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We’re unsure if e-cigarettes are harmful, but it still makes sense to restrict them

https://theconversation.com/were-unsure-if-e-cigarettes-are-harmful-but-it-still-makes-sense-to-restrict-them-55777

E-cigarettes have rapidly risen in popularity in recent years and are now the subject of heated debate as to whether they are effective in helping smokers quit tobacco or whether they are actually making smoking attractive to young people. Are they a way for Big Tobacco to protect its profits in markets where smoking is declining and lure people back into nicotine addiction or are they just a fashion that will quickly lose its appeal?

Given that vaping has been around for barely a decade and studies into the long-term effects take time, we cannot answer these questions with certainty yet. The benefits of e-cigarettes’ continue to be debated – and the potential risks to non-smokers and young people remain under-explored.

This makes it difficult to make recommendations, but politicians across the world are nonetheless having to decide what to do. The latest country to confront this question is Scotland, where the parliament has just voted to ban under-18s from using e-cigarettes. One of a raft of restrictions, this imposes the same age limit as for traditional cigarettes, bringing Scotland broadly into line with England and Wales. Was it the right thing to do?

Different countries have taken different approaches to vaping. Canada has technically made sales illegal, though regulation remains largely unenforced. While regulation across the US is mixed, San Francisco has just raised the minimum buying age from 18 to 21 years.

In some European countries, – among them Bulgaria, Ireland and Poland – sales and advertising are unregulated. In May, however, new EU regulations will impose standardised quality control on liquids and vaporisers across the union as well as requiring disclosure of ingredients in vaping liquids and child-proofing and tamper-proofing for liquid packaging. They will also restrict cross-border advertising. Wales meanwhile looks likely to extend its restrictions by introducing a ban on e-cigarettes in public places.

The ayes and the noes

In the run up to the vote on the new Scottish Health Bill, opponents and supporters of e-cigarette regulations fiercely debated which approach was the most sensible. Opponents usually argue that vaping is less harmful than traditional cigarettes and effective in helping smokers to quit. They want minimal restrictions on availability and complete freedom for advertising, promotion and the use of e-cigarettes in public. Restrictions, they argue, might prevent smokers from switching to safer alternatives and reduce the chances of curbing tobacco consumption.

Supporters of regulation say that children and young people need to be protected from using products which imitate smoking and from developing nicotine addiction. They also favour regulation to ensure product safety and quality. They advocate a precautionary approach until there is evidence that e-cigarettes do not undermine our recent successes at controlling tobacco.

As well as banning sales to under-18s, the new Scottish laws require retailers to ask for proof of age when selling to someone that looks under 25 (similar to alcohol). They ban the sale of e-cigarettes from vending machines, make it an offence to buy on behalf of someone under 18, and require retailers to put their names on a product register. Scottish ministers will also have the power to further restrict or prohibit advertising and promotions in future.

Tighter shackles, please

While the evidence about the risks of e-cigarettes is likely to remain unclear for several years, the Scottish parliament can at least say it is doing what the country wants. A large majority of respondents backed regulation in the consultation of 2014, including representatives of health bodies, local authorities, charities, academics and members of the public. As well as supporting a ban on sales to under-18s or adults buying e-cigarettes on their behalf and preventing young people from seeing advertising and promotions, respondents also widely endorsed restricting the use of e-cigarettes in public places.

‘Save me from myself’ Milles Studio

The Scottish public’s desire for these kinds of rules is also reflected in research I co-published that looked at debates about e-cigarettes in the UK media and found that supporters of regulation greatly outnumbered opponents. I have also been involved in a new study, about to be published, which investigates the views of UK adolescents on regulation. We found they have a very sophisticated understanding of the advantages and disadvantages. While aware of the potential benefits of e-cigarettes to smokers – including those teenage smokers who want to quit – young people overwhelmingly support strong e-cigarette regulation. This includes restrictions on sales to minors, marketing and the use of e-cigarettes in public places.

The reality is that, until the jury returns, it makes sense to trust the public to reach a view from the best information on e-cigarettes that is available. Even if current regulations were to end up looking disproportionate in years to come, no one will be able to accuse the Scottish government of ignoring people’s concerns and taking public health issues lightly. In a situation where no one really knows what to do for the best, regulation which restricts access and promotion to young people looks like the best policy.

Truth about illicit tobacco reveals decline

http://www.scotsman.com/news/sheila-duffy-truth-about-illicit-tobacco-reveals-decline-1-3989150

BUT IT still needs robust enforcement to keep it in check, says Sheila Duffy

Illicit tobacco is one of those subjects (like e-cigarettes) where the quantity of the media coverage is not always matched by the quality.

