By Rachael Morris

 

The Scottish Government have asked all NHS Health Boards to ensure their grounds are smoke free by April 2015. A survey by BBC Scotland revealed that all but one health board will completely ban the use of e-cigarettes. Only NHS Lothian will allow restricted use of the devices in designated areas away from hospital entrances.

A spokesperson for the Scottish Government said: “It is a matter for boards to decide how they implement and enforce their smoke-free policies, this includes whether they chose to incorporate a ban on e-cigarettes.”

E-cigarettes are battery operated vapour inhaler devices which contain three main ingredients – nicotine, flavouring and propylene glycol. They produce a light and tar-free vapour.

A spokesperson for NHS Greater Glasgow and Clyde said: “The NHS in Scotland only recommends the use of safe and effective products to support patients and ensure visitors remain smoke-free.

“Currently, e-cigarettes are not regulated and not licensed in the UK.  They are quite new on the market so there is still more to learn about their effects.”

Due to the fact that e-cigarettes are a relatively new phenomenon, not a lot of research has been carried out and so the short and long-term effects are still mostly unknown. Furthermore, since e-cigarettes are not yet regulated in the UK it would be reasonable to presume that the contents cannot be entirely trusted.

However, proponents argue that banning the use of e-cigarettes in public spaces is counter-productive. If both cigarettes and e-cigarettes are prohibited there is no incentive to switch and smokers will be discouraged from trying an increasingly popular alternative.

E-cigarettes can be a useful harm reduction tool as they allow smokers to get a nicotine fix without inhaling the deadly tar in cigarettes. The cartridges are available with varying nicotine strengths, thus allowing a smoker to gradually reduce their nicotine intake without noticeably reducing the frequency with which they smoke.

Allison Brisbane, Information Officer for ASH Scotland, said: “There is no evidence yet that they are a good method for quitting smoking. But they have to be better than cigarettes.”

Brisbane continued: “There is the possibility that some e-cigarettes could become available on prescription in the next few years.

“Then we would find ourselves in a weird situation where people are prevented from using prescribed equipment in hospital grounds.”

Whilst no e-cigarettes are currently available on the NHS, the Scottish Government said that if e-cigarettes should become available, it would be for NHS boards to decide whether this warranted an amendment to their smoke free policies.

One potential safety issue argued by opponents of e-cigarettes is that by mimicking the look and habit of smoking they provide negative role models. This could potentially be solved by drawing a distinction between e-cigarettes that resemble traditional cigarettes and some new vaping devices

Opponents also argue that the variety of fruit and candy flavourings available attract underage children to e-cigarettes, which can then become a gateway for regular cigarettes. However, it is hard to distinguish a valid difference between the sale of toffee apple e-cigarettes, crushed cola sidekick, and flavoured cigars, so long as the products are sold according to their age restrictions. It would be naïve to argue that the sweet flavours of these products are the root of the problem.

Another one of the biggest concerns about the e-cigarette industry is the heavy investment from big tobacco companies. People fear, based on years of evidence of bad behaviour, that the tobacco industries are getting involved in the e-cigarette market in order to undermine laws on cigarette advertising and smoking in public spaces. Globally, the tobacco industry is enormous and still growing in the developing world. Opponents ask why big tobacco companies would genuinely support e-cigarettes if they are likely to shrink that market.

In the end, only good scientific evidence will persuade the critics that e-cigarettes are not a danger and opponents argue that until this evidence is readily available we should opt to be safe rather than sorry. Brisbane said: “There’s not enough research yet. But you might see that begin to come out in the next couple of years.”}