Irish expert: banning e-cigarettes will only lead to more smokers

Today’s news, May 8, reports that an Irish expert told the Wall Street Journal that Ireland should not completely ban the sale of e-cigarettes, but there may be more regulations on who can purchase them.

Previously, Australia announced a ban on recreational e-cigarettes, and e-cigarettes will no longer be sold in general stores and convenience stores.

The government will raise product standards for e-cigarettes, including restrictions on flavors and colors, to address the growing black market.  

It will also require packaging similar to that of drugs, reduce the maximum allowable nicotine concentration and volume, and ban the use of disposable e-cigarettes.

In Ireland, these devices are about the size and shape of a highlighter and have nicotine e-liquid already included when sold.

Currently, there are no mandatory age restrictions on the sale and marketing of e-cigarettes in Ireland, but a bill proposing to ban the sale and purchase of e-cigarettes by anyone under 18 will be announced in the coming weeks.  

While it states that it will continue to review new research, the HSE currently does not recommend using e-cigarettes as a smoking cessation method. It states that based on the evidence so far, it finds that they are not as effective for quitting smoking as nicotine gum or patches.

There are also no e-cigarettes on the Irish market that have been authorized by the Health Products Regulatory Authority (HPRA) as smoking cessation aids.

However, the NHS in the UK does recognize that e-cigarettes can help with quitting smoking. Although it does not regulate them, it points out that nicotine vaping is much less harmful than smoking and is one of the most effective tools for quitting smoking.

A general practitioner specializing in addiction medicine told the Wall Street Journal that he believes Australia’s ban on e-cigarette sales is completely counterproductive.  

"Safer than Smoking"

Dr. Garrett McGovern, also the clinical lead for addiction at HSE, stated that Australia’s ban will reduce the number of people using e-cigarettes.

"Some people are in my position, and they think this is a good thing. They have not really accepted the idea of e-cigarettes. I am not one of those people." he said.

"E-cigarettes are much safer than smoking, and we do need to continue our strategy to make Ireland as smoke-free as possible. I believe e-cigarettes can play a role, as can nicotine replacement therapies and counseling, along with various other interventions."

"I think if we are going to do anything in Ireland, we need to look at how many people are using e-cigarettes... The vast majority of people using these devices are actually smokers trying to quit, so we should applaud them and set up barriers on the road."

McGovern stated that he supports implementing restrictions, such as age limits on purchasing e-cigarettes, which he believes should have happened long ago.

"Any place selling them is very enticing and very colorful in terms of candy, and that kind of thing is wrong. We need to tighten up on that."

But he added that if we make it harder to access them, we will have more smokers.  

E-cigarettes are battery-powered devices that heat nicotine mixed with flavorings and other chemicals to create an aerosol that you inhale. They are sold in some supermarkets, independent e-cigarette shops, and online.

According to the Irish Vape Vendors Association (IVVA), approximately 200,000 people in Ireland use e-cigarettes, and in 2018, the country spent about 70 million euros on e-cigarettes.  

Many organizations are calling for more regulations regarding the use and sale of e-cigarettes in Ireland.  

The Irish Cancer Society states that while e-cigarettes are less harmful than combustible cigarettes, health risks still exist.

In a statement on their website, they said: There is not enough evidence to prove that e-cigarettes are effective smoking cessation aids; other methods, such as nicotine replacement therapies and prescription medications, have been shown to effectively help people quit smoking.

"More evidence is needed on the long-term health effects of using e-cigarettes. Due to clever marketing, e-cigarette use is increasing among young people and may become a gateway to smoking."

"Investment is needed in smoking cessation strategies, and we know this will impact supporting people to quit smoking."

There are also concerns about the increasing number of teenagers vaping recreationally. #p#分页标题#e#

In an interview with the Wall Street Journal, Professor Des Cox, a pediatric respiratory medicine consultant at the Irish Children's Health Center in Claremorris, stated that Australia has taken bold measures to address the alarming rise in teenage vaping.

Ireland should consider adding restrictions on the sale of e-cigarette products beyond the current bill, but not necessarily limiting them to prescription drugs.