To be fair to hard-pressed journalists it is hard to resist a succession of helpful public relations companies providing them with ready-made news stories which can support dramatic headlines on the “booming” illicit trade, corner shops closing, “unhealthy” fake fags and international crime networks.

At the same time leaked documents have revealed details of tobacco industry plans to use the media to scaremonger over illicit as part of their effort to oppose plain, standardised packaging for tobacco.

Those seeking an unbiased estimate of the scale and trends in illicit tobacco should use the annual figures from Her Majesty’s Revenue and Customs (HMRC), which is as close as we’re going to get to an expert, unbiased voice. So we’re always keen to see the annual Tax Gaps report from HMRC, and the 2014-15 figures were published recently.

Anyone who had been following the tobacco-industry sourced media stores must have found the figures a bit surprising. So let’s set them out clearly.

The best estimate of the illicit market remains static at 10 per cent of manufactured cigarette sticks.

The best estimate of the illicit share of the hand-rolling tobacco market was down from 39 per cent to 35 per cent.

These are percentages of an overall tobacco market which continues to decline.

So a static percentage of the market actually relates to a decline in the amount of illicit tobacco used (for example, the reported rise in illicit market share in cigarette sticks from 9 per cent to 10 per cent in 2013-14 actually related to a 7 per cent drop in numbers of illicit cigarettes).

These figures indicate that the illicit tobacco market is at historically low levels – in 2000-1 HMRC estimates were that 22 per cent of cigarettes and 61 per cent of hand-rolling tobacco was illicit.

The decline in overall volume since then has been 76 per cent in illicit cigarette sticks and 33 per cent in illicit hand-rolling tobacco. Could any unbiased observer conclude that these figures are “booming”?

This is not to play down the importance of illicit tobacco, which brings criminal elements into communities, bypasses health regulations we have worked long and hard to achieve and deprives the Exchequer of much-needed tax revenue.

Nor is it to say that everything’s in hand – the reduction in illicit tobacco is the planned and deliberate result of robust enforcement measures, including restrictions on the tobacco companies themselves.

To keep the lid on illicit tobacco we need to ensure that robust enforcement is not hampered by budget cuts and austerity.

And we need to generate a community discussion, to lower the demand for the product, with NHS Greater Glasgow and Clyde having created useful tools to support that. What it does mean is that the idea of a “booming illicit trade” at the centre of tobacco company campaigns against public health measures is, appropriately enough, not the real deal.

• Sheila Duffy is chief executive of ASH Scotland

Law Society welcomes ban on smoking in cars with children

https://www.lawscot.org.uk/news/2015/12/law-society-welcomes-ban-on-smoking-in-cars-with-children/

Smoking in cars where children are present will now be a criminal offence, after the legislation was passed by the Scottish Parliament today, 17 December.

The Smoking Prohibition (Children in Motor Vehicles) (Scotland) Bill was debated this afternoon at stage 3 by MSPs. When the legislation comes into force, it will be a criminal offence to smoke in a car where a child is present. An amendment to the bill tabled by Jackson Carlaw MSP proposed a review of the legislation after 5 years.

Alison Britton, convener of the Law Society of Scotland’s health and medical law committee said:

“The passing of this bill is great news for the health and wellbeing of children, the harmful effects of tobacco and smoking are undisputed, as well as the effects of second hand smoke. We had hoped that the legislation be extended to expressly prohibit the use of e-cigarettes as well as conventional cigarettes, especially in relation to young people, so it is disappointing to see this hasn’t been included.

“We also proposed a review of the legislation within five years to ascertain how well it was working, and we are disappointed that MSPs voted against such a review. Taking into account there will undoubtedly be an updating of research, not only into the effects of e-cigarettes, but the harmful effects of tobacco in general in the next few years, this would have potentially given us the opportunity to ensure that the legislation remained fit for purpose.”

Scotland to ban smoking in cars with children

http://www.bbc.com/news/uk-scotland-scotland-politics-35126453

Scotland is to ban smoking in cars that are carrying children after MSPs voted unanimously in favour of a change in the law.

The new legislation will mean fines of up to £100 for anyone who smokes in a car which has a passenger under the age of 18.

It aims protect children from the harmful effects of second-hand smoke.

The Smoking Prohibition (Children in Motor Vehicles) Bill was introduced by Liberal Democrat MSP Jim Hume.

Mr Hume’s mother died of cancer caused by second-hand smoke.

‘Healthiest start’

He told MSPs that the concentrations of harmful tobacco particles in the very close confines of a car were far greater than from smoke in bars, which had already been banned.

