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May 17th, 2016:

10 common questions about e-cigarettes answered

1. Are e-cigarettes safer than smoking?

Dr McEwen: Yes. Experts think that e-cigarettes are, based on what we know so far, much safer than cigarettes. Smoking is associated with a number of very serious health risks to both the smoker and to others around them. So switching from tobacco to e-cigarettes substantially reduces a major health risk.

2. Is nicotine dangerous?

Dr McEwen: Nicotine doesn’t cause smoking-related diseases, such as cancers and heart disease, but it is addictive. However, there’s a common misconception that you can overdose on nicotine using e-cigarettes. But you are in no danger of poisoning yourself, nor have there been any cases of overdose from inhaling the nicotine-containing fluid that an e-cigarette vaporises, known as e-liquid. So you can use your e-cigarette as often as you need to help manage nicotine withdrawal and urges to smoke.

Much the same as with Nicotine Replacement Therapy, if you do have more nicotine than you’re used to, then you might feel a little nauseous or lightheaded, both of which pass quickly. If this happens, just reduce the level of nicotine in the e-liquid that you buy, or use the e-cigarette less.

3. Do e-cigarettes produce harmful chemicals or blow up?

Dr McEwen: Some studies have found chemicals in e-cigarette vapour that are known to cause health problems. But these studies have tended to use artificial conditions, and when good quality e-cigarettes are used normally (e.g. not overheated), there are far fewer harmful chemicals present in the vapour than in tobacco smoke. If the e-liquid is being overheated it tends to produce an acrid, unpleasant taste – you’ll know if this happens.

As with any rechargeable device, such as mobile phones and laptops, it’s important to charge e-cigarettes with the right charger, and don’t leave it unattended while charging. Ensure that you buy from reputable suppliers and avoid generic charging equipment. There have been reported cases of e-cigarettes causing fires, but far fewer than the number caused by cigarettes, which are the most common cause of lethal house fires.

4. Is it OK to smoke and vape at the same time?

Dr McEwen: There’s no evidence that smoking cigarettes and vaping at the same time is any worse than just smoking tobacco. But the greatest health benefits are seen when people stop smoking tobacco completely, so quitting smoking should be the goal.

Some people manage to switch completely to vaping quickly, while others take a little time. You may have to try a number of different e-cigarettes and e-liquids before you find one that helps you to stop smoking completely, but this is quite normal.

5. Can I use an e-cigarette in the Stop Smoking Services?

Dr McEwen: Yes. If you choose to use an e-cigarette, Stop Smoking Services can still support you in your quit attempt – and these services the most effective way to quit.

Their trained stop smoking practitioners provide behavioural support, advice on what might be the best way for you to stop and access to approved stop smoking medications.

6. Which e-cigarette should I start with?

Dr McEwen: This is very much a personal choice. The refillable tank system e-cigarettes might take a bit of getting used to, but they allow you to use more flavours, and generally deliver more nicotine than e-cigarettes that look like tobacco cigarettes. Users tend to say these types are more satisfying. Specialist e-cigarette retailers can give you advice, and you can also chat to other e-cigarette users on a range of internet forums.

How much nicotine you need will depend upon how much nicotine you’re used to getting from your cigarettes. And, of course, how much nicotine you get from your e-liquid will depend upon the type of e-cigarette that you use and how you use it. As a rough guide, most 20-a-day smokers find that 18mg/ml (1.8 per cent) nicotine is sufficient, so you could start with this and see how you get on.

7. How should I use my e-cigarette to help me to stop smoking?

Dr McEwen: Using an e-cigarette is different from smoking a cigarette. It usually involves taking slower and longer puffs over a longer period of time. This is because e-cigarettes heat a coil in a liquid (think of a kettle). You may find you need to take a few puffs on an e-cigarette at times when you wouldn’t have smoked, but this is nothing to worry about, and the way you use your e-cigarette will develop over time. It’s not like a cigarette, which you smoke from start to finish. With an e-cigarette you can use it once or twice, and then put it away. If you find you’ve got it in your mouth all the time, you might need to use a stronger e-liquid.

If you get a bit of a cough when you use your e-cigarette, this isn’t unusual and it might help to switch from an e-liquid with a high proportion of propylene glycol to one with more vegetable glycol, which can be more soothing.

8. Will e-cigarettes be cheaper for me than smoking?

Dr McEwen: Yes, and you’ll notice savings very quickly compared with buying cigarettes. A starter kit for the tank-style devices can range from £20-70. You’ll then only need to replace the atomiser (heating coil or ‘head’) occasionally for a couple of pounds and, more regularly, buy your e-liquid, which can start at £3.00 for 10 ml. How often you need to change the atomiser will depend on how you use the device, but typically it’ll be around every two weeks or when you get a ‘burnt’ taste or low vapour production.

9. Can I use e-cigarettes in places where I can’t smoke?

Dr McEwen: There are no laws preventing or restricting where you can use e-cigarettes. Some places, such as some sports stadiums and most airports, do not allow vaping while others do. If there are no signs indicating this then you should always ask. But it helps to be respectful when using e-cigarettes around others, especially non-smokers.

10. Is second-hand vapour from e-cigarettes dangerous? How can I protect my children?

Dr McEwen: Unlike second-hand smoke from cigarettes – which is known to cause cancer – there’s no evidence that second-hand e-cigarette vapour is dangerous to others. Some studies have found traces of toxic chemicals in second-hand vapour, but at such low levels that they’re not harmful to those around you. E-cigarettes aren’t recommended for use by non-smokers and children.

