Minister says more evidence needed on e-cigarettes

13 March 2015
Image of Professor Chris Bullen
Professor Chris Bullen

The need for more examination and investigation into the role of e-cigarettes was called for by the Associate Minister of Health at a symposium at the University of Auckland this week.

Different perspectives on the science, use and regulation of e-cigarettes were shared at New Zealand’s first day-long symposium on the alternative device, held at the University of Auckland this week.

Participants included smoking cessation researchers, government policy makers, healthcare groups, tobacco control lobby groups, individuals and industry representatives.

The Symposium was organised by the University of Auckland’s Centre for Addiction Research and the Tobacco Control Turanga, led by Professor Chris Bullen (who is also director of the National Institute for Health Innovation).

The morning session was attended by the Associate Minister of Health (with responsibility for tobacco control) the Hon Peseta Sam Lotu-Iiga who said that there was not yet enough evidence to allow the unregulated use of e-cigarettes.

He said the Government valued the role of nicotine therapies in smoking cessation, but the role of e-cigarettes as a form of nicotine replacement therapy required careful examination and investigation.

“That’s why today is important – being the first national symposium of its kind on e-cigarettes bringing together the latest expertise and data, and the viewpoints of experts and key stakeholders from here and around the world,” he said.

“At present there is not enough evidence to recommend e-cigarettes as an aid to quit smoking and the Ministry of Health continues to assess new evidence about e-cigarettes as it arises.”

“Any manufacturer of e-cigarettes can currently register their product as a medicine through MedSafe for the purpose of helping people to stop smoking.  To date, no company has chosen to do so,” said the Hon Peseta Sam.

“I’m concerned about young people’s experimentation and use of cigarettes and e-cigarettes and what we really need to figure out and understand is the products’ effects on young people, especially the risk to them becoming addicted to nicotine, or possible switching to tobacco products.

“We need both evidence and caution,” he said.  “It would be helpful if the tobacco control sector here could come together on how to respond to these products so there is some form of consensus on the policy and regulatory options on how to best proceed.”

He said this would assist not only Cabinet, but also the wider public in formulating informed views on these new products.

“I’m aware the current regulatory framework will need improvement to better protect consumers and public health, and discussions will have to continue beyond what happens here today.”

Visiting keynote speaker, Professor Wayne Hall from the University of Queensland, said a ban on nicotine in e-cigarettes could do more harm than good, both here in New Zealand and in Australia.

“It’s quite clear from our surveys that lots of smokers are ignoring the law and importing nicotine refills or buying it illegally. It’s more open in New Zealand – I’ve seen a vapour shop with big signs up on Queen Street and e-cigarettes for sale.”

In Australia, e-cigarette refills are illegal to sell over the counter but can be legally bought online from overseas suppliers for personal use.

He said the law created a situation where people were resorting to the black market to buy products that contained a less harmful form of nicotine than normal tobacco cigarettes.

"You can buy cigarettes, but you're not allowed to buy something that's probably a lot safer, at least in the short term," he said.  “There is a middle ground here. We could allow these products to be sold and regulate their sale, minimising their promotion and sale to young people under the age of 18.

“The government needs to acknowledge the widespread use of e-cigarettes by removing the ban and regulating the nicotine products to ensure their safety. Some form of regulation is fine, but just having a ban is not realistic.

“The consequence of framing the debate as anything goes, or a ban - is that you give the market to the big companies, most of which are owned by the tobacco companies. That’s an unintended consequence of what they are doing.”

Professor Chris Bullen advocated for a balanced scientific approach to considering a way forward for e-cigarettes in New Zealand and the goal of SmokeFree NZ by 2025.

“Currently we have a regulatory context where nicotine is regulated as a medicine except where it is in tobacco and we need to think about the appropriateness of that,” he said. “We won’t make that goal if we continue with our ‘business as usual’ tobacco control strategies. We do need to think outside the box and of innovation, and the question is, are e-cigarettes part of trying to reach that target.”

Professor Bullen outlined the Cochrane Review findings on e-cigarettes published in December last year, that found that while e-cigarettes containing nicotine were more effective than e-cigarettes without nicotine in helping smokers kick the habit, the results needed to be confirmed by more studies.

 The results had shown the beneficial effects of e-cigarettes, but were limited by the small number of trials and limited sample of people who were analysed in the studies, he said. About nine percent of smokers who used e-cigarettes were able to stop smoking at up to one year. This compared with around four percent of smokers who used the nicotine-free electronic cigarettes.

The Symposium heard other presentations including current trends in e-cigarette use in New Zealand, the Māori and legal perspectives, a vaper’s story, and from healthcare professionals, Ministry of Health policy makers, and challenges for research and regulation of diverse e-cigarette products and of user behaviours.


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