Harsh Regulations Have Turned Vapers into Activists

For 30 years, Cheryl Richter was a pack-a-day smoker. She’d tried everything to kick the habit but nothing worked. Nothing, that is, until her first electronic cigarette. She hasn’t bought a pack since.

Not only that, but since she had this road-to-Damascus experience, she’s pretty much devoted her life to vaping, which to her, is more than a business. It’s her passion and way of helping people. In 2009, Richter partnered with her brother’s friend, Chris Mikovits, to sell batteries and atomizers—which turn the liquid inside e-cigarettes into a vapor—that they imported from China.

They quickly introduced products of their own. Mikovits created “drip tips” for e-cigarettes, as the devices were leaking and leaving nicotine on people’s lips. Richter, who’d always been fond of baking and didn’t like the taste of the e-liquid coming from China, began devising her own recipes. She spent two years perfecting one for pumpkin pie-flavored juice. “I was just absolutely nuts about getting it right,” Richter said.

E-liquid bottles lined up inside Richter and Mikovits’ shop. Under the new FDA regulations, products that were not on the market as of February 15, 2007—including e-liquids—will have to go through a pre-market approval process that small business owners like Richter worry will be unaffordable. Photo: Natasa Bansagi

Richter and Mikovits now run a retail store called Vape Den in Port Chester, New York, as well as an online wholesale business. But Richter and Mikovits are more than just entrepreneurs—they are advocates for vaping as an alternative to cigarette smoking and defenders against what they see as regulatory excess.

“It’s just something that I’m extremely passionate about, and now having done this for so long and seeing some of my customers that have been smoke-free for so long and, hearing their stories,” Richter said, “I know I’m doing the right thing.”

They have travelled to Capitol Hill on multiple occasions to talk to legislators, crusading for an evolving industry whose customers seem to share more than just a habit, but also a sense of mission and community.

“I think that in 20 years from now when the books are written about this, this is going to be the pivotal time in history.”

New rules regulating e-cigarettes—which will require warning labels, ingredient and product listings; the pre-market review of any products that were not on the market as of February 15, 2007; and a ban on sales to people under 18, among other things—were finalized last month. Small entrepreneurs in this industry fear that they may not survive the costly proposed measures. For example, Richter said that every e-liquid she makes and sells—each flavor, size, and nicotine level—would need to be approved for sale. This means approving 75 flavors at six different milligram levels, with cost estimates ranging from hundreds of thousands to over $1 million per application.

Richter said advocacy brings together the vaping community, especially at her shop, where it often comes up in discussions. “We feel vulnerable almost, we feel that we’re in a fight, so that kind of bonds the community as well,” she said in December, before the regulations were released. And, she contends, a lot of people agree with her.

Mikovits’ drip tips, on display inside Vape Den in Port Chester. Photo: Natasa Bansagi

She cited the founder of Americans for Tax Reform, Grover Norquist, who, in an address to members of the Smoke-Free Alternatives Trade Association during a fly-in to Capitol Hill in February, went so far as to claim that the millions of vapers in the US could be a deciding factor when it comes to selecting a president. “That is a huge voting block, and they are single-issue voters,” Richter said, adding that vape shops across the country—including hers—have been registering people to vote. In 2014, she said National Vapers Club compiled a database where any state or federal legislation related to e-cigarettes could be browsed to determine the bills’ co-sponsors, who voted for each bill, and how. The group plans to do this again in 2016.

In response to the regulations, she said a coalition has formed between consumer vaping and industry associations—a total of seven—and that together they are looking into what kind of litigation they might pursue. At her shop, Cherry Vape, Richter is focusing on effecting change by educating her clients.

“I think that in 20 years from now when the books are written about this, this is going to be the pivotal time in history, right now: you know, what did we do, what did we do when the government said, no, you have to keep smoking,” Richter said.

“Did we roll over, or did we prevail with a fight?”

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Viewpoint: Are e-cigarettes really a menace?

Michael Mosley vaping

E-cigarettes, devices that give you a nicotine-hit by heating up a liquid which you then inhale, have become all the rage. But is the concern about them justified, asks Michael Mosley.

A few years ago they were a rarity, but now there are nearly three million e-cigarettes out there. Many people think that they are as bad for you as normal cigarettes. But are they?

