Questions need to be asked about e-cigarettes

The debate about the use of e-cigarettes within our society is underway. The Welsh Government has faced an onslaught of criticism for daring to consider the impact of e-cigarettes on the health of the nation and proposing new measures to protect people’s health from an emerging threat.

There’s a lot of misunderstanding about what we’re suggesting, so let me explain our proposals.

Our Public Health White Paper does not propose a ban on e-cigarettes. It does not propose new restrictions on their sale. It does not even contain a firm commitment to bring them into line with conventional cigarettes by restricting their use in enclosed public spaces. It asks for views and further evidence on the idea that such a ban would be beneficial to public health in Wales.

We need to ask ourselves whether the current exemption on e-cigarettes from the existing smoking ban makes its enforcement more difficult. Whether allowing e-cigarettes to be used in enclosed public spaces contributes to the re-normalisation of smoking and whether e-cigarettes act as a gateway product introducing a new generation to an addictive and harmful habit.

In the world of politics it is often said that actions speak louder than words. That’s why the voluntary introduction of restrictions on the use of e-cigarettes by companies and organisations as varied as Wetherspoons; Arriva Trains; Ryanair; Glyndwr, Aberystwyth and Cardiff universities; some health boards; Caerphilly Council; the Welsh Rugby Union, Swansea’s Liberty Stadium and a growing list of others is so important. They have moved to bring e-cigarettes into line with conventional cigarettes because, in the practical business of enforcing the ban on smoking in enclosed public spaces, the use of e-cigarettes makes that more difficult.

There is evidence to suggest e-cigarettes are a source of second-hand exposure to nicotine and some scientists are calling for more research into the health consequences for children, pregnant women and people with heart conditions.

Turning to the wider issues of re-normalisation and e-cigarettes as a gateway product, the support for the precautionary approach, which underpins our White Paper proposals, comes from expert organisations such as Public Health Wales, the UK Chief Pharmaceutical Officers, the British Medical Association, Cancer Research UK and the Directors of Public Protection Wales,

We do not want to interfere with the use of e-cigarettes as an aid to giving up smoking. However, we must remember that, in comparison with other available stop-smoking aids, e-cigarettes are the only method, which involves the ingestion of that highly-addictive substance nicotine directly into the lungs. A New Zealand study, published in The Lancet last September, found that e-cigarettes were no more effective than nicotine patches at helping smokers to quit.

There is strong emerging evidence that the tobacco industry is deliberately and cynically positioning e-cigarettes in order to create – as their advertising says – the “Future of Smoking”.

A survey of Paris schoolchildren found two thirds of 12 to 14-year-old e-cigarette users were non-smokers. The researchers concluded that for teenagers, e-cigarettes were not a product to aid quitting tobacco, but designed for experimentation and initiation into cigarette use. And here in the UK, a study by the Centre for Public Health at Liverpool John Moores University found use by non-smokers is not uncommon.

In the US, Congress is moving to strengthen the regulation of e-cigarettes – a report published on Capitol Hill last month described the way the industry targets e-cigarettes at children with flavours like Cherry Crush and Chocolate Treat.

Other nations, including Belgium, Australia and Brazil, find the evidence in relation to e-cigarettes so alarming and overwhelming, they are banned. In the United States a ban on ‘vaping’ in enclosed public spaces is already in place in New Jersey and North Dakota; bills to do the same thing are being introduced in California, Massachusetts and Connecticut. Meanwhile, cities are already enforcing a ban in Boston, New York, Washington, Los Angeles and Chicago.

We want to bring Wales into line with those forward-thinking areas around the world which have already recognised the potential harm of e-cigarettes to public health and have taken steps accordingly.

We therefore have a choice. Do we want to be where public health medicine in Wales has so often been in the past – at the progressive, cutting-edge of protection from harm? Or do we want future generations to look back and shake their heads at our inability to see where the evidence was leading and to take the practical steps we had the power and the authority to take?