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E cigarettes: Health promotion and petition
- 1. E-CIGARETTES When the old turned to the new Quach Ha Linh – MPH Student
- 2. WHAT IS AN E-CIGARETTE?
- 3. WHAT IS AN E-CIGARETTE?
- 4. E-CIGARETTES – MYTH #1: CHEMICAL CONTENT
- 5. E-CIGARETTES – MYTH #1: CHEMICAL CONTENT?
- 6. E-CIGARETTES – MYTH #2: NICOTINE CONTENT? Combustible Cigarettes Electronic Cigarettes 1 cigarette = 1mg nicotine 20 mg nicotine in 1 pack 1 e-cigarette cartridge = approx. 20 mg of nicotine
- 7. E-CIGARETTES – MYTH #3: ADDICTION?
- 8. E-CIGARETTES – MYTH #4: SMOKING CESSATION?
- 9. E-CIGARETTES – MYTH #5: HEALTH AND SAFETY
- 10. E-CIGARETTES IN HONG KONG • The current use rate of e-cigarettes among young smokers aged 15-19 years (15.8%) was significantly higher than that of smokers aged 30 years or above. • Ever use of e-cigarettes among primary 2 to primary 4 students increased by 55% from 2016-2017 to 2017-2018. • Currently, e-cigarettes with nicotine are not banned in Hong Kong
- 11. Why e-cigarettes are so appealing? TRENDY REBELLIOUS
- 12. SEX AND FUN APPEAL GLAMOROUS BY CELEBRITIES
- 13. COMPACT AND FLAVOURFUL SOCIAL MEDIA MARKET
- 14. BUT THE TRUTH IS… •E-cigarettes aren’t good for our HEALTH, our CHILDREN and our air quality •E-cigarettes are not safe •E-cigarettes are unregulated •Smoking cessation and claim benefits over conventional e- cigarettes are UNPROVEN
- 15. WHAT CAN YOU DO? To protect yourself, your family and community… • Help us to convey these message about the danger of e-cigarettes to your community. Log into https://www.smokefree.hk for more information! • Join us to SUPPORT TO ENACT THE TOTAL BAN OF E-CIGARETTES AND OTHER NEW TOBACCO PRODUCTS IN HONG KONG!
- 17. don’t let the size fool you. SIGN to STOP ALL CIGARETTES ARE H ARM FU L 衞生署控煙酒辦公室 Tobacco and Alcohol Cont rol O ce Depart ment of Healt h
- 18. References1. National Academies of Sciences Engineering, and Medicine. Public health consequences of e-cigarettes Washington, DC: The National Academies Press; 2018. 2. Hedman L, Backman H, Stridsman C, et al. Association of electronic cigarette use with smoking habits, demographic factors, and respiratory symptoms 3. National Academies of Sciences Engineering, and Medicine. Public health consequences of e-cigarettes Washington, DC: The National Academies Press; 2018 4. Glantz SA, Bareham DW. E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications. Annual Review of Public Health. 2018;39(1):215-35. 5. Rigotti NA, Chang Y, Tindle HA, et al. Association of e-cigarette use with smoking cessation among smokers who plan to quit after a hospitalization: A prospective study. nnals of Internal Medicine. 2018;168(9):613-20. 6. http://smokefree.hk/UserFiles/resources/about_us/cosh_reports/COSHRN_C20.pdf. JAMA Network Open. 2018;1(3):e180789. 7. Primack BA, Soneji S, Stoolmiller M, Fine MJ, Sargent JD. Progression to traditional cigarette smoking after electronic cigarette use among US adolescents and young adults. JAMA pediatrics. 2015;169(11):1018-1023. 8. Conner M, Grogan S, Simms-Ellis R, Flett K, Sykes-Muskett B, Cowap L, et al. Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study. Tobacco Control. 2018;27(4):365-72 9. Vasiljevic M, Petrescu DC, Marteau TM. Impact of advertisements promoting candy-like flavoured e-cigarettes on appeal of tobacco smoking among children: an experimental study. Tob Control. 2016;Dec 1;25(e2):e107-12. 10. Statistics and market data on Consumer Goods & FMCG. https://www.statista.com/markets/415/consumer-goods-fmcg. 11. Electronic Cigarette Market by Product Type, Flavor and Distribution Channel – Global Opportunity Analysis and Industry Forecast, 2017–2023. https://www.researchandmarkets.com/research/pjkd84/global_electronic?w=5. 12. https://www.fda.gov/TobaccoProducts/PublicHealthEducation/ProtectingKidsfromTobacco/ucm405173.htm 13. http://www.monitoringthefuture.org//pressreleases/18drugpr.pdf 14. Glantz SA, Bareham DW. E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications. Annual Review of Public Health. 2018;39(1):215-35. 15. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm620184.htm 16. https://www.federalregister.gov/documents/2018/11/05/2018-24126/eliminating-youth-electronic-cigarette-and-other-tobacco-product-use-the-role-for-drug-therapies 17. Nicotine in tobacco is exempted from being regulated as “Part 1 poison” under Cap. 138: see regulation 8 of and Schedule 2 to the Pharmacy and Poisons Regulation (Cap.138A).