He added: “Around 60,000 children are put in this position each week in Scotland.

“This legislation will, of course, address that situation and help to ensure that all our children and young people have the best and healthiest start in life.”

The bill was backed by the Scottish government and opposition parties in the Scottish Parliament.

Public health minister Maureen Watt said the legislation would contribute to the Scottish government’s drive to cut the number of children exposed to second-hand smoke from 12% to 6% by 2020.

And she said that Scotland had shown itself to be a “world leader on tobacco control”.

Publicity campaign

A publicity campaign will be carried out to raise awareness of the change in the law.

The new legislation has also been supported by public health and anti-smoking campaigners, who have said that second-hand smoke can reach very high levels when someone lights up in a car.

They have also said that about a fifth of 13 and 15-year-olds in Scotland are exposed to tobacco smoke during car journeys.

Sheila Duffy, chief executive of health charity Ash Scotland, said: “This is a victory for doctors, nurses, parents and, most of all, for children.

“We know the immense harm done to children by second-hand smoke. Meningitis, lung cancer and even cot death have been linked to tobacco smoke.

“I’m delighted that we’ve introduced this sensible measure to protect children’s health.”

‘Strong signal’

Dr Peter Fowlie, officer for Scotland for the Royal College of Paediatrics and Child Health, said: “Scottish Parliament’s move to ban smoking in cars carrying children not only protects children from terrible conditions linked to second-hand smoke such as bronchiolitis, pneumonia and asthma, but also sends a strong signal that smoking is not cool – it kills.

“Today’s decision is something to be celebrated and we as paediatricians applaud parliamentarians for taking such bold steps to protect child health.”

But smokers’ group Forest had argued that the bill was the “worst kind of gesture politics” and represented a worrying intrusion into people’s private space”.

A ban on smoking in cars carrying under-18s came into force in England and Wales earlier this year.

Northern Ireland is also looking at introducing a similar ban.

Teenage perceptions of electronic cigarettes in Scottish tobacco-education school interventions

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Pupils ‘use e-cigarettes as gateway to smoking’

http://www.heraldscotland.com/news/14102547.Pupils__use_e_cigarettes_as_gateway_to_smoking_/

SCHOOL pupils are using e-cigarettes as a gateway to smoking, according to a new study which raises concern over the “misleading promotion” of the products.

The research also found that most high school students find the fruity, sweet-like flavourings of e-cigarette liquids attractive.

It was suggested that some pupils use e-cigarettes to dupe their parents, who would otherwise smell tobacco on their clothes.

Others told researchers that they had seen fellow pupils openly selling and smoking e-cigarettes in class.

The study was led by researchers from Edinburgh and Stirling University, and published by the Royal Society for Public Health.

The team – led by Dr Marisa de Andrade – interviewed 182 13-to-16 year-old students from seven schools across Fife.

The study said: “In one school, it was suggested that up to 30 students used e-cigarettes and some then went on to use cigarettes.”

Pupils from the school told researchers: “I think that’s why most people go on from e-cigarettes to actual cigarettes, just to see what it’s like, the actual ones, and then they get addicted to it.”

Another added that e-cigarette users “might not feel like they’re getting anything from the e-cigs, like a kick from it, they might get a better kick from a fag”.

Others told of the growing popularity of vaping, with one saying: “At one point I just saw everyone walking around with them … we all had one.”

Another teenager from the same school told the researchers “people in the school were selling them” and a pupil had been seen smoking in class.

They said: “I thought it was a pen until I saw the smoke coming out of his mouth in English.”

Several of the students also told researchers that e-cigarettes are more acceptable than regular cigarettes as they do not “leave a trace of smell”.

One said: “Your parents won’t know either because if you’re out with friends and they’re all smoking and that, and you decide you want to have one then they’ll smell it on you.

“But if you have an e-fag then they can’t smell it on you at all.”

In the course of their research the academics also found that many of the students compared e-cigarettes with sweets.

One pupil said that vaping device itself “looks like sweets” as others told them “I just wanted to try it because it was, like, a fruity flavour.”

Another described the smoke of e-cigarettes as “a powdery flavoured thing … almost like a sherbert” as others said that – like sweets – the e-cigarette fluids are “really cheap” and readily available in newsagents and corner shops.

One said: “I work in a shop and at the till area … there is a massive line, it’s like a metre long, of different flavours. There is blueberries, bananas , Red Bull, Lucozade flavours, apple.”

The study concludes: “Much more needs to be done to protect children from misleading messaging and promotion.”

