The Irish Vape Vendors Association (IVVA) welcomes the release of a new study, funded by Cancer Research UK, which recognises the role reputable vape shops and their employees play in helping smokers switch to vaping.

The study, led by Dr Emma Ward, of the University of East Anglia and published in the International Journal of Environmental Research and Public Health, found that vape shop assistants were “really keen to understand customers’ smoking preferences and are able to give tailored advice about the most appropriate products.” It also suggested that health professionals could benefit from understanding the role that vape shops play in reducing smoking.

The researchers undertook interviews with smokers who had switched to vaping to attempt to quit smoking and worked with six shops in both London and East Anglia to observe interactions between staff and customers.

Dr Ward said: “Previous evidence suggests that 90 per cent of attempts to quit smoking eventually end in relapse. Smokers are addicted to nicotine, but there are also lots of complex psychosocial behaviours associated with smoking. Nicotine replacement therapy doesn’t always address the behavioural and social aspects of smoking, but switching to e-cigarettes can be a really effective way to stop.

The researchers said that an unsatisfying vaping set-up, device malfunction, or a lack of access to vape supplies can trigger a smoking relapse. But that support from vape shops can help sustain smoking abstinence. They found that shop assistants trouble shoot with customers if they had relapsed and try and find a solution, such as fixing their device or upping their nicotine strength.

The study recommends that future research in the UK should evaluate joint working between Stop Smoking Services and vape shops to help smokers achieve and maintain smoking cessation.

Joanne O’Connell of Vapourpal Ltd and Director of the Irish Vape Vendors Association (IVVA), said:

“We very much welcome this latest research. Reputable vape shops know how important it is to spend time with smokers to get them on their vaping journey. A good vape shop will stock a range of compliant liquids and devices, and ensure smokers have best experience to help them switch, along with advising them on suitable liquids, flavours and nicotine strengths.

The way that reputable vape shops help and advise smokers has already been outlined in last year’s HIQA report. We’re now calling on Ministers Simon Harris and Catherine Byrne to have some dialogue with the independent vape industry so we can move forward with better information for smokers and the public about these products. If we had the right regulations in place, more Irish smokers will be attracted to making the switch.”

A Qualitative Exploration of the Role of Vape Shop Environments in Supporting Smoking Abstinence : http://www.mdpi.com/1660-4601/15/2/297/htm

eurekalert.org/pub_releases/2018-02/uoea-vsc020718.php

A new evidence review on e-cigarettes and vaping, published today by Public Health England and undertaken by leading independent tobacco experts, provides an update on PHE’s 2015 review. The report covers e-cigarette use among young people and adults, public attitudes, the impact on quitting smoking, an update on risks to health and the role of nicotine. It also reviews heated tobacco products.

The lead author of the report is Ann McNeill, Professor of Tobacco Addiction in the National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience at King’s College London. The key findings of the report are that:

• Vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits;
• E-cigarettes could be contributing to at least 20,000 successful new quits per year in the UK and possibly many more;
• E-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country;
• Many thousands of smokers there incorrectly believe that vaping is as harmful as smoking; around 40% of UK smokers have not even tried an e-cigarette;
• There is much public misunderstanding about nicotine. Less than 10% of adults understand that most of the harms to health from smoking are not caused by nicotine;
• The use of e-cigarettes in the UK has plateaued over the last few years at just under 3 million;
• The evidence does not support the concern that e-cigarettes are a route into smoking among young people. Youth smoking rates in the UK continue to decline. Regular use is rare and is almost entirely confined to those who have smoked.

Reacting to the report, Declan Connolly, Director of the Irish Vape Vendors Association said:

”Vaping is now the most popular tool among Irish smokers who make a quit attempt despite being bombarded with misleading news reports on vaping. Our neighbors in the UK are strides ahead of us in terms of countering misinformation and acknowledging the vital contribution that vaping and the independent vape industry has made towards reducing smoking.”

”If our government are serious about reducing smoking then the Department of Health should be doing everything in their power to foster conditions which sees more smokers informed about vaping and the benefits of smokers making the switch. Unfortunately we see no commitment from the government to invest in research and there are still public bodies and health charities which have not updated their positions in a number of years. This has to change and we call on Ministers Catherine Byrne and Simon Harris to meet with the independent vape industry and begin a dialogue. We have a tool to help reduce smoking at no cost to the state, we should be encouraging it.”

McNeill A, Brose LS, Calder R, Bauld L & Robson D (2018). [Evidence review of e-cigarettes and heated tobacco products. A report commissioned by Public Health England. London: Public Health England.

https://www.gov.uk/government/news/phe-publishes-independent-expert-e-cigarettes-evidence-review

The IVVA have consistently called for vape products not to be subjected to tobacco-like excises taxes. We therefore welcome the Government’s decision not to apply an excise tax on liquids in today’s Budget 2018 announcement. This will act as a further incentive to smokers who wish to switch to a safer alternative.

The Royal College of Physicians, London and Public Health England have found that the risks of vaping are likely to be less than 5% of the risks of smoking. Researchers at the University of St Andrews in Scotland estimate that the cancer risks are 1% that of tobacco cigarettes.

However, with a recent study from the US highlighting how many early deaths from smoking could be avoided if smokers switched to vaping, it is clear that the Government need to do more to inform smokers about e-cigarettes.