Editor's Notes
- E-cigarettes heat a solution using battery power (called the “e-liquid”) in a cartridge (also known as a “tank”) with a metallic coil to deliver an aerosol that users inhale through a mouthpiece in a way that simulates the act of cigarette smoking..
- They may look like conventional tobacco products such as cigarettes or cigars, or they can take the form of other ordinary items such as pens, USB memory sticks and other larger cylindrical or rectangular devices. The e-liquid is a chemical mixture typically composed of propylene glycol, glycerin, flavourings, and other additives.
- There is now conclusive evidence that, in addition to nicotine, most e-cigarette products contain and emit numerous potentially toxic substances which are harmful to health. Studies have demonstrated that formaldehyde, an irritant and cancer-causing chemical, could be formed during “vapourisation” of e-liquids. Besides, most e-cigarettes contain propylene glycol, a known irritant when inhaled. Inhalation of irritants may induce airway disorders such as asthma and other inflammatory lung diseases.
- E-cigarettes give off more than just “water vapor.” E-cigarettes produce a vapor (also referred to as aerosol) upon each inhalation that resembles and tastes like the smoke produced by cigars and cigarettes. While the health effects of the vapor are unknown, initial lab tests conducted by the FDA found detectable levels of toxic cancer-causing chemicals, including an ingredient used in anti-freeze. Instead of comparing the aerosol from e-cigarettes to secondhand smoke, we should be comparing it to clean air. We’ve worked hard for the right to breathe clean air and e-cigarette vapor doesn’t meet this standard.
- The exact dose of nicotine the e-cigarette user will receive depends entirely on how fast and how hard they drag from the device. The as advertised “safer and healthier” product is simply the most extreme way of pumping nicotine into the brain on demand. There is no research that proves it is safer. Years ago filtered cigarettes were supposed to be a “safer way” of smoking. Filtered cigarette users inhaled more deeply and frequently with each filtered cigarette they smoked. The same is to be expected with e-cigarette users – They may find them as fuel but never satisfy their nicotine addiction.
- Despite what manufacture tells you, Research on the efficacy of e-cigarettes for smoking cessation meanwhile is inconclusive to date. There is limited evidence that e-cigarettes may be effective aids to promote smoking cessation. Studies say published in 2018 revealed that the odds of quitting smoking was 27% lower in those who used e-cigarettes compared with those who did not use e-cigarettes, which implied that smokers who used e-cigarettes were significantly less likely to stop smoking cigarettes. In fact, people who smoke e-cigarettes are more likely to take up conventional cigarettes in the future.
- e-cigarettes contain harmful chemicals including formaldehyde, polycyclic aromatic hydrocarbons(“PAHs”) and poly-brominated diphenyl ethers (“PBDEs”), etc. Formaldehyde and PAHs are known carcinogens that are hazardous to health. PBDEs are associated with thyroid hormone disruption, reduction of fertility, affect fetal development. Long-term use of e-cigarettes is expected to increase the risk of various heart and lung diseases, cancers as well as some other diseases associated with smoking. In addition, e-cigarettes increase exposure of non-smokers and bystanders to a number of toxicants and nicotine in second- and third-hand smoke. There are also concerns about the quality control of e-cigarettes, such as uneven delivery of inhaled nicotine, leakage of chemicals, inconsistent labelling of content and potential fire danger. We observe that the e-cigarettes sold locally are mostly manufactured by small manufacturers with limited quality control to ensure quality and consumer safety. Some battery-activated heating element in e-cigarettes may be unsafe. There were cases of e-cigarette explosion during heating or charging reported in oversea countries.
- According to the Tobacco Control Policy-related Survey 2015 conducted by COSH, The current use rate of e-cigarettes among young smokers aged 15-19 years (15.8%) was significantly higher than that of smokers aged 30 years or above. According to the School-based Survey on Smoking conducted by the School of Public Health, the University of Hong Kong in 2016-2017, 2 340 Primary 4-6 students (1.4%) had ever used e-cigarettes (down from 2.6% in 2014/15). The number of ever and current e-cigarette users among Secondary 1-6 students was 29 380 (8.7%) and 2 770 (0.8%) respectively (a slight decrease from 9.0% and 1.3% respectively in 2014/15). Among those primary school students who had ever used both e-cigarettes and conventional cigarettes, nearly 70% tried e-cigarettes first. On the other hand, the Hong Kong Council on Smoking and Health’s surveys showed that ever use of e-cigarettes among primary 2 to primary 4 students increased by 55% from 2016-2017 to 2017-2018. In Hong Kong, any e-cigarettes with nicotine are categorized as pharmaceutical products and must be registered with the Pharmacy and Poisons Board of Hong Kong before sale or distribution. According to the Smoking (Public Health) Ordinance, no person shall smoke an e-cigarette in statutory no-smoking areas. So now we come back to that question, why do we care about e-cigarettes?