Sheila Duffy, chief executive of Action on Smoking and Health (ASH) Scotland, said: “E-cigarettes are less harmful than tobacco but are not completely safe and we believe there should be restrictions on advertising that targets children.”

Public Health Minister Maureen Watt said: “The Scottish Government agrees that electronic cigarettes need appropriate regulation.

“While we accept that the devices may potentially help people smoke fewer cigarettes, or even stop altogether, we recognise that there are also risks involved.

“We have included a range of provisions to regulate the sale of these products in the Health Bill which is being considered by the Scottish Parliament at the moment.

“It contains measures to regulate e-cigarettes including age restrictions, proxy purchase, marketing restrictions and the creation of an e-cigarette retailers register.”

She added: “Local authorities are responsible for ensuring schools are health promoting.”

It is time to take on the multimillion e-cigarette industry that is damaging the nation’s health

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Expert criticises “harmful” e-cigarette marketing

http://heraldscotland.com/news/health/13847553.Expert_criticises__quot_harmful_quot__e_cigarette_marketing/

A HEALTH academic has criticised “harmful” e-cigarette marketing tactics and called for new guidelines to regulate the industry.

Linda Bauld, Professor of Health Policy at Stirling University, has said there is “cause for concern” in the way companies are pushing their products.
The professor, who is also deputy director of the UK Centre for Tobacco and Alcohol Studies, warns that there are also “no controls” when it comes to alcohol adverts in the UK and she is now calling for tighter regulations across the advertising industry.

E-cigarette companies are currently allowed to advertise their products within a regulatory framework, meaning they cannot make smoking cessation claims or target youngsters.

But Ms Bauld said there was still reason to be wary.

“I’d say that the evidence of marketing being targeted at children is mixed, but there’s definitely a lot of it,” she said. “It’s a cause for concern and we need marketing regulations. The Advertising Standards Authority has a role to protect the public against harmful advertising.

“They brought in regulations last year to allow the public to complain about e-cigarette adverts. There have been a number of complaints and two adverts were forced to be withdrawn, so we do have some controls in place.”

Her comments come after a Scottish Government-commissioned survey found that thousands of pupils had been exposed to e-cigarette marketing, with 60 per cent seeing the products for sale in shops, shopping centres or stalls.
Ms Bauld also criticised the alcohol industry’s approach to advertising.

She said: “We have the same for alcohol adverts and it doesn’t make a difference – they do all the things they aren’t supposed to do.

“We need to crack down on the marketing of alcohol as there are no controls at all in Scotland and it’s so prevalent all across our society.”

New proposals may lead to e-cigarette adverts only being shown at the point of sale – in the shops where they can be bought.

Ms Bauld added: “I have a mixed view about it. I think you need some marketing of e-cigarettes to encourage the adults who want to stop smoking to try it.

“It’s hard to know what to do – whether we take it all away or keep it going in order to aid those wanting to stop smoking.

“I’m in favour of e-cigarettes as a quitting tool for current smokers.”

She also aired her concerns about e-cigarette companies being “bought up” by tobacco giants.

“One of the issues for us is that e-cigarette companies have been increasingly bought up by the tobacco industry,” she said.

“Ideally they should be distributed by independent companies as the objective of the tobacco industry is to keep people smoking. We want to try and keep a lid on some of the tobacco companies’ involvement.”

John Watson, deputy chief executive at Action on Smoking and Health (ASH) Scotland, agreed that the marketing is showing a disturbing trend.

“We’re concerned at some of the marketing we’ve seen around e-cigarettes,” he said. “It’s hard to walk down the street without seeing adverts and some of them are reminiscent to old tobacco adverts.

“We should restrict marketing that’s going to encourage young people to smoke but there is also the potential to help current smokers stop.”

Experts are yet to conclusively determine the health risks of e-cigarettes, which have helped some smokers quit but still contain the highly addictive substance nicotine.

Half of current cigarette smokers reported using e-cigarettes and some 14 per cent of ex-regular smokers used an e-cigarette. The most common methods used to quit smoking were nicotine patches (36 per cent) and e-cigarettes (32 per cent).

Leading Scots academic slams “harmful” e-cig marketing tactics

http://www.deadlinenews.co.uk/2015/10/14/leading-scots-academic-slams-harmful-e-cig-marketing-tactics/

A LEADING Scots health academic has slammed “harmful” e-cigarette marketing tactics.

Linda Bauld, Professor of Health Policy at Stirling University, has said there is “cause for concern” in the way companies are pushing their products.

The professor, who is also deputy director of the UK Centre for Tobacco and Alcohol Studies, warns that there are also “no controls” when it comes to alcohol adverts in the UK.

