E-cigs: Help or Hindrance?

201609-Phillips-Fiona-Ms-Aug-16Cancer Council WA urges caution on the E-cigarette debate.

There’s plenty of vigorous debate about the safety and efficacy of electronic nicotine and non-nicotine delivery systems better known as E-cigarettes (ECs). Unsurprisingly, there are more questions than answers.

  • Are e-cigarettes a safe and effective way to help smokers to quit?
  •  Are they a hindrance, adding fuel to Big Tobacco’s fire to keep smokers smoking?
  • Will they encourage young people to commence smoking?
  • Will they mark the beginning of the end for tobacco products?

201609-Slevin-Terry-Mr-Aug 16Mr Terry SlevinThere are some who are openly enthusiastic about the potential benefits of ECs. Many others are far less so. However it seems prudent that while the debate rages on, particularly in the UK, we take a cautious approach. It’s important to be sure that these products are both safe and effective.

There is no doubt that, despite the prohibited sale of ECs, smoking rates are falling in Australia. The adult smoking rate in WA in 2002 was 21.6%, thirteen years later it was 12.5%. Increasing tobacco excise, the introduction of plain packaging and ongoing community education programs are all a factor in the downward trend.

It is currently unlawful to sell ECs containing nicotine in any form. Nicotine is a scheduled poison and can only be lawfully sold in the form of legal tobacco products and approved nicotine replacement items.

However, laws in WA, SA and Qld also prohibit the sale of non-nicotine ECs due to the fact that they resemble tobacco products. Despite these bans, it doesn’t prevent the online sale and marketing of ECs, with or without nicotine.

Some would argue that the uptake of ECs by young people is of growing concern. A recent NSW study showed that approximately 16% of the 18 – 29 year-olds used ECs.

While most would agree that ECs are less harmful that cigarettes, the evidence increasingly shows that ECs are far from harmless. There are others who argue that they are counterproductive in the effort to actually quit smoking. On the other hand, some suggest that the EC is a ‘magic bullet’ despite the fact that there is a paucity of supporting evidence that they are any more effective than unassisted cessation or conventional nicotine replacement therapy.

Big Tobacco’s investment in the EC market is significant and increasing. The tobacco industry is spending millions developing nicotine delivery products of their own. Significantly, the marketing of ECs is almost identical to the promotion of traditional cigarettes decades ago. Recent research shows that some aspects of EC marketing have the potential to drive former smokers back to cigarettes.

There are many viable options for current smokers. There are five different TGA approved and well-researched forms of nicotine replacement therapy widely available. An encouraging word from a GP is an important factor in encouraging smokers to quit the habit.

Until ECs have been approved by the TGA as a safe and effective therapy it would seem prudent that the marketing, sale and use of these products remains prohibited.