I am writing in response to your recent article, ‘Call for ban on e-cigarettes in public places’ As a campaign that has the interests of e-cigarette users at heart, we are concerned that your journalist reproduced the comments of the British Medical Association (BMA) Scotland and Public Health Minister Michael Matheson MSP, without subjecting them to any scrutiny, if she had, she would have found them wanting.
In the article BMA Scotland made a number of statements that we unchallenged:
- Increasing numbers of children use e-cigarettes,
- E-cigarettes are a gateway to smoking tobacco cigarettes, and
- E-cigarettes help normalise smoking.
Where to begin?
Research, including a recent survey commissioned by Action on Smoking and Health (ASH), has shown time and time again that e-cigarettes are not attractive to young people, and are therefore not used as a gateway to smoking tobacco cigarettes. Although awareness of e-cigarettes was widespread amongst young people aged 11 to 18, the ASH survey found no evidence that young people either used or perceived e-cigarettes as being a gateway to smoking.
Evidence produced by a variety of organisations including ASH and the American Cancer Society (ACS) clearly shows that flavours do not entice non-smokers to use e-cigarettes either, especially the young, as they have no interest in the product.
Researchers from the ACS looked specifically into the enticement of flavours. They found that flavours did not increase the attractiveness of e-cigarettes to teenagers. Rather, “Even after controlling for other statistically significant correlates, the odds of a smoker being willing to try an e-cigarette were 10 times those of a non-smoker.”
Tobacco cigarettes are the gateway to tobacco smoking, not e-cigarettes. Also, there is no evidence what so ever that e-cigarettes help ‘normalise smoking’.
The article goes on to report a motion being debated at the BMA Scotland conference welcoming moves by the MHRA to regulate e-cigarettes as a medicine. Again, had your journalist carried out any independent research, she would have discovered that this is not actually what the MHRA intends to do.
On the 12th of June 2013 the MHRA stated that they wished to regulate ‘nicotine containing products’ (e-cigarettes) in line with the proposed EU Tobacco Products Directive (TPD), which at that time supported the medicinal regulation of all e-cigarettes.
However, on the 8th of October 2013 MEPs voted against the medicinal regulation of e-cigarettes, a move that was later supported by the Member States in Council. Since then the MHRA is on record as stating that it no longer proposes to introduce the blanket medicinal regulation of e-cigarettes. The TPD, passed in Strasbourg two weeks ago, proposes medicinal regulation only for those products which seek to make a medicinal claim or those products with a nicotine strength greater than 20 ml.
We welcome the aspect of the BMA Scotland’s motion that calls on the Scottish Government to ban the sale of e-cigarettes to under 18s, and have been calling on the Scottish Government to do this ourselves. However, it is ludicrous to propose that e-cigarettes should be sold only alongside nicotine replacement therapies (NRT). E-cigarettes are not some form of more effective NRT; they are a viable alternative to conventional tobacco cigarettes and should be on sale anywhere tobacco cigarettes are sold.
Finally, on the idea that e-cigarette use should be banned in public. E-cigarettes are not just popular with those who use them; there is widespread support for them amongst the public at large. A recent poll by the BBC found that 75 per cent of the public would be happy if their friends or family switched from smoking tobacco cigarettes to using e-cigarettes, and 62 per cent of the public said that e-cigarettes should not be banned in public.
With a ban on the advertising and promotion of e-cigarettes soon to be introduced, following the passing of the TPD, where are smokers to find out about e-cigarettes, particularly if they are banned in public places? Smokers need to see people using e-cigarettes in public, they need to be able to go up and speak to e-cigarette users so that they can find out further information and then hopefully make the switch.
Of course there must be a consideration of those who do not use e-cigarettes, but who would be impacted by second-hand vaping. However, highly credible research undertaken by Dr Konstantinos Farsalinos, M.D., Researcher, Onassis Cardiac Surgery Center, Athens Greece and Researcher, University Hospital Gathuisberg, Leuven, Belgium; and Professor Riccardo Polosa, Full Professor of Internal Medicine, University of Catania and Scientific advisor for LIAF – Italian League for Anti-Smoking, has proven that there is no problem with passive vaping. The research concluded, “Based on the existing evidence from environmental exposure and chemical analyses of vapor, it is safe to conclude that the effects of EC use on bystanders are minimal compared with conventional cigarettes.”
All those with a genuine interest in public health need to stay focussed on the bigger picture – significantly reducing the number of people who die from tobacco related illnesses. Conventional nicotine replacement therapies are not tackling this in any significant number, but e-cigarettes could. Already 1.3 million smokers have switched to e-cigarettes throughout the UK.
It is vitally important that all those reporting on or writing about e-cigarettes do so responsibly. Irresponsible reporting has the potential to put smokers off making the switch to a safer alternative. We are a campaign representing e-cigarette users; we have no interest in articles promoting e-cigarettes uncritically either. All we are asking for is balanced and factual reporting.
Save E cigs.
 ASH surveyed 12,597 adults in 2010 – the questions focused on e-cigarette use and awareness in Great Britain. The preliminary survey was followed up by an additional study of adult smokers and non-smokers in February 2012 and more recently in 2013. ASH also surveyed children and young people aged 11 to 18 in March 2013.
 Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review:
Konstantinos E. Farsalinos and Riccardo Polosa
published online 13 February 2014 Therapeutic Advances in Drug Safety