% less likely to quit smoking than smokers who do not. 3. E-cigarettes are addictive Many of those opposed to e-cigarettes are concerned at the impact of an addictive, harmful substance on vapers (those who smoke e-cigarettes), especially those who begin using the product while young. It has been found that nicotine is highly addictive in whatever form it is consumed and it may lead to changes in the brain that increase the risk of addiction to other drugs, especially in young people. Nicotine may also impair prefrontal brain development in adolescents, leading to attention deficit disorder and poor impulse control. Further, adolescents have been found to be more vulnerable to addiction than adults because their still-developing brains. The effect of the different delivery modes on the nature of nicotine addiction has not been conclusively determined; however, even the evidence cited by manufacturers of e-cigarettes indicates there is addictive behaviour in response to e-cigarettes. An article published in White Cloud on October 1, 2015, intending to demonstrate that e-cigarettes are less addictive than tobacco cigarettes, made the following observations, 'A 2014 study conducted by the Penn State College of Medicine and published in the peer-reviewed Nicotine & Tobacco Research journal assessed the addictive nature of e-cigs using online surveys of ex-smokers who are current vapers. Survey respondents reported formerly smoking an average of 24 cigarettes every day and currently having about 24 vape sessions a day.' The article concluded that these former tobacco smokers claimed to feel less dependent on their new habit; however, its author acknowledges that the incidence of product use was the same in each case, stating, ' On the surface, it appears that their addiction is the same...' K. Vendrell Rankin, director of Texas A&M University Baylor College of Dentistry's Tobacco Treatment Services, has explained the addiction mechanism, stating, 'Everybody has a certain amount of nicotine receptors in the brain. When you start smoking, vaping or supplying nicotine to them, they multiply. If you stop smoking or vaping, the receptors don't go away... Nicotine in any form triggers the release of neurotransmitters such as adrenaline and dopamine, which dramatically impacts a number of body systems. Dopamine floods the brain, and nicotine cravings increase.' 4. E-cigarettes might undermine the success of Australia's anti-smoking programs, especially among the young Opponents of e-cigarettes claim that they may actually undermine the success of Australia's public health campaign to halt smoking in this country. Critics of the product claim that rather than help people quit smoking tobacco-based cigarettes, the products an actually initiate smokers, either becoming a source of addiction themselves or acting as a gateway drug leading people to take up tobacco smoking. It is claimed that these risks are particularly great for young people who are attracted by the supposed safety of e-cigarettes and the range of fruit and candy flavours in which they are available. Becky Freeman, a tobacco control expert at the University of Sydney, has described how one online Australian retailer, Vapeking, 'uses juvenile cartoon imagery on its website to promote flavours such as sunrise and wicked watermelon'. Another flavour is promoted by encouraging customers to 'wake up to the taste of sweetened condensed milk, dried red berries and a healthy serving of sweet honey coated cereal'. Electronic cigarettes, or e-cigarettes, are now the most popular form of nicotine use among American middle and high school students, with an estimated 3 million students using them. There has been a 10-fold increase in the use of e-cigarettes among United States high school students between 2011 and 2015 - from 1.5 percent to 16 percent, with more teens using these products today than smoke cigarettes. Cancer Council Australia has warned of e-cigarettes capacity to encourage their users to transition to tobacco smoking. The Council cites evidence from a meta-analysis of nine studies tracking 17,389 people aged 14 to 30, published in the Journal of the American Medical Association's Paediatrics. The study found initial e-cigarette users are more than three times more likely than non-e-cigarette users to subsequently become tobacco smokers. Dr. Benard Dreyer, president of the American Academy of Paediatrics, has stated, 'Nicotine ... is highly addictive and has clear neurotoxic effects. E-cigarettes have the potential to addict the next generation and it's a major public health concern to us.' The worry that smoking e-cigarettes could lead to smoking tobacco cigarettes is of particular concern when children are involved. Simon Chapman, Emeritus Professor in the School Public Health at the University of Sydney, has stated, 'There's not much of a step between inhaling nicotine through e-cigarettes and children thinking "maybe I'll give smoking a try as well".' 5. E-cigarettes are being used by the tobacco industry to compensate for the dwindling traditional cigarette market Opponents of e-cigarettes do not see them as primarily a product designed to reduce reliance on traditional cigarettes. Rather, they claim, the tobacco industry is attempting to diversify what it manufactures as its traditional product loses popularity and market share. For opponents of e-cigarettes, the product is essentially smoking via a different delivery system and the health impacts are questionable. Cathy Callaway, associate director of state and local campaigns for the American Cancer Society Cancer Action Network has stated, 'If the [tobacco] industry can keep people addicted to tobacco products, they'll be more likely to continue to purchase products, and the industry makes money.' As of February 2017, global e-cigarette sales were approximately $5 billion a year; however, the e-cigarette industry is expected to grow 24 percent through 2018. Though e-cigarettes were not initially developed by the traditional tobacco industry, big tobacco companies have rapidly developed their own e-cigarettes and bought out independent e-cigarette companies. In June 2014, Philip Morris International (PMI) acquired the Nicocig brand, which has more than one-quarter of the market share in the United Kingdom. PMI has made heavy investments in heat-not-burn technology. In August 2013, Imperial Tobacco acquired Dragonite (previously Ruyan), a Chinese company, for $75 million. In February 2014, Imperial made a deal with Boots Pharmacy chain in the United Kingdom to sell a new e-cigarette brand called Puritane. The popular American e-cigarette brand VUSE, is owned by R.J. Reynolds Vapor Company, a subsidiary of the tobacco giant Reynolds America, while British American Tobacco (BAT), the largest tobacco company in Europe, launched Vype, a now-popular brand of e-cigarette, around four years ago. There are many who object to the tobacco industry developing a market for a new addictive product. In an opinion piece published in STAT on May 8, 2017, Amy Fairchild and Ronald Bayer stated, 'E-cigarettes don't just represent a promising means to help people stop smoking, but also a way to market the recreational use of nicotine. That means an industry in the business of addiction will profit from tobacco harm reduction.' |
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