Here's a summary of the Bill. A more detailed analysis is below.
A Bill to regulate e-cigarettes was introduced in the Seanad this week. It would make it more difficult to buy, sell, and use e-cigarettes and its aim is obviously to discourage and prevent their market growth.
But what’s the context to this?
We know over 5,000 smokers die in Ireland every year,[1] we know that smokers are interested in alternatives,[2] that some see e-cigarettes as an option, that their use is growing,[3] and that about half of those who switch to give up, manage this. [4] So e-cigarettes are sold as a way to give up and there’s some evidence to say they achieve this.
But we also know e-cigarette vapour isn’t harmless, and can still disrupt airways.[5] And we also know that e-cigarettes are attracting teens, with one US report showing a year-on-year doubling of e-cigarette use by teens, from 3.3% in 2011 to 7% in 2012.[6] This isn’t surprising when the product is sold using names like razzletaz and gummy bear and flavours like cherry and chocolate.
To tackle this, the US has plans to ban selling to under 18s, put health warnings on packaging, and require manufacturers to report ingredients,[7] and the EU has already begun to harmonise quality, mandate health warnings, and put limits on advertising.[8] Meanwhile, British American Tobacco has also put forward its vision of ensuring quality, protecting children, and encouraging innovation.[9] Although the latter means getting around regulation.
So this is the context of this Bill. But what would it do?
· Vaping would be banned on public transport, at work, and in cars with children
· Sellers would need to register
· Advertising and sponsorship would be prohibited
· Standardised packaging would be introduced
· And there would be child-proof caps on nicotine bottles.
So the Bill applies strict regulation. And it treats all kinds of cigarettes equally.
But is this kind of regulation appropriate? If we don’t yet know the dangers of e-cigarettes, should we wait? Doing so poses two risks. One, we do not know the long-term effects of e-cigarettes. And two, some people who might otherwise not smoke might start on e-cigarettes and graduate.
The facts are that we know e-cigarettes are less harmful, and we know quality control can reduce harm, and we know that giving up is the least dangerous option. This Bill assumes e-cigarettes are as dangerous as cigarettes. Those against the Bill will say we do not know that. If we treat them equally then smokers may not give up. It may keep people on cigarettes and may not make the situation better.
But if we do decide to regulate at all, do we go for a soft approach and embrace the positives of e-cigarettes, like that they help people give up smoking? Or do we opt for the hard approach, and say nicotine is terrible, and that’s it?
This Bill is in the latter category and has its pros and cons. It tries to solve a problem, but does so before the evidence is available. Instead, it recognises that the market moves fast and that “E-cigarettes are evolving so quickly that we actually don’t know what people are smoking”.[10] The Bill tries to get in there before the market does. And that is its strength: it is skeptical of the market, and wants to solve any failures before they occur. Economically this makes perfect sense, but whether it discourages people from quitting remains unclear.
[1] Healthy Ireland – A Framework for Improved Health & Wellbeing 2013-2025, Department of Health 2013, 10
[2] Centers for Disease Control, 2011
[3] Cancer Society, December 2014
[4] 55% succeed, Irish Cancer Society, December 2014
[5] Press Release, European Respitory Society, 2 Septmeber 2012
[6] Centers for Disease Control and Prevention, March 2014
[7] Food and Drug Administration, April 2014
[8] Tobacco Products Directive 2014/40/EU
[9] BAT position paper, 2014
[10] Mirjana Djordjevic, US National Institute of Health Tobacco Control Research, 16 February 2015 C&EN 93(7)