I’ve recently spent a couple of months making a documentary about e-cigarettes, trying to find out truth behind the headlines. I took up heavy vaping (that’s what you do when you inhale vapour from an e-cigarettes). I have never smoked anything before and I wanted to see what effects inhaling nicotine in the form of an e-cig would have on a non-smoker. The results surprised me.

Everyone knows that smoking is bad for you and can lead to lung cancer. It also increases your risk of dying from a range of other conditions including heart attack, stroke and dementia. If you’re a man you might like to know (but then again you might not) that smoking is one of the main causes of impotence.

Fans of e-cigarettes say vaping can reduce the burden of smoking either by making it easier for smokers to quit or by providing them with a safer way for them to get a nicotine hit.

Michael Mosley and Hon Lik, the inventor of the e-cigarette
Image captionMichael Mosley and Hon Lik, the inventor of the e-cigarette

Critics, however, say that we are gambling with a technology we don’t understand and that there is no convincing evidence that e-cigarettes help people quit smoking. It may even encourage non-smokers to start.

Some countries have warily embraced e-cigarettes, while others have effectively banned them.

The UK has so far adopted a liberal approach, but on Friday new European legislation will come into force which will limit the size of refills and the nicotine content of the fluids. Vaping will become more restricted.

So, who’s right? Are e-cigarettes one of the greatest public health measures ever invented, with the potential to save millions of lives, or are they just another cunning way to keep us hooked on nicotine? I was keen to find out.

Well the scientific consensus is that vaping, at least in the short term, is a lot safer than conventional smoking. A recent study for Public Health England concluded that e-cigarettes are 95% less harmful than normal cigarettes.

To be honest when I took up vaping I wasn’t that worried about the short term health effects. What I was far more concerned about was getting hooked on nicotine. Yet as the weeks went by and I puffed away, nothing happened. When I leapt out of bed I didn’t feel a longing to reach for my machine. If anything I found it a bit of a chore.

Chatting to experts I discovered, to my considerable surprise, that although cigarettes are highly addictive, nicotine alone may not be. Although no-one knows for sure, research in animals suggests that nicotine is far more addictive when delivered in combination with the other chemicals found in regular cigarettes.

And nicotine in its pure form may have an upside. There’s evidence it can help patients with Alzheimer’s and Parkinson’s disease.

The National Institute on Aging in the US has recently funded a trial of 300 patients with mild cognitive impairment (a precursor to Alzheimer’s). The patients, none of whom are smokers, will be randomly allocated to either nicotine patches or placebo patches. Over the next few years they will have regular health checks, as well as memory and cognition tests.

Michael Mosley
Image captionEverybody agrees that smoking is bad for you

A similar, smaller study, published in 2012, found that non-smokers given nicotine patches saw improvements in memory, attention and reaction times.

But before you start slapping on the patches or firing up an e-cig you should aware that though nicotine may help people who already have impaired memory, there’s no evidence it will help the rest of us. Although I was tested before and after doing a month of heavy vaping, the nicotine didn’t enhance my brain, apart from a small improvement in my fine motor skills.

But the main health justification for e-cigarettes is that they can help those who are keen to quit smoking tobacco, quit. So do they?

There have been very few randomised controlled trials, but the ones that have been done suggest it does.

When Horizon conducted a small study where we randomly allocated a group of hardcore smokers to either e-cigs, nicotine patches or simply giving up (going cold turkey), we found the vapers and those who slapped on the patches were far more successful at abandoning their cigarettes.

E-cigs are not risk free and after a month of heavy vaping there were signs of increased inflammation in my lungs (which rapidly reversed when I stopped). Nonetheless I think that for smokers e-cigarettes could prove to be a game changer.

There is a huge amount at stake. A billion people worldwide spend around £500bn a year on cigarettes and around half of them will die of smoking related diseases. In the UK alone smoking kills around 100,000 a year. Anything which gets people off cigarettes is going to save a lot of lives.

Smoking, cigarettes and vaping: Everything you need to know about the new laws

Cigarettes

New laws are coming in tomorrow which will change the lives of smokers and vapers across Europe.

According to Action on Smoking and Health (ASH) there’s around 10million smokers in the UK and a further 2.6million are puffing on e-cigarettes.

