Regulations needed on e-cigarettes

By Wen Chi-pang 溫啟邦  / 

Wed, Sep 18, 2019 - Page 8

Electronic cigarettes contain only nicotine — unlike traditional cigarettes, they have neither tar nor tobacco. The thinking behind them is to satisfy addicted smokers’ craving for nicotine by giving them a temporary fix, offering a high-tech solution.

Few people know that the e-cigarette was invented by Chinese chemist Han Li (韓力), who became vice president of Liaoning University of Traditional Chinese Medicine, where he was responsible for developing new technologies.

Han had been hit hard by the death of his father from lung cancer and he was also a smoker. He threw himself into researching a safer alternative and came up with the e-cigarette, which was eventually put into commercial production by British multinational tobacco company Imperial Tobacco.

There are many reasons that people are attracted to e-cigarettes over conventional cigarettes. The first is that they come in many varieties, using fruit and other flavorings, and many young people like to inhale the vapor because they enjoy the taste.

Second, they are very discreet, not much bigger than a USB flash drive, so they are very convenient to carry. They also do not produce smoke and the vapor does not attract attention.

Third, they are being promoted by tobacco companies, which say that they are virtually harmless.

Studies in the UK have shown that they are 95 percent less harmful than smoking tobacco, which means they present a mere 20th of the risk, and that they can help smokers kick the habit.

Many pro-smoking people are giving them a go.

In the US, they have been given the nod by US President Donald Trump, and the US Food and Drug Administration has relaxed restrictions on them.

E-cigarettes have proven extremely popular among US high-school students: For every five high-school students, one uses e-cigarettes. There are more than 3 million US high-school students using them and they have become something of an overnight sensation in the country.

However, they are less popular in the UK, which has stricter restrictions.

Many experts have said that the vapor from e-cigarettes is, theoretically at least, safer, as it does not contain tobacco.

However, nicotine can negatively affect brain development in young adults, and many people have experienced seizures and epilepsy, with problems arising in the cranial nerves.

E-cigarettes also carry the potential risk of exploding and causing burns, and small children, to whom they are toxic, could accidentally use them.

There is also the potential for nonsmokers to become addicted to traditional cigarettes, regardless of whether they are using e-cigarettes at the same time.

More than 400 cases, in virtually every US state, of e-cigarette users developing pulmonary ailments such as coughing, chest pains, asthma and shortness of breath have been reported, giving rise to concerns that these symptoms are indicative of a pulmonary disease cluster.

E-cigarettes are neither tobacco nor medicine, nor are they foodstuffs, even though flavoring has been added, so they slip between the cracks of classification. Doctors have identified symptoms, but they have no idea how to report them.

Many people are now questioning whether the pulmonary problems being reported are related to e-cigarettes, and a study of computed tomography scans published in the New England Journal of Medicine appeared to confirm this.

Even more serious is that there have already been five fatal cases involving people aged 17 to 35. Previously perfectly healthy people, after contracting pneumonia as a result of using e-cigarettes, have had to be hospitalized, with the more serious cases resulting in death.

The health risks posed by conventional cigarettes were only established following decades of research, as the problems they cause are mostly chronic diseases such as lung cancer, chronic obstructive pulmonary disease, chronic emphysema and heart disease, as well as strokes.

It is still too early to determine whether e-cigarettes constitute a risk of chronic disease, but it seems that there have already been many cases of acute pneumonia caused by damage to the lungs.

E-cigarettes look cool, but image-conscious young people have been inhaling large amounts of the vapor these products emit, and it is a matter of considerable concern that this might, in the long term, contribute to many of them developing chronic diseases.

The Ministry of Health and Welfare should amend regulations and prohibit the use of e-cigarettes before they become more widely used in Taiwan, so that cigarette companies do not have the chance to start flooding the market with these products.

Wen Chi-pang is an honorary research fellow at the National Health Research Institutes.

Translated by Paul Cooper