Burning questions on vaping risks

SEAN PARNELL

MAY 24, 2019
The Australian

Whatever the election outcome, tobacco excise will continue to raise revenue for the government and provide a financial disincentive to smoking. The major parties have vowed to continue working to reduce the smoking rate and Labor, in particular, has a broader preventive health strategy. Unexpectedly, there is also a bipartisan stand against the vaping lobby and its push to make nicotine more readily available for use

in e-cigarettes.

The US has relatively liberal regulations on

e-cigarettes, while New Zealand recently relaxed restrictions on nicotine use, prompting lobbyists to point to various potential health and economic benefits should Australia do the same.

But in a recent debate, federal Health Minister Greg Hunt declared the increasing number of young vapers in the US a “public health disaster” that belied industry claims that e-cigarettes could be used as a smoking cessation aid.

“The tobacco industry is backing this vaping push, it’s not something I support,” Hunt said. “It is far more a case of (e-cigarettes) being a ramp on, rather than a pathway off, smoking.”

Opposition health spokeswoman Catherine King agreed, saying the evidence supported the retention of Australia’s nicotine restrictions, not expanding the market for the tobacco industry.

Last year, the Australian Institute of Health and Welfare reported the main reason people aged 18 to 24 gave for using e-cigarettes was “out of curiosity” (70.7 per cent), whereas for people aged 50 to 59 it was “to help me quit smoking” (51 per cent).

A public health assessment of e-cigarette use is being conducted by the Australian National University’s National Centre for Epidemiology and Population Health at a cost to taxpayers of $825,000.

The assessment, launched by Hunt last year and set to continue under the next government, includes an update of the evidence on the health impacts of e-cigarettes, and what would happen if the laws and policies on nicotine changed.

It is paying special attention to indigenous communities, where smoking rates have not declined at the rate authorities expected, and whether there is any truth in the “hardened smoker” hypothesis.

Interestingly, given the furious lobbying efforts to date, the assessment also will provide the government with a framework “for the ongoing integration and application of emerging findings on e-cigarettes over time”.

The commonwealth policy on vaping may be firm and have bipartisan support, but it is likely to be contested — as is often the case in the tobacco control arena.

The slow pace of regulation of e-cigarettes may have left consumers at risk.

According to Flinders University’s Joshua Newman, a politics and public policy expert, governments have done little to regulate e-cigarettes or better understand their impact.

“For instance, we have no idea what the long-term effects are of persistent daily inhalation of propylene glycol, a major component of e-cigarette liquid,” Newman says.

“No one has been using them long enough. It’s therefore far too early to declare

e-cigarettes safe for daily use.”

Notwithstanding the debate over the possible use of e-cigarettes as a smoking cessation aid, Newman suggests consumers are already at risk in the absence of regulation.

“E-cigarettes that are labelled ‘nicotine-free’ can actually contain nicotine,” he says. “Devices are poorly made and leak toxic nicotine juice on users. Cheap batteries explode in people’s pockets. There are no child safety features.

“Customs and importation are not controlled. Sales are not policed or properly taxed.”

Research from the US suggests nicotine may be harmful to embryos, even without the toxins associated with burning tobacco.

Australian experts say the research, published in the journal Stem Cell Reports, should come as another warning to avoid smoking, and smokers, if you are planning a baby.

“Everyone knows that smoking when pregnant can lead to problems with the baby’s growth and long-term metabolic adverse effects in the children born to smoking mothers,” says University of Queensland associate professor

Gino Pecoraro, a practising obstetrician and gynaecologist.

“There is now evidence to suggest that nicotine — a chemical found in high concentration in cigarette smoke — can actually affect the RNA of developing human embryonic stem cells.”

Alexandra Harvey from the University of Melbourne says the findings should be significant for up to 12 per cent of women who smoke before they learn they are pregnant, particularly those who switch to nicotine replacement therapies in the belief they are safer.