mh-ecig-mainmmarlboroa_01Not everyone is happy about e-cigarettes. Dr Phil Banfied, chairman of the British Medical Association’s Welsh Council, wants to see proof of their safety.

To emphasize the need for caution with these new drug (nicotine) delivery devices, he reminded the audience at a BMA Welsh Council meeting that thalidomide, which was originally thought to be safe, turned out to be a disaster. Predictably, he was attacked for this comment by a representative of the Electronic Cigarette Industry Trade Association (ECITA) who dismissed it as ‘alarmist nonsense’. They would say that, wouldn’t they.

Dr Banfield is quite right. E-cigarettes have only been in use for a few years; who knows what will happen after, say, twenty years of regular use? It’s clear they’re not only being promoted as a smoking cessation aid – a dubious concept anyway – but as an alternative, even if supposedly safer, way of absorbing nicotine into your body, and many people may do this long-term. E-cigarettes are a huge unregulated public health experiment.

ECITA is not the only body poised ready to counter any move to restrict or raise concerns over e-cigarette use. There’s also the New Nicotine Alliance (NNA), surprisingly, a registered UK charity, that ‘is concerned with improving public health, through a greater understanding of “new” (risk-reduced) nicotine products and their uses.’

Anyone can campaign for anything they like, within reason, but is it right and proper for the NNA to be a registered charity? I wrote to the Charity Commissioners about this. They told me that the NNA was registered with the following objects:

To preserve and protect the health of the public against the harmful effects of cigarette smoking by:

  • Advancing the education of the public and organizations about ways to reduce harms associated with cigarette smoking
  • Advancing the education of the public and organizations about the effects of nicotine and its use
  • Promoting scientific research into the safer uses of nicotine
  • Providing information to the public and organizations about the risks of smoking and safer ways of using nicotine

All this advancing, promoting, and providing is just a smoke-screen. Why do we need a lay organisation for these purposes? There are already campaigns run by the NHS and its affiliate, Public Health England, that propagate such information. Their views are backed up by reports from the UK Royal College of Physicians, the National Organisation for Health and Care Excellence (NICE), and other official bodies.

The main concern of the NNA seems to be to oppose legislation intended to regulate e-cigarettes which might restrict their availability or ban vaping in public places. In other words, what they are promoting, if indirectly, is drug (nicotine) addiction.

I wrote to the Charity Commissioners again and said this:

I understand that the Commission accepted the application of the New Nicotine Alliance because its stated objects meet your criteria.

I am sorry to trouble you further but there is one question you have not yet answered.

It is clear from the New Nicotine Alliance’s website that their main aim is not just the advancement of health (by unconventional means); it is to promote drug (nicotine) addiction through e-cigarettes.

Will you please tell me whether it is a proper use the  Commission’s powers to grant charitable status to an organization whose main object is to promote drug addiction.

They replied thus:

In the context of charity law, education is interpreted very broadly and it should allow those being educated to make up their own minds on controversial issues…I can find no evidence to suggest that…the charity actively promotes drug use.

Well, that’s a bit surprising. What is vaping if not drug (nicotine) use? The labelling of e-cigarette liquid, under laws which came into effect in May 2016, must now make this explicit: ‘This product contains nicotine which is a highly addictive substance.’

The NNA claims to have contributed to ‘what is known as “tobacco harm reduction” – a term used…to describe ways of reducing harm from cigarette smoking without necessarily giving up the use of nicotine.’ It seems they want to have their cake and eat it.

It all comes back to the important question raised by Dr Banfield: are e-cigarettes safe?

Apart from this, there are other concerns about the increasing use of these new nicotine delivery devices:

  • It is likely there will be an uptake of e-cigarettes among people, especially children and adolescents, who would not otherwise use them
  • E-cigarettes contain substances such as formaldehyde which can cause cancer, as well as various flavourings and other substances which may be harmful to health
  • If e-cigarettes are used to reduce smoking, as opposed to quitting, there may be no overall benefit for health
  • One study shows that dual use (smoking and vaping) was above 80 per cent after 12 months follow-up
  • There is no evidence which clearly shows that e-cigarettes are as effective as established cigarette quitting aids

While medical organisations and governments grapple with these issues, I would modestly suggest the following completely safe alternative to smoking: not using nicotine at all, in any form.

Text © Gabriel Symonds