Stronger regulations for E-cigarettes needed in SA

Dr Dominique Stott, Executive: Medical Standards and Services at PPS.

E-cigarettes have come under intense scrutiny in the past few months over the number of potentially harmful side effects that they may have to first-hand and passive smokers. According to a report released by the World Health Organisation (WHO) in August this year, stronger regulations and controls are needed to reduce the risks associated with the use of e-cigarettes.

The report detailed that while few studies have been done on the effects of e-cigarettes, medical professionals and governments need to consider greater controls on the products, as common side effects that have already been attributed include: nausea, headaches, breathing difficulties, red eyes, dizziness and a number of other health-related problems.

Dr Dominique Stott, Executive: Medical Standards and Services at PPS, hails the move by the WHO, saying that tobacco has been directly and indirectly linked to 100 million deaths worldwide in the 20th century alone. “This figure must be brought down by any means possible, including the introduction of any regulations or controls that could prevent the inhalation of toxic and carcinogenic substances.”

She explains that e-cigarettes (also known as Electronic Nicotine Delivery Systems) were developed approximately ten years ago as an alternative to smoking, as well as an aid to stopping altogether. “The development of the device was based on the principle of providing the same effects of smoking nicotine when the vapour was inhaled, without the 7000 toxic substances in traditional cigarettes - of which at least 70 are known to be carcinogenic. The ‘smoke’ produced is actually a vapour made up of propylene glycol (an inert substance considered harmless for oral ingestion) and nicotine.”

“Currently, there is no conclusive evidence that supports the argument that e-cigarettes aid smokers in stopping,” she explains. “The reality is that, despite being marketed as a healthy alternative, the devices still contain nicotine, which is addictive and when stopped still causes withdrawal symptoms. This means that it is easy for a user of the device to easily move back to traditional cigarettes if they are made available, regardless of the dangers associated with them.”

Dr Stott says that using e-cigarettes is still classified as smoking. “Many insurance companies now do blood and urine tests to ensure that those who say that they are non-smokers really are. Due to the well-known side effects of nicotine and associated risks of smoking (such as heart disease, strokes, cancer and lung risks) an individual’s insurance premium may be doubled, depending on the type of insurance product.”

As there are no current regulations for the development and usage of e-cigarettes, there is the danger that the device itself, or the contents of the vapour cartridge, may be contaminated by toxic substances, she adds.

Dr Stott points out that the devices have been marketed as a fashionable alternative to cigarettes and have gained popularity with the development of flavoured vapours. “Through the glamourizing of e-cigarettes by tobacco companies, smoking may become as popular as it was 20 years ago. Despite TV adverts for cigarettes being banned in 1999, there is no similar control over the marketing of e-cigarettes. All the ground gained by public health campaigns to end smoking are in jeopardy as a result.”

Stronger regulation of e-cigarettes could ensure that only those over the age of 18 will be able to purchase the devices, any unsafe substances would be prevented from being used in them and greater protection of second-hand (passive) smokers would be developed.

Norway, Brazil and Singapore have completely banned the devices, with the UK banning sales to under-18s. Due to the concern raised by the WHO regarding their usage, the United States has regulated e-cigarettes as tobacco products. Australia regulates imports, sales and marketing of the devices and New Zealand requires registration as a pharmaceutical.

“It would be promising to see similar regulations enacted in South Africa to protect consumers, especially those inhaling second-hand smoke, from this seemingly ‘better’ option to cigarettes,” concludes Dr Stott.