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24 Jun 2014

Public health experts worldwide have urged the World Health Organisation to ignore tobacco industry claims about e-cigarettes and instead focus on the evidence in assessing their health implications.

Leading Australian public health advocates Professor Stephen Leeder, Professor Alan Lopez, Professor Ian Olver, Professor Mike Daube, Professor Simon Chapman and Associate Professor Freddy Sitas are among 129 international public health physicians and campaigners who have written to the WHO Director General Dr Margaret Chan in support of the organisation’s evidence-based approach to electronic nicotine delivery systems (ENDS).

Their call has come amid mounting international concern about the rapid, and largely unregulated, growth in e-cigarettes, which are often being spruiked as a safe alternative to tobacco products and an aid in kicking the smoking habit.

The global market for e-cigarettes – battery-powered devices that vaporise a solution that users then inhale - is growing at a massive rate. A recent US study identified more than 500 brands offering more than 7760 flavours, with an extra 10 brands being added every month. They are often marketed by tobacco companies.

Late last month a group of doctors and academics wrote to the WHO urging it, in the interests of harm reduction, to resist pressure to subject e-cigarettes to significant restrictions contained within the Framework Convention on Tobacco Control. The letter can be viewed at: http://nicotinepolicy.net/documents/letters/MargaretChan.pdf

In particular the group, who identified themselves as “specialists in nicotine science and public health policy”, argued it would be counterproductive to ban advertising of e-cigarettes “and other low-risk alternatives   to smoking”, and said it would be “inappropriate” to apply passive smoking protections to vapour products.

But in their counter letter, sent on 16 June, the public health experts urged the WHO to take a sceptical approach to such claims until such time as they have been subjected to rigorous assessment. The letter can be viewed at: http://tobacco.ucsf.edu/sites/tobacco.ucsf.edu/files/u9/Chan-letter-June...

In particular, they said the WHO should be wary of the tobacco industry’s role moving into and driving the e-cigarette market.

“Manufacturers of ENDS are making a range of false and unproven claims, misleading the public into thinking these products are harmless (they are not) and effective cessation aids (unknown),” the experts wrote.

They said there was insufficient evidence to back the claim they were an effective aid to giving up smoking, and instead there were disturbing signs that young people who had never smoked were using e-cigarettes.

And they warned that there was “good evidence” that e-cigarettes released several toxic substances including ultrafine particles, propylene glycol, nitrosamines, nicotine, volatile organic compounds and carcinogens.

“Proposals to allow EBDS use in indoor spaces like workplaces, bars and transportation could see significant exposure to these substances,” they cautioned.

“The absence of detailed evidence on health effects is not evidence that no effect exists. Rather, insufficient time has elapsed to determine what effects exist and their magnitude on a population level.”

The WHO said it was currently reviewing the existing evidence around ENDS and preparing a paper for submission to the meeting of the Parties of the WHO Framework Convention on Tobacco Control, to be held later this year.

It said it was also working with national regulatory bodies to look at regularity options, as well as with toxicology experts to understand more about the impact ENDS may have on health.

In Australia, it is illegal to sell e-cigarette liquids that contain nicotine, and the Sun-Herald has reported that Supreme Court of Western Australia has effectively banned e-cigarettes outright in the state in a landmark judgement against a company, called HeavenlyVapours, that had been selling the dispensers and nicotine-free “e-juice” through a website.

It had been prosecuted under the Tobacco Products Control Act, which prohibits the sale of anything such as food or a toy that mirrors a tobacco product.

The newspaper added that, in New South Wales, more than a dozen Sydney retailers faced legal action after being caught selling illegal nicotine-laced e-liquids late last year.

Adrian Rollins
 


Published: 24 Jun 2014