But new rules will be enforced under the Tobacco and Regulated Products Regulations 2016 in the hopes of slashing the number of nicotine addicts by 2.4million.

New laws are coming in tomorrow which will change the lives of smokers and vapers across Europe.

According to Action on Smoking and Health (ASH) there’s around 10million smokers in the UK and a further 2.6million are puffing on e-cigarettes.

But new rules will be enforced under the Tobacco and Regulated Products Regulations 2016 in the hopes of slashing the number of nicotine addicts by 2.4million.

The change affects cigarettes, hand-rolling tobacco and e-cigarettes manufactured for sale in the UK.

All products will have to comply with the regulations from 20 May 2016 but there will be a one-year transitional period while old stock is sold off.

Here’s everything you need to know about the new rules:

CIGARETTES

Standardised plain packaging

In a bid to discourage smokers from being attracted to pretty packaging, all cigarette boxes and rolling pouches will be standardised.

You will no longer be able to spot a pack of Pall Mall from Marlboro and all packets will have the same olive-green colour, opening and font styles.

This means “lipstick-style” packs aimed at women, such as Vogue cigarettes, will also be outlawed.

New cigarette packet design

Graphic health warnings

At least 65% of the packaging on show must be covered with public health warnings, graphic photos and text to demonstrate the damage that smoking does to your health.

On top of the warnings, there’ll be a ban on promotional statements such as “this product is free of additives” or ”is less harmful than other brands”.

Other misleading descriptions such as “lite”, “natural” and “organic” will no longer be allowed.

Ban on 10-packs of cigarettes

All packs must contain a minimum of 20 cigarettes to make room for the health warnings.

Small bags of rolling tobacco will also be banned – with pouches forced to weigh at least 30g while the current smallest pouch size is 8g.

Menthol and flavoured tobacco to become illegal

It’s very bad news for menthol fans because the flavoured fags will be phased out from tomorrow before becoming completely illegal by May 20 2020.

Other flavours which will become extinct in the next four years include fruit, spice, herbs, alcohol, candy or vanilla.

 

Cigarettes

WARNING: All packs will be plastered with health advice

E-CIGARETTES AND VAPING

Smaller, weaker containers

While there’s currently no limitation on the size of refill containers, it will now be capped at 10ml and 2ml for disposable e-cigarettes, cartridges and tanks.

This rule change could have a knock-on effect on the price of each container, as vaping fans will no longer be able to buy in bulk.

Secondly the maximum strength of a vile of vaping liquid will drop to 20mg per ml of nictotine, down from 24mg.

Zero nicotine products are not included in the legislation change.

 

Woman vaping

VAPING: The changes will also affect e-cigarettes

Packaging with health warnings

Similar to cigarettes, electronic fag packaging will also require health warnings.

Around 30% of the packet should be plastered with advice, stating: “This product contains nicotine which is a highly addictive substance.”

E-cigarettes must be childproof

The vaping liquid is potentially dangerous if it’s ingested so new rules state e-cigarettes must be childproof and tamper-proof.

Adverts will change

Under the new laws, e-cigarette companies won’t be able to claim that vaping is beneficial to peoples’ health.

This means they can’t draw comparisons between vaping versus smoking tobacco either.

Celebrities will be banned from endorsing e-cigarettes and free samples won’t be allowed to be given out in promotional campaigns.

Greater government scrutiny

Vaping giants will have to submit information to the government detailing exactly what their products contain before they are allowed to sell them in the UK.

It’s about to become illegal to advertise e-cigarettes

It's about to become illegal to advertise e-cigarettes

It will soon become illegal to advertise most e-cigarettes.

The new law is being brought in as part of the EU’s Tobacco Product Directive, which is coming into force on Friday.

According to new laws being brought in to regulate tobacco sales, any promotion, sponsorship or advertising of e-cigarettes or their refill containers will be prohibited.

The ban will apply to most mainstream media platforms – including the internet, television and radio.

For now adverts on outside posters and on the sides of buses are still allowed, as long as the bus isn’t leaving the UK.

And where ads are permitted, they won’t be allowed to make claims about e-cigarettes helping people to give up smoking.

People say e-cigarettes can help people quit smoking (Picture: Getty Images)

However, there are a couple of exceptions.

