30 November 2019 | New Scientist | 21Numerous deaths and
thousands of cases of lung
injury have been linked to
vaping. Reclassifying vaping
products as medical devices
might limit their appeal as
lifestyle products and put
them under greater regulatory
control. They could then also
be better targeted towards
people who already smoke.
So far, only two products in
the UK have got this approval.
Both were authorised as
nicotine replacement therapies
and could have been made
available on prescription in
the UK, but their owner, British
American Tobacco, eventually
changed tack, deciding to focus
on consumer products rather
than medical ones.
There were moral and ethical
concerns that the UK National
Health Service would be
subsidising products developed
by the tobacco industry, says
Ben Hawkins at the London
School of Hygiene and Tropical
Medicine. He worries that
tobacco companies may
rebrand as nicotine technology
firms, which might enable
them to get around an
international treaty that limits
industry representatives from
lobbying governments.
Sarah Jackson at University
College London has another
concern. Were e-cigarettes
to be classified as medical
devices, tobacco firms may be
the only ones able to afford to
put them through the expensive
licensing process. “If the only
provider of e-cigarettes was
the tobacco industry, that
would be a precarious position
to be in,” she says.
Medical e-cigs
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There are now fewer than
100 left in the wild.to the image of e-cigarettes. In the
US, Juul Labs has marketed them
as a trendy lifestyle product.
But in the UK, young people
are more likely to consider
e-cigarettes as an aid to quitting
smoking, says Bauld. That might
have something to do with the
EU imposing much stricter rules
on their advertising. Television,
radio and magazine ads are
banned, for instance.
There is an argument that
classifying vaping products as
medical devices could shift their
image in the US, too – although
this may bring other problems
(see “Medical e-cigs”, left).In the meantime, e-cigarettes
may be a useful tool for people
who are trying to stop smoking.
An influential study published
earlier this year concluded that
the use of e-cigarettes seems
to work better than other forms
of nicotine replacement therapy
when it comes to quitting. And,
in the UK at least, it appears
to be cheaper than these other
techniques, too, says Sarah
Jackson at University College
London, who conducted a
cost-comparison survey.
Epidemiologists think that
smoking rates are falling faster
in the UK than in Australia
at least in part thanks to the
popularity of e-cigarettes in the
UK. They are banned from being
made or sold in Australia.
So, for smokers, switching to
e-cigarettes as a way to give up
smoking seems like a sensible
choice. But anyone else might
want to consider the unknown
health risks of vaping. “There’s
a lot we don’t know,” says Tarran. ❚cigarettes, they truly are 95 per
cent safer, with the remaining
5 per cent of risk down to low
levels of toxic substances in
e-cigarette vapour, which may
have long-term effects for health.
In the US, however, the CDC is
warning that nicotine can harm
the developing adolescent brain.
And a US survey published last
year found that young people who
vape are twice as likely to become
smokers. This trend hasn’t been
found in the UK, however.
At the same time, there is
evidence that e-cigarette vapour
may be more harmful than it
appears – for adults as well as
young people. Robert Tarran at
the University of North Carolina
criticises the “95 per cent safer”
figure because it was based on
a comparison of the number
of chemicals in e-cigarette
vapour and tobacco smoke. “The
number of chemicals is irrelevant,”
he says. “No one knows what
concentration these chemicals
are reaching in the lungs.”
Tarran’s team has found markers
of lung disease in samples taken
from people who vape. He says
these markers are the same as
those found in the lungs of people
with emphysema, a condition that
causes shortness of breath and
shortens life expectancy. “If you
vape over a lifetime, you probably
have a high chance of getting it,”
says Tarran. “From everything
I’ve seen in the lung, it doesn’t
seem to be safer than smoking.”
E-cigarettes haven’t taken off
among young people in the UK
as they have in the US. A survey
published in June suggests that
84 per cent of young people in the
UK have never tried e-cigarettes.
Over half who have used them
have done so just to “give it a
try” – only 1 per cent said they
did so because it “looks cool”.
The difference may come down“ Every US state apart
from Alaska has
reported cases of lung
injury linked to vaping”TOP:^ TES
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