The smoking ban has stretched far and wide across Europe over the past decade and this has resulted in a difference to the way in which those who continue to smoke conduct their habit.
However, the availability of e-cigarettes (the smoking of which is commonly known as vaping) has changed the smoking habit once again, prompting questions about how healthy an e-cigarette can be, if used in the long term.
Electronic cigarettes are devices that mimic real cigarettes. They deliver nicotine through vapour rather than smoke. This method is thought to be potentially less harmful than smoking tobacco.
Importantly, e-cigarettes are not regulated medicines, so the ingredients and amount of nicotine contained within each e-cigarette may vary.
The UK Government’s medicines watchdog will decide next year whether to introduce more stringent checks on e-cigarettes.
We are short on studies and research, which is disconcerting when you think how quickly the product has been accepted into society.
The e-cigarette was invented in 2003 by a Chinese chemist and is now a fast-growing market. However, in the UK, a pub chain with over 900 branches has already banned customers from using e-cigarettes because it is too difficult to distinguish them from real cigarettes.
Some UK rail companies have also banned the use of e-cigarettes at their stations and on trains; and now the British Medical Association (BMA) has recommended that they should be included in the ban on smoking in public places.
This has caused controversy. Prof. John Britton, who chairs the Royal College of Physicians’ Tobacco Advisory Groups, says: “If all smokers in Britain stopped using cigarettes and started on e-cigarettes, we would save five million deaths in people who are alive today.”
On the other hand, there are side effects. Users who inhale too deeply, for example, may inhale some of the liquid nicotine instead of the vapour, which could make the dose unsafe. E-cigarettes are not safe for pregnant women because the nicotine passes through the placenta.
In addition, electronic cigarettes could damage your lungs, as they cause less oxygen to be absorbed by the blood.
This is according to the preliminary findings of a small study investigating the short-term effects of smoking an e-cigarette. The study looked at the lung function of non-smokers and smokers with and without lung conditions.
Carried out by researchers from the University of Athens in Greece, sources of funding for this study were not reported.
Initial findings of a study on e-cigarettes were also published after the 2012 annual congress by the European Respiratory Society (ERS) held in Vienna.
Researchers studied 32 people, comprising eight non-smokers, 11 smokers without existing lung conditions and 13 smokers with existing lung conditions – either chronic obstructive pulmonary disease (COPD) or asthma.
Each participant smoked a single e-cigarette for 10 minutes and had their airway resistance measured, using a number of different respiratory tests before and immediately afterwards.
Respiratory tests carried out by the researchers included: a test looking at various measures of lung function; static lung volume; airway conductance (a measure related to airway resistance); and single-breath nitrogen test (a measure of how adequate inspiration and expiration are). The abstract did not include details of the chemical make-up of the product, such as the dosage of nicotine.
In discussing the study, one of the researchers, Christine Gratziou, said: “We found an immediate rise in airway resistance in our group of participants, which suggests e-cigarettes can cause immediate harm after smoking the device.”
She added that more research was needed to be able to understand whether this harm also had lasting effects in the long term.
Prof. Gratziou, who is also chairman of the ERS Tobacco Control Committee, also said: “The ERS recommends following effective smoking cessation treatment guidelines based on clinical evidence, which do not advocate the use of such products.”
However, in Germany, the Federal Institute for Risk Assessment says it “does not recognise that e-cigarettes and their liquids represent a health risk” and that while potential health risks from inhaling nicotine, propylene glycol and chemical additives are small, almost any chemical can make its way into a product.
The e-cigarette was invented in 2003 by a Chinese chemist and is now a fast-growing market
Penny Woods, chief executive of the British Lung Foundation, adds: “Concerns have persisted over the range and safety of some of the ingredients found in the vapour that users inhale.”
Robert West, professor of health psychology and director of tobacco studies at the Cancer Research UK Health Behaviour Research Centre, University College London, says the only potential problem is “clever marketing”.
Without regulation, he could see e-cigarettes being directed at teenagers through trendy product designs and celebrity endorsement.
Deborah Arnott, chief executive of anti-smoking health charity ASH, agrees that the benefits outweigh the risks. But she too asks for tight regulations: “There is no evidence that they get people into smoking by acting as a gateway. Behavioural psychologists tell us that substituting behaviour is easier than extinguishing it. The sucking, shape, finger feel and act of exhaling – all these help the transition from real cigarettes more easily than gum or patches.
“However, e-cigarettes aren’t regulated and we would always recommend, in the first instance, that smokers try licensed nicotine replacement therapies.”
kathryn@maltanet.net