Zero nicotine e-cigarettes – for example, 100 per cent herbal vapes – are not covered by the new laws because they’re not tobacco products.

On the other end of the scale, if an e-cig contains more than 20mg/ml of nicotine then, under the TPD, it will need to be medicinally licenced.

Because of this, high-nicotine e-cigs will be regulated by the Medicines and Healthcare Products Regulatory Agency instead, and are subject to the same advertising regulations as over-the-counter medicines.

This means e-cigs with higher than 20mg cannot be endorsed by celebrities, given out as free samples, or marketed to children.

Where can’t I advertise e-cigs?

It will be illegal to advertise e-cigarettes…

  • On broadcast TV as an advert or sponsorship
  • As a product placement on broadcast TV
  • On the radio as an advert or sponsorship
  • On on-demand TV as an advert, sponsorship or product placement
  • In newspapers, magazines and periodicals, except for trade publications and non-EU publications
  • With internet display adverts, over email or by text messaging, except for trade and non-EU publications
  • As an ad or promotion on a company’s own website or on any other non-paid-for online space under their control – however, strictly factual ‘how to’ videos are permitted

Some in the industry think the new regulation on advertising will be excessively restrictive.

Richard Hyslop, chief executive of the Independent British Vape Trade Association, told Metro.co.uk: ‘There is never a situation where it is better to smoke than it is to vape.

‘Vaping is now recognised by the UK Government as the most popular form of support to stop smoking.

‘However, with virtually all forms of advertising for vape products being banned how are smokers to be exposed to vaping?

‘This advertising ban can only result in a situation where fewer smokers make the switch the vaping – a significantly less harmful alternative.’

Where can I advertise e-cigs?

It will still be permitted to advertise e-cigarettes…

  • On blogs, in tweets, or in other independently compiled, non-paid-for reviews
  • In the e-cigarette trade press and in trade-to-trade communications
  • At the cinema
  • In faxes
  • On posters on the sides of buses that are not travelling outside of the UK
  • On leaflets
  • In direct, hard-copy mail

However, others are welcoming the law change.

Brett Horth, CEO of e-liquid manufacturer Vapour Labs, told Metro.co.uk: ‘Whilst the TPD regulations may seem strict to some, we feel it is hugely positive for the industry and we encourage its enforcement today.

‘TV, radio and online advertising has been banned, however outdoor advertising – such as on vehicles or billboards – is still allowed, which provides us with an all-new opportunity!’

 

Smoke and mirrors: the truth about vaping

vaping-thetimes-160517

Horizon: E-Cigarettes: Miracle or Menace?

BBC Two – 9.30pm on Sunday 22nd May 2016 

When the editor of the BBC science series Horizon asked me if I fancied making a programme about e-cigarettes that would involve “vaping” (inhaling nicotine-laden vapour) for a month my initial reaction was: “Hell, no.”

Then I thought about it a bit. I was worried that if I took it up I might get addicted (I’d never smoked), but I was also curious. What would it be like? What effect would it have on me? There has been a huge surge in the use of e-cigarettes over the past couple of years, yet very few studies on the effects of vaping on non-smokers. Time, I decided, to do one, with me as the subject.

I hate cigarettes, really hate them. I’ve never smoked, partly because when I was young I didn’t see the point, but mainly because when I was about 12 my dad offered me £100 if I didn’t smoke before the age of 18. I can’t remember if he ever paid me.

If I was even a little tempted to smoke, going to medical school put me off. One of the first patients I saw was Sarah, a 65-year-old woman who was dying of emphysema, a very common disease of the lungs caused by smoking. Even with an oxygen mask she struggled for breath. She’d been smoking 40 a day since she was 15 and she reckoned that she’d spent about £90,000 on cigarettes (at today’s prices it would be more like £290,000).

I also remember a young man called Alex with Buerger’s disease, a relatively rare condition where you get inflammation and clotting in your arteries and veins. Almost everyone who has Buerger’s smokes, and quitting smoking is the only way to stop it progressing. Despite knowing the risks Alex just couldn’t stop. He eventually developed gangrene and had to have a limb amputated.