In order to prevent accidental poisoning, for example by young children drinking e-liquids, you should store your e-cigarettes and liquids away safely, just as you would with household cleaning products and medicines.

The National Centre for Smoking Cessation and Training trains stop smoking practitioners to deliver effective support to people wanting to move away from tobacco.

They’ve developed a briefing to support local Stop Smoking Services to incorporate e-cigarettes into their everyday practice.

Australia versus Philip Morris. How we took on big tobacco and won

Previously sealed documents reveal the tobacco giant Philip Morris lost its case against Australia over plain packaging because the international tribunal considered it an “abuse of rights”.

Philip Morris sued Australia under the provisions of an obscure Hong Kong Australia investment treaty in 2012 after British American Tobacco and Japan Tobacco lost a challenge to the plain packaging legislation in the High Court.

As had its competitors in the failed High Court challenge, the manufacturer of Marlboro and Longbeach cigarettes argued Australia had confiscated its trade marks, turning from “a manufacturer of branded products to a manufacturer of commoditised products”.

Philip Morris wanted the tribunal to order Australia to withdraw the law or to award damages of at least $US4.2 billion plus compound interest at the Australian bank cash management rate dating back to the to the law’s introduction.

Its use of an outside tribunal rather than an Australian court to sue the government was unusual, in that it was making use of a provision available to foreign companies under trade agreements but denied to Australian companies.

The government spent more than $50 million defending the case, assembling a team including two Queens Counsels and two Senior Counsels and ferrying to Singapore witnesses including the former treasurer Wayne Swan and former judge Roger Gyles QC.

The 186-page judgement, unsealed on Tuesday, shows the tribunal rejected the claim at the first hurdle, finding Philip Morris had moved its Australian and Asian headquarters to Hong Kong for the express purpose of making the claim.

“The tribunal cannot but conclude that the initiation of this arbitration constitutes an abuse of rights, as the corporate restructuring by which the claimant acquired the Australian subsidiaries occurred at a time when there was a reasonable prospect that the dispute would materialise and as it was carried out for the principal, if not sole, purpose of gaining treaty protection,” the judgement finds.

A spokesman for assistant health minister Fiona Nash said she welcomed the decision which validated the government’s decision to take on Philip Morris.

Originally rare, the use of so-called investor-state dispute settlement provisions in international treaties has ballooned in the past decade. Australia’s Productivity Commission counted 42 in 2014.

Productivity Commission count of iinvestor-state dispute settlement cases

Productivity Commission count of iinvestor-state dispute settlement cases

Investor-state dispute settlement provisions have been included in Australia’s recently-signed treaties with Korea and China and the 12-nation Trans-Pacific Partnership which has been signed but not yet ratified by the Australian parliament.

La Trobe University public health academic Deborah Gleeson said the victory would add to momentum for the spread of plain packaging legislation around the world, but she said it didn’t mean that investor-state dispute settlement provisions weren’t a threat to public health.

“If we ratify the Trans-Pacific Partnership transnational corporations based in the United States will gain an avenue to sue Australia. There’s an exclusion for tobacco control measures, but no solid exclusion for other health measures.”

Australia continues to face challenges to its plain packaging laws in the World Trade Organisation from tobacco-growing nations including Cuba, the Dominican Republic, Honduras and Indonesia. The Ukraine withdrew its challenge last year.

Court condemns tobacco giant Philip Morris over secret bid to sue Australia

Tribunal rejected the move to challenge plain packaging laws, calling it an ‘abuse of rights’

An international tribunal has unveiled a secret ruling confirming it rejected a bid by tobacco giant Philip Morris to sue Australia over its plain packaging laws, calling the attempt “an abuse of rights”.

In its heavily redacted 186-page ruling dating from 17 December 2015, the permanent court of arbitration said it had no jurisdiction over the case brought by Philip Morris.

In 2012 Australia became the first country to mandate that cigarettes must be sold in plain packages, in an attempt to reduce smoking rates. This initiative has since been followed by other nations including France and Britain.

But big tobacco firms including Philip Morris have launched legal challenges against such laws, arguing the rules impinge on their trademark intellectual property.

Philip Morris, manufacturers of some of the world’s most recognisable brands, including Marlboro, lodged the challenge with the arbitration court based in The Hague in 2011 after the plain-packaging legislation was passed, using a 1993 trade deal between Australia and Hong Kong that included foreign investment protections.

But the permanent court of arbitration found in its unanimous ruling that “the main and determinative, if not sole, reason” for a restructuring of the company as far back as 2005 was to enable it “to bring a claim under the treaty, using an entity from Hong Kong” after it received ample warnings that such legislation was being considered.

“The record indeed shows that the principal, if not sole, purpose of the restructuring was to gain protection under the treaty in respect of the very measures that form the subject matter of the present arbitration,” the court ruled.

It added: “The tribunal cannot but conclude that the initiation of this arbitration constitutes an abuse of rights.”

The court therefore found that Philip Morris’s claims were “inadmissible” and it was “precluded from exercising jurisdiction over this dispute”.

The ruling came after a closed-door hearing held in Singapore in February 2015.

Canberra had welcomed the decision saying “plain packaging is a legitimate public health measure”.

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