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E-cigarettes are they ok to use?

It’s very possible you may have recently seen someone smoking inside only to realise on closer inspection that it’s not a real cigarette that’s causing the smoke. It’s most likely that what you’ve witnessed is someone using an e-cigarette.

So what are e-cigarettes and are they a better option to tobacco cigarettes and to help people to quit smoking?

Electronic cigarettes, also known as e-cigarettes deliver nicotine (although some are nicotine free) through a battery powered system. They are often made to resemble the look of cigarettes or cigars and produce a mist for inhalation to simulate the act of cigarette smoking.

They are being marketed as cheap and healthier alternatives to cigarettes as well as an option for smokers when smoking is not permitted since they do not produce tobacco smoke. However there is a lot of debate regarding their safety.

Where did they come from?

E-cigarettes initially emerged in China in 2003 and have since become widely available globally; particularly over the internet. Most e-cigarettes that are available in Australia are still being manufactured in China.

How do they work?

A typical e-cigarette consists of three components: a battery, an atomiser and a cartridge containing nicotine. Most replacement cartridges contain nicotine suspended in propylene glycol or glycerine and water. The level of nicotine in the cartridges may vary and some also contain flavourings. 

The Benefits

Supporters of e-cigarettes claim that they are a useful tool to help people to quit smoking (although the Therapeutic Goods Administration has not approved their use as smoking cessation agents). E-cigarettes are also seen by some people as a safer alternative to burnt tobacco as they are free of the tar and ingredients of traditional cigarettes. It is also claimed that e-cigarettes do not provide second hand smoke and can assist smokers to cope with their addiction in situations where they are required to be smoke-free such as on airplanes.

The Health Concerns

There are numerous health concerns regarding e-cigarettes, below outlines some of the main issues that have been raised:

  • They haven’t been thoroughly tested - There are concerns regarding the unknown long term safety of e-cigarettes. The World Health Organisation has advised against them, saying their potential health risk 'remains undetermined'. Due to these concerns e-cigarettes have not been approved by the Australian Therapeutic Goods Administration for use as aids in withdrawal from smoking (however, they are still available for purchase without this approval).
  • Poor regulation - Most e-cigarettes that are available in Australia are manufactured in China where their manufacture is not regulated and few manufacturers disclose the ingredients of their products. This means that e-cigarettes may deliver unreliable amounts of nicotine, or contain toxic chemicals, pesticides or carcinogens.
  • Inconsistent nicotine dose - Some overseas studies suggest that e-cigarettes containing nicotine may be dangerous as they can deliver unreliable doses of nicotine (above or below the stated quantity), or be leaking nicotine. Leaked nicotine is a poisoning hazard for the user as well as others around them, particularly children, as dangerous and lethal doses of nicotine can be absorbed through the skin.
  • Local legislation - The Queensland state government has included e-Cigarettes use within the same legislation that govern the use of normal cigarettes.
  • International bans - Late in 2013 news broke that Spain was planning to ban e-cigarettes from public places like hospitals and schools because of their possible health risks. Around the same time New York City also voted to extend its strict smoking ban to e-cigarettes, barring them from bars, restaurants, parks, beaches and other public places.

The potential impact on the community

The Therapeutic Goods Administration site states the following:

“The Australian Government is concerned about the use of electronic cigarettes in Australia. The impact of wide scale use of these devices on tobacco use is not known, and the outcome in the community could be harmful.”

Concerns have been expressed about the impact that e-cigarettes may have on the wider community, including:
• Some flavours may appeal to children.
• They may become a gateway to smoking or to nicotine addiction to new smokers, particularly among children and young people.
• They may undermine the comprehensive indoor smoking restrictions and smoke-free air policies.
• They may delay a smoker’s decision to quit.

Other concerns relate to the involvement of tobacco companies in the e-cigarette market and there is growing concern that “Big Tobacco” will have a renewed presence in a declining marketplace.

Are e-cigarettes better for your asthma than normal cigarettes?

As e-cigarettes are relatively new to the market, we don’t yet have enough evidence to know if they are a safer alternative that tobacco cigarettes. As a way of quitting smoking, there are certainly some benefits, but nicotine replacement therapy with the supervision of a medical professional is a more effective and proven option. 

The Asthma Foundation notes that any inhaled substance may provoke asthma, either making controlled asthma persistent or making persistent asthma life threatening and strongly recommends against the use of any product which involves inhalants. 

Are there other alternatives?

For some smokers wishing to quit (especially heavy smokers), Nicotine Replacement Therapy (NRT) can be a good option to consider in a quit smoking plan. Unlike e-cigarettes NRT products, have been rigorously assessed for efficacy and safety and approved by the Therapeutic Goods Administration for use as aids in withdrawal from smoking. If you plan on using a NRT it worth a trip to your GP first as you may be eligible for discounts on these products.

If you would like more information about different NRT products available in Australia visit the ‘I Can Quit’ website.

Getting help to quit smoking?

Quitting smoking is difficult, and most people make several attempts before they quit for good. It is usually easier with the right support and information, which can be available from your doctor, pharmacist, or QUIT on 131 848, or www.quitnow.info.au

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