Fans of e-cigarettes claim that vaping could help people like Alex and Sarah, either by making it easier for them to quit or by providing a safer way for them to get a nicotine hit. It is said that smokers smoke for the nicotine but die from the tar, so why not give them one and not the other?

Critics, however, say that we are gambling with a technology we don’t understand and that there is no convincing evidence that e-cigarettes help people to quit smoking. It may even encourage non-smokers to start.

There is a huge amount at stake. A billion people worldwide spend about £500 billion a year on cigarettes and about half will die of smoking-related diseases. In the UK alone smoking kills about 100,000 a year. If e-cigarettes take even a small fraction of the cigarette market, that is a lot of money and a lot of lives.

Some countries have warily embraced e-cigarettes, while others have effectively banned them. The UK has so far adopted a liberal approach, but in a few days’ time there will come into force European legislation that will limit the size of refills and the nicotine content of the fluids. Vaping will become more restricted.

So who’s right? Are e-cigarettes one of the greatest public health measures invented, with the potential to save millions of lives, or are they just another cunning way to keep us hooked on nicotine? I was keen to find out.

I started by having a range of physical and mental tests, including cognitive tests such as reaction times, then headed for my nearest e-cigarette shop. They come in lots of different shapes and sizes but all work on the same principle: there’s a battery that powers a heating element, a coil. There’s a chamber into which you pour your “e-liquid” which usually, but not always, contains nicotine. The heat from the coil turns the liquid into vapour, which you then inhale. There’s no burning and therefore fewer noxious chemicals involved. The e-liquids come in many flavours, from pina colada to menthol. I went for mint.

I bought a nice, geeky-looking device, with a big, shiny canister and lots of buttons. Then I went home to start vaping. I’d been given a schedule that began gently, then rapidly built to the point where I was taking about 120 puffs a day at a moderately high nicotine dose (the equivalent of a heavy smoker trying to give up). The plan was to do this for a month.

Initially I did a lot of coughing and found the head rush unpleasant, but after a while I started to enjoy the experience. It was a bit like having a very strong cup of coffee, except the effects were almost instantaneous. Blowing smoke was also fun, in an adolescent sort of way, though my friends and family were not impressed.

What was vaping doing to my body, though? According to some scientists, quite a lot of damage. In a recent widely reported study ominously titled Electronic cigarettes induce DNA strand breaks and cell death, researchers found evidence that e-cigarettes are “as harmful as tobacco”.

Addictive or not, it seems nicotine by itself is not that bad for you They took human epithelial cells, the sort that line your mouth, trachea and lungs, and exposed them to vapour from e-cigarettes. Some of this vapour had nicotine in it, some didn’t. When they examined the cells afterwards they found DNA damage and cell death. Although there was more damage in the cells exposed to nicotine-laden vapour, it was still detectable in the nicotine-free vapour. This was the sort of damage that, according to the report, can “set the stage for cancer”. Scary stuff. The lead researcher was quoted as saying that e-cigarettes “are no better than smoking regular cigarettes”.

What the press release that promoted this study didn’t mention, and what most of the headlines missed, was that the researchers had also exposed some cells to tobacco smoke. The results of this were nothing short of cataclysmic. Most of the cells exposed to tobacco smoke died within 24 hours. By contrast, the cells exposed to e-cigarette vapour survived for up to eight weeks.

As a cancer charity researcher quickly tweeted, instead of the headline “Vaping no better than smoking regular cigarettes”, they could have said “Cells can survive for eight weeks in e-cig liquid but only 24 hours in cigarette extract”. Not, perhaps, quite as catchy.

To be honest, when I took up vaping I wasn’t that worried about the short-term health effects. There have been a number of major reports, such as the one from Public Health England, that state that e-cigarrettes are “around 95 per cent safer than tobacco”.

What I was far more concerned about was getting hooked on nicotine. Yet as the weeks went by and I puffed away, nothing happened. When I leapt out of bed I didn’t feel a longing to reach for my machine. If anything I struggled to keep up with my schedule. Once the novelty had worn off it became a bit of a chore.

Chatting to experts, I discovered to my considerable surprise that although cigarettes are highly addictive, nicotine alone may not be. Although no one knows for sure, research in animals suggests that nicotine is far more addictive when delivered in combination with the other chemicals found in regular cigarettes.

