Why is the EU considering restricting e-cigarettes?

The EU is currently considering limiting the levels of nicotine in e-cigarettes

– which many ex-smokers and retailers say will not provide sufficient doses of nicotine to satisfy carvings.

This could have serious implications for smokers trying to quit – so why would Brussels issue a directive limiting nicotine levels in e-cigarettes to just 4mg, when the alternatives to using them – ie smoking tobacco and shisha pipes – are potentially much more deadly?

E-cigarettes entered the marketplace in 2003 courtesy of the China, which started manufacturing electronic cigarettes to help its population of heavy smokers quit.

Electronic cigarettes are largely unregulated in the UK – consumers have to be 18 to buy them, but they are not classed as a healthcare product and therefore have not been subjected to clinical tests to determine their safety.

What is known is that e-cigarettes supply comparable levels of nicotine to ”vapers” – the term coined to describe those who use them – while reducing the levels of harmful by-products of smoking tobacco, such as carbon monoxide, benzene, cancer-causing nitrosamines and diethylene glycol. Using electronic cigarettes also completely prevents disease which results from the tar in tobacco. Tar from tobacco accumulates in the lungs and can line all the organs of the body, and is the main cause of heart disease and lung disease among smokers.

The actual smoke from tobacco is also carcinogenic – which means it can cause changes to the DNA of the body’s cells to the extent that cancers develop as a result.

Cells in the body divide and multiply naturally, but when a chemical or other toxic substance causes a change in the DNA of a cell, the cell begins to divide more rapidly, replicating the change which has occurred in its DNA – the part of it which contains all the instructions to keep it healthy and working normally.

This is why some cancers can spread rapidly and why smokers are especially prone to cancers in the lungs, breast, mouth and oesophagus and reproductive organs.

Electronic cigarettes dispense nicotine in a vapour which is free from smoke – and electronic cigarettes are available in around five different nicotine strengths, so smokers (vapers) can choose their preferred level of nicotine and even swap between strengths according to their needs.

This can be very helpful when trying to cut down on tobacco and having to deal with nicotine cravings as a result.

Currently, electronic cigarettes are not recommended as a smoking cessation aid in the EU. In the UK, nicotine patches and gum are prescribed by the NHS in its smoking cessation programme.

But patches and gum do little to replace the need to handle a cigarette – which over time becomes an essential part of the smoking experience for the smoker.

Because e-cigarettes appear to offer a more complete solution to satisfying a nicotine craving and the need to hold a cigarette, it is hard to understand why the EU would wish to review its Tobacco Products Directive limiting levels of nicotine in e-cigarettes to the point they may be rendered useless as a tool to help smokers quit or cut down on their smoking.

Many ex-smokers who have used e-cigarettes to quit have spoken out against the proposal – which may force ex-smokers back into smoking tobacco if they cannot use e-cigarettes to help control their craving, with all the potential health risks and cost to the health service which that might entail.

A report in Warwickshire newspaper the Rugby Observer quotes two ex-smokers who fear the impact of any EU directive to limit nicotine levels in e-cigarettes will push them back into tobacco use.

Sam Fairgrieves and her husband had been heavy smokers for 20 years before turning to electronic cigarettes:
“Since the day we started using electronic cigarettes we haven’t touched a real cigarette and haven’t wanted to either. Having the ability to start on the high nicotine liquids and gently wean yourself onto lower doses is why, in our opinion, this is so successful. You can do it at your own pace, without any of the bad side effects from nicotine withdrawal, until eventually you have dropped right down to zero nicotine.
“If the EU get their own way, then they are going to force people back into smoking, plain and simple.”

In May 2012 the World Health Organization’s (WHO) World No Tobacco Day focused on how the tobacco industry “undermines” the fight against what the WHO terms “the tobacco epidemic”.

The WHO says on its website that tobacco is the only product which kills 50% of its users when it is used “exactly as intended” – and goes on to point out how the tobacco industry has “developed tactics” to undermine any of the progress made towards reducing tobacco use and need.

These tactics include the tobacco industry “using front groups to promote its interests, interfering with political and legislative processes; manipulating scientific evidence and the mass media; and seeking to convey a responsible and respectable image”, says the WHO.

In 2010 Cancer Research UK funded research by academics at the universities of Bath and Edinburgh for the EU Smokefree Partnership, which revealed that a major tobacco company had “played a key role in dampening the impact” of EU Public Health legislation, with major corporations “bringing about fundamental changes to the way in which new policies are assessed”.

The research was published in the journal Tobacco Control and the Public Library of Science (PLoS) of Medicine and suggests that the tobacco lobby in the EU is so powerful that the market share electronic cigarettes have gained among smokers has become a real concern. Lead researcher of the Cancer UK-funded study Dr Anna Gilmore said:
“Our research reveals how large corporations have secured fundamental changes to the EU policymaking system in order to prevent legislation that might damage their profits.”
Jean King, Cancer Research UK’s Director of Tobacco Control said:

“This research is yet more evidence of the tobacco industry’s tactics of trying to protect their profits at the expense of people’s lives. It shows why it’s so important to isolate them from the development of any health policy.

“The World Health Organization has said ‘there is a fundamental and irreconcilable conflict between the tobacco industry’s and public health policy interests’.

“If trends continue, tobacco will kill1,000 million people in the 21st century. Health not profits must remain the priority in health policies. It’s important that all governments ensure that the tobacco industry and its representatives do not influence policies aimed at protecting the health of their citizens, in order to reduce the devastating impact that tobacco has on so many lives.”

The EU’s redrafted Tobacco Products Directive proposes to regulate electronic cigarettes as medicinal products and limit nicotine levels as a result, rather than allowing smokers to select the nicotine level which is suitable to satisfy their cravings when trying to cut back on smoking.

In a letter to MEPs sitting on the EU Parliament ENVI Committee, public health scientist Professor Gerry Stimson (formerly of Imperial College London) has pointed out that EU proposals may actually end up “smothering the e-cigarette market with red tape” – meaning another generation of tobacco addicts will most likely face a painful death while tobacco companies continue to profit.
Around 6 million people currently die every year as a result of tobacco-related diseases.
Prof Stimson is a member of NICE (National Institute for Health and Care Excellence) in the UK and you can read his letter to MEPs about electronic cigarette regulation by the EU here.