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May 24th, 2016:

Enact the amendment to the licence conditions to specifically forbid smoking and make the licensee answerable

Dear Madam,

Thankyou for your pointless reply mentioning licence condition 7, which we have been telling you needs amendment by the addition of one simple sentence.

This would effectively add 13,000 additional enforcement staff to TCO.

We will accordingly publish your reply on our website and encourage all members of the public henceforth seeing illegal smoking offences in licensed premises to report the matter to the police, as a complaint against the licensee under Condition 7 of the liquor licence, instead of Tobacco Control Office.

I am sure the police will welcome your expert advice and workload, so we copied them also.

James Middleton
Clear the Air


Sent: 24 May, 2016 04:11 PM

Subject: Re: LiquorLic-Apathy-remainsabject.pdf

Dear Mr. Middleton,

Thank you for your email on 13.5.2016 suggesting amending the licensing conditions for liquor licence to specifically forbid smoking and make the licensee liable for that. Your email has been considered by the Liquor Licensing Board (the Board).

The Board is established under the Dutiable Commodities (Liquor) Regulations, Cap. 109B as a statutory body to consider applications for liquor licences. Where applications for liquor licence are made to the Board, the Board will consider each application on its individual merits and decide on whether or not to grant a liquor licence based on the circumstances and evidence of each case as well as comments and reports from government departments and the Hong Kong Police Force, who is the enforcement agent of Cap. 109B. If the Board decides to grant a liquor licence, it may grant a liquor licence without conditions or subject to such conditions as it thinks fit.

At present, licensing condition 7 for liquor licence stipulates that “The licensee shall not permit any person to occupy or use any portion of the premises for any immoral or illegal purpose.” As the enforcement agent of Cap. 109B, Police will conduct regular inspections and investigate complaints against liquor licensed premises. Whether or not the licensee is in breach of licensing condition depends on the circumstances of the case and the evidence available. Police will take appropriate enforcement actions against the licensee, including issue of advice, warnings or summons, if there is any breach of licensing conditions or the provisions of Cap. 109B. Any breach of the licensing condition(s) by individual licensee should be reported to the Police for investigation and enforcement actions where appropriate.

Under such circumstances, the Board considered that it would not be necessary to amend the existing licensing conditions for liquor licence.

Regarding your complaint against the premises “Sawadee Thai” in Yuen Long for placing ash trays on tables, your complaint has been referred to the Police and Tobacco Control Office for investigation and follow-up actions under their purviews.

Best regards,

Maggie YIU
for Secretary, Liquor Licensing Board


Date: 13/5/2016 15:55
Subject: LiquorLic-Apathy-remainsabject.pdf

Liquor Licensing Board
Chairman and Members

Dear Sir,

I refer to our letter to the Liquor Licensing Board , already 5 years ago now, attached.

Almost 7,000 people died per year in Hong Kong from smoking related illnesses.

21% of them were from passive smoking, no doubt including workplace staff.

If people cannot go out to bars and smoke, they will stop.

I would urge you to enact the amendment to the licence conditions to specifically forbid smoking and make the licensee answerable for same.

As an example I go to a restaurant near my home, Sawasdee Thai in Yuen Long.

Despite numerous complaint reports and warnings they actually place ash trays on tables, as do many licensed premises throughout HKG as the licensees are basically bullet proof – only the smoker gets targeted and the Tobacco Control Office has been allocated less than 50 staff per shift to cover HKI, Kowloon, NT, Islands, Marine and Planet HKG, so the chances of being caught in flagrante delicto are negligible, as the massively underfunded TCO only can respond days later to such complaints.

The fact that the seeming friend of Big T tax revenues, Financial Secretary, received $6.3 billion in tobacco excise tax (aka the white elephant concrete pouring fund) and allocates only $160 million to tobacco related control measures is despicable, as is the Health Bureau and HK Government abject lack of political will to do anything about this mess.

If you will not make a simple amendment to all licenses, then blood is on your hands and remains there for your previous non action.

The licensees currently encourage smoking with no onus on them otherwise, through flawed legislation.

Only Macau and Hong Kong do not place the onus on the licensee to enforce the law.

You can change that without even going to Legco.

Get moving.

Yours faithfully,

James Middleton

Tobacco control strategies need a refresh, researchers say

BUFFALO, N.Y. – The tobacco product landscape has changed significantly with the introduction of alternatives that are much less harmful than traditional cigarettes.

Compared to cigarettes, which kill 3 in 5 smokers prematurely, some non-combusted products — including snus, other smokeless tobacco products and electronic cigarettes or vapes — are estimated to be more than 90 percent less harmful.

But decades-old tobacco control strategies that rely on an “all or nothing” approach haven’t kept up with these changes, and are confusing the general public. Writing in the journal BioMed Central Public Health, two researchers say it’s time for tobacco control themes to be modernized.

“Not since the invention of the cigarette rolling machine in 1882 has the product landscape changed so dramatically. For the first time in over a century, there are products that could make the defective and deadly cigarette obsolete,” says Lynn T. Kozlowski, PhD, a co-author of the paper and professor of community health and health behavior at the University at Buffalo.

“The dramatic landscape change warrants a rethinking of past tobacco control strategy, from an all-or-nothing approach to a harm-reduction approach,” adds Kozlowski, who has written extensively on the need for including a harm-reduction approach in tobacco control efforts.

Kozlowski wrote the paper with David B. Abrams, PhD, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the Truth Initiative in Washington, D.C.

Abrams is also professor of health behavior and society at Johns Hopkins University, and an adjunct professor of oncology in the Lombardi Comprehensive Cancer Center at Georgetown University Medical Center.

The researchers write that the long-held tobacco control strategy that lumps all tobacco products together — regardless of the differences in harm — is negatively impacting public health.

“In the past few years, more smokers now wrongly believe that Alternative Nicotine Delivery Systems, including electronic cigarettes, are as harmful or more harmful than cigarettes and are thus less likely to switch to them to quit smoking,” says Kozlowski.

They argue that, while there is some risk in using any product that delivers nicotine, dramatic differences in harm exist between deadly cigarettes — by far the most lethal — and other products like e-cigarettes and smokeless tobacco, and that these differences need to be communicated to the public.

“Smokers who cannot, or do not, wish to quit smoking can now switch to a substantially less harmful, but reasonably satisfying, alternative way to get their nicotine. People smoke for the nicotine but die mostly from the tar,” said Kozlowski.