Addictive or not, it seems that nicotine by itself is not that bad for you. A report put out by the Royal Society for Public Health last year said that though 90 per cent of the public think that nicotine is harmful, in fact it is “no more harmful to health than caffeine”. And, like caffeine, nicotine has potential health benefits. A natural plant alkaloid, it binds to and stimulates receptors in the brain that are important for thinking and memory. Dr Lynne Dawkins, an addiction expert, tells me: “There is emerging evidence that in certain conditions, such as Alzheimer’s and Parkinson’s disease, nicotine may have a cognitive-enhancing effect.”

To test this claim the National Institute on Aging in the US has funded a trial of 300 patients with mild cognitive impairment (a precursor to Alzheimer’s). The patients, none of whom are smokers, will be randomly allocated to nicotine patches or placebo patches that they will have to wear for 16 hours a day. Over the next few years they will have regular health checks as well as memory and cognition tests. A similar, smaller study, published in 2012, found that non-smokers given nicotine patches saw improvements in memory, attention and reaction times.

Yet before you start slapping on the patches or firing up an e-cig you should be aware that though nicotine may help people who already have impaired memory, there’s no evidence it will help the rest of us. Although I was tested before and after a month of heavy vaping, the nicotine didn’t enhance my brain, apart from a small improvement in my fine motor skills that could apparently make me slightly better at sewing.

The main health justification for e-cigarettes is not that they can help to improve your memory but that they can help those who are keen to quit smoking tobacco — but do they? A recent meta-analysis (comparing lots of different studies) concluded that they don’t. Surprisingly enough this paper concluded that vapers are less likely to give up smoking than those who try other methods. It led to headlines along the lines of “E-cigarettes don’t help smokers quit — they may actually have the opposite effect”.

Like so much of the evidence used to attack or justify vaping, this finding was hugely contentious. Critics, such as Professor Peter Hajek from Queen Mary University of London, described it as “grossly misleading”. Professor Robert West of University College London pointed out that if this were true then quit rates would be falling in countries such as the UK where e-cigarettes are taking off. This isn’t happening. If anything we are seeing the reverse.

When Horizon conducted a small study in which a group of hardcore smokers were randomly allocated e-cigs, nicotine patches or going cold turkey, we found the vapers and those who slapped on the patches were far more successful at abandoning their fags.

E-cigs are not risk-free, and after a month of heavy vaping there were signs of increased inflammation in my lungs (which reversed rapidly when I stopped). Nonetheless I think that e-cigarettes could prove to be a game-changer, one of the great inventions of the age. That said, I have no desire to ever take another puff again.

Horizon: E-Cigarettes: Miracle or Menace? is at 9.30pm on Sunday, BBC Two

 

NHS Lanarkshire to consider allowing e-cigarettes on hospital grounds

NHS Lanarkshire chiefs are set to review their smoking policy at hospitals after new evidence on the benefits of ‘vaping’.

The smoking ban at Hairmyres Hospital, and other hospitals across the area, could be relaxed following a Health Scotland review, which showed that using e-cigarettes can help give up smoking tobacco.

NHS Greater Glasgow & Clyde have taken action based on the figures, and say e-cigarettes can now be used on hospital grounds by patients, visitors and staff.

However, the substitute will not be allowed within buildings, or at entrances or exits to hospitals and other health facilities.

Now, NHS Lanarkshire are set to consider if they should also allow the devices on hospital grounds following the new information.

NHS Lanarkshire’s director of public health medicine Dr Harpreet Kohli revealed that they are willing to review the policy if and when new evidence emerges.

Dr Kohli said: “NHS Lanarkshire introduced a no smoking policy which banned smoking on all our grounds and vehicles in 2008 and it was updated in 2014 to include electronic cigarettes as these devices are currently unregulated.

“There remains concern over their safety and efficacy.

“We’re aware new evidence is emerging in relation to electronic cigarettes and we will review our policy as required in the future in line with the evidence base.

“We fully support the Scottish Government’s Tobacco Control Strategy for Scotland which has tasked NHS Boards to become completely smoke free on hospital grounds.”

From August 2008, lighting up a cigarette has been banned throughout NHS Lanarkshire’s grounds under the revised No Smoking Policy.

The policy means people are no longer allowed to light up anywhere inside NHS Lanarkshire premises or within the grounds, including areas around hospital and health centre entrances and car parks.

A woman smokes an e-cigarette. (Photo by Peter Macdiarmid/Getty Images)

http://www.dailyrecord.co.uk/news/local-news/nhs-lanarkshire-consider-allowing-e-7852462#BgwDbcA8Bg8qV3UY.97

E-cigarettes should be offered to smokers, say doctors

man vaping

Smokers should be offered and encouraged to use e-cigarettes to help them quit, says a leading medical body.

The UK’s Royal College of Physicians says there is resounding evidence that e-cigarettes are “much safer” than smoking and aid quitting.

With the right checks and measures, vaping could improve the lives of millions of people, it says in a new, 200-page report.

It says fears that e-cigarettes are a gateway to smoking are unfounded.

But, by and large, people who want to use electronic cigarettes will still need to buy them rather than get them on the NHS.

Do e-cigarettes make it harder to stop smoking?

Are e-cigarettes safe?

Should we switch from tobacco to e-cigarettes?

UK doctors can only prescribe e-cigarettes if they have been licensed as a “quit smoking aid” – something that requires strict regulation.

Few manufacturers go down this route and instead sell products to satisfy users’ desire for nicotine without the harmful chemicals produced by tobacco.

Best way to quit?

Sales of e-cigarettes have been rising steadily since the first went on sale in 2007 in the UK.

Since 2012, they have replaced nicotine patches and gum to become the most popular choice of smoking cessation aid in England.

Around one in 20 adults in England uses e-cigarettes, and nearly all of these are ex-smokers or current smokers who are trying to cut down or quit.

E-cigarettes have remained controversial and this year ministers in Walesattempted to ban them from public places.

The Royal College of Physicians says smokers who use e-cigarettes or prescribed medications – with support from their doctor – are more likely to quit permanently.


Graphic: What's inside an E-cigarette?

1. On some e-cigarettes, inhalation activates the battery-powered atomiser. Other types are manually switched on

2. A heating coil inside the atomiser heats liquid nicotine contained in a cartridge

3. The mixture becomes vapour and is inhaled. Many e-cigarettes have an LED light as a cosmetic feature to simulate traditional cigarette glow.

Different brands of e-cigarettes contain different chemical concentrations.


And in terms of long-term health hazards, e-cigarettes are at least 95% safer than regular cigarettes – something Public Health England has also said.

But that does not mean they are entirely risk-free.

Prof Simon Capewell, of the Faculty of Public Health, said there were still many unknown factors.

“We don’t know enough yet about the long-term effects of vaping on people’s health, which is why we need more research.

“The best thing anyone can do if they want to quit smoking is talk to their GP: there’s solid evidence that NHS quit-smoking services help people kick the habit for good.”

But Prof John Britton, who co-authored the RCP report, says e-cigarettes are extremely positive for public health and should be “encouraged and endorsed”.

He said: “The public need to be reassured this is not a new nicotine epidemic in the making. E-cigarettes have very little downside and a lot of potential benefit.”

According to Public Health England, smokers should consider using e-cigarettes alongside NHS quit-smoking services.

Around a third of UK smokers try to quit each year, but only one in every six of those succeeds.

New EU laws are due to come into force in May that will set safety and quality standards for all e-cigarettes and refills. Manufacturers will be required to disclose the purity of their products to consumers.

Dr Tim Ballard, from the Royal College of GPs, said: “Moving forward we would be looking for clear evidence that making e-cigarettes available on prescription as part of a wider smoking cessation scheme is a wise use of both scant NHS funds and GP practice resources, before the College could get behind it.

“It is not just the cost of the product that needs taking into account, but the time and resources that are involved in assessing patients, and monitoring their progress over a prolonged period of time.

“We reiterate our calls for NICE to take a leading role in establishing whether making e-cigarettes available on prescription is the best way forward.”

A Department of Health spokesperson said: “The best thing a smoker can do for their health is to quit smoking.

“We know that there are now over a million people who have completely replaced smoking with e-cigarettes and that the evidence indicates that they are significantly less harmful to health than smoking tobacco.

“We want to see a wide range of good quality e-cigarettes on the market including licensed products whose safety, quality and effectiveness are independently assured.”

  • 28 April 2016