In the UK, where 3 million smokers are already using the products, Public Health England have included vaping in their month long public information campaigns during October.

This has been a response to the potential benefits of the products, and increase in the number of people there who wrongly believe that vaping is harmful or as harmful as smoking and are being put off by misinformation.

Gillian Golden of the IVVA said:

“In Ireland we see the same thing, smokers have been put off switching due to sensational media reports and they wrongly believe that there’s no point in giving vaping a try.

Independent Irish businesses are prohibited from advertising vaping products to adult smokers, and new regulations on the products themselves make them less attractive.

The Government clearly agrees that by not taxing them, they’re of benefit to public health so we would now welcome action by the Government and the Department of Health which encourages smokers to make the switch.”

Ends.

Royal College of Physicians, London Report: https://www.rcplondon.ac.uk/news/promote-e-cigarettes-widely-substitute-smoking-says-new-rcp-report

Public Health England Report: https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review

Up to 6.6 million early deaths in America might be averted over 10 years if smokers switched to e-cigarettes, and the nicotine delivery devices should be adopted as part of an “endgame for cigarette smoking” – Reuters : https://www.reuters.com/article/us-health-ecigarettes/switching-to-e-cigarettes-could-save-6-6-million-american-smokers-researchers-idUSKCN1C72UJ

This week, IVVA along with the Independent British Vape Trade Association (IBVTA) wrote a letter to Ryanair regarding the changes to their cabin baggage policy.

The wording of the policy change would have meant that vapers travelling on a Ryanair flight would not be permitted to bring their device with them in their cabin baggage.

We are pleased to see that the wording of the policy has now changed, with “electronic cigarettes” removed from the section listing prohibited items. The policy now reads :

8.3.3  You may carry electronic cigarettes on board but are strictly forbidden to use electronic cigarettes or any other type of cigarette on board the aircraft.

Below is the letter that was sent.

Dear Mr Jacobs,

The Independent British Vape Trade Association (IBVTA) and the Irish Vape Venders Association (IVVA) are the leading trade associations for the independent vape industry in the UK and Ireland respectively. All our members are free from any control or ownership by the tobacco or pharmaceutical industries.

We note that the Terms and Conditions of your cabin baggage policy were changed on the 10th of August last, and we are seeking clarification on the section ‘’Passengers are prohibited from carrying the following items into either airport security restricted areas or Cabin Baggage or Checked Baggage’’; Section 8.9.1 includes the term ‘’electronic cigarettes’’.

The wording suggests that Ryanair’s policy should take precedence over and above what an airport authority might deem acceptable within their own policy. In the case of Dublin and Cork airports for example, DAA have informed us that their policy on vape devices being carried through airports has not changed. While passengers and the public are not permitted to vape inside terminal buildings, they are permitted to carry their devices and liquids used in the devices through the airport.

In Irish law, for example, section 6.1 (29) of the Airport bye-laws of 2014 (S.I 618 of 2014) already makes provisions about the safety of items brought through the airport. A vaping device itself is benign. When switched off a vaping device poses no risk to either passengers or staff. Airport security already inform customers during security checks that liquids in cabin baggage should be placed in clear plastic bags with their other liquids, and that spare batteries should be in protective cases. This practice is endorsed by both of our associations in our battery safety advice to members and consumers.

Can Ryanair clarify if this policy change is intended to over-ride existing policies by each of the airport authorities of the 33 countries they operate in, and how you intend to enforce it?

2.9 million people in the UK alone have taken steps to reduce or eliminate their smoking by using a vaping device. In total there are at least 15 million vapers across the EU. Ryanair seems to understand and accept the benefits of safer consumption of nicotine, through the prior sales of your own branded products.

In our view, this policy change by Ryanair sends the wrong message to smokers and vapers. In allowing passengers to bring cigarettes on board, but not vape products, it implies that Ryanair considers vaping to be more harmful than or as harmful as smoking. In reality, we know that vaping is at least 95 per cent less harmful than smoking.

Smokers who have switched to vaping rely on their vape devices to prevent them returning to smoking, by banning vape products from Ryanair flights you therefore leave vapers with little choice other than to fly with another airline or fly with Ryanair and potentially run the risk of returning to smoking. If it is the former then Ryanair will potentially lose millions of customers as a direct result of this change in policy.

Given that there are no health grounds to ban vape products on planes, and given that there are already well-established measures and practices in place to prevent accidents, we see no reason for Ryanair to ban vape products in this way, and look forward to the company reversing this change at the earliest opportunity.

Yours sincerely

Richard Hyslop
Chief Executive
Independent British Vape Trade Association (IBVTA)

Gillian Golden
Administrator
Irish Vape Venders Association (IVVA)

Today it was announced by the University of Limerick that their new smoke-free policy defines “smoking” as including “the use of electronic cigarettes (…) whether or not the deliver a nicotine dose or not.”

The IVVA is committed to seeing the delivery of policies on vape products and their use, which are evidence based. One of the biggest obstacles to this delivery is the continued conflation of smoking and vaping; treating both product categories the same, despite vaping being far safer than tobacco smoking and a proven pathway to smokers becoming smoke-free.

If a smoker chooses to vape instead, they should be supported in doing so. Banning an adult smoker or vaper from using their vaping device send the message that the two categories of product pose the same risks. This is not the case.