In their paper, Kozlowski and Abrams trace the history of tobacco control strategies in the U.S. since efforts began in 1964. They discuss the push that year toward low tar — or so-called “light” — cigarettes, sales of which boomed. At the time, public health officials believed that a smoker’s risk of lung cancer could be reduced by lowering the amount of tar in cigarettes.

The utter failure of these low tar/light combusted cigarettes to actually be less harmful does not mean that the same is true for modern non-combusted products like e-cigarettes, the researchers say.

In the 1980s, broader bans on cigarette advertising were proposed, and the dominant theme was that smoking is bad and there are no other product options to consider.

“Since 1964, major themes missed a core principle: The substantially greatest harm is from the toxic smoke of combusted, inhaled tobacco,” Kozlowski and Abrams write.

At the same time as a harm reduction stance is adopted for smokers of deadly combusted tobacco, it is important to complement the decades of successful tobacco control, to minimize the use of any nicotine-containing products by underage youth, they say.

The new tobacco rules the U.S. Food and Drug Administration proposed earlier this month now include the regulation of previously unregulated cigars of all types, e-cigarettes and hookah.

“Despite our best efforts to prevent youth tobacco and nicotine use, most adult users will still likely have begun in their youth, and these adult users need legal options that are much less harmful than cigarettes,” Kozlowski warns.

“Regulation should be used to strike the balance so urgently needed between protecting non-users, especially youth, while maximizing benefits of newly regulated non-combustible e-cigarette products that have been shown to help current smokers either to switch or, ideally, to quit,” Kozlowski added.

The regulations need to be reasonable and proportionate so as not to stifle innovation or make the least harmful products subject to the most burdensome regulations, while allowing the most harmful combustible products to be subject to the most regulations, according to the researchers.

Why does health insurer AXA have €1.8 billion invested in tobacco?

It may come as a surprise to discover that AXA, one of the largest providers of health and life insurance, has €1.8 billion in assets in the smoking/tobacco industry.

The French insurance company has revealed it is planning to sell its tobacco assets, citing the impact it has on public health.

A sensible move, but why invest so heavily in an industry that is sure to contribute to health and life insurance pay outs? The fact that AXA admits the divestment will cost the company reveals that it was a profitable venture, despite the obvious connection between smoking and ill health. A change of hearth, it seems, is behind the decision.

Chief Executive Thomas Buberl said in a company statement: “We strongly believe in the positive role insurance can play in society, and that insurers are part of the solution when it comes to health prevention to protect our clients. Hence, it makes no sense for us to continue our investments within the tobacco industry.

“With this divestment from tobacco, we are doing our share to support the efforts of governments around the world. This decision has a cost for us, but the case for divestment is clear: the human cost of tobacco is tragic; its economic cost is huge. As a major investor and a leading health insurer, the AXA Group wants to be part of the solution, and our hope is that others in our industry will do the same.”

AXA will sell its equity holdings in tobacco companies and will stop all new investments, running off its existing bond holdings. The move should be welcomed, and has already been praised by health groups.

AXA released the below infogrpahic with the annoucement:


Little girl caught on camera smoking e-cigarette claims “it’s just a toy” as parents watch

Worrying footage has emerged showing children as young as six apparently smoking e-cigarettes with their parents close by.

The distressing new trend of children ‘vaping’ seems to be on the rise with mums and dads openly condoning the behaviour.

The video, filmed in the Sham Shui Po District of Hong Kong, sees primary school aged children puffing e-cig smoke while they play in parks and playgrounds.

The youngsters seemed to be under the impression e-cigs are harmless.

One of the girls, unnamed in reports, was quoted as saying: “[E-cigarettes] aren’t bad for health.

“It’s a toy, the smoke is fake.”

The interviewees also claimed there is “no nicotine or tar” inside the e-cigs, a statement challenged by Hong Kong doctors who say that all forms of e-cigs contain substances that may cause addiction.

Citing a 2016 study from the Hong Kong Baptist University, reports say that some e-cigs on the market that were advertised as “nicotine free” in fact contained between 1.7 and 1.490 nanogrammes of nicotine per millimetre.

Reports also found that the schoolgirls were able to obtain their “toys” for as cheap as 20 HKD (about £1.75) each from a local shopping centre, where they come in a range of attractive colours and with creative patterns.

Worrying research has also been done by Hong Kong’s Food and Health Bureau, which interviewed 16,000 primary school and 41,000 middle school pupils.

The results found that 2.6% of primary school pupils and nine percent of middle school pupils interviewed were regular e-cigarette users.

Chan Mai-fai, a committee member of the Hong Kong Vape Association, told local media it has been urging the Hong Kong government to impose stricter regulations on the sale and use of e-cigarettes.

In particular, Chan believes all e-cigs should be registered, and that they should only be made available to people over 18 years of age.

Nicotine-free e-cigarettes are currently not regulated in Hong Kong, while the Pharmacy and Poisons Ordinance governs the sale and use of “vapes” containing nicotine, the unregistered sale of which comes with a fine of up to 100,000 HKD (around £8,860).

Cigarette and Tobacco Excise Tax to Increase June 1

The excise tax rate on cigarettes will increase 45 percent and the tax on cigars and other tobacco products will increase 25 percent, the Internal Revenue Bureau announced Tuesday. The Legislature increased the taxes earlier this year in an effort to raise revenue and to discourage smoking.

The IRB’s excise tax system and the appropriate online tax forms have been revised to reflect the change beginning on the implementation date, June 1, 2016. Excise taxpayers are urged to update their internal systems to reflect the increase in tax for these two categories.

Taxpayers who have questions concerning the increase in the tax rates can call the Office of Chief Counsel at (340) 715-1040 ext. 2248.

“The Harvest is in My Blood” Hazardous Child Labor in Tobacco Farming in Indonesia

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Ayu is a petite, soft-spoken 13-year-old girl from a village near Garut, in the mountains of West Java, Indonesia.[1] She is one of five children in her family, and her parents are farmers who cultivate tobacco and other crops on a small plot of land. “Since I was a kid, I’ve been going to the fields,” she said. “My parents plant tobacco. Mostly I help my parents and sometimes my neighbors. I have an older sister, an older brother, and two younger siblings. They help too.”

Ayu is in her first year of junior high school, and she mostly helps on the farm outside of school—early in the morning before classes, in the afternoons, and on weekends and holidays. But she told Human Rights Watch she occasionally missed school to work in tobacco farming. “My mom asked me to skip school last year when it was the harvest,” she said.