"Of course, e-cigarettes are not as harmful as cigarettes, but they are not harmless either. Emerging research suggests that long-term vaping may increase the risk of heart and lung diseases," he said.

Research

The European Commission's Scientific Committee on Health, Environmental and Emerging Risks found moderate evidence that e-cigarettes are a gateway to smoking among young people.

It also found insufficient evidence supporting the effectiveness of e-cigarettes in helping smokers quit.

However, McGovern stated that the evidence supporting the gateway theory is very unstable.

He said: You do one thing first, and then downstream you do another thing; the idea that one leads to another is really nonsense.

In 2020, a review by the Health Research Board (HRB) found that compared to never users of e-cigarettes, teenagers who use e-cigarettes are three to five times more likely to start smoking.

HRB also stated that e-cigarettes as a smoking cessation device are not regulated or approved, and their safety beyond 12 months is unclear.

Cox stated that some Irish studies also indicate an increase in the number of teenagers vaping.

"One study reported that from 2015 to 2019, the number of teenagers aged 15-17 in Ireland increased by 50%. Teenagers who vape are inhaling harmful substances that may have long-term effects on their lungs and hearts."

"Additionally, teenagers who use e-cigarettes are four times more likely to continue using tobacco products than others, which is indeed concerning."

But McGovern believes that teenagers getting into vaping does not necessarily mean they will continue using e-cigarettes or continue smoking.

The Irish Tobacco Free Research Institute conducted a review in 2019 of 1,949 students aged 15-16. The results showed that 39% had tried e-cigarettes, and 16% were current users.

In contrast, 32% of respondents reported having tried smoking, and 14% of respondents reported currently smoking, with 5% smoking daily.

Luke Clancy, founder and current CEO of the Irish Tobacco Free Research Institute, told the Wall Street Journal that limiting e-cigarettes to prescription only means you can rely on them as a smoking cessation treatment.

"One advantage of the Australian system is that you have to be a smoker to get into trouble; if that happens, it means our children won't get addicted." he said.

"Many manufacturers and sellers have been emphasizing how important they are for quitting smoking. The HSE does not recommend using them for smoking cessation because there is not enough evidence. Also, because the products cannot be guaranteed to be medicinal."

"So if they do that here, what will it do to ensure that e-cigarettes are as they say they are and that they have the ingredients they claim? That would be a good thing."

He expressed hope that e-cigarettes with medicinal value could be provided free of charge to those wanting to quit smoking.

Government Bill

The HRB review is intended to help inform the Department of Health's policies regarding e-cigarettes.  

The government's Public Health (Tobacco and Nicotine Inhaling Products) Bill will prohibit the sale of e-cigarettes to children and is expected to be announced this summer.

The bill will prohibit anyone under 18 from buying or selling e-cigarettes and will also ban the sale of e-cigarettes in vending machines or pop-up stores.  

The bill will also prohibit advertising e-cigarettes within 200 meters of public transport, cinemas, and schools.

The bill will also introduce a requirement that anyone wishing to sell e-cigarettes must obtain a license, which must be renewed annually and can be revoked for violations of tobacco control laws.

Health Minister Stephen Donnelly announced these proposals last year, stating that these measures aim to protect our children and young people from starting to use e-cigarettes.

"We recognize that nicotine is a highly addictive drug, and we are taking action today to make it harder for our young people to access these products and to remove advertising for these products from our children's daily lives."

However, Cox believes that the bill is still far from sufficient.

"Young people are clearly targeted by e-cigarette companies because of their habits. We face the risk of a new generation of young people becoming addicted to nicotine." he said.

"In addition to prohibiting the sale of e-cigarettes to anyone under 18, Ireland also needs to strengthen restrictions on e-cigarette flavors, advertising, marketing, and packaging. The government should ban all flavors except tobacco flavors and restrict e-cigarette advertising, marketing, and packaging like tobacco products."

Clancy agrees that the bill needs to go further, including banning flavorings and disposable e-cigarettes.

"The pollution problem caused by plastic e-cigarettes is well known, and on the other hand, they are electronic devices. This means they are batteries, which use scarce lithium necessary for important things in life, and they are just putting it into these discarded items." he said.