We have written the following letter to the President and Students Union of UL regarding their new policy :

Dear Professor Fitzgerald, and Students Union leadership,

The decision to include the use of e-cigarettes in the University of Limerick’s ban on smoking is not grounded in evidence and runs counter to the public health goals of reducing the harms of smoking.

Vaping is not comparable to smoking. E-cigarettes do not contain tobacco, nor do they produce smoke. There is no legal requirement to include vaping in bans on smoking, and neither is there a scientific basis. It is the byproducts of combustion such as tar and carbon monoxide that make smoking so deadly, not the use of reduced-risk nicotine products.

The Royal College of Physicians, London, and Public Health England both conducted comprehensive evidence reviews of the safety of vaping products and concluded that they are at least 95% safer than smoking.

A 2015 study by the School of Public Health at Drexel University in Philadelphia looking at the effects of second hand vaping found that exposure to bystanders poses no apparent concern.

Public Health England, in their 2016 guidance to owners and managers of public spaces on policies on vaping made clear that “international peer-reviewed evidence indicates that the risk to the health of bystanders from secondhand e-cigarette vapour is extremely low and insufficient to justify prohibiting e-cigarettes. This evidence should inform risk assessments.”

Smokers who switch to vaping are reducing their risk of exposure to toxins by 97%, according to a University College London study which was funded by Cancer Research UK. They are reducing their levels of exposure to carcinogens by 99%, according to the findings of a study by the University of St Andrews, Scotland.

The adult students and staff of the University of Limerick who have made the choice to use an e-cigarette as a means to displace their smoking are now banned from doing so, even if they are not even using nicotine in their device.

Vaping does not “re-normalise” smoking. Fears that young people might see people vaping and then go on to become long term smokers are unfounded. There is no evidence in Ireland, the UK or the US that this is the case. Research which has been conducted in this area includes that by Cancer Research UK, ASH, and the Smoking Toolkit Study, which is conducted by Prof Robert West of University College London.

Vaping is a proven pathway out of smoking, with over 6.1 million people in the EU now ex-smokers because they switched. To restrict smokers and vapers from using their vaping device “gives the message to the the public about them being as dangerous as smoking”, according to Prof Linda Bauld of the University of Stirling.

A number of English Hospital Trusts including Colchester, and Nottingham University Hospitals are lifting their bans on vaping. According to Dr Stephanie Fowlie, medical director at the Nottingham trust, they “can’t ignore the potential benefits of electronic cigarettes”.

The UK Centre for Tobacco and Alcohol Studies say vaping may help explain the record fall in UK smoking rates, with Prof John Britton says that the UK’s policy of supporting and encouraging smokers to switch “could generate huge benefits in public health

For the sake of the choices that the adult smokers at UL have available to them, we hope that this policy is reversed in a timely manner, and that adult smokers there who are trying to stop their tobacco habit by vaping are supported rather than punished.

We would welcome the opportunity to meet with your office or management at the University of Limerick to discuss this matter further.

There is also a dialogue event taking place in Dublin in October, the details of which are available at this link : https://gfn.net.co/dialogues/autumn2017/dublin

We would like to extend an open invitation to your office and officers of the Students Union to come along and take part in constructive discussion on the topic.

The IVVA have written the following letter to the Editor of The Irish Times regarding a story published today on vaping among young people:

The IVVA recognise that experiences of vaping are unique to each person, but feels that a recent piece published by The Irish Mirror and lifestyle website DublinLive goes so far as to be promoting smoking over a product that is proven to be safer, and is proven to be effective in smokers cutting down or eliminating their smoking habit.

In the piece ”Vogue Williams: ‘I took up smoking again after I got addicted to vaping”’, there is a call for vaping products to be taxed in the upcoming budget, because Ms Williams, an Irish TV presenter who was a smoker who then switched to vaping, returned to smoking again because she found herself using her vapouriser more than she expected.

There is no robust case for applying an excise tax on a product that helps smokers get away from smoking. Keeping vaping cheaper than cigarettes acts as a further incentive for smokers to switch to these safer alternatives, beyond the more obvious incentive of the health benefits of not smoking. The liquids used by vapers in their devices is already subject to 23% VAT, a higher rate than some other nicotine products which have a low impact on smoking reduction.

Moreover, experts in tobacco control and public health do not agree with taxing vape products. Dr Patrick Doorley of ASH has previously indicated this in an interview on Today FM and tobacco control law expert and Ottowa University Associate Professor David Sweanor strongly advised against this in an Irish Times column last year. Earlier this year, in response to the European Commission’s proposed introduction of excise taxes on vape products, Cancer Research UK wrote that :

“Taxing e-cigarettes creates a barrier to smokers accessing them, especially poorer smokers, for whom smoking prevalence is much higher than the rest of the EU population. This would make it harder for them to access e-cigarettes to quit smoking. The goal of tobacco taxation is to reduce the prevalence of smoking and the wide range of serious diseases caused by combustible tobacco – since evidence indicates e-cigarettes are contributing to a reduction in smoking prevalence, they should not in our view be subject to additional taxation.”

