Electronic Cigarette Smoking

Electronic Cigarettes: A Risk and Regulatory Analysis

Introduction

Tobacco smoking is one of the largest preventable causes of chronic disease and premature death in the world today. Despite increased education and scientific research, smoking habits and nicotine addiction persist. It is estimated, for example, that today’s global smoking population stands at one billion, approximately half of whom will experience health problems or premature death as a result of their exposure. Tobacco smoking and disease cause around five million deaths each year, including 700 000 within the European Union and 480 000 within the USA (including deaths from second hand smoke) . It is even estimated that smoking will contribute to one billion tobacco-related

Quitting before the age of 35 lowers morbidity and mortality risk by over 90%, whilst cessation at any age brings benefits. After 10 years without smoking the risk of contracting lung cancer drops to half of someone who continues to smoke and after 15 years the risk of heart attack decreases to the same as someone who never smoked. Yet quitting remains difficult. 80% of those who quit without some form of aid fail within one month and only 3% succeed each year. Against this backdrop, a new form of nicotine delivery device is gaining traction. Invented in China in 2003, the electronic cigarette delivers inhaled doses of vaporised nicotine without the many toxic chemicals produced through tobacco combustion. It is estimated that electronic cigarettes are 95% less harmful than traditional cigarettes and present an opportunity to reduce the prevalence and adverse effects of tobacco smoking. Despite early promise, the risks associated with electronic cigarettes are subject to fierce debate and their regulatory framework remains in its

Farsalinos and Stimson (2014) argue that ‘electronic cigarettes are not used as medications and are not used as treatment – they are neither medicine by function nor necessarily presentation.’ A survey by Dawkins, Turner, Roberts and Soar (2013) suggests they are used as an enduring smoking substitute rather than as smoking cessation medication, whilst work by Etter and Bullen (2011) concedes that although the primary purpose of electronic cigarettes is to deliver nicotine via a less harmful product, this does not constitute definition as a medicinal product. Such an argument would suggest low-fat milk represents a medicinal product because it less harmful than full-fat milk. Finally, some work has attempted to construct an electronic cigarette risk definition separate from either tobacco or medicinal influence. Arguments here recognise the similarities between electronic and tobacco cigarettes but caution any equality in risk evaluation. There is no tobacco in electronic cigarettes and it is therefore inappropriate to assimilate the two products given their different risk profiles. They are not related, it is argued, they merely live in the same