Anti-tobacco campaigner Professor Luke Clancy has warned that the unrestricted availability of electronic cigarettes could undermine the lifesaving achievements of the smoking ban by 'renormalising' smoking in society.
Ireland celebrates the tenth anniversary of the ban on smoking in workplaces next month.
Research published by the TobaccoFree Research Institute Ireland (TFRI) has shown that this historic legislation prevented well over 3,700 smoking-related deaths in the three years following the ban and provided an incentive for thousands of smokers to kick the habit.
Yet all this good work could be undone if strict regulations on advertising, packaging and availability of e-cigarettes are not introduced by the Irish Government without delay, according to Prof Clancy, Director General of the TFRI and a consultant respiratory physician.
He told irishhealth.com that the debate over whether e-cigarettes as a nicotine delivery system are less or more harmful than cigarettes is a 'smokescreen' and not the issue that should cause real concern.
"We've spent a lot of time and effort trying to denormalise the act of smoking and now this device could be used to renormalise it," he warned.
"Proponents want to have the debate about the actual substance - nicotine - and whether being addicted to e-cigarettes would be less harmful than being addicted to tobacco, but the question should be, what is the overall effect of the use of this product likely to be? Is it going to diminish the number of people who are smoking cigarettes? I don't think so."
He said that the workplace smoking ban has proved hugely successful in Ireland. "We're coming up to the tenth anniversary and what this law has helped to achieve, more than anything else, is to denormalise smoking; it has led to people to try to quit because they found it inconvenient not being able to smoke in public areas.
"With the e-cigarette, that incentive has now been removed. It is my view that e-cigarettes tend to neutralise the effect of smoke-free laws and that is a bad thing."
E-cigarettes are battery-operated devices, often designed to look like regular tobacco cigarettes, which heat a liquid containing nicotine, turning it into a vapour that is inhaled and creating a vapor cloud that resembles cigarette smoke.
Prof Clancy pointed out that many tobacco companies are now buying into the booming e-cigarette market, which he believes is a sinister development.
"What is emerging is that increasingly the tobacco industry is getting involved in this business and you have to ask why? Is this so that they can help people to stop smoking? That seems inherently implausible. In my opinion, with regard to tobacco control, e-cigarettes will prove to be a bad development; I've no doubt about that.
"E-cigarettes can be used by the industry to re-glamorise smoking; some young people who are very impressionable will see celebrities openly using e-cigarettes in magazines and on TV, and it can have an influence on their behaviour and choices.
"It is wrong that e-cigarettes are being advertised openly, encouraging addiction. Children experiment with cigarettes all the time, now they're being told here's a safer cigarette, so they'll probably try that as well.
"Surveys in France have shown that 7% of children who are non-smokers have tried e-cigarettes, so it is likely that there are some children who are not even smokers who will become addicted to nicotine using e-cigarettes, and the likelihood for them is to progress onto tobacco cigarettes."
Prof Clancy allowed that e-cigarettes might prove useful as a smoking cessation aid, although he stressed that this had not been definitively proved in clinical trials.
"Could they be used as a smoking cessation aid? Possibly. They are a better nicotine delivery system than we currently have but so far there's no solid evidence to support the claim that e-cigarettes make it easier to give up. My concern is that e-cigarettes may prove a deterrent to people joining smoking cessation services and really trying to tackle their nicotine addiction, and an encouragement to continue."
Agreement was reached this week on new EU legislation that will revise the tobacco rules and, for the first time, regulate the marketing and sale of e-cigarettes across member states.
The new EU Tobacco Products Directive asserts that e-cigarettes must be licensed as medicinal products if they have a nicotine concentration of greater than 20 milligrams per millilitre (mg/ml), and/or are marketed as a smoking cessation aid. Products below this nicotine threshold may be sold as consumer products provided they are childproofed, carry health warnings, and are subject to the same advertising restrictions as tobacco products.
Once it comes into force in May, member states will have two years to introduce the legislation but Prof Clancy has urged the Government not to wait that long.
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