A vaper finding themselves vaping more often than expected is a clear sign to those qualified that they are not getting enough nicotine to satisfy their cravings. When a smoker first switches to vaping from smoking, the level of nicotine they use is very important. Higher levels of nicotine make the transition to vaping easier. Too low a nicotine level, and they may use their device more to compensate. Therefore, the IVVA consider comments to smokers and vapers in the Irish Mirror article to be unqualified.

A visit to a reputable vape shop would have been able to help find the higher strength liquid needed and prevented a relapse to smoking. This advice is also contained in the UK’s NCSCT guidance to smoking cessation advisors, published in 2016 –

“How often should I use my e-cigarette to help me to stop smoking?

As often as you need to help manage nicotine withdrawal and urges to smoke. You will soon discover the best way for you of using your e-cigarette, and find that you’re using it when you feel a need to top-up. It’s not like a cigarette, which you would smoke from start to finish, with an e-cigarette you can sip on it once or twice, and then put it away. If you find you’ve got it in your mouth all the time, you might need to use a stronger e-liquid.”

There is currently somewhat of a crisis with public misperceptions that vaping isn’t any better for you than smoking. As more evidence emerges that vaping is a safer alternative to smoking, public perceptions of their relative safety are going in the wrong direction. According to Eurobarometer figures, between 2014 and 2017 the numbers of Irish people who wrongly believe that vaping is harmful or as harmful as smoking rose by 11%.

The IVVA’s view is that this is exacerbated by misleading messages that smokers and vapers receive through the media.

In England, the situation has warranted the public health and anti-smoking groups there tackling it through public information campaigns. The new Tobacco Control Plan for England also takes steps towards this.

The IVVA want to work with the government here to deliver a similar message to Irish smokers and we have written to the Department of Health and the Minister of State for Health Promotion on numerous occasions in relation to this.

In addition, current rules that place a cap on strengths of nicotine in liquids illustrate how counter-productive and unfit for purpose the regulations are. England has committed to reviewing these regulations to enure that vaping reach its full potential, and we urge the Department of Health here to do the same.

It is never safer to continue to smoke than to switch to vaping, so we wish Ms Williams well in her journey to becoming smoke free and we hope she finds what works for her. We also hope that smokers are not put off trying vaping, or that current vapers return to smoking, on the back of articles like these.

https://www.irishtimes.com/opinion/now-is-not-the-time-to-tax-e-cigarette-liquid-1.2768585

https://www.ivva.ie/wp-content/uploads/2017/02/IVVA-final-submission-to-consultation-on-tobacco-excise.pdf

http://www.ncsct.co.uk/publication_electronic_cigarette_briefing.php

https://www.rcplondon.ac.uk/news/promote-e-cigarettes-widely-substitute-smoking-says-new-rcp-report

https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review

[vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1519″ img_size=”medium” align=”vc_align_center”][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]New Cancer Strategy should have acknowledged harm reduction opportunities, say independent vape industry.

The 2017-2026 Cancer Strategy published today misses out an opportunity to harness the enormous public health benefits of vaping, say the Irish Vape Vendors Association. The measures included in the strategy document to strengthen cancer prevention in the context of smoking rely on the existing Tobacco Free Ireland plan, delivered by Healthy Ireland.

But neither of these two frameworks acknowledge that if smokers can’t or don’t want to quit smoking, switching to a safer way of consuming nicotine like vaping is a valid and desirable outcome.

We’re seeing the biggest reduction in smoking in recent times by our neighbours in England, where harm reduction has been part of the national conversation for 3 years now. Across the EU, 6.1 million smokers have chosen to switch to safer consumer products and become smoke free, British cancer researchers are trialing how vaping can improve the lives of smokers who have received a cancer diagnosis, and there’s a concerted effort to inform smokers about vaping.

In Westminster last week, British Labour MPs Sir Kevin Barron and Gloria De Piero described support for vaping a social justice issue, given that vaping is cheaper than smoking and those on lower incomes are more likely to smoke. In the Cancer Strategy published today, lung cancer shows strong patterns of increasing incidence with increasing deprivation.

Ireland should be at the stage where the Department of Health no longer ignores the benefits of smokers switching to vaping, so to find zero mention of harm reduction policies in today’s publication was somewhat disappointing.[/vc_column_text][/vc_column][/vc_row]

[vc_row 0=””][vc_column 0=””][vc_empty_space][vc_single_image image=”1508″ img_size=”medium” align=”vc_align_center”][vc_empty_space 0=””][vc_column_text 0=””]The public have been misled on the risks of vaping in public.

The results of a new survey on attitudes to tobacco and e-cigarettes published by the European Commission on Tuesday in advance of World No Tobacco Day, found that 63% of EU citizens favoured banning their use in public places where smoking is prohibited.

This is a shocking statistic and is the culmination of both sustained misinformation of risks by opponents to the technology, and some of the provisions in new EU regulations on the products.

According to the Royal College of Physicians, London and Public Health England, vaping is at least 95% less harmful than smoking lit tobacco. But new EU rules on things like nicotine levels, and nicotine warning labels which need to be applied to device packaging, even those which do not contain nicotine, were based on exaggerations of the risks involved. This contributes to a negative perception by the public who then believe smoking and vaping carry similar risks.

“There is no scientific basis for banning vaping in public, but when people mistakenly think that the vapour produced by these products might harm them, they are more likely to call for bans,” said Gillian Golden of the IVVA, “the irony is that public use bans would have an overall negative effect on public health, if they make smokers less likely to switch to the safer alternative.”

