European tobacco control expert echoes Donald Trump’s concerns about e-cigarettes designed to mimic the taste of sweets and desserts
The government agency charged with protecting the nation’s health is under fire for defending e-cigarette flavours.
A leading European expert on tobacco control said that flavours were responsible for luring children into vaping, amid mounting concern over its effects on human health.
Alarm in the US over what has been labelled an “epidemic” in teen vaping, as well as the deaths of six people who have used e-cigarettes and the hospitalisation of hundreds more, has seen President Donald Trump announce plans to ban flavours in e-cigarettes, at least for a temporary period.
On Saturday, England’s chief medical officer, Prof Dame Sally Davies, also expressed concern about children using e-cigarettes. In an interview with Civil Service World, she asked: “Is this a ticking time bomb? Will they turn out to have long-term consequences?”
With many e-cigarettes designed to mimic the taste of popular sweet brands, desserts and tropical fruits, there are concerns that flavours are encouraging teenagers to try vaping, a claim denied by the industry. Emerging evidence also suggests that chemical reactions created by the addition of some flavours may be harmful to human health.
Despite this, Public Health England (PHE) backs their use, insisting that flavours help adult smokers switch to less harmful e-cigarettes. But Prof Charlotta Pisinger, chair of the European Respiratory Society Tobacco Control Committee, an international coalition of doctors and scientists, whose research has been shared with the European parliament, criticised those who defended their use.
“In Europe we have banned flavours from cigarettes because we know it attracts young people to smoking,” she said. “Cigarettes should taste like cigarettes not like candy. E-cigarettes taste like candy and, frequently, we see in small shops where they are sold, e-cigarettes on one side and candy on the other. Of course it attracts children.”
Martin Dockrell, tobacco control programme lead at PHE, warned last week: “Banning flavours would likely provoke vapers to relapse back to smoking, leading to more adult smoking role models for young people, which we know is the key driver in young people starting to smoke.”
But Pisinger said she was in “no doubt” there should be a ban on flavours in e-cigarettes. “I know opponents will say flavours are essential because there will be heavy smokers who want to quit with e-cigarettes and they will not find it as attractive, but we have to think about the new generation of young people so that they don’t get addicted to these products. It is much more important that we don’t experience a new epidemic of e-cigarettes. We know there is substantial evidence that use of e-cigarettes increases the risk of smoking conventional cigarettes. So it will also kickstart a new smoking epidemic.”
Unlike in the US, e-cigarettes are promoted in the UK as smoking cessation aids rather than a lifestyle choice. Heavy restrictions mean they cannot be marketed at youth. Pisinger, though, questioned whether e-cigarettes really helped smokers quit.
“It is important to remember that none of these very, very rich tobacco companies and e-cigarette companies have registered their product as a smoking cessation product. The only reason why they haven’t done it is they have no evidence that vaping is a good cessation tool. If it was effective they would have tried to have it approved,” she said.
Some experts believe the recent health problems in the US are linked to people inhaling vitamin E acetate, a cannabis vape oil cutting agent used by black market dealers. The UK, in contrast, has so far reported few health problems associated with e-cigarettes.
The Medicines and Healthcare products Regulatory Agency (MHRA) operates a yellow card adverse-reaction reporting system. In the last five years it has received 74 reports relating to health concerns associated with e-cigarettes, of which 49 were considered to be serious.
However, Pisinger said there was no room for complacency. “We are gaining more and more insight as to what is going on in the body when people vape, how it might affect the cardiovascular system, the lungs etc, and evidence is piling up that these products are harmful. We might be surprised that the harm is greater than we thought because there is a huge problem with all the research we have done so far. People are comparing this to conventional cigarettes, but the products are extremely different. We are looking for apples but maybe we should be looking for pears. This is something new.”