The Welsh government proposes to ban e-cigarettes from enclosed public places, citing fears that the devices could “normalise” smoking once again. But are they justified?
Launching a consultation, Welsh Health Minister Mark Drakeford said: “e-cigarettes contain nicotine, which is highly addictive, and I want to minimise the risk of a new generation becoming addicted to this drug.”
Wales was the first country in the UK to ban smoking in public places in 2007, and the rise in the use of e-cigarettes has led to concerns that they are undermining the enforcement of that ban.
E-cigarettes don’t contain tobacco and are designed to vaporise a chemical mixture, usually including nicotine. Their use has risen significantly, with a recent study suggesting that the number of regular smokers in England using e-cigarettes has risen from around 2 per cent in 2011 to around 14 per cent in August 2013.
Use of e-cigarettes by never smokers remains extremely rare Smoking in England
The Welsh government white paper, Listening to you: Your health matters, reports: “There have been suggestions that that the use of e-cigarettes may undermine the smoking ban on the basis that people seeing them being used may mistakenly believe that they are permitted to smoke in premises where smoking is prohibited.
“The directors of Public Protection in Wales have reported difficulties with enforcing the current smoking ban due to the ease of mistaking an e-cigarette for a conventional one.”
Some pubs have already banned e-cigarettes to spare their staff the task of working out whether customers are smoking real cigarettes or e-cigarettes.
According to the white paper, “there are also fears that widespread use of e-cigarettes might normalise the act of smoking in public once more, and could act as a gateway to the smoking of conventional tobacco products.”
But are such fears justified?
Many smokers use e-cigarettes as part of a strategy to quit smoking. Recent research by Smoking in England concluded that “evidence does not support the view that electronic cigarettes are undermining tobacco control and they may be contributing to a reduction in smoking prevalence through increase success at quitting smoking.”
The same research finds that the increase in electronic cigarette use prevalence may have stalled, and that “use of e-cigarettes by never smokers remains extremely rare.”
The E-cigarette Industry Trade Association (ECITA) told Channel 4 News in a statement: “ECITA believes that banning these products in public spaces could potentially dissuade people from switching from the harmful traditional cigarette to an electronic one, and this could have adverse effects on the massive public health potential these products can bring.”
Our research suggests that experimentation with e-cigarettes by non-smoking children is more widespread than previously thought Professor Karen Hughes, Liverpool John Moores University
Given the short history of e-cigarettes, health professionals are faced with a lack of research into their use. A number of e-cigarettes are on sale in flavours that, according to the Welsh government white paper, “can be particularly attractive to adolescents.”
A study by the Centre for Public Health at Liverpool John Moores University published last month, interviewed 5,845 pupils aged 14-17 at schools in Cheshire and Merseyside. One in eight reported having used e-cigarettes – most of them were current or ex-smokers.
However one in eight of the e-cigarette users had never smoked tobacco cigarettes and a further one in five e-cigarette users had tried regular cigarettes but not liked them.
The research found that e-cigarette use among the young participants was “strongly associated with alcohol use”, often in unsupervised settings, such as parks or the street.
Professor Karen Hughes, author of the study, said “our research suggests that experimentation with e-cigarettes by non-smoking children is more widespread than previously thought.
“Teenagers are sharing them with friends in social settings and their flavours, designs and the ability to personalise devices and show individuality are making them almost collectable in some circles.”
The report concludes that “those most likely to use e-cigarettes are those that are already engaged in risk substance abuse behaviours”, and it calls for action to tackle this to be a priority, particularly the development of information for young people on the potential risks and harms associated with e-cigarette use.
New rules banning the sale of e-cigarettes to under-18s across the UK are now going through the legislative process and will be in force imminently.
From 2016 e-cigarettes will be licensed and regulated in the same way as other medicines, meaning more stringent checks and tests by the Medicines and Healthcare Products Regulatory Agency (MHRA).