English health authorities have been accused of ignoring the potential harms of vaping in the face of mounting evidence by a leading expert.
The endorsement of e-cigarettes by Public Health England (PFE) is “out of step” with other parts of the world, according to Professor Martin McKee of the London School of Hygiene and Tropical Medicine.
In the US, several states have launched campaigns to warn teenagers about the risks of nicotine addiction, and some areas – like San Francisco – have banned them outright.
“The nicotine in e-cigarettes is not a harmless drug and then there all these other things such as flavourings that are inhaled,” he told the Press Association.
“We haven’t had e-cigarettes for long enough to know the true effects”.
PHE has championed vaping as a quitting aid for smokers, claiming that it is 95 per cent safer than smoking.
However there have been several studies, though few in humans, which show that high concentrations of the e-cigarette vapour, or particular ingredients, can damage the lungs.
“First of all, you’ve got to show that they’re safe,” Mr McKee said, arguing that “safer than cigarettes” was not a sufficient justification.
He also warned there was no evidence “at the population level” that they were useful as a quitting aid.
The marketing of nicotine-infused liquids in fruit flavours more commonly found in sweets and sugary drinks is another concern, with experts saying they are being “pushed very hard to children”.
This raises the chance of them becoming addicted to nicotine, and then exposed to an array of poorly studied chemicals – particularly if given the impression that vaping is safe.
A report published by PHE in February said that regular use of e-cigarettes among young people remains low.
But its figures showed that the number of UK children and teenagers trying vaping has doubled in recent years.
Some 15.9 per cent of children aged 11 to 18 reported having tried vaping, according to 2018 data, a rise from 8.1 per cent in 2014.
E-cigarettes have become a new frontier for tobacco giants, with many promoting their own version of e-cigarettes or “smokeless” heat-not-burn tobacco products.
Many have also drawn up voluntary codes of conduct for the marketing of the devices, but Mr McKee said this was a PR trick trying to make them look like part of the solution after years “as international pariahs”.
Dr Aaron Scott, from the University of Birmingham has shown in his own work that e-cigarette vapour is not harmless.
“We don’t know what the long-term data is but we have shown that it’s cytotoxic and it’s pro-inflammatory, just like cigarette smoke is over the short-term.”
He said longer term data is needed before claims about e-cigarette safety could be made, but these studies are not funded “because PHE want to push the message that they [e-cigarettes] are not harmful”.
“I think we should be more cautious,” he said of e-cigarette regulation. “You can go into a pound store anywhere in the country and buy e-cigarette liquid for £1.”
Professor John Newton, director of health improvement at PHE, said their guidance is based on the best current evidence.
“There is widespread academic and clinical consensus that while not without risk, vaping is far less harmful than smoking,” Mr Newton said.
He added that e-cigarette regulation in the UK is the “some of the strictest in the world” with advertising bans and maximum nicotine contents.
Additional reporting by PA