Re: Protecting children from harms of vaping

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Re: Protecting children from harms of vaping

Dear Editor

We read with interest the article on “Protecting children from the harms of vaping” It struck a tone which we fear will further mislead the public.

The proportion of young people who currently vape has increased (1) however this is not due to vaping being promoted as a cessation tool for adults. Claims that youth vaping risks becoming a potential ‘public health catastrophe’ leading to a ‘generation hooked on nicotine’ are not substantiated by the evidence in the UK.

Most children and young people do not vape, 98.3% who have never smoked are also not currently vaping according to a recent survey from ASH UK (2), meaning that current use is predominantly amongst ex-smokers and most overall use remains experimental. Access via shops being one of the key issues.

We agree that vaping is not risk free, however vaping is much less harmful than smoking and vapes remain an important tool for helping adult smokers to stop. The counterfactual smoking kills one in two users if used as intended and costs the economy, the NHS and social care billions each year. Harm reduction in this context is part of the solution in lifting people out of poverty and reducing health inequalities.

It is important to harness the population benefit of e-cigarettes to support adults away from tobacco addiction whilst avoiding unintended consequences of children starting to vape. We support the strengthening of nicotine vape regulations under the Tobacco and Related Product Regulations (2016) (3) to prohibit child-friendly packaging and labelling of vaping products and to prevent heavy promotion of vaping on social media and at point of sale.

Furthermore, flavours have been found to be extremely important in adults switching to vaping and sustaining use away from tobacco, banning these could potentially dissuade adults from trying nicotine vapes or lead to a return to tobacco.

With regards to knowing what is in vapes, the latest review from OHID (4) suggests there is significantly lower exposure to harmful substances from vaping compared with smoking, as shown by biomarkers associated with the risk of cancer, respiratory and cardiovascular conditions There are a number of ingredients which are prohibited in nicotine vapes including vitamins, stimulants such as caffeine or taurine, colourings and chemicals which are carcinogenic, mutagenic and reprotoxic in their unburnt form.

E-cigarettes have been on the market in the UK for 15 years and have been the most popular quitting aid since 2013. During that time vaping has not been associated with widespread health problems in the UK (5).

UK regulations prohibit the use of any ingredient in nicotine vapes that poses a risk to human health, including vitamin E acetate which causes serious respiratory disease when vaped (known as ‘EVALI’), This occurred predominately in the US where people altered the content of their vapes.

Most young people who try vaping do not get addicted to nicotine. Those who vape are much less likely to be dependent than those who smoke disputing the claim that lifelong addiction to nicotine is inevitable.

The current UK policy aims to balance the benefit of a harm reduction to both protect children and support adult smokers to quit. Regulation needs to be balanced and continued monitoring of trends and surveillance of youth use is needed, as is more funding for enforcement nationally. Restrictions on advertising also need to be strengthened in the UK.

Read full article here.

Sarah Hepworth – BMJ – 2022-12-16.

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