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E-cigs and children: Are e-cigarettes a good thing?

You might have seen the TV adverts or the shops popping up on our high streets. You may have sat next to someone in a pub smoking one, unsure whether to ask them to stop. You might have even let your child taste it. Smoker or not, you cannot escape the E-cigarettes leap from Z list to A list in under seven years.

Though as numbers of users increase and profits for the manufacturers surge, the question now is are E-cigarettes a good thing?

Huge debate

There is enormous debate in the UK public health community about E-cigarettes. It is polarising the very people employed to protect our heath. With confusion amongst this group it is no wonder the general public have no idea whether E-cigarettes are a good thing or a bad thing.

It is not their fault. We have worked with a lot of public health professionals and one thing we know for sure is that evidence is king. And this is probably the reason why we have a public health community so divided.

We still don’t know enough about the role E-cigarettes play in introducing people to smoking – otherwise known as gateway effects. We don’t really know if E-cigarettes are in fact encouraging people to continue smoking or supporting people to quit. Some public health professionals are concerned that E-cigarettes are re-normalising smoking, especially for young people, potentially undoing all the hard work of the last 30-50 years.

Lets not be scared to talk about E-cigarettes. Lets ask questions. Although I wasn’t around in the 1950′s, I believe people thought smoking cigarettes was a good thing at one time and the tobacco companies told us as much. Sixty years later, I wonder, have we seen the arrival of the new wolf in sheep’s clothing?

The role of marketing

Over the last 12 months, we have seen the marketing of E-cigarettes shifting from being an “aid” to stop smoking to something we must desire, something we must have and something we must taste. Over the past year alone, the E-cigarette market has increased by 340%, and it is estimated to be worth £340 million in 2015.

Only yesterday I saw an advert on TV for E-cigarettes. It was sexual. It was alluring, it was inviting. I thought we banned smoking advertisements didn’t we?

But what worries me most is how the big players of the tobacco industry are moving faster than Usain Bolt in the E-cigarette market. Tobacco companies are buying shares in E-cigarette companies, buying e-cigarette companies, or making their own brands. For example, Altria, the owner of Philip Morris International (the company that owns tobacco brands such as Marlboro) created it’s own e-cigarette brand (MarkTen) in 2013 as well as companies such as Lorillard who are buying e-cigarette companies. As they become more and more involved in E-cigarettes the marketing efforts double and the range of flavoured products seem to be increasing.

This is where I have a problem. I am not against e-cigarettes if they are not harmful and help existing smokers to quit. Our work with young people over the last 12 months has found that young people find E-cigarettes highly appealing. The allure of the different flavours from redbull, strawberry milkshake and gummy bear flavour E-cigarettes are creating a generation of vapour hungry school kids.

There have been claims that the large variety of flavours now available (there are over 300) target children instead of adults. How many adults do you know that would pick a gummy bear flavoured E-cigarette?

There is no doubt that awareness of E-cigarettes amongst youth groups is high. A recent study by ASH Wales (2014) found that 79.6% of 13-18 year olds were aware of E-cigarettes in Wales. What we don’t have is a lot of evidence on how many young people are using them – in England, Wales or anywhere else for that matter.

However, we conducted a survey in June 2014 with headteachers and teachers across England and of the 72 schools that took part, 53 schools told us that they were confiscating up to 10 E-cigarettes a week.

If you do your maths, this means that in just 53 schools, around 500 E-cigarettes are confiscated by teachers every week. So lets stop saying that kid’s aren’t interested. They are. So what are we going to do about it? Should we be doing anything?

Focus groups we conducted in Wales with 11-12 year old girls found that most were aware of e-cigarettes even at this age. Many had also tried them. In one town in Wales, almost all the girls we spoke to had tried it at least once and they found purchasing e-cigarettes easy obtaining them from shops, parents and friends.

Even pizza takeaways are selling E-cigarettes to kids – but interestingly only if you are aged over 7 years. Other places have strict policies on selling to under 18′s even though it is not the against the law. Some E-cigarette websites say that they will not sell to under 18′s. Yet we carried out tests and found that it was in fact very easy to buy online whether you were over 18 or not.

If there is no evidence of harm, why will some sell to under 18′s and others not? Is there something we don’t know?

Although e-cigarettes are an alternative for those who are trying to quit smoking, the E-cigarette could pose some threats to the public. Predominantly, there are health concerns surrounding the welfare of non-smokers who inhale the vapour. The chemicals in the e-cigarette cartridge could potentially be poisonous.

I read a story last week of one woman who burnt the back of her throat smoking an e-cigarette. In a recent report, 51.1% of E-cigarette related poisoning incidents in the US involved children under the age of five. In the UK, 36.5% involved “very young children”. To put this into perspective, in 2012 there were 29 cases of poisoning from E-cigarettes, but across the five years before, there were just 36 cases.

Incidents such as this fueled campaigners and governments to place more restrictions on the use of E-cigarettes. In France, Normandy has banned the use of E-cigarettes in public spaces, which is likely to lead to a nationwide ban. In Spain, a national ban on E-cigarettes was enforced, banning the use of E-cigarettes in public spaces.

In addition to health concerns, there have also been social concerns surrounding the use of E-cigarettes, with Wales being the first in the UK to move towards a ban of smoking E-cigarettes in public spaces over fears that it could re-normalise smoking tobacco cigarettes.

What is the government position?

E-cigarettes are not regulated in the same way tobacco is, which is why the government plans to ban e-cigarettes for those under the age of 18. Until then, even pizza takeaways can continue to sell to our 7 year olds until the law is changed.

Currently there is very little regulation in the UK for E-cigarettes. in January 2014, the Medicines and Healthcare Products Regulatory Agency did not place restrictions on the marketing of E-cigarettes. A review of the EU Tobacco Products Directive (2001/37/C) regulation is due to come into action in 2016 which would make any E-cigarette cartridges containing more than 20mg/ml to be regulated as medicines.

The purpose of the review of the regulation is to ensure that members of the public remain safe. Under the new regulations, e-cigarette packets will be required to have health warnings on their packaging as well as information on the ingredients and nicotine content.

Another sign that E-cigarettes are not “as good” as people might think – or are led to believe?