The IVVA supports the measure by Leo Varadkar during his time as Minister for Health of leaving it up to individual premises and business owners whether they allow vaping or not, but there is now an urgent need for better communication on vaping by government and those working in public health. New EU regulations which came into force last year prohibit manufacturers and suppliers from making comparisons between their products and tobacco cigarettes and prohibit most forms of advertising of the products to existing smokers.

‘’Reducing the harms of smoking is such an important public health issue for Ireland at a time when our health system is under strain. It’s time for the smokers to get truthful and accurate information about the differences between smoking and vaping,’’ Golden said, ‘’banning people from using these products in public places is not the answer.’’

The new regulations on the devices and liquid refills include the requirement that ingredient lists, toxicological risk information and emissions test results are notified to the HSE 6 months in advance of new products going onto the market.

An analysis of a British YouGov survey, published by members of the UK Centre for Tobacco and Alcohol Studies, ASH and Cancer Research UK in February of this year, found that those who never smoked or vaped, or were less likely to be informed of the relative risks of vaping compared to smoking, were more likely to support bans in public spaces.

Last year, Public Health England published a policy guidance document for employers and organisations to support how they can devise and implement policies on vaping so that vaping can be better supported. In announcing that document, they said: ‘’In contrast to the known harm from exposure to secondhand smoke, there is currently no evidence of harm from secondhand e-cigarette vapour and the risks are likely to be extremely low. There is also no evidence so far that e-cigarettes are acting as a route into smoking for young people.’’

ENDS.

EU Commission press release: http://ec.europa.eu/newsroom/sante/newsletter-specific-archive-issue.cfm?newsletter_service_id=327&newsletter_issue_id=3764&page=1&fullDate=Tue%2030%20May%202017&lang=default

New EU regulations: http://www.hse.ie/eng/about/Who/TobaccoControl/Tobaccoproductdirective/

Royal College of Physicians report: https://www.rcplondon.ac.uk/news/promote-e-cigarettes-widely-substitute-smoking-says-new-rcp-report

Public Health England report: https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review

European Journal of Public Health, ”Restrictions on the use of e-cigarettes in public and private places—current practice and support among adults in Great Britain”: https://academic.oup.com/eurpub/article/3061230

Public Health England: ”Vaping in public places: advice for employers and organisations” : https://www.gov.uk/government/news/vaping-in-public-places-advice-for-employers-and-organisations

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[vc_row 0=””][vc_column][vc_empty_space][vc_single_image image=”1497″ img_size=”medium” align=”vc_align_center”][vc_column_text 0=””]Regulating vape products – which contain no tobacco – with a tobacco-like regulatory framework is ill fitting considering the differences in the risks to users, and the fact that vaping is used as a safer alternative to smoking.

Despite our view that they are not fully fit for purpose, the new regulations on vape products within the EU Tobacco Products Directive, transposed into Irish law (S.I. 271 of 2016), now place restrictions on vape products and the manufacturers, distributors and retailers operating in the market, and our members have to abide by them.

More smokers switching to vaping represents an opportunity to add to the reduction in the rates of smoking, in a landscape where Ireland has set a target of a prevalence of less that 5% by the year 2025.

However, consumers and the wider public should be confident that the products they see for sale are being sold in Ireland legally, have gone through the necessary testing and reporting requirements, and that regulations are being adequately enforced.

Today we have written to the Environmental Health Service Tobacco Control Operational Unit, the Department of Health, and Members of the Oireachtas to outline our concerns.

IVVA members have spent considerable amounts of time and money to become compliant within the deadlines. Regrettably, this has had to come about despite delays with clarification and engagement from the HSE and Department of Health.

On some technical aspects, we are still waiting for what is required within the statutory instrument; the publication of the list of products that can be legally sold here, and the list of retailers that have registered for cross border sales, by the HSE.

This lack of clarity on a common understanding of the regulations, alongside the opinion held by some that there will be little or no enforcement, has caused many suppliers and businesses to unknowingly or willfully ignore their legal responsibilities.

These are complex regulations, in which there are contradictory elements, some of which will be practically unenforceable. Others, such as the advertising and promotion restrictions, will be very difficult to enforce as the regulations are open to numerous interpretations. However, some elements are clearer.

It is now an offence to sell liquid refills containing nicotine in bottles larger than 10ml, a tank that is over 2ml in volume, and all products covered by the regulations must have been notified to the HSE 6 months in advance and carry the correct labels.

During the allowed sell through period, our members have been clearing old stock at cost or loss levels, sourcing new suppliers, investing in testing and notification of products, redesigning packaging & labeling, and as per the deadline of May 20th, removed any remaining non compliant products from the market, and they have absorbed the considerable costs involved.

We were advised in writing by the HSE National Tobacco Control Office on the 2nd of May that:

‘‘Staff members are trained in all aspects of the legislation relevant to an inspection. Standardised protocols and inspection records are also developed and followed by the Environmental Health Service”

However, we have reasonable grounds to believe that all not all staff have received this training. Since there are shops all over the country still selling non compliant products since the deadline of May 20th passed, this is concerning.

Since the publication of this EU Directive in 2014, it has been clear that flaws and contradictions in the regulations mean independent Irish businesses will lose customers to the huge black and grey market that will inevitably emerge. IVVA members will have to work against that backdrop, and the presence of the tobacco industry now operating in this market.

