Extreme caution needed on electronic cigarettes

Electronic cigarettes containing nicotine cannot be lawfully sold in Australia. These devices have never been legal here because of the restrictions that apply under poison control regulations.

Now that electronic cigarettes are becoming more prevalent around the world, there is growing interest in their sale in Australia. Like most issues that involve public policy, science and commercial interests, the facts become confused in the debate.

Here are some factual reasons why Cancer Council urges caution on electronic cigarettes and would like to see a tightening of the loopholes around their availability.

Australian kids and cigarettes

The changed culture around the acceptability of cigarette use in Australian kids is one of our nation's great public health success stories. Thirty years ago, one in five Australian kids aged 12 to 15 would light up in a typical week. Now it's around one in 25 and dropping.

The behaviour of Australian teenagers reflects that of adults. Kids smoked in large numbers because it was aspirational and precocious. Tobacco advertising also sought to glamorise cigarette use in a way that appealed to young people. One look at the online marketing of electronic cigarettes and you can see the same old tactics for luring and addicting young people, repackaged for the digital age. But if electronic cigarettes do not become commonplace, history says their appeal to young Australians will be limited.

Electronic cigarettes and quitting

Electronic cigarettes are promoted as a less-harmful alternative to tobacco smoking and in some cases as a way for smokers to quit. But there is a lack of evidence that electronic cigarettes help smokers to quit. There are also concerns that electronic cigarettes could keep smokers addicted to tobacco by providing a nicotine hit in smoke-free places.

Therapeutically approved nicotine replacement products are already available as an aid to quitting - and these are not promoted in a way that glamorises their use and poses a risk to impressionable young people.

Moreover, while electronic cigarettes are almost certainly less harmful than smoking, they are not harmless. As well as the risk that they may re-normalise cigarette use in young people, there are concerns that electronic cigarette vapours and other unknown contents could cause harms in users and in nonusers exposed to second-hand emissions.

The ethics of promoting electronic cigarettes

There is a myth that electronic cigarettes are a threat to the tobacco industry, so they must be a good thing. The fact is, major tobacco companies are investing heavily in the development and promotion of electronic cigarettes. That alone should indicate that there are parallel and overlapping markets for combustible and electronic cigarettes.

It is also a serious concern that non-nicotine electronic cigarettes are available in Australia, can be lawfully sold to children, and are subject to no controls. This is despite the risks they pose in re-normalising cigarette use in young people - to whom they are clearly targeted, with fruit and energy drink flavours, as well as tobacco flavours.

So when weighing up the risks and potential benefits of electronic cigarettes, we must exercise extreme caution.

Evidence of the harms of combustible cigarettes was not available when they were aggressively marketed from the early 20th century. By the middle of this century, around one billion people will have died prematurely because they smoked - most of them having been addicted to nicotine when they were young.

The lesson is simple: once a harmful, addictive product is in wide circulation it is very difficult to reign in the damage, especially when it is targeted at young people.

We have too much at stake to risk a return to the bad old days when the majority of Australians regularly sucked on a cigarette and kids thought it was cool to emulate them.