Sunday 16 December 2018

To vape or not to vape? The e-cigarette debate

The vaping debate is characterised by confusion and contradiction - but those who have converted to e-cigarettes seem convinced.

Gillian Fitzpatrick E cigs vamping story at Lillies Bordello Grafton st
Gillian Fitzpatrick E cigs vamping story at Lillies Bordello Grafton st
Gillian Fitzpatrick. Photo: Ronan Lang
Aaron switched to e-cigarettes in April
Gillian Fitzpatrick.
An e-cigarette.

Gillian Fitzpatrick

The World Health Organisation this month insisted that e-cigarettes should be banned from use indoors because the risk to third parties was too great.

The health body's decision to weigh in on the vaping debate has added further confusion to what is already a cloudy issue.

Gillian Fitzpatrick.
Gillian Fitzpatrick.

While many highly-respected groups have sounded warning bells over vaping, there is also a vociferous health lobby rallying against over-regulation, arguing that getting smokers to switch to e-cigarettes could actually save lives.

The UK-based anti-smoking charity QUIT was among the high-profile voices raised in protest at WHO's call for a ban.

It cited university studies that prove those who have never smoked are extremely unlikely to use e-cigarettes - despite EU and WHO assertions to the contrary.

"Evidence does not support the view that e-cigarettes are undermining tobacco control," the study added.

Gillian Fitzpatrick E cigs vamping story at Lillies Bordello Grafton st
Gillian Fitzpatrick E cigs vamping story at Lillies Bordello Grafton st

Also quick to criticse WHO's call for a blanket ban was Professor Ann McNeill of King's College London's Institute of Psychiatry.

In response to the study, Prof McNeill stated: "Although e-cigarette vapour may be an irritant to people in close proximity to the e-cigarette user, there is no evidence of harm from other people inhaling e-cigarette vapour - unlike the known risks of second-hand cigarette smoke. There is also, as yet, no evidence that e-cigarettes are renormalisng smoking."

Medically referred to as Electronic Nicotine Delivery Systems (Ends), e-cigarettes release a nicotine-infused vapour - but, significantly, they contain no tobacco or tar.

However, with such an onslaught of contradictory information, when it comes to legislation, taxation and regulation, many governments, it seems, are unsure of their next move.

Aaron switched to e-cigarettes in April
Aaron switched to e-cigarettes in April

A Department of Health spokesperson confirmed to the Irish Independent that they will "continue to monitor the evidence on the potential harm and the potential benefits of e-cigarettes before deciding the best approach".

They acknowledged that scientific studies and current research is at times conflicting.

Though the devices are currently unregulated, the spokesperson said the Government was poised to take action, recently approving the "drafting of legislation".

"Areas under consideration in the proposed legislation include the prohibition of the sale by and to those under 18 years," they added.

An e-cigarette.
An e-cigarette.

In Ireland, much has been achieved in the last decade in terms of reducing the number of smoking-related deaths and illnesses: a ban in public places; a reduction in the number of smokers by 7.5pc; a reduction in the number of cigarettes sold annually by 1.5bn. The figures from 2004 to the present day are certainly impressive. Little wonder, then, that a bolstered Leinster House has stated that it is committed to making Ireland smoke-free by 2025.

And as those tobacco sales fall, e-cigarette sales rise rapidly. In 2013, e-cigarette sales in Ireland grew by an eye-watering 478pc. It's a pattern being repeated globally. In the UK e-cigarette users have snowballed from 700,000 in 2012 to 2.1 million in 2013. In the US, sales grew 115pc each year between 2009 and 2012.

The industry is conservatively valued at $2bn and the companies behind e-cigarettes, most of which are based in China (the inventor is a Chinese medical researcher), state absolutely that their product is the lesser of two evils, and could save millions of lives globally.

International health authorities, however, are less confident. ASH Ireland says it "is keeping the issue of e-cigarettes constantly under review", but does worry that the devices represent just "another addictive product with few benefits and little impact on smoking cessation possibilities".