However, we hope that the government and the HSE recognise the value of the independent vape industry and work with the IVVA to get regulation and enforcement right – for the sake of consumer safety as well as for the longevity of independent businesses.

We are confident that despite these burdensome and ill-fitting regulations, Ireland can at least in part realise the public health gains that a reduction in smoking would bring if compliant independent companies can operate and compete in a fair marketplace.

As a responsible trade association for the independent companies in this industry, we trust the Environmental Health Service Tobacco Control Operational Unit is engaging with local enforcement offices and this lack of compliance is addressed.[/vc_column_text][/vc_column][/vc_row]

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With the full impact of the TPD regulations coming into force this month, a new phase begins for the independent vape industry in Ireland.

The coming months will be challenging as the enforcement of the regulations takes shape, and other Irish & EU regulations that affect how vape companies do business are decided on.

However, with the growing acceptance of vaping as a safer alternative to smoking in Ireland and beyond, there are opportunities for Irish vape companies to expand and thrive in this regulated market.

The IVVA, acting as the credible voice for the independent vape industry, will continue to work on our robust strategy that ensures the needs and views of the small businesses in this industry are heard by policy makers and wider stakeholders.

Topics that will be covered in this seminar include:

– Industry engagement and the implementation of TPD
– Opportunities arising from compliance
– Fighting the proposed excise tax at national and EU levels
– Getting your business GDPR ready
– Insuring your business with industry-specific solutions
– Overview of current scientific evidence
– Industry standards – CEN TC 437 and beyond

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The cost is €55 per delegate including refreshments.

Completed booking forms should be returned via e-mail to admin@ivva.ie before close of business on Monday 8th of May.

Payment can be accepted via PayPal (click below)

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_gmaps link=”#E-8_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” size=”300″][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Parking is available close to the hotel at two Q-Park locations:

Q-Park Dawson Street at Schoolhouse Lane
Q-Park Setanta at Setanta Place

You can pre-book your parking online by following either of the links above.

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Irish Vape Vendors Association welcomes the motion on vaping passed by doctors at the Irish Medical Organisation (IMO) annual conference in Galway today.

The general motion, proposed by Dr Garrett McGovern and seconded by Dr Cathal O’Suilliobhain, both GPs, was carried with amendment, and reads:

The IMO recognises e-cigarettes as a potentially effective tool for smoking cessation and a far safer alternative to tobacco. The burden of tobacco harm in Ireland continues to be high and any intervention that reduces this toll should be welcomed.

Dr Garrett McGovern at General Motions Session 1 #IMOAGM17 pic.twitter.com/NOGFtsH0yv

— Irish Medical Org (@IMO_IRL) April 21, 2017

“Recognition by the IMO that switching to vaping is safer than continuing to smoke sends a positive message to Irish smokers who may have been previously misled by media scare stories”, said IVVA administrator Gillian Golden.

”What we need now is for the government and the HSE to consider whether the policies on these products are evidence based and if the current EU regulations on them will be enforced efficiently. Currently, independent vape companies are waiting over 5 months for the HSE to make public the list of products which can legally be sold after May 19th.

As well as manufacturers being left not knowing if their products can be sold after the May deadline, individual shop owners are being offered products by distributors outside of Ireland which may not be compliant with the new regulations.

However, due to the HSE’s delay, they have no way of checking if these products have gone through the necessary safety tests and notification process to be sold legally on the Irish market.

Consumer safety is of utmost importance to the IVVA, so we hope the situation can be rectified swiftly”.

ENDS.

IMO motions in full : http://www.imo.ie/news-media/agm/agm-2017/motions/general-motions-2017/index.xml[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1456″ img_size=”medium” align=”vc_align_center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Last year, the EU Commission began seeking opinion from member states on its regular revision of the directive on the structure and rates of excise duty applied to manufactured tobacco (Directive 2011/64/EU).

One of the proposals advanced by the Directorate-General for Taxation and Customs Union (DG TAXUD), is to bring vape products under the directive, which would apply an excise tax regime on the products.

The IVVA opposes this on a number of grounds, and we recently made a submission to the public consultation which ended on the 16th of February.

The full submission can be found here, and covers the reasons and evidence that this excise tax would be bad for public health, bad for the consumer, and bad for the independent vaping industry.

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[vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1188″ img_size=”medium” align=”vc_align_center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Irish Vape Vendors Association comment on new study which shows that vaping is a safer alternative to smoking.

Researchers from University College London, in a study funded by Cancer Research UK, followed smokers who switched entirely to e-cigarettes and measured levels of 26 potentially harmful chemicals in the body, by looking at samples of their urine and saliva. They compared the results with smokers who used NRT such as patches, gums or lozenges found that the both groups had reduced their intake of toxins to similar levels.

This new research adds to the extensive arsenal of evidence which shows that for smokers, vaping is a safer alternative, and comes a day after a different study fund that across the EU, smokers in the UK are switching to vaping faster than any other country.

A recent HIQA draft Health Technology Assessment on smoking cessation interventions found that if the rate of Irish smokers switching to vaping was similar to that of the UK, it would represent a cost saving to the state.