- Clearly, E-Cigarettes is very appealing, especially to youth. Glamorous marketing of these products includes tv and magazine ads, online promotions, social media, billboards and even shout outs from celebrities. These advertisements dress up e-cigarettes as a better smelling, cheaper and guilt free alternative to smoking. The tobacco industry is using the same marketing tricks for e-cigarettes that they once used for traditional tobacco products. Since e-cigarettes are not regulated, marketing strategies which are illegal for tobacco products are fair game when it comes to e-cigarettes. The volume of e-cigarette marketing is increasing daily. This amplified attention could lead to the re-normalization and social acceptability of smoking cigarettes. Most e-cigarettes do not provide details on their ingredients and only address the variety of flavours. They are marketed as non-addictive, aid for smoking cessation, accredited and environmentally friendly which mislead consumers on their safety and attract the youth to use. Youngsters are the main target of the marketing strategies adopted by Hong Kong and overseas e-cigarette suppliers and sellers. The price is set at an affordable level for them. The flavours, designs and packaging of e-cigarettes are diverse. The flavours include fruits, soft drink and tobacco. Most e-cigarettes are sold on consignment at retail outlets and shopping centres specializing in trendy items, or through online platforms such as social media. It is very difficult to monitor the safety claims of products sold and verify the buyers’ ages at online platforms.
- Clearly, E-Cigarettes is very appealing, especially to youth. Glamorous marketing of these products includes tv and magazine ads, online promotions, social media, billboards and even shout outs from celebrities. These advertisements dress up e-cigarettes as a better smelling, cheaper and guilt free alternative to smoking. The tobacco industry is using the same marketing tricks for e-cigarettes that they once used for traditional tobacco products. Since e-cigarettes are not regulated, marketing strategies which are illegal for tobacco products are fair game when it comes to e-cigarettes. The volume of e-cigarette marketing is increasing daily. This amplified attention could lead to the re-normalization and social acceptability of smoking cigarettes. Most e-cigarettes do not provide details on their ingredients and only address the variety of flavours. They are marketed as non-addictive, aid for smoking cessation, accredited and environmentally friendly which mislead consumers on their safety and attract the youth to use. Youngsters are the main target of the marketing strategies adopted by Hong Kong and overseas e-cigarette suppliers and sellers. The price is set at an affordable level for them. The flavours, designs and packaging of e-cigarettes are diverse. The flavours include fruits, soft drink and tobacco. Most e-cigarettes are sold on consignment at retail outlets and shopping centres specializing in trendy items, or through online platforms such as social media. It is very difficult to monitor the safety claims of products sold and verify the buyers’ ages at online platforms.
- Clearly, E-Cigarettes is very appealing, especially to youth. Glamorous marketing of these products includes tv and magazine ads, online promotions, social media, billboards and even shout outs from celebrities. These advertisements dress up e-cigarettes as a better smelling, cheaper and guilt free alternative to smoking. The tobacco industry is using the same marketing tricks for e-cigarettes that they once used for traditional tobacco products. Since e-cigarettes are not regulated, marketing strategies which are illegal for tobacco products are fair game when it comes to e-cigarettes. The volume of e-cigarette marketing is increasing daily. This amplified attention could lead to the re-normalization and social acceptability of smoking cigarettes. Most e-cigarettes do not provide details on their ingredients and only address the variety of flavours. They are marketed as non-addictive, aid for smoking cessation, accredited and environmentally friendly which mislead consumers on their safety and attract the youth to use. Youngsters are the main target of the marketing strategies adopted by Hong Kong and overseas e-cigarette suppliers and sellers. The price is set at an affordable level for them. The flavours, designs and packaging of e-cigarettes are diverse. The flavours include fruits, soft drink and tobacco. Most e-cigarettes are sold on consignment at retail outlets and shopping centres specializing in trendy items, or through online platforms such as social media. It is very difficult to monitor the safety claims of products sold and verify the buyers’ ages at online platforms.
- However, the truth about e-cigarettes is that…
- So who we are and what we do? Protecting the public health has topped the priority list of Hong Kong Council on Smoking and Health since its establishment. COSH has been sparing no efforts on raising public awareness on tobacco hazards and encouraging smokers to quit smoking through a series of education and publicity programmes for all walks of life. We also proactively advocate the Government for strengthening the tobacco control policies and collaborate with different sectors of the community to strive for a smoke-free Hong Kong.