I have been following the reports on e-cigarettes and vaping in the media and wish to raise several important points.
Firstly, according to authoritative reports on e-cigarette, its safety and efficacy in cessation have not been established. The official report by the World Health Organisation clearly states e-cigarettes are not free from toxicants and they have been approved as ‘safe’ for use.
Their efficacy as a smoking cessation device has not been systematically evaluated yet. The evidence on the effectiveness of e-cigarettes as smoking cessation is limited.
Secondly, in recent times more research on risks of using e-cigarettes have emerged:
- E-cigarette vapour can contain cancer-causing formaldehyde at levels up to 15 times higher than regular cigarettes. The finding was published this year in New England Journal of Medicine.
- Department of Environmental Health Sciences at Johns Hopkins University: “E-cigarette vapour alone produced mild effects on the lungs, including inflammation and protein damage.”
- American Lung Association: Early studies show that e-cigarettes contain nicotine and other harmful chemicals, including carcinogens. A 2014 study found that e-cigarettes with a higher voltage level and have higher amounts of formaldehyde, a carcinogen.
- E-cigarettes make teenagers four times more likely to move on to real smoking, health experts warn. The study was published in Jama Pediatrics.
According to the California Department of Health, the e-cigarette heats e-liquid that generally contains nicotine, flavourings, additives, and propylene glycol. The heated e-liquid forms an aerosol that is inhaled by the user. The aerosol has been found to contain toxic chemicals like formaldehyde, lead, nickel, and acetaldehyde all of which are chemicals known to cause cancer, birth defects, and other reproductive harm.
These chemicals travel through the circulatory system to the brain and all organs.
The aerosol also contains high concentrations of ultrafine particles that are inhaled and get trapped in the lungs.
E-liquids are available in numerous candy and fruit flavours, including bubble gum, cherry and chocolate, which are especially appealing to youth and small children who may accidently ingest them.
Accidental ingestion
The vaping community has ignored the problem of accidental ingestion - even a small amount of e-liquid may be lethal to a small child. E-cigarette cartridges can leak and are not equipped with child-resistant caps, creating a potential source of poisoning.
The US Centers for Disease Control reports the number of calls to poison centers involving e-liquids rose from one per month in 2010, to 215 per month in 2014. More than half of the calls to poison centres about e-liquids involved young children under age five years.
Thirdly, vaping renormalises smoking. This has the potential to roll-back years of anti-smoking campaign efforts of both the Health Ministry and health professionals to educate the public on the dangers of smoking. Besides it will pose enforcement problems in public places that already have no-smoking zones established.
Fourthly, the pharmaceutical industry that normally promotes a variety of smoking cessation devices has not bought into e-cigarettes as a cessation device. Instead, transnational tobacco companies have bought e-cigarettes business and are promoting and marketing them as a less harmful. If e-cigarettes are indeed less harmful alternative, the tobacco companies should recall their more harmful regular cigarettes and stop selling them.
Vaping is not harm-free. Vapers, who are not experts on e-cigarettes, have run away with extoling its merits. The risks of vaping and e-cigarettes have been down-played and even ignored.
Many countries have already banned the sale of e-cigarettes, namely Brunei, Thailand, Cambodia, Singapore and Brazil. Japan and Australia have banned e-cigarettes with nicotine. The decision for the Health Ministry is clear - e-cigarettes must be banned.
MARY ASSUNTA is senior policy adviser, South-East Asia Tobacco Control Alliance (Seatca).
