• Clive Bates is a long standing advocate of harm reduction approaches in public health, David Sweanor is a Canadian lawyer who has worked on tobacco control policies since 1983, and Murray Laugesen, adjunct professor at University of Canterbury, is a researcher of e-cigarettes.
Close on its recent passage of the legislation for plain packaging, government policy makers now have the time to look at the scientific evidence suggesting nicotine e-cigarettes and their liquids could benefit New Zealand's half million smokers.
This evidence shows:
• Smokers who switch to e-cigarettes are likely to avoid at least 95 per cent of the major smoking-related risks for cancer, heart disease and respiratory illness, according to Public Health England. They will also experience significant short-term gains in health and, in high tobacco tax jurisdictions such as NZ, they are likely to be financially better off.
• It is unethical to deny a smoker access to products that are much safer than the dominant product on the market, cigarettes.
• The availability of e-cigarettes is not an alternative to conventional anti-smoking policy but complementary. By providing smokers with an easier way of responding to high taxes, the overall tobacco control policy will become both more responsive and more humane. This is particularly important where smoking is concentrated at high levels among Maori and Pacific Islanders.
• There is no credible evidence to suggest that e-cigarettes induce young people to smoke, or reduce the rate that adults quit smoking. The evidence shows what a neutral observer would expect: people use much safer products to reduce their health risks or to quit smoking.
• E-cigarettes pay their own way in switching from smoking. The individual bears the cost, at no cost to the public purse.
• A widespread switch to e-cigarettes would cut exposure to second-hand tobacco smoke as they pose no material risk to bystanders.
• The quality of products available from reputable manufacturers is now very high and they are on widespread sale in the Europe, North America and throughout Asia without any major problems.
• There is a growing international experience with the regulation of e-cigarettes as consumer products. By changing tack NZ can take a leadership role in this.
But government consultation with the public did not ask who should sell them. University of Otago researchers have asked for vape shops and pharmacies to do so. This we disagree with: if you want cheap toothpaste, do you go to the pharmacy or to a supermarket? Similarly the first-choice e-cigarette in NZ, the cig-alike, is most likely to be sold in a supermarket in future. But if the e-cigarette has a refillable tank or big battery you would probably go to a vape shop.
To spread the expertise we suggest the Ministry of Health may wish to employ an expert to train vape shop staff in this work. In contrast, pharmacies are not geared to provide the expensive range of hardware involved in servicing this new industry. As for tobacco retailers, their turnover is falling and two-thirds of their customers die early.
With respect to advertising, e-cigarette retailers (who are mostly anti-smoking) have a problem - they are selling a product which does not kill, yet they need advertising space to show the shape and size of the scores of products they sell. There needs to be a provision to separate those who sell smoking products (no advertising) and those selling vaping products (under a voluntary code).
As for what spaces should be vapefree, we would say "yes" to places like airlines, operating theatres and wards where people are being kept alive with difficulty: e-cigarettes should be banned, just as if people were drinking alcohol. And we would say "no" to places where the place is smokefree, as in bars, but where smoking an e-cigarette would be permissible if the manager permitted it. We also say a firm "no" to making the streets of Wellington smokefree. Denying e-cigarette users the ability to vape would be wrong.