The Irish Vape Vendors Association highlighted in their submission to the HIQA public consultation on the assessment, that policies on vaping would need to change before the same level of uptake was seen here.

The Irish implementation of EU regulations on e-cigarettes mean that Irish smokers would have to wait 6 months longer to access the same products as smokers in the UK or France.

‘’The EU regulation will slow innovation in this fast paced marketplace anyway, but knowing how much of a positive these products are for smokers it makes little sense to hold them hostage’’, said IVVA administrator Gillian Golden.

‘’To see the full public health gains that vaping represents, we need a suite of policies that supports both the smokers switching, and the independent businesses who serve the market’’.

http://scienceblog.cancerresearchuk.org/2017/02/06/new-study-comes-the-closest-yet-to-proving-that-e-cigarettes-arent-as-dangerous-as-smoking/

http://www.cityam.com/258441/british-smokers-switching-e-cigarettes-faster-than-anyone

https://www.ivva.ie/latest-news/hiqa-draft-report-highlights-issues-policies-vaping/

https://www.ivva.ie/wp-content/uploads/2017/02/IVVA-HIQA-HTA-Submission-Upload.pdf

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[vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1182″ img_size=”medium” align=”vc_align_center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The consultation period for public submissions to the Health Information and Quality Authority (HIQA) draft Health Technology Assessment (HTA) on smoking cessation interventions closed today.

In drafting our submission, the IVVA highlighted a number of instances where the conclusions drawn in the draft assessment  – that more smokers switching to vaping would represent a cost saving for the state – are impeded by the current policies on vaping and vaping products in Ireland.

These policies will likely impede vaping reaching its full potential as safer alternative to smoking in Ireland.

Specifically, the regulations which transpose the EU Tobacco Products Directive, the bans on their use in some public places, and only regarding vaping in the context of a cessation attempt rather than also as a harm reduction tool.

The responses to the consultation will be collated by HIQA, who will issue a final report to be delivered to the Department of Health and which will ”underpin a planned national clinical guideline on smoking cessation interventions and will inform policy decisions about potential improvements to the provision of smoking cessation services in the public health service.”

The IVVA’s response in full can be found here.

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[vc_row][vc_column][vc_empty_space][vc_single_image image=”1422″ img_size=”medium” align=”vc_align_center”][vc_empty_space][vc_column_text]The IVVA welcomes the Health Technology Assessment on smoking cessation interventions published by HIQA today.

One of the headline take-aways from the report is that HIQA clearly state that providing inaccurate information on comparative risks is unethical as it fails to allow people to make informed choices. Hopefully, this means we will see a reduction in the level of misinformation about vaping prevalent not only in the medical arena, but also in media and political discourse.

Although the terms of reference of the assessment only looked at vaping products in a clinical smoking cessation context, it is none the less welcomed that HIQA acknowledge the wider public health potential of tobacco harm reduction through smokers switching to vaping.

However, it is now increasingly accepted that random control trials are not the best way to measure effectiveness of e-cigarettes for quitting, dues to the amount of variables in devices and the number of different combinations of device, nicotine strength and flavour.

As yet, Ireland is lacking the kind of after market population level studies that will give us a true picture of their role in reducing smoking.

An analysis of Eurobarometer data recently published in the journal ”Addiction” found that across the EU, vaping has been responsible for 6.1 million smokers eliminating their tobacco use.

Most notably, however is the recognition in the assessment that if the numbers of smokers switching to vaping increases, it will represent a considerable cost saving to the state and the numbers of people making quit attempts will increase.

Current regulations introduced under the EU Tobacco Products Directive, however mean that businesses who manufacture and supply vaping products cannot advertise them or their benefits, which will have a negative effect on their uptake among smokers.

The IVVA is also currently in consultation with the Department of Health and HSE’s Office of Tobacco and Alcohol Control on a provision of the directive that could see Irish consumers having to wait 6 months before new products reach the market here, when in both the UK and France these waiting times have been considerably reduced.

The HIQA Health Technology Assessment is a lengthy and detailed report, so the IVVA will be giving it careful consideration over the consultation period, which ends on February 3rd.[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1192″ img_size=”medium” align=”vc_align_center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The Irish Vape Vendors Association is deeply disappointment with ASH Ireland’s media announcement today that smokers should not turn to vaping.

Less than 3 hours into the new year, smokers were told that a product that has already seen thousands of Irish smokers switching away from smoking lit tobacco shouldn’t even be considered, in a piece in the Irish Independent which cites ASH Ireland’s Dr Pat Doorley.

Smokers switch to vaping for many different reasons, including as a means to cut down or eliminate their smoking completely, and the IVVA is of the opinion that unless the relative risks are communicated accurately and honestly to Irish smokers, policies will continue to wrongly treat vaping the same as smoking.

”It is deeply disappointing that any Irish anti-smoking group would not want smokers to switch to safer nicotine products, especially at this time of year when people are thinking of changing old habits”, said IVVA Administrator, Gillian Golden, ”it sends out the incorrect message to smokers here, when English stop smoking services and public health organisations are encouraging their use, all on the back of extensive evidence that vaping is far less harmful than smoking.”

The IVVA welcomes the relative risk message communicated by the Royal College of Physicians – ”Although it is not possible to precisely quantify the long term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure.”