She told Human Rights Watch she vomits every year while harvesting tobacco:

I was throwing up when I was so tired from harvesting and carrying the [harvested tobacco] leaf. My stomach is like, I can’t explain, it’s stinky in my mouth. I threw up so many times…. My dad carried me home. It happened when we were harvesting. It was so hot, and I was so tired…. The smell is not good when we’re harvesting. I’m always throwing up every time I’m harvesting.

The symptoms she described—vomiting and nausea—are consistent with acute nicotine poisoning, an occupational illness specific to tobacco farming that occurs when workers absorb nicotine through their skin while having contact with tobacco plants.

Ayu also helps her father mix the toxic pesticides he applies to the tobacco. “I just put three or four cups of the chemical in the bucket, put in the water, and mix it with [a piece of] wood, and my dad puts it in the tank,” she explained. “The smell is so strong. It makes my stomach sick.” Like most of the farmers in her village, Ayu’s parents sell the tobacco they grow to the leader of their village, who pools together tobacco from dozens of farmers, transports it to a warehouse in Central Java, and sells it to a tobacco trader there. The trader buys tobacco from many different suppliers, repackages it, and sells it on the open market to Indonesian and multinational tobacco manufacturing and leaf supply companies.

This report—based on extensive research including interviews with more than 130 children who work on tobacco farms in Indonesia—shows that child workers are being exposed to serious health and safety risks. The dangers include acute nicotine poisoning from contact with tobacco plants and leaves, and exposure to toxic pesticides and other chemicals. Few of the children we interviewed, or their parents, were trained on safety measures or knew the health risks of the work. While Indonesian child labor laws are generally in line with international standards, our research shows that inadequate regulations and poor enforcement of the law, particularly in the small-scale farming sector, leave children at risk. The report concludes with detailed recommendations to the Indonesian government, tobacco companies, and other relevant players in the tobacco industry, including that authorities should immediately prohibit children from performing any tasks that involve direct contact with tobacco, and that companies should improve their human rights due diligence procedures to identify and end hazardous child labor on tobacco farms.

Indonesia is the world’s fifth-largest tobacco producer, home to more than 500,000 tobacco farms nationwide. Though domestic and international laws prohibit children under 18 from performing hazardous work, thousands of children like Ayu work in hazardous conditions on tobacco farms in Indonesia, exposed to nicotine, toxic pesticides, extreme heat, and other dangers. This work could have lasting consequences on their health and development.

The government of Indonesia has a strong legal and policy framework on child labor. Under national labor law, 15 is the standard minimum age for employment, and children ages 13 to 15 may perform only light work that is not dangerous and does not interfere with their schooling. Children under 18 are prohibited from performing hazardous work, including any work in environments “with harmful chemical substances.” Indonesia’s list of hazardous occupations prohibited for children does not specifically ban work handling tobacco. Human Rights Watch believes that available evidence demonstrates that any work involving direct contact with tobacco in any form constitutes work with harmful chemical substances, and should be prohibited for all children.

Nicotine is present in all parts of tobacco plants and leaves at all stages of production. Public health research has shown that tobacco workers absorb nicotine through their skin while handling tobacco, particularly when the plant is wet. Studies have found that non-smoking adult tobacco workers have similar levels of nicotine in their bodies as smokers in the general population. Nicotine is a toxin, and nicotine exposure has been associated with lasting adverse consequences on brain development. The use of protective equipment is insufficient to eliminate the dangers of working with tobacco and may lead to other dangers, such as heat illness.

Despite the domestic and international prohibitions on hazardous child labor, Human Rights Watch documented children engaging in hazardous work in tobacco farming in four Indonesian provinces, including the three provinces responsible for almost 90 percent of tobacco production each year: East Java, Central Java, and West Nusa Tenggara. Children we interviewed worked directly with tobacco plants, handled pesticides, and performed dangerous physical labor in extreme heat, putting them at risk of short and long-term health consequences.

Some of the hazards faced by child tobacco workers in Indonesia are not unique to tobacco farming. Children working in other crops may also be exposed to pesticides, work in high heat, and face other dangers. However, handling tobacco is inherently hazardous work for children, due to the nicotine in the plant, and tobacco farming inevitably requires workers to have significant contact with the plant during cultivation, harvesting, and curing.

Many Indonesian companies and the largest multinational tobacco companies in the world purchase tobacco grown in Indonesia and use it to manufacture tobacco products sold domestically and abroad. Several of the largest multinational tobacco companies in the world have acknowledged the risks to children of participating in certain tasks on tobacco farms. These companies ban children under 18 from performing some of the most hazardous tasks on farms in their supply chains, such as harvesting tobacco or applying pesticides to the crop. But none of these companies have policies and procedures sufficient to ensure that tobacco entering their supply chains was not produced with hazardous child labor. As a result, these companies risk contributing to the use of, and benefitting from, hazardous child labor.

On three research trips between September 2014 and September 2015, Human Rights Watch interviewed a total of 227 people, including 132 children ages 8 to 17 who reported working on tobacco farms in 2014 or 2015, and 88 other individuals, such as parents of child workers, tobacco farmers, tobacco leaf buyers and sellers, warehouse owners, village leaders, health workers, representatives of nongovernmental organizations, and others. In addition, we met or corresponded with officials from several government bodies, including the Ministry of Manpower and Transmigration, the Ministry of Health, the Ministry of Agriculture, the Ministry of Education and Culture, and the Indonesian Child Protection Commission.

Human Rights Watch sent letters to four Indonesian companies and nine multinational tobacco manufacturing and leaf supply companies, to share our research findings and request information on each company’s policies and practices regarding child labor in Indonesia. As detailed below, seven multinational companies responded in detail. We sent several letters and made numerous phone calls to each of the four Indonesian companies in an effort to secure a meaningful response, but none provided any substantive response. Human Rights Watch analyzed the human rights due diligence procedures of those companies that responded in detail to our letters as thoroughly as possible, based on information provided by the companies, publicly available information on their websites, and interviews with child workers, tobacco farmers, and traders in Indonesia.

Most of the children interviewed by Human Rights Watch started working in tobacco farming before age 15, the standard minimum age for employment in Indonesia. Approximately three quarters of the children we interviewed began working in tobacco farming by age 12. Most children worked on tobacco farms throughout the season, from planting through the harvest and curing process.

Children interviewed for this report typically worked on small plots of land farmed by their parents or other family members. In addition to working on land farmed by their families, many children also worked on land farmed by their neighbors and other members of their communities. Some children did not receive any wages for their work, either because they worked for their own families or exchanged labor with other families in their communities. Other children received modest wages.

