E-cigarettes - not all in favour of the vapour
E-cigarettes are causing a stir, with the latest whiff of contention stemming from Scotland, where health boards are banning their use on National Health Service premises. Just as they've done with cigarettes.
The devices, marketed by manufacturers as an aid to quit smoking or as a healthier alternative to tobacco, are already banned in Irish hospitals and health care centres, where authorities claim there is no evidence of their long-term safety.
Indeed, a recent study published in the online journal PLOS ONE cast concern over their use, showing that in animal models even relatively brief use of e-cigarettes may have significant consequences to respiratory health.
The authors noted that despite the common perception that e-cigarettes are safe, they need to be tested more rigorously in users for their effects on immune response and susceptibility to bacterial and viral infections.
But despite their safety still in question, e-cigarettes are gaining popularity with smokers as well as those who shouldn't be anywhere near them: one Welsh study showed three times as many children in Wales have tried e-cigarettes compared to smoking tobacco.
Who would have guessed that these gimmicky devices that come in the shape of cigarettes or cigars, and sometimes made to look like pens or USB memory sticks, would ever take off? But they have, and those who view them as safer than smoking can see the bright side.
E-CIGARETTE USE IN NEW ZEALAND
The most recent survey undertaken in New Zealand found that 23 to 39 per cent of smokers claimed to have purchased an e-cigarette. But less than 5 per cent of smokers used them on a daily basis.
Oliver Knight-West, research fellow at the National Institute for Health Innovation at the University of Auckland, isn't surprised by the scale of use in New Zealand.
"We've seen a huge increase in their use all over the world. And I imagine that will only increase. The quality and type of products available have improved and increased in diversity, even over the last year," he says.
"The main driver is that people want to do something for their health – cost is another driver as well."
Knight-West sees their use as a sign that people are choosing safer alternatives to smoking. Academics on the other side of the fence might see it differently, he notes.
"It's positive in that people should be given access to safer alternatives to smoking, and electronic cigarettes are unquestionably safer than smoking a tobacco cigarette," he says.
"But on the other side of the coin, people are certainly concerned that increasing use of e-cigarettes might re-normalise and reintroduce smoking, and undo a lot of the hard work done in the past two to three decades."
ARE THEY REGULATED?
In New Zealand, it's illegal to sell an e-cigarette that contains nicotine, states the Ministry of Health.
It's also illegal to sell an e-cigarette that claims to help smokers quit, because e-cigarettes are not an approved smoking cessation medication in New Zealand.
But you can legally buy e-cigarettes that don't contain nicotine.
Knight-West says people also purchase tank systems that can have nicotine added to them, so they're customised in terms of flavour and strength.
E-cigarettes containing nicotine are available online from overseas websites, and many people are obtaining them that way, he says.
HOW THEY WORK
E-cigarettes do not burn or use tobacco leaves but instead vaporise a solution the user than inhales. This solution is typically made up of nicotine and propylene glycol, with or without glycerol and flavouring agents, plus other chemicals.
These devices come with cartridges of the liquid that is vapourised and rechargeable batteries.
The Ministry of Health has good advice on its website regarding their use. It states that:
- There is not enough evidence to recommend e-cigarettes as an aid to quit smoking.
- Smokers should continue to use approved smoking cessation aids, such as patches, lozenges and gum.
- A World Health Organization report released in August last year claimed e-cigarettes and similar devices require global regulation in the interest of public health.
- The same report says they increase the exposure of non-smokers and bystanders to nicotine and a number of toxicants.