Time: 2023-05-08
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Irish experts told The Wall Street Journal that the sale of e-cigarettes, or e-cigarettes, should not be completely banned in Ireland, but there could be more regulation on who can buy them.
It follows Australia's announcement that it will ban recreational vaping, which will no longer be sold in general and convenience stores.
The country's government will raise product standards for e-cigarettes, including limiting flavors and colors, in response to a growing black market.
It would also require drug-like packaging, reduce maximum allowable nicotine concentrations and volumes, and ban disposable e-cigarettes.
In Ireland, the devices are about the size and shape of a highlighter and are sold with nicotine e-liquid inside.
There are currently no mandatory age restrictions on the sale and marketing of e-cigarettes in Ireland, but a proposed bill banning the sale and purchase of e-cigarettes by anyone under the age of 18 will be announced in the coming weeks.
The HSE does not currently recommend vaping as a smoking cessation method, although it says it continues to review new research. It said based on the evidence so far, it found it was less effective for smoking cessation than nicotine gum or nicotine patches.
There are also no e-cigarettes on the Irish market authorized by the Health Products Regulatory Authority (HPRA) as smoking cessation medicines.
However, the NHS in the UK does acknowledge that e-cigarettes can help with smoking cessation. While it doesn't prescribe them, it states that nicotine vaping is much less harmful than smoking and is one of the most effective tools for quitting smoking.
A GP who specializes in addiction medicine told The Wall Street Journal that he believes Australia's move to ban the sale of e-cigarettes is completely counterproductive.
"Safer than smoking"
Dr Garrett McGovern, who is also HSE's clinical lead for addictions, said the ban in Australia would reduce vaping.
"There are people in my position who think it's a good thing. They don't really embrace the idea of vaping. I'm not one of those people," he said.
"Vaping is much safer than smoking and we really need to continue our strategy of trying to get Ireland as close to smoke-free as possible and I believe vaping has a role to play, as does nicotine replacement therapy and counselling, and various other interventions .”
"I think if we're going to do anything in Ireland we have to look at how many people are vaping... the vast majority of people using these devices are actually smokers trying to quit, so we should be doing that for They applaud, we should put obstacles in the way."
McGovern said he was in favor of imposing restrictions, such as an age limit on the purchase of e-cigarettes, which he said was long overdue.
"Anywhere that sells them is very tempting and very colorful in terms of candy, and that kind of thing is wrong. We need to tighten up on that."
But he adds that if we go down a path where it's harder to get to them, we'll have more smokers.
E-cigarettes are battery-operated devices that heat nicotine and mix it with flavorings and other chemicals to form an aerosol that you inhale. They are sold in some supermarkets and independent vape shops, as well as online.
Around 200,000 people in Ireland use e-cigarettes, according to the Irish Vaping Vendors Association (IVVA), and the country spent about €70 million on them in 2018.
A number of organizations have called for the introduction of more regulations on the use and sale of e-cigarettes in Ireland.
The Irish Cancer Society said that while e-cigarettes were less harmful than combustible cigarettes, health risks remained.
In a statement on their website, it said: "There is not enough evidence to prove that e-cigarettes are an effective cessation aid for smokers; while other methods, such as nicotine replacement therapy and prescription medicines, have been shown to be effective in helping people quit smoking."
"More evidence is needed on the long-term health effects of e-cigarette use. Thanks to clever marketing, e-cigarette use is increasing among young people and may act as a gateway to smoking."
"Investment in cessation strategies is needed, and we know this will make a difference in supporting people to quit."
There are also concerns about the growing number of teens vaping recreationally.
In an interview with The Wall Street Journal, Professor Des Cox, consultant pediatric respiratory medicine at the Irish Children's Health Center in Crumlin, said Australia had taken a bold approach to vaping in response to alarming numbers of teenage vapers. increase.
Ireland should consider adding restrictions on the sale of vaping products beyond the current bill, but perhaps not so much as to make them only prescription drugs.
"Of course, e-cigarettes are not as harmful as cigarettes, but they are not harmless. There is emerging research suggesting that long-term vaping may increase the risk of heart and lung disease," he said.