Children in all four provinces said that they worked in tobacco farming to help their families. The World Bank reports that 14.2 percent of Indonesia’s rural population lives below the national poverty line, almost double the urban poverty rate. According to the International Labour Organization (ILO), “poverty is the main cause of child labor in agriculture” worldwide. Human Rights Watch research found that family poverty contributed to children’s participation in tobacco farming in Indonesia. “I want to help my parents make a living,” said 11-year-old Ratih, who worked on her parents’ tobacco farm in Jember, East Java. Sinta, a 13-year-old girl who worked on tobacco farms in her village in Magelang, Central Java, said, “I work so I can help my parents, to make life easier. To make it not such a difficult life.”

“My kids are helping me in the field so I can save money on labor,” said Ijo, a farmer in his mid-40s and father of four interviewed in Garut, West Java, in 2015. He said he was conflicted about his 12-year-old son helping him on the farm: “Of course I don’t want my kids working in tobacco because there’s a lot of chemicals on it, and it could harm my kids. But they wanted to work, and we are farmers.… I need more money to pay the laborers. But my son can help all season. You can imagine that I can save a lot of money when he joins me in the field. It’s complicated.”

Hazardous Work in Tobacco Farming

While not all work is harmful to children, the ILO defines hazardous work as “work which, by its nature or the circumstances in which it is carried out, is likely to harm the health, safety or morals of children.” The ILO considers agriculture “one of the three most dangerous sectors in terms of work-related fatalities, non-fatal accidents, and occupational diseases.”

Human Rights Watch found that many aspects of tobacco farming in Indonesia pose significant risks to children’s health and safety. Children working on tobacco farms in Indonesia are exposed to nicotine, toxic pesticides, and extreme heat. The majority of children interviewed for this report described sickness while working in tobacco farming, including specific symptoms associated with acute nicotine poisoning, pesticide exposure, and heat-related illness, as described below. Some children reported respiratory symptoms, skin conditions, and eye irritation while working in tobacco farming.

All children interviewed for this report described handling and coming into contact with tobacco plants and leaves containing nicotine. In the short term, absorption of nicotine through the skin can lead to acute nicotine poisoning, called Green Tobacco Sickness. The most common symptoms of acute nicotine poisoning are nausea, vomiting, headaches, and dizziness. Approximately half of the children we interviewed in Indonesia in 2014 or 2015 reported experiencing at least one symptom consistent with acute nicotine poisoning while working in tobacco farming. Many reported multiple symptoms. For example, Nadia, a 16-year-old girl in Bondowoso, East Java, said she vomits every year in the harvest season while bundling and sorting harvested tobacco leaves with other women and girls in her village. “Sometimes I get a headache. Sometimes I’m even throwing up … [It happens] when we string the leaves because we’re sitting in the middle of a bundle of tobacco.… It happens when the tobacco is still wet and just coming from the fields.… Every time it’s the beginning of the season, we’re throwing up.”

Rio, a tall 13-year-old boy, worked on tobacco farms in his village in Magelang, Central Java, in 2014. He told Human Rights Watch, “After too long working in tobacco, I get a stomachache and feel like vomiting. It’s from when I’m near the tobacco for too long.” He likened the feeling to motion sickness, saying “It’s just like when you’re on a trip, and you’re in a car swerving back and forth.”

The long-term effects of nicotine absorption through the skin have not been studied, but public health research on smoking suggests that nicotine exposure during childhood and adolescence may have lasting consequences on brain development. The prefrontal cortex, the part of the brain responsible for executive function and attention, is one of the last parts of the brain to mature and continues developing throughout adolescence and into early adulthood. The prefrontal cortex is particularly susceptible to the impacts of stimulants, such as nicotine. Nicotine exposure in adolescence has been associated with mood disorders, and problems with memory, attention, impulse control, and cognition later in life.

Many child tobacco workers interviewed for this report also said they handled or applied pesticides, fertilizers, or other chemical agents to tobacco farms in their communities. Some children also reported seeing other workers apply chemicals in fields in which they were working, or in nearby fields. A number of children reported immediate sickness after handling or working in close proximity to the chemicals applied to tobacco farms.

Sixteen-year-old Musa, for example, said he used a tank and handheld sprayer to apply a liquid chemical to his family’s tobacco farm in Garut, West Java, in 2015. He said he became very ill the first time he applied pesticides, after mixing the chemicals with his bare hands: “The first time, I was vomiting.… For two weeks, I couldn’t work. I went to the doctor. The doctor told me to stop being around the chemicals. But how can I do that? I have to help my parents. Who else can help them but me? … I mixed it with my hands. Suddenly I was dizzy. My parents told me to go home. I stayed home for two days, and my dad told me to rest for longer. It was a terrible feeling. For two weeks, I was always, always vomiting.”

Rahmad, a 10-year-old boy, described being exposed to pesticides while working on his family’s farm in Sampang, East Java, in 2015, “When my brother is spraying, I am cleaning the weeds. It stinks…. It smells like medicine. I feel sick. I feel headaches, and not good in my stomach. I’m in the same field…. Every time I smell the spray I feel dizzy and nauseous.”

Children are uniquely vulnerable to the adverse effects of toxic exposures as their brains and bodies are still developing. Pesticide exposure has been associated with long-term and chronic health effects including respiratory problems, cancer, depression, neurologic deficits, and reproductive health problems. In particular, many pesticides are highly toxic to the brain and reproductive health system, both of which continue to grow and develop during childhood and adolescence.

Few of the children interviewed by Human Rights Watch said that they had received any education or training about the health risks of working in tobacco farming. Very few children said that they wore any type of protective equipment while handling tobacco, and many said they wore no or inadequate protective equipment while working with pesticides or other chemicals.

Many children described working in high heat on tobacco farms. Some children we interviewed said that they had fainted, and others said that they felt faint or dizzy or suffered headaches when working in very high temperatures. Working in extreme heat can place children at risk of heat stroke and dehydration, and children are more susceptible than adults to heat illness.

Most children interviewed reported that they suffered pain and fatigue from engaging in prolonged repetitive motions and lifting heavy loads. Some children also said they used sharp tools and cut themselves, or worked at dangerous heights with no protection from falls.

Impact on Education

Most children interviewed by Human Rights Watch said they attended school and worked in tobacco farming only outside of school hours—before and after school, and on weekends and school holidays. However, Human Rights Watch also found that work in tobacco farming interfered with schooling for some children.

