Health chiefs across the UK have been urged to take a less
negative attitude towards e-cigarettes and embrace their use
in the battle against more harmful tobacco smoking. The
Royal Society for Public Health (RSPH) says a public
education programme is needed to differentiate the problem
of addiction to nicotine, which is an ingredient in both e-
cigarettes and tobacco, from the inhaling of dangerous
chemicals such as tar and arsenic in tobacco cigarettes.
NHS stop smoking services should offer more help to people
seeking to end their habit by using e-cigarettes, the
society says, calling also for new “exclusion zones”
barring smoking, but not e-cigarettes, outside schools, bars
and pubs and in public squares and parks.
Smoking cessation services are unable to provide e-
cigarettes to people trying to quit tobacco because none yet
have a medicines licence, unlike other nicotine replacement
therapies (NRTs), such as gum, lozenges and patches. But the
RSPH says more services should follow the example of those
in Leicester and north-east England in offering behavioural
support to those wanting to quit tobacco and using e-
cigarettes to try to do so.
Chief executive Shirley Cramer said: “Over 100,000 people
die from smoking-related disease every year in the UK. While
we have made good progress to reduce smoking rates, one in
five of us still does [smoke]. Most people smoke through
habit and to get their nicotine hit.”
The RSPH would rather people didn’t smoke, said Cramer, but
getting people on to nicotine rather than using tobacco
would make “a big difference” to the public’s health.
E-cigarettes: is vaping any safer than old-fashioned smoke?
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“Clearly there are issues in terms of having smokers
addicted to nicotine, but this would move us on from having
a serious and costly public health issue from smoking-
related disease to instead addressing the issue of addiction
to a substance which, in and of itself, is not too
dissimilar to caffeine addiction.”
The society, which commissioned an online survey of 2,072
adults from polling company Populus earlier this month, said
it was concerned to find that nine in 10 still regarded
nicotine itself as harmful. It was more encouraged by
indications that half those surveyed would be more likely to
use areas outside bars and restaurants if there were tobacco
exclusion zones and by support for other parts of its
package.
The RSPH advocates licensing all tobacco sellers so that
local authorities can ban sales by any shops that fail to
obey legislation such as age restrictions and display bans.
It calls too for the mandatory sale of NRTs in shops selling
tobacco, and repeats a call first made last year to rename
e-cigarettes nicotine sticks, vapourisers or nicotine
control products.
The package put forward by the charity – which includes
more than 6,000 public health professionals in its ranks –
would, if widely adopted by the government and other
authorities, represent the biggest shift in attitudes
towards e-cigarettes in the decade since they came on to the
UK market.
An estimated 2.6m people now use e-cigarettes, which have
experienced such a surge in popularity that more than one in
seven tobacco smokers are now thought to use them. But
official and medical attitudes towards both some forms of
tobacco control and e-cigarettes vary considerably across
the UK and there are already signs of alarm that putting
nicotine addiction on a near-par with that for caffeine
might undermine the wider no-smoking message.
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Public Health England, a government body, has commissioned a
review of evidence on e-cigarette safety and the behaviour
of both tobacco and e-cigarette users by academics at King’
s College, London and Queen Mary University, London. It is
expected to be published within months.
Boris Johnson, the Mayor of London, has shown no interest in
the capital following New York in banning smoking in many
open public places, although a voluntary ban has been tried
in two public squares in Bristol and is being evaluated.
Brighton and Hove council, which already has voluntary bans
in its children’s play areas, is considering extending the
measure to beaches and other open spaces.
Meanwhile, the Welsh government is preparing to extend the
current ban on tobacco smoking in enclosed public places to
e-cigarettes too, believing it will help prevent e-
cigarettes “re-normalising” smoking. Yet legislation soon
to take effect in both England and Wales will ban smoking of
tobacco, but not e-cigarettes, in cars carrying under-18s.
The Department of Health in England said:“The best thing a
smoker can do for their health is to quit completely.
However, for those not ready to quit, evidence shows using
e-cigarettes, in the short term, poses a lower risk to
health than smoking.”
It added: “We are regulating these products to make sure
they are even safer and want to see local stop-smoking
services welcoming smokers wishing to use e-cigarettes to
support their quit attempts. Although we recognise that e-
cigarettes may help adults to quit, we still want to protect
children from becoming addicted to nicotine, which is why we
have made it illegal for under-18s to buy them.” There were
no proposals in the pipeline to introduce any further
smoke-free legislation.
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Hazel Cheeseman, director of policy at health charity Ash,
was more positive about the RSPH package. “Scientists have
known for many years that it’s the smoke in cigarettes that
’s deadly, not the nicotine. Unfortunately, this is not
well understood by smokers, medical professionals or the
media, many of whom still think nicotine causes heart
disease and cancer,” she said. “The persistence of this
misconception will cost lives as smokers who otherwise would
switch to alternative sources of nicotine are put off. The
time for this misunderstanding to be put right is long
overdue.”
The Electronic Cigarette Industry Trade Association (Ecita)
welcomed recognition that e-cigarettes “have an important
role to play in reducing the harm associated with smoking
combustible cigarettes”. They were “first, and foremost, a
low-risk alternative to lit tobacco, and studies show that
users can become smoke-free when using these products,” it
said.
“It is unfortunate that so much misinformation has been
disseminated about electronic cigarettes in the last few
years. This has contributed significantly toward a growing
fear and confusion surrounding these products.”
Pro-tobacco group Forest supported proposals that would make
it easier for smokers to use e-cigarettes, but director
Simon Clark said renaming e-cigarettes was a “silly” idea.
“It ignores the fact that e-cigs are popular because they
mimic the act of smoking. The name is part of their appeal.
“Calling them nicotine sticks or vapourisers suggests a
medicinal product, and that misses the point. For many
consumers, e-cigarettes are a recreational product. If
public health lobbyists don’t understand that, they could
sabotage a potentially game-changing device.”
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