The EU voiced its concerns in February, releasing a statement highlighting concerns that e-cigarettes are increasingly used by teenagers.

Equally cautious is the Irish Cancer Society, which says it does not "currently recommend e-cigarettes to those trying to quit smoking".

Dr Tony Cox, president of the Irish College of General Practitioners, told Clare FM last month that he's concerned the devices are untested and are glamourising smoking, adding that, in his opinion, there are always safer ways to kick the habit.

But on the ground, many users in this country are adamant that e-cigarettes have changed their lives for the better. Plenty confirm that vaping is cheaper, cleaner and less damaging to their bodies than combustible tobacco products.

Anthony Madden opened his Healthier Smoker store in Rathmines in February and has been pleasantly surprised by how busy business has been.

For €30, he offers a vaping starter pack containing a vaporiser and charger, as well as 12ml of liquid - and they have been flying off the shelves.

"We've had a consistent flow of customers through the doors since we got off the ground earlier this year," he says.

Anthony was inspired to set up his shop after his heavy-smoker mother developed a cancerous growth on her neck.

"She couldn't afford to buy cigarettes, so she rolled her own. She claimed she was having a pack of tobacco a week, but in reality I know it was closer to one a day. Having that growth on her neck should have been the ultimate wake-up call but within three days of coming home from hospital she was back smoking again."

Eager to find an alternative to help his mother kick her addiction, he looked into vaping.

"She'd tried all the gums and sprays but those did very little. I encouraged her on to the e-cigarettes last November, and she hasn't looked back. You feel very helpless when someone you love is sick, so it's been brilliant to have been able to help her off tobacco."

Another success story is 32-year-old Aaron Kavanagh, a medical devices graduate who is based in Kilcock in Co Kildare. He had been smoking for a decade before making the switch to vaping in April.

"I was smoking a packet of cigarettes a day," Aaron says. "Then I moved on to rolling my own tobacco - primarily because I was in college at the time and it was much cheaper - but I was easily getting through two or three pouches a week."

Aaron says he tried to quit, but always came up against an obstacle.

"Typically, every time I made a stab at quitting, something stressful came up. There was always a good reason to put it off."

He also says he tried patches, sprays and gums, but found them expensive and ineffective. Eventually, it was his mother who provided the inspiration he needed. "She smoked heavily for years - 40 years in fact - and was getting through about 40 cigarettes daily. But she swapped over to vaping without a hitch and I guess I thought, if someone like her who smoked so much for so long can quit, then I've no excuse."

He reveals that though the transition wasn't seamless - "the first week you do go through all the usual withdrawal symptoms: you've a cough, you feel sick, headaches" - it has certainly been easy on his pocket.

"I've gone from spending around €70 a week to €5 every three weeks. For the first three months or so I put away the money I was saving. By the end I had saved close to €900."

According to one recent study, people like Aaron who switch from tobacco products to e-cigarettes can expect to reap the rewards.

Led by Prof Robert West and Dr Jamie Brown of University College London, their findings state that for every one million smokers who switch to e-cigarettes, close to 7,000 premature deaths would be prevented.

And just this month, Peter Hajek, an addiction researcher at Queen Mary University of London, slammed knee-jerk, anti-e-cigarette reactions as unnecessary and unhelpful.

The conventional cigarette, he said, "endangers users and bystanders and recruits new customers from among non-smoking children who try it". In contrast, he added, the e-cigarette is "orders of magnitude safer, poses no risk to bystanders, and generates negligible rates of regular use among non-smoking children who try it".

While no one can entirely dismiss the unknown - the product is simply too new to be considered absolutely harmless - Aaron argues that "given the choice of a cigarette that has a 50 percent chance of killing me, and a vapour product that seems in all likelihood to be a lot safer, I'm confident that my choice is the right one".

Ireland's smoke-free by 2025 aims were always going to be ambitious. However, as scores of vaping enthusiasts and medical professions alike will now argue, those aims may yet be realised because of - rather than in spite of - the rise of e-cigarettes.

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