A few children had dropped out of school before turning 15—the compulsory age for schooling in Indonesia—in order to work to help support their families. These children often said their families could not afford to put them through school, or relied on them to work. Even though the Indonesian government guarantees free public education, and interviewees in most communities said they did not have to pay school fees to attend public schools, the costs of books, uniforms, transportation to and from school were prohibitive for some families. For example, Sari, a bright-eyed, 14-year-old girl in Magelang, Central Java, told Human Rights Watch she dreamed of becoming a nurse, but she stopped attending school after sixth grade in order to help support her family. “I want to go back to school to achieve my dreams for the future, but we don’t have much money to do that.”

Some children said they missed some days of school during busy times of the growing season. Eleven-year-old Rojo, the oldest child in his family, said he missed school to work in tobacco farming three or four times during the 2014 harvest season in Sampang, East Java: “My dad asked me to go to the field earlier, and not go to school,” he said. “I was worried I wouldn’t pass the exams.”

Some children interviewed said they found it difficult to combine school and work, and described fatigue and exhaustion or difficulty keeping up with schoolwork. Awan, a slender 15-year-old boy from Pamekasan, East Java, described how he balanced school and work during the high season: “When the harvest is coming, I have to wake up early in the morning, and I have to be [work] in the fields until 6:30 a.m., then go to school, and then continue in the fields in the afternoon…. We go [to the fields] around 4:30 or 5 a.m. It’s still dark, but I use a headlamp. I feel like I want to sleep longer. It’s tiring.” He told Human Rights Watch that this grueling schedule made it difficult for him to keep up with his schoolwork: “It’s harder to study than it is before the harvest,” he said. “It makes me so tired.”

Government Response

Under international law, the Indonesian government has an obligation to ensure that children are protected from the worst forms of child labor, including hazardous work, which is defined as “work which, by its nature or the circumstances in which it is carried out, is likely to harm the health, safety or morals of children.”

Indonesia has ratified several international conventions concerning child labor, including the ILO Worst Forms of Child Labour Convention, the ILO Minimum Age Convention, and the United Nations (UN) Convention on the Rights of the Child (CRC). The ILO Worst Forms of Child Labour Convention requires member states to take immediate action to prevent children from engaging in the worst forms of child labor and to provide direct assistance for the removal of children already engaged in the worst forms of child labor.

Indonesia has strong laws and regulations regarding child labor, aligned with international standards, and has implemented a number of social programs to address child labor. Under Indonesian law, the general minimum age for employment nationwide is 15. Children ages 13 to 15 may participate in light work as long as the work does not interfere with their physical, mental, or social development. Indonesian labor law prohibits hazardous work by everyone under 18, and a 2003 decree from the Minister of Manpower and Transmigration details the list of specific tasks that are prohibited for children under 18. The list explicitly prohibits children from working in environments “with harmful chemical substances.” Under this provision, any work involving direct contact with tobacco in any form should be considered prohibited due to the high probability of exposure to nicotine and pesticides.

However, gaps in the legal and regulatory framework, and inadequate enforcement of child labor laws and regulations leave children at risk. The Indonesian government’s hazardous work list does not specify that the prohibition on children’s work with harmful chemical substances includes work handling tobacco, despite the dangers of nicotine exposure. This ambiguity leaves children vulnerable.

In addition, the government of Indonesia does not effectively enforce child labor laws and regulations in the small-scale farming sector. The Ministry of Manpower and Transmigration—the agency responsible for the enforcement of child labor laws and regulations—has about 2,000 inspectors carrying out labor inspections nationwide, in all sectors, far too few for effective labor enforcement in a country of more than 250 million people. In a meeting with Human Rights Watch, a ministry representative explained that labor inspections are done only in large-scale agro-industry, not in the small-scale agricultural sector where the vast majority of children interviewed for this report worked.

Tobacco Supply Chain and Corporate Responsibility

While governments have the primary responsibility to respect, protect, and fulfill human rights under international law, private entities, including businesses, also have a responsibility to avoid causing or contributing to human rights abuse, and to take effective steps to ensure that any abuses that do occur are effectively remedied. This includes a responsibility to ensure that businesses’ operations do not use, or contribute to the use of, hazardous child labor.

The United Nations (UN) Guiding Principles on Business and Human Rights, which the UN Human Rights Council endorsed in 2011, maintain that all companies should respect human rights, avoid complicity in abuses, and ensure that any abuses that occur in spite of these efforts are adequately remedied. The guidelines, widely accepted as an authoritative articulation of businesses’ human rights responsibilities, specify that businesses should carry out effective human rights due diligence, a process to identify potential risks of human rights abuse connected to their operations and take effective steps to prevent and mitigate negative human rights impacts linked to their operations. Businesses also have a responsibility to ensure that the victims of any abuses that occur in spite of these efforts are able to secure an appropriate remedy.

Tobacco grown in Indonesia enters the supply chains of Indonesian tobacco companies of various sizes, as well as the world’s largest multinational tobacco companies. The largest companies operating in Indonesia include three Indonesian tobacco manufacturers—PT Djarum (Djarum), PT Gudang Garam Tbk (Gudang Garam), and PT Nojorono Tobacco International (Nojorono)—and two companies owned by multinational tobacco manufacturers—PT Bentoel Internasional Investama (Bentoel), owned by British American Tobacco (BAT), and PT Hanjaya Mandala Sampoerna Tbk (Sampoerna), owned by Philip Morris International. Other Indonesian and multinational companies also purchase tobacco grown in Indonesia, as described below.

Tobacco farmers interviewed by Human Rights Watch sold tobacco in a number of ways. Most farmers sold tobacco leaf on the open market through intermediaries, or “middlemen.” In this system, small farmers described selling tobacco to a central farmer or leader in the village, or a local buyer, who would pool tobacco from many small producers and sell it to warehouses owned by local businessmen or by larger national or multinational companies purchasing tobacco leaf.

As an alternative to this system, some farmers had relationships with individual tobacco companies and had opportunities to sell tobacco directly to representatives of the company, rather than through intermediary traders. Under this system, some farmers signed written contracts to sell tobacco directly to tobacco product manufacturing or leaf supply companies.

Human Rights Watch interviewed more than 60 tobacco farmers, tobacco leaf buyers and sellers, and warehouse owners in the four provinces where we conducted research. We identified human rights risks, including child labor and occupational health and safety hazards, in both the open market system and the direct contracting system.

Most farmers and traders selling tobacco exclusively through the traditional open market system acknowledged that it was common for children to work in tobacco cultivation. Most of them stated that neither the government nor those purchasing tobacco leaf had ever communicated with them regarding child labor standards or expectations. Interviewees said that they were not aware of any attempts on the part of buyers, including companies with explicit policies that prohibit child labor, to verify the conditions in which tobacco was grown or inspect for child labor.