Research by the European Commission's Scientific Committee on Health, Environment and Emerging Risks found moderate evidence that vaping is a pathway for young people to smoke.
It also found insufficient evidence to support the effectiveness of e-cigarettes in helping smokers quit.
However, McGovern said the evidence supporting the gateway theory is very shaky.
He said: "The idea that you do one thing first and then do another thing downstream so that one leads to the other is really nonsense.
In 2020, a Health Research Board (HRB) review found that teens who used e-cigarettes were three to five times more likely to start smoking compared to teens who had never used e-cigarettes.
The HRB also said e-cigarettes are not regulated or approved as a smoking cessation device, and their safety beyond 12 months is unclear.
Cox said some Irish surveys had also shown an increase in teenage vaping.
“A study reports a 50% increase in the number of teens aged 15-17 in Ireland from 2015 to 2019. Teenagers who vape are inhaling harmful substances that can have long-term effects on their lungs and hearts Influence."
"In addition, youth who use e-cigarettes are four times more likely to continue to smoke tobacco products, which is really concerning."
But McGovern argues that teens getting involved with vaping doesn't necessarily mean they'll continue using vaping or continue smoking cigarettes.
The Tobacco Free Institute of Ireland conducted a review of 1,949 students aged 15-16 in 2019. It found that 39 percent had tried e-cigarettes and 16 percent were current users.
In contrast, 32 percent of respondents said they had tried smoking, while 14 percent said they currently smoked, 5 percent of whom smoked daily.
Professor Luke Clancy, founder and current director-general of the Smoke-Free Institute of Ireland, told the Wall Street Journal that only prescribing e-cigarettes means you can rely on them as a smoking cessation treatment.
"One of the great strengths of the Australian system is that you need to be a smoker to get in trouble, and if that happens it means our kids won't be addicted," he said.
"Many of those who make and sell them have been emphasizing how important they are for smoking cessation. The HSE does not recommend their use for smoking cessation because there is insufficient evidence. Also because the product is not guaranteed to be medicine."
“So, if they do that here, what that does, will guarantee that e-cigarettes are what they say they are, and that they have the ingredients they say they have, and you can rely on them. That would be a good thing.”
He said he would like to see e-cigarettes with medicinal properties made available for free to people who want to quit smoking.
government bill
The HRB review was conducted to help inform the Department of Health's policy on vaping.
The government's Public Health (Tobacco and Nicotine Inhalation Products) Bill, which will ban the sale of e-cigarettes to children, is expected to be published this summer.
The bill would prohibit anyone under the age of 18 from buying or selling e-cigarettes, and would not allow the sale of e-cigarettes in vending machines or pop-up stores.
The bill would also ban vaping advertisements within 200 meters of public transport, cinemas and schools.
The bill would also introduce for the first time a requirement that anyone wishing to sell e-cigarettes must obtain a license, which must be renewed annually and can be revoked for violating tobacco control laws.
Announcing the proposals last year, Health Secretary Stephen Donnelly said: "These measures are designed to protect our children and young people from starting to vape.
"We recognize that nicotine is a highly addictive drug, and we are taking action today to make these products less accessible to our young people and to remove advertising for these products from our children's everyday lives."
However, Cox believes the bill does not go far enough.
“Teenagers and young adults are clearly being targeted by vaping companies for their habits. We are at risk of a new generation of young people becoming addicted to nicotine,” he said.
“In addition to banning the sale of e-cigarettes to anyone under the age of 18, Ireland also needs to tighten restrictions on e-cigarette flavors, advertising, marketing and packaging. The government should ban all flavors except tobacco flavors and treat them like tobacco products Restrict advertising, marketing and packaging of e-cigarettes."
Clancy agrees that the bill needs to go further, including a ban on flavors as well as a ban on single-use e-cigarettes.
"The pollution problem caused by plastic e-cigarettes is well known, but the flip side is that they are electronic devices. That means they are batteries, which means they use the scarce lithium that is necessary for the important things in life, and they just dump it into these discarded things," he said.
"These are electronic devices that should be disposed of, like you dispose of old cell phones, and they just throw them away, which is pollution."