An analysis of the results of the 2014 Eurobarometer survey, published in the journal ‘Addiction’, found that across the EU, 6.1 million people are no longer smoking, having fully switched to vaping, and the Healthy Ireland Survey published in 2016 found that of the 10% of smokers who stopped, 32% of them had used e-cigarettes.

”Evidence and pragmatism should be paramount in formulating policies to reduce the harms from smoking. Smokers should be encouraged to give vaping a try, they shouldn’t be put off by ideological positions that are not in step with current evidence”, said Golden.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The image at the top of this post is part of an infographic published by Public Health England to accompany their landmark review on vaping products.[/vc_column_text][/vc_column][/vc_row]

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The ESRI (Economic and Social Research Institute) have today published the latest findings of the ”Growing up in Ireland Survey”. The survey is a government-backed initiative in conjunction with the Department of Children and Youth affairs, and Trinity College, Dublin, and which looks at a range of aspects of the lives of just over 6,000 17/18 year olds who have been participating in the study since 2007, when they were 9 years old.

We noted some figures on smoking and vaping in the part of the report that looks at risky health behaviours and sexual activity, and below is the IVVA’s brief statement on it.

The IVVA note from the ESRI ‘Growing up in Ireland’ survey published today that on the topic of the numbers of those surveyed, ”ever use” of vaping products seems to be the measurement, but ”prevalence” is the term used in the report findings.

‘Ever-use’ can best be described as a measurement of experimentation, however it doesn’t tell us how these products are used, how often, why, or even what types of products being used – eg – if that experimentation is with products containing nicotine, or with products containing zero nicotine.

And while we do understand that funding may be an issue for these types of studies in Ireland, we do feel that the public money spent on research needs to reflect a good return on investment.

Even though our members do not sell to those aged under 18, until such time as the retailers licensing regulation comes into being, enforcing this for retailers across the sector, young people will still most likely experiment with these products.

What would be useful, is for data to be gathered before that sales ban comes into force and, say, a year afterwards, to monitor any possible effects that the ban has had, such as:

– have experimentation rates gone up or down, or remained static?
– has the ban had any effect on smoking rates?
– has there been any change in the types of products being experimented with?
– can it be ascertained where young people are accessing the products from, pre and post ban?

The IVVA would also query the ESRI’s inclusion of the following statement:

”Substantial controversy surrounds the use of e-cigarettes (also known as “vaping”) whose impact on health is as yet unknown.”
 

The IVVA would agree with UK Centre for Tobacco and Alcohol Studies’ (UKCTAS) critique of the recent WHO report on vaping products, in which they state that:

”To address this problem of misperception of risk, the Royal College of Physicians proposes the following carefully worded statement that reflects a degree of uncertainty, but aims to align risk perceptions more closely to the current understanding of science:

“Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure”.

We believe this remains the best most realistic formulation at present, and that it errs on the side of caution.”

The ESRI survey reports:

”A  majority  (83%)  of  those  who  had  smoked  an e-cigarette  had  also  smoked  other  cigarettes.  This means that 17% of 17/18-year-olds who had smoked e-cigarettes had not previously smoked tobacco- based cigarettes (not shown here)”

Firstly, it is extremely important that terminology used in research reflects the real world, and it isn’t possible to ‘smoke’ an e-cigarette. The terminology used in the ESRI report unfortunately conflates vaping and smoking and ignores the fact that the two activities do not present anything like the same levels of risk.

Secondly, it is somewhat disappointing to already see comments on social media which claim that the ESRI survey shows vaping is acting as a ”gateway” from vaping to smoking in Irish youth, when neither of the two statements above could possibly demonstrate this.

The members of IVVA are supportive of a ban on sales to those under 18. However, we feel that real world effects of this policy should be carefully monitored, and this requires good data from before, as well as after the policy is implemented.

Resources:

ESRI Growing Up In Ireland findings (page 7/8)
http://www.esri.ie/pubs/SUSTAT59.pdf

UKCTAS comments on WHO report – (pages 14/15)
http://ukctas.net/pdfs/UKCTAS-response-to-WHO-ENDS-report-26.10.2016.pdf

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[vc_row][vc_column][vc_empty_space][vc_single_image image=”1367″ img_size=”medium” align=”vc_align_center”][vc_empty_space][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The Irish Vape Vendors Association is looking forward to welcoming independent retailers and e-retailers to their 2nd annual Industry Seminar, to be held at the Clarion Hotel, Liffey Valley, Dublin in September 16th.

Speaking about the seminar, IVVA administrator Gillian Golden said:

”The next year will be a challenging one for small businesses in this sector as the EU TPD comes into enforcement, and new regulations covering both products and businesses come into being. The IVVA is fully committed to providing help and support to vendors, as well as a robust strategy for engagement with policy makers and wider stakeholders to ensure the growth of the vaping sector in Ireland.”

The day promises attendees industry insights, guest speakers, compliance guidance and discussion and networking that should prove invaluable for vape shops and online vendors alike.

Booking forms can be downloaded in PDF form here and returned via e-mail to admin@ivva.ie to book your place.

Directions and more information about the Clarion Hotel, Liffey Valley, can be found here.

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Proposals by the Department of Finance to tax electronic cigarettes in a similar way to tobacco products, poses a risk to public health in Ireland. Government data reveals an e-cigarettes tax could cost almost 250,000 quality