Farmers producing and selling tobacco through the direct contracting system said that they had received some training and education about child labor and health and safety from the tobacco companies with whom they contract. At the same time, Human Rights Watch found that companies’ human rights due diligence practices were not sufficient to eliminate hazardous child labor in the supply chain. Most farmers in the direct contracting system reported that children under 18 still participated in many tobacco farming tasks, and some farmers insisted there were no restrictions at all on children’s work in tobacco farming. Most farmers said there was no meaningful consequence or penalty if children were found working, even in the event of repeated violations. In the absence of any meaningful penalties, many farmers largely disregarded any efforts by companies to dissuade them from allowing children to work.

Human Rights Watch found that companies purchasing tobacco on the open market and through the direct contracting system risk purchasing tobacco produced by children working in hazardous conditions.

Human Rights Watch sought information regarding the human rights due diligence policies and procedures of 13 companies, including four Indonesian tobacco product manufacturers, seven multinational tobacco product manufacturers, and two multinational leaf merchant companies. Ten companies responded. Of the four Indonesian tobacco companies, two replied (Nojorono and Wismilak), but neither provided a detailed or comprehensive response to the questions we posed. A representative of Wismilak sent an email to Human Rights Watch stating that the company could not respond in detail because it is not “directly connected with the tobacco farmers,” but did not identify other actors in the supply chain who are directly in contact with growers. Nojorono replied in a letter and referred Human Rights Watch to GAPPRI (Gabungan Perserikatan Pabrik Rokok Indonesia), a cigarette manufacturer’s association, for information regarding tobacco farming, including child labor. Human Rights Watch subsequently wrote to GAPPRI, but they declined to meet with us. The largest Indonesian tobacco companies, Djarum and Gudang Garam, did not respond to Human Rights Watch, despite repeated attempts to reach them.

All of the multinational companies purchasing tobacco from Indonesia that responded to Human Rights Watch have child labor policies that are largely aligned and appear consistent with international standards, in particular key ILO conventions. However, none of the companies prohibit children from performing all tasks that could pose threats to their health and safety. This means that none of the companies have policies sufficient to ensure that all children are protected from hazardous work on tobacco farms in their supply chains.

Human Rights Watch analyzed the information on human rights due diligence provided by those companies that responded to our letters. Few of the companies are sufficiently transparent regarding their human rights due diligence procedures, particularly regarding their monitoring of their child labor policies throughout the supply chain, as well as the results of internal monitoring and external audits. Transparency is a key element of effective and credible human rights due diligence. Among the companies we studied, Philip Morris International appears to have taken the greatest number of steps to be transparent about its human rights policies and monitoring procedures, including by publishing on its website its own progress reports as well as several detailed reports by third party monitors.

Most multinational tobacco companies operating in Indonesia source tobacco through a mix of direct contracts with farmers and purchasing tobacco leaf on the open market, with some companies relying more heavily on one or the other purchasing model. Many companies acknowledged that they carry out little or no human rights due diligence in the open market system. However, all companies sourcing tobacco from Indonesia have responsibilities to carry out robust human rights due diligence activity and ensure that their operations do not cause or contribute to human rights abuse, even in complex, multilayered supply chains. Although most of the companies who responded to Human Rights Watch acknowledged child labor and other human rights risks in the open market system, none of the companies described having procedures in place that are sufficient to ensure that tobacco entering their supply chains was not produced with hazardous child labor.

The Way Forward

Based on the findings documented in this report, our analysis of international standards and public health literature, and interviews with experts on farmworker health, Human Rights Watch believes that any work involving direct contact with tobacco in any form should be considered hazardous and prohibited for children under 18, due to the health risks posed by nicotine, the pesticides applied to the crop, and the particular vulnerability of children whose bodies and brains are still developing.

We recognize that small-scale farming is an important part of Indonesia’s agricultural sector, and that in some areas, children have participated in family farming for generations. Though it may take time to change attitudes and practices around children’s role in tobacco farming, significant change is possible. In Brazil—the world’s second-largest tobacco producer and a country, like Indonesia, where tobacco is cultivated largely on small family farms—Human Rights Watch found that a strict and clear government ban on child labor in tobacco farming, and comprehensive health and safety education and training, were helping to eliminate hazardous child labor in the crop. The Brazilian government had established meaningful penalties for child labor violations, applied both to farmers and the companies purchasing tobacco from them, and the penalties pushed people to end or limit their children’s work on the farm. Indonesian authorities should take note of this approach.

As part of its efforts to eradicate the worst forms of child labor by 2022, the government of Indonesia should update its list of hazardous occupations for children, or enact a new law or regulation, to prohibit explicitly any work involving direct contact with tobacco in any form. There may be some light work on tobacco farms that is suitable for children, particularly in the early stages of tobacco production. For example, planting tobacco while wearing suitable gloves or watering tobacco plants with small, lightweight buckets or jugs could be acceptable tasks for children, as long as they were not working in extreme heat or dangerous conditions, and the work did not interfere with their schooling. However, Human Rights Watch believes that many aspects of tobacco farming in Indonesia constitute hazardous child labor under international standards, particularly most tasks involved in topping, harvesting, and curing tobacco, as there is no viable way to limit children’s direct contact with tobacco during these stages of production.

The government should vigorously investigate and monitor child labor and other violations in small-scale agriculture, including through unannounced inspections at the times and locations at which children are most likely to be working.

In addition, Indonesian authorities should take immediate steps to protect child tobacco workers from danger. The government should implement an extensive public education and training program in tobacco farming communities to promote awareness of the health risks to children of work in tobacco farming, particularly the risks of exposure to nicotine and pesticides.

All companies purchasing tobacco from Indonesia should adopt or revise global human rights policies prohibiting hazardous child labor anywhere in the supply chain, including any work in which children have direct contact with tobacco in any form. Companies should establish or strengthen human rights due diligence procedures with specific attention to eliminating hazardous child labor in all parts of the supply chain, and regularly and publicly report on their efforts to identify and address human rights problems in their supply chains in detail.

EU tobacco laws take effect

A raft of new EU tobacco rules – including the introduction of standardised packaging for tobacco products in the UK – began on Friday 20 May.

Under the EU Tobacco Products Directive (EUTPD2), packs of 10 cigarettes will be banned, with pictorial health warnings covering 65% of the front and back of packets made mandatory as part of a wider body of measures that will also ban menthol and flavoured cigarettes from May 2020.

The European Court of Justice had earlier ruled that EUTPD2, which had been held up by a series of legal challenges, was lawful.

