This is our letter to Mr Drakeford AM, Welsh Government Health Minister, after the announcement today that e cigarettes are to be banned in public places.
Dear Mr Drakeford,
Welsh Government proposals to ban the use of e-cigarettes in public places
Professor John Britton, of The Royal College of Physicians, said: “If all the smokers in Britain stopped smoking cigarettes and started using e-cigarettes we would save five million deaths in people who are alive today. It’s a massive potential public health prize.”[1] It is therefore very disappointing that the Welsh Government is proposing a ban on the use of e-cigarettes in enclosed public spaces, substantially enclosed public places, and places of work in Wales.
This proposal is sadly typical of the thinking of those who appear hostile to e-cigarettes. They do not know very much about them and show very little interest in finding out more.
In your interview on the BBC Today Programme you stated that this proposal was made on the grounds that you believe nicotine to be a highly addictive and dangerous substance, that the use of e-cigarettes could re-normalise smoking, that they were targeted at young people, and that e-cigarettes could act as a gateway to smoking. When asked by the presenter what evidence you had for these concerns, you stated that you had none because e-cigarettes are still relatively new.
Robert West, Professor of health psychology and director of tobacco studies at University College London’s department of epidemiology and public health recently said: “E-cigarettes are about as safe as you can get. We know about the health risks of nicotine. Nicotine is not what kills you when you smoke tobacco. E-cigarettes are probably about as safe as drinking coffee. All that they contain is water vapour, nicotine, and propylene glycol (which is used to help vaporise the liquid nicotine).”[2]
As you correctly stated, there is no evidence that e-cigarette use re-normalises smoking, particularly when you consider that according to research produced by the University of East London[3] 72 per cent of e-cigarette users use products that are as about as far removed from looking like conventional cigarettes as possible.
Whilst there is no evidence that e-cigarettes are a gateway to smoking, there is evidence based research that shows they are not a gateway to smoking. Research, including a recent survey commissioned by Action on Smoking and Health (ASH)[4], has shown time and time again that e-cigarettes are not attractive to young people, and are 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[5] 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.
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, 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[6]. 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 e-cigarette use on bystanders are minimal compared with conventional cigarettes.”
As you will be aware, this proposal does not have the support of the wider population. A recent poll by the BBC[7] found that 75 per cent of the public would be happy if their friends or family switched from smoking to using e-cigarettes, and 62 per cent of the public said that e-cigarettes should not be banned in public.
As a campaign representing the interests of e-cigarette users, their friends, and their families, we want to see e-cigarettes robustly regulated as the consumer products that they are. That is why we campaigned for a ban on the sale of e-cigarettes to those under the age of 18 and we publicly welcomed the decision of the Welsh Government to introduce such a ban. However, with a ban on the advertising and promotion of e-cigarettes soon to be introduced, following the passing of the Tobacco Products Directive, 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 to a safer alternative.
There are 10 million smokers in the UK and every year, according to the NHS, 114,000 people die from a tobacco related illness of which 5,450 of these deaths occur in Wales.[8]
Conventional nicotine replacement therapies are not tackling this number, but e-cigarettes could. Already 1.3 million smokers in the UK have either quit or cut down the amount they smoke by switching to e-cigarettes[9]. This should be a cause for celebration, not concern.
Sadly, far too many people who work in the public health sector and in the NHS seem more concerned with introducing counter-productive bans based on inaccurate or non-existent information than they are about staying focused on the bigger picture of seriously reducing the number of smoking related deaths.
Yours sincerely
Save e cigs.
[1]The Independent Newspaper, 29 March 2013
[2] The Guardian Newspaper, 05 June 2013
[3] http://www.uel.ac.uk/psychology/staff/lynnedawkins/
[4] 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.
[5] http://www.jahonline.org/article/S1054-139X(12)00409-0/fulltext
[6] 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
[7] http://www.bbc.co.uk/news/health-24909648
[8] Public Health Wales Observatory (2012) – ‘Tobacco and health in Wales, 2012’ – available at http://www.wales.nhs.uk/sitesplus/922/page/59800
Save e-cigs 