Professor Bauld has called for tighter marketing controls for e-cigarettes

And she is now calling for tighter regulations across the advertising industry.

Currently, e-cigarette companies are allowed to advertise their products within a regulatory framework, meaning they cannot make smoking cessation claims or target youngsters.

But Professor Bauld suggests there is still reason to be wary.

“I’d say that the evidence of marketing being targeted at children is mixed, but there’s definitely a lot of it,” she said.

“It’s a cause for concern and we need marketing regulations. The Advertising Standards Authority has a role to protect the public against harmful advertising.

“They brought in regulations last year to allow the public to complain about e-cigarette adverts. There have been a number of complaints and two adverts were forced to be withdrawn, so we do have some controls in place.”

However, she warned that the alcohol industry may be bending the rules when it comes to advertising.

She said: “We have the same for alcohol adverts and it doesn’t make a difference – they do all the things they aren’t supposed to do.

Experts are unsure about the long-term health risks of using e-cigarettes

“We need to crack down on the marketing of alcohol as there are no controls at all in Scotland and it’s so prevalent all across our society.”

New proposals may lead to e-cigarette adverts only being shown at the point of sale – in the shops where they can be bought.

Professor Bauld added: “I have a mixed view about it. I think you need some marketing of e-cigarettes to encourage the adults who want to stop smoking to try it.

“It’s hard to know what to do – whether we take it all away or keep it going in order to aid those wanting to stop smoking.

“I’m in favour of e-cigarettes as a quitting tool for current smokers.”

She also aired her concerns about e-cigarette companies being “bought up” by tobacco giants.

“One of the issues for us is that e-cigarette companies have been increasingly bought up by the tobacco industry,” she said.

“Ideally they should be distributed by independent companies as the objective of the tobacco industry is to keep people smoking . We want to try and keep a lid on some of the tobacco companies’ involvement.”

There are also concerns about the way alcohol is advertised

John Watson, deputy chief executive at Action on Smoking and Health (ASH) Scotland, agreed that the marketing is showing a disturbing trend.

“We’re concerned at some of the marketing we’ve seen around e-cigarettes,” he said.

“It’s hard to walk down the street without seeing adverts and some of them are reminiscent to old tobacco adverts.

“We should restrict marketing that’s going to encourage young people to smoke but there is also the potential to help current smokers stop.”

Experts are yet to conclusively determine the health risks of e-cigarettes, which have helped some smokers quit but still contain the highly addictive substance nicotine.

A spokesman for the Advertising Standards Authority said: “The UK advertising rules require e-cigarette ads to be responsible with a particular emphasis placed on protecting young people and non-smokers.

“The ASA will not hesitate to take action against any ad that breaks the rules and if an e-cigarette ad encouraged young people to try vaping it would be banned.

“Similarly, the UK alcohol advertising rules are robust with the strict controls applying equally to Scottish media.

“The evidence to date suggests that the current rules are a proportionate and reasonable response to concerns about the potential for alcohol advertising to encourage irresponsible consumption or under-age drinking.

“If anyone has concerns about ads for these products then they should lodge a complaint with us so that we can ensure the rules are being followed.”

School pupils ‘exposed to e-cigarettes’

More than half of secondary school pupils questioned in a study said they had been exposed to e-cigarette marketing.

The Scottish government-commissioned survey found 60% of pupils questioned had seen e-cigarettes for sale in shops, shopping centres or stalls.

About a quarter (26%) had seen outdoor poster adverts.

And 23% of the 2,016 11 to 18-year-olds questioned had seen or heard adverts on TV or radio in the past week.

Although 16% had used an e-cigarette, most had only tried them “once or twice”, the survey found.

Only 5% of pupils who had never smoked tobacco had tried e-cigarettes. Curiosity was the main driver for use, sometimes motivated by seeing a friend or family member trying them, the report found.

‘Less harmful’

The forthcoming Health Bill proposes a ban on the sale of e-cigarettes to under-18s, “proxy purchase” by adults for minors and restrictions on the marketing of the products.

Public health minister Maureen Watt said: “This is an extremely useful survey, that gives us one of the first good indications of young people’s awareness and experience of e-cigarettes.

“Of particular interest is the large number of children who are being exposed to marketing of these products.

“While more research is needed, e-cigarettes are almost certainly less harmful than tobacco and if people are using them as an aid to quit smoking that is a good thing.

“However, the Scottish Government does not believe that children should have access to them. This is the balance we are aiming for in our forthcoming Health Bill.

“We would consult with stakeholders to consider where exemptions might apply, such as at point of sale where.