The introduction of the new directive coincides with the UK government’s adoption of plain packaging in the UK following a High Court ruling that dismissed a legal challenge brought by major tobacco companies who questioned the lawfulness of the move. Legislation on plain packaging has also been passed in France and Ireland, following Australia in 2012.

“We believe this will have a substantial impact on the business – all this is serving to do is to put British duty free shops at a competitive disadvantage,” an industry source told Frontier.

Japan Tobacco International (JTI) has called the new EU measures “extreme” in “a package of some of the strictest anti-tobacco measures in the world”.

“This is an attack on adult consumers’ freedom of choice and yet another example of extreme regulation,” said Ben Townsend, JTi’s EU affairs vice-president.

“The measures in the directive are so complex that regulators in many EU countries have struggled to draft the national laws it requires – leaving everyone confused in a last-minute scramble to comply ahead of the deadline.”

A statement obtained by Frontier from Imperial Tobacco UK confirmed the company’s disappointment at the plain packaging decision, adding that it would take time to review the judgement before considering its legal position.

“As a responsible business we have been preparing for all possible outcomes and are ready to comply with the introduction of both the plain packaging legislation and the revised EU Tobacco Product Directive,” said a spokesperson.

“Products manufactured before 20 May can continue to be sold by retailers for a further 12 months and our main focus is to support our trade customers through this transition period.

“We have been preparing for plain packaging and EUTPD2 for around three years and are confident that our brand and product portfolios are well positioned.”

British American Tobacco (BAT) was adamant that the decision, delivered in a 386-page written ruling by Mr Justice Green, did not represent closure on the issue of the lawfulness of plain packaging.

“We believe that the judgment contains a number of fundamental errors of law and we are applying for leave to appeal the decision,” a spokesperson said in a statement.

“It’s important to appreciate that a UK decision is not a precedent for other governments to introduce plain packaging.

“No two jurisdictions are the same and any government considering plain packaging will need to ensure that it complies with the fundamental rights of businesses relevant to that country, and be mindful of the World Trade Organisation dispute on plain packaging, which is still ongoing.”

EU Member states, including the UK, agreed to revise provisions on tobacco under EUTPD2 in 2014 in an attempt to harmonise trading conditions.

Tobacco packaging guidelines from the UK Department of Health state the move towards plain packaging is intended to reduce the appeal of tobacco products to consumers, particularly among young people.

The regulations, which apply to England, Northern Ireland, Scotland and Wales, also include other rules under EUTPD2, such as minimum-sized health warnings for all tobacco products.

All relevant products branded, manufactured or imported into the UK must now comply with the new EUTPD2 and standardised packaging if they are to be consumed in the UK, the guidelines continued.

The rules apply to individual cigarette sticks, cigarette packs and hand rolling packs – which must weight a minimum of 30g – but do not apply to cigarette papers or e-cigarettes, which are subject to separate rules.

Pipe tobacco, water pipe tobacco, blunts and some cigars and cigarillos are classified as ‘other tobacco products’ (OTPs). OTP’s are not subject to standardised packaging, but will be subject to separate packaging requirements under EUTPD2.

The same applies to cigars, cigarillos and smokeless tobacco, which are exempt from standardised packaging but subject to EUTPD2 criteria, and will have to comply with general health warnings.

Packs should be cuboid in shape and non-shiny drab dark brown, with brand names permitted according to set font, size and position types. Trademarks, logos, colour schemes and promotional images are also prohibited.

Companies have until 21 May 2017 to comply with the rules, enabling retailers to sell old branded stock.

In a separate development, tobacco – including e-cigarette – suppliers will need to register their businesses if they provide cross-border distance sales, including online.

This applies to companies established in the UK selling tobacco products and/or e-cigarettes to consumers in one of the 28 member states designated within the European Economic Area (EEA) – plus Iceland, Liechenstein and Norway – alongside businesses established in the EEA or any country selling to UK consumers.

Taxing To Promote Public Goods: Tobacco Taxes

EXPANDING THE GLOBAL TAX BASE: “Taxing To Promote Public Goods: Tobacco Taxes”

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Use of e-cigarettes stalls in the US, as more Americans believe they’re not healthier than conventional cigarettes

About 10 percent of the 9,766 adults surveyed use the device
This year a growing percentage expressed negative attitudes
47 percent of respondents said vaping was not healthier than smoking

Use of electronic cigarettesand other vaping devices has stalled in the United States asmore Americans question their safety, according to a new onlineReuters/Ipsos poll.

About 10 percent of the 9,766 adults surveyed between April19 and May 16 use the devices, the same percentage as in asimilar Reuters/Ipsos poll in May, 2015. This year, however, agrowing percentage of participants expressed negative attitudestoward e-cigarettes.

Forty-seven per cent of respondents saidvaping was not healthier than smoking conventional cigarettescompared with 38 percent who felt that way a year ago.

Forty-three percent said they did not believe vaping couldhelp people quit smoking compared with 39 percent who held thatview in 2015. A majority of participants – 66 percent – say thatvaping can be addictive compared with 61 percent in 2015.

Additionally, 49 percent said this year that it could have asimilar effect to that of second-hand tobacco smoke comparedwith 42 percent last year.

Use of electronic cigarettes and other vaping devices has stalled in the United States as more Americans question their safety, according to a new online poll

Use of electronic cigarettes and other vaping devices has stalled in the United States as more Americans question their safety, according to a new online poll

The growing concerns about the devices could hit theiralready slowing sales, especially for smaller e-cigarette andvaping companies. Many of these brands have lost market share tobig tobacco companies, such as Altria and ReynoldsAmerican Inc. Some do not expect to survive with newU.S. rules to regulate the e-cigarette market.

‘In some ways, a move away from e-cigarettes is actuallypositive for Altria and Reynolds,’ said Morningstar analyst AdamFleck, pointing out it may help sustain sales of conventionalcigarettes, whose margins are much higher.

Sharra Morris, 42, a mental health counselor in Moore,Oklahoma, started using e-cigarettes in February despite somemisgivings about their safety. She tried vaping to help her quitsmoking regular cigarettes.

‘The question now is: are they really safe?’ said Morris,who likes to vape using liquids flavored to taste like FruitLoops cereal and Snickerdoodle cookies. ‘What will they tell usin 20 years?’

E-cigarettes are metal tubes that heat liquids typicallylaced with nicotine and deliver vapor when inhaled. The liquidscome in thousands of flavors, from cotton candy to pizza.

Use of the devices has grown quickly in the last decade,with U.S. sales expected to reach $4.1 billion in 2016,according to Wells Fargo Securities. Sales were down 6 percentin the first quarter of 2016, however.

