Independent experts back stronger government stance on e-cigarette threat

Leading independent health groups have backed a whole-of-government statement issued today highlighting concerns about “the direct harms e‐cigarettes pose to human health”.

Cancer Council Australia, the Public Health Association of Australia, Lung Foundation Australia and Thoracic Society of Australia and New Zealand commended all nine federal, state and territory governments, and federal health minister Greg Hunt’s national leadership, for standing firm on evidence-based health policy and ignoring recent lobbying from commercial interests.

The latest communique, released by the intergovernmental Ministerial Drug and Alcohol Forum today, reflects evidence “in Australia and overseas implicating e-cigarettes in a range of harms to population health”.

It follows a communique last month from COAG Health Council expressing “deep concern at emerging evidence of serious health risks associated with e-cigarettes and the international evidence of e-cigarette uptake by non-smokers and, in particular, by young people” – at the same time as a group of retailers push for an erosion of safeguards to promote e-cigarettes.

Professor Sanchia Aranda, CEO, Cancer Council Australia said, “Electronic cigarette entrepreneurs in the retail sector are only concerned with selling products, not with public health and helping people quitting smoking. Outside of their interests in profits, their only arguments for selling e-cigarettes rest on health claims that are bogus.

“E-cigarette use has been linked with an outbreak of lung-related disease and deaths in the US that is still under the close scrutiny of the Centres for Disease Control (CDC). Several US states have also announced that they are tightening regulation around flavoured e-cigarettes as part of efforts to stem large increases in use of e-cigarettes by teenagers.

“There are increasing concerns worldwide about the health impacts of e-cigarette use, and countries including India, Thailand, Singapore, Brazil, Cambodia and Malaysia have introduced bans.

“Australia has taken a precautionary approach to e-cigarettes, with good reason. A range of independent organisations, including the National Health and Medical Research Council, Therapeutic Goods Administration and World Health Organization have concluded that there just isn’t enough evidence to make a call on e-cigarettes as safe, or an effective aid for people to quit smoking.

“Big Tobacco is notorious for using third parties to promote its interests and undermine public health, and e-cigarette companies are using similar tactics. As a signatory to the WHO Framework Convention on Tobacco Control, the Australian Government has a commitment to protect public health policies from commercial and other vested interests of the tobacco industry.

“We commend the Health Minister Greg Hunt for his ongoing support for evidence-based health policy, in the face of a new lobbying offensive from commercial interests promoting e-cigarettes,” Professor Aranda said.

Professor Aranda also rejected industry claims that the decline in Australian smoking rates has stalled. She said the decline had slowed, but from an all-time high point of success – just before e-cigarettes emerged as a tobacco industry diversion tactic from proactive, evidence-based tobacco control.

“No proper review in the world has concluded that e-cigarettes work as a quitting tool, but they have reported evidence of e-cigarettes posing a major risk to young people. When it comes to continuing to drive down smoking rates, we need to focus on what we know works. Australia is a tobacco control success story.

“Since 2001 initiatives like plain packaging, tobacco taxes, public campaigns and subsidy of proven smoking cessation medications have resulted in 1.6 million fewer Australians smoking than would have been the case had smoking prevalence continued at 2001 levels.

“To continue to drive down smoking rates, we need more funding for mass media campaigns and to find more ways to support smokers to quit – including more tailored behavioural support from services like Quitline and appropriate nicotine replacement products. We welcome the commitment from Minister Hunt to reinstate the National Tobacco Campaign and to work towards a less than 10% smoking rate by 2025.”

Professor Bruce Thompson from the Thoracic Society also stressed that there is a lack of robust evidence to support use of e-cigarettes for smoking cessation.

“The lung is a very fragile organ: it is rarely able to recover from injury. The aerosol produced by e-cigarettes can contain a range of ingredients, including solvents and flavouring agents. 

“E-cigarettes have been found to contain ingredients such as heavy metals, formaldehyde and particulate matter that can damage lungs, increase the risk of cardiovascular disease and even cause cancer.  We know e-cigarettes cause damage in the cells of the lung, they are not proven as effective cessation aids and we do not believe industry, with their aim of selling products, has a role to play in effective public health.”

Health experts said claims that e-cigarettes are 95% safer than traditional e-cigarettes weren’t backed up by valid studies.

Terry Slevin, CEO of the Public Health Association of Australia said, “The tobacco industry and e-cigarette proponents rely heavily on claims that use of e-cigarettes is 95% safer than traditional cigarettes. 

 “This claim has been discredited – and is based on an “guestimate” by 12 individuals, some with links to the tobacco industry, and is not based on scientific evidence. 

“E-cigarettes are relatively new and there is no long-term data on their safety. They also contain a range of unknown ingredients which make it hard to make general statements around their safety.”

Lung Foundation Australia Chairman and leading respiratory physician, Professor Christine Jenkins believes the growing evidence proving e-cigarette use as a precursor to smoking in young people should be enough reason alone to ensure these devices are not readily available in the market.

“Smoking rates in young Australians are among the lowest in the world. Evidence increasingly demonstrates youth transition from e-cigarettes and personal vaping devices to traditional cigarettes is highly likely, and the use of these products damages the lung with or without nicotine. Maintaining a strong stance on e-cigarettes is critical to prevent the next generation of lung cancer and Chronic Obstructive Pulmonary Disease patients,” Professor Jenkins said.