Using e-cigarettes – knows as ‘vaping’ – is viewed overseas as a safer alternative to smoking, but research is now raising serious health concerns. David Smiedt looks at the pros and cons
Next time you pass an office building, look at the furtive clutch of smokers outside. You’ll notice a few of them ‘vaping’ on an e-cigarette – a device that looks like an old-school audio cassette with a mouthpiece.
Rather than burning tobacco, they use a heating element, a disposable or refillable cartridge that contains a flavoured or nicotine-based liquid, and an atomiser that turns it into an aerosol or ‘vapour’ to be inhaled.
In the past few years, vape stores have emerged around Australia, where these products are marketed as tools for people who are trying to quit tobacco or who want a ‘healthier’ option.
The current tobacco-quitting recommendations – which are backed by services such as Quitline – aim to wean people off the addictive nicotine in cigarettes with gum, patches and sprays, often used in combination with counselling services and apps.
It’s a strategy that’s paying dividends, with Better Health Victoria reporting that in 2016, 61 per cent of Aussies who’d ever smoked had quit. Mainly using traditional methods.
Vaping, however, hasn’t proved as successful. As is often the case with new products, marketers bolt out of the blocks but peer-reviewed
studies only come to fruition years down the track. It’s only now that large credible data is emerging about e-cigarettes.
What the science says
In January, The National Academies of Sciences, Engineering and Medicine in the US collated 800 studies on e-cigarettes and concluded there’s a big question mark over their public health outcomes.
It found that ‘e-cigs’ entice young people to start smoking actual cigarettes, but also noted there’s “conclusive evidence that completely substituting e-cigarettes for combustible tobacco cigarettes reduces users’ exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes”.
Yet the fact remains that e-cigarette users are still inhaling artificial substances into their lungs. One small US study from The University of California, Los Angeles found that users presented with higher amounts of certain heart disease markers.
Additional US data from Johns Hopkins University found high levels of toxic metals in the liquid that creates the aerosol inhaled by e-cigarette users.
Kelly Kennington, manager of the Make Smoking History campaign at the Cancer Council WA, is unequivocal in her view of e-cigarettes. “Cancer Council WA, along with many other leading health organisations, are very concerned about the growing evidence of direct health harms associated with vaping, including increased risk of respiratory disease, cardiovascular disease and carcinogenesis,” she says.
The debate in Australia
Some experts are critical of Australian authorities’ hard-line approach against e-cigarettes, especially as health organisations in the EU, UK and New Zealand seem more open to them as a harm-reduction tool compared with tobacco. In fact, the Royal College of Physicians in the UK says they “appear to be effective” as a smoking cessation tool.
It’s a view that some Aussie doctors aren’t entirely opposed to, with Dr Colin Mendelsohn, an associate professor of public health at the University of New South Wales, telling the ABC: “We have a very large population of smokers who can’t quit with what we’re currently doing.”
However, Maurice Swanson, president of the Australian Council on Smoking and Health, doesn’t believe e-cigarettes are the solution.
“It’s very premature to calculate predictions on the harms of vaping compared to cigarettes, due to relatively few high-quality studies, the absence of long-term follow-up, lack of standardised testing methods and rapid changes in e-cigarette products,” he says.
“Because cigarettes are the most harmful legal product that’s available to consumers, everything will appear ‘less damaging’ in comparison, he adds. “E-cigarette aerosol is a mixture of ultra-fine particles of metals, nicotine, and other ingredients such as flavouring and glycols. The long-term health effects or safety of inhaling these substances as aerosol hasn’t been evaluated.”
Swanson is also concerned with the manner in which e-cigarettes are being presented to younger potential smokers.
“The major international tobacco companies own all the top e-cigarette brands and these companies have a vested interest in continuing to promote smoking behaviour and products among young people,” he explains. “E-cigarette marketing mirrors the glamourising tactics that were previously used by tobacco companies.”
For now, it’s a case of approaching e-cigarettes with extreme caution – that’s the stance of Professor Christine Jenkins, chairwoman of the Lung Foundation Australia.
“We recognise that in the short term, e-cigarettes may be less harmful than cigarette smoking and understand there’s a push for e-cigarettes to play a role in smoking cessation,” she says. “But the evidence for their effectiveness in smoking cessation isn’t yet established. It’s time to focus on supporting the uptake of the tried and tested methods of smoking cessation.”
Are e-cigs legal?
It depends on what’s in them, your age and where you live. E-cigarettes are governed by the same laws as tobacco, so you have to be over 18 to buy them. It’s legal to use non-nicotine e-cigarettes anywhere in the country but e-cigarette liquid with nicotine has to be prescribed by a doctor. According to e-tailer Oz Vapour, you can buy nicotine products from overseas for personal use (except in Queensland) but you still need a prescription and in the NT you need a permit. Strict laws apply to the sale of e-cigs in Queensland and WA.
SOURCE: The Sunday Times