The healthcare community remains deeply divided over thedevices. Some healthcare experts are concerned about how littleis known about the potential health risks. They are especiallyworried about rising teen e-cigarette use, and fear that may geta new generation hooked on nicotine.

Some support them as a safer alternative to tobacco smokefor smokers who have been unable to quit.

Dr. Michael Siegel, a professor at the Boston UniversitySchool of Public Health, has advocated vaping as a way to weansmokers off conventional cigarettes. He blames negativepublicity for the growing concerns about the devices, andbelieves most are unwarranted.

‘There have been public health scares, and they areworking,’ said Siegel. ‘They are dissuading a lot of people fromtrying these products.’

The U.S. Food and Drug Administration issued its first rulesregulating e-cigarettes earlier this month, banning their saleand advertising to minors and requiring that manufacturerssubmit their products for approval.

At least one lawsuit has been filed in response to the newrules and more are expected. Many smaller companies say thetesting requirement is too burdensome because it will costhundreds of thousands of dollars per product, and they oftenmanufacture dozens. They say the rules favor the large players,such as Altria and Reynolds.

Companies selling in the United States are banned frommarketing the products as smoking cessation devices. Aboutthree-quarters of people who switch between e-cigarettes andtraditional cigarettes said in the Reuters/Ipsos survey theytried them to quit conventional cigarettes, but still smoketobacco ‘on occasion.’

Many are like Michael Whittaker, a 47-year-old deliverydriver from Halifax, Massachusetts, who took up vaping a fewmonths ago. ‘I figured it might be better for me and I mightsmell better.’

Now he is trying to cut back on both, which is common fordual users.

About 80 percent of people who switch between e-cigarettesand traditional cigarettes said they vape ‘in places whereregular cigarettes are prohibited,’ such as public buildings, or ‘when I’m near people who don’t like tobacco smoke.’

About half of those who currently vape or said they usede-cigarettes in the past said friends and family encouraged themto try the devices. The Reuters/Ipsos poll has a credibilityinterval, a measure of its accuracy, of plus or minus 1.1percentage point for all respondents and 5.6 percentage pointsfor questions asked of people who switch between conventionaland e-cigarettes.

A concern for healthcare professionals is that while 29percent of those who stopped vaping said in the poll they ‘quitall nicotine products,’ almost half returned to conventionalcigarettes.

Of those who went back to traditional tobacco products, 57percent said they returned to conventional cigarettes becausevaping was not satisfying, and 10 percent said it was notconvenient enough. U.S.-approved smoking cessation products andstrategies include medications, patches and counseling, many ofwhich are now covered by insurance.

‘We think there are certainly more and better ways to helpsmokers to quit,’ said Erika Sward of the American LungAssociation. ‘When you’re going to e-cigarettes, you’re notquitting, you’re switching,’ she said.

Number of people using e-cigarettes DOUBLES in just two years with 1 in 10 Europeans saying they’ve tried one

Proportion of people who have tried on in UK increased from 8.9 – 15.5%
Country with highest use was France while Portugal had lowest uptake
Debate over health risks with some worrying it acts as ‘gateway’ drug
Authors and charities say it should be promoted as smoking substitute

The number of people who have tried e-cigarettes almost doubled in two years, a major study has found.

Nearly one in six people in the UK have now used the devices – 15.5 per cent, up from 8.9 per cent two years earlier.

Doctors back e-cigarettes as an effective method of quitting smoking, with the NHS cleared this year to prescribe the devices for the first time.

But researchers at Imperial College London are worried that many of the people who try ‘vaping’ are non-smokers.

Although experts agree that e-cigarettes are far safer than smoking tobacco, some are concerned that they are also used as a fashionable ‘lifestyle’ habit for people who have never smoked.

They warn that these devices may even lead some people to take up smoking cigarettes – the so-called ‘gateway’ effect.

And they are concerned that we do not yet know enough about the long-term dangers of using the devices.

Lead author Dr Filippos Filippidis from the School of Public Health at Imperial said: ‘This research shows e-cigarettes are becoming very popular across Europe – with more than one in ten people in Europe now having tried one of the devices.

However there is debate about the risks and benefits associated with e-cigarettes.

‘For instance we don’t know whether we may start to see diseases emerge in 10 to 20 years’ time associated with some of the ingredients.

‘We urgently need more research into the devices so that we can answer these questions.’

His team examined the use of the devices across the European Union between 2012 and 2014.

The team, whose work is published in the medical journal Tobacco Control, found that in the UK the proportion of people who had tried an electronic cigarette was higher than the European average.

In Britain in 2012 the rate was 8.9 per cent compared to 7.2 per cent in the rest of the EU. By 2014 it had increased to 15.5 per cent in Britain, compared to 11.6 per cent elsewhere.

Dr Filippidis added: ‘Although this data shows most of the people who use e-cigarettes are current or former smokers – which suggests the devices may be helping some of them quit smoking – it is worrying that some people who have never smoked are using them.

‘This raises the question of whether they could be a “gateway” to smoking conventional cigarettes.’

Television and radio adverts for e-cigarettes were last week banned, in a bid to cut down the degree to which they are used by non-smokers.

The EU directive warned that e-cigarettes ‘mimic’ and ‘normalise’ the act of smoking, adding: ‘For this reason, it is appropriate to adopt a restrictive approach to advertising electronic cigarettes and refill containers.’

The new study used data from 53,000 people in the EU. They found that the country with the highest e-cigarette use was France, with one in five people saying they had tried them.

The nation with lowest number of people who had tried an e-cigarette was Portugal.

The research also showed the proportion of people across the EU who considered e-cigarettes dangerous had also nearly doubled, from 27 per cent to 51 per cent.

The authors wrote: ‘This analysis of the most up-to-date data from the whole of the EU shows that although perceptions that e-cigarettes are harmful are increasing, levels of those who ever use them are also increasing.’

Scientists and health policy experts are divided over e-cigarettes.

A recent report by the Royal College of Physicians concluded that e-cigarettes are likely to benefit the health of the nation.

The report’s authors suggested that e-cigarettes should be widely promoted as a substitute for smoking.

Dr Penny Woods, chief executive of the British Lung Foundation, said: ‘We know that many people are using e-cigarettes to help them quit the much more harmful practice of smoking, including people with lung conditions.

‘For them, quitting tobacco is often the single most important thing they can do to turn their health around.

‘We therefore support calls for more research into vaping, we need to be clear on whether e-cigarettes are a safe way of helping them quit.’