Electronic cigarettes have been increasing in popularity over the past few years with Europe itself having over seven million vapers (as users of electronic cigarettes are called). Celebrities like Kate Moss and Leonardo DiCaprio have taken to vaping. However, vaping has had, perhaps, more than its fair share of controversies. Vaping in the presence of customers caused a Mother care employee to be suspended. Similarly, Michelle Capewell, a 41 year old employee of a store was directed by her manager to leave the store for taking a puff on her e-cigarette. More importantly, these electronic alternatives to tobacco smoking have resulted in a sharp polarisation of opinion.
Some experts on public health argue that these devices could actually reduce the deaths from tobacco related ailments while others are vociferous in their opposition stating that it will only make smoking more attractive, especially to the youth. Around 100,000 people die annually in the UK alone from diseases directly related to the use of tobacco cigarettes.
The confusion surrounding the electronic device only deepened with the Euro MPs failing to pass a proposal by the European Commission to regulate e-cigarettes as medicines.
E-cigarettes are devices that use the power from a battery to vapourise smoking liquid containing propylene glycol which is laced with nicotine. Propylene glycol is better known as the ingredient for making theatrical smoke. The user inhales the vapour and experiences a nicotine high similar to that of tobacco cigarettes but devoid of the ash, tar and other harmful chemicals inhaled with smoke from conventional tobacco cigarettes.
Many e-cigarettes are designed to look like tobacco cigarettes and are fitted with an LED at the far end which glows with each drag on the mouthpiece, giving the electronic device an appearance similar to a burning cigarette. According to Jeremy Mean, who is with the Medicines and Healthcare Regulatory Authority (MHRA), electronic cigarettes offer the user the “cigarette experience” unlike the other nicotine replacement therapy (NRT) currently in vogue such as gums, sprays and patches. He feels that the motions of smoking, including having something to hold, are also important to smokers and therefore, he opines, e-cigarettes may be more effective in helping people quit smoking.
The results of a study which appeared in The Lancet in September, involving 657 smokers, showed that, over a six month period, about 6% of users of both nicotine patches and electronic cigarettes had quit smoking. However, there was a far greater reduction in the use of tobacco cigarettes among the users of e-cigarettes who did not quit, as compared to the users of nicotine patches.
Research manager with Action on Smoking and Health (ASH), Amanda Sandford states that electronic cigarettes cannot be said to be absolutely safe in the absence of sufficient evidence. However, she goes on to state that the electronic product is far safer than the tobacco version. Further, the risk of passive smoking is almost eliminated as the vapour exhaled by the user is believed to contain mere traces or no toxins at all.
The MHRA’s push to regulate e-cigarettes as medicines is mainly aimed at addressing concerns about the product’s quality and safety. Regulation is set to kick in from 2020 in the UK. Jeremy Mean states that their tests have found a lack of standardisation on the amount of nicotine delivered by e-cigarettes and therefore, some users may not be able to effectively control their nicotine intake.
Anti e-cigarette advocates feel that e-cigarettes would make smoking more acceptable and would be the first step towards tobacco addiction. Jeremy Mean states that regulation is required to ensure that non-smokers, children and people aged below 18 years are not induced to use the product. He advises people looking to quit smoking to stick with accepted NRT products including gums, patched and sprays.
Amanda Sandford, is convinced that e-cigarettes can reduce the harmful effects of tobacco smoking but knows that it is not a cure for all ailments. According to her, their research has found that only a third of the people switching to e-cigarettes actually stick with this product with the rest giving them up. The reasons for giving up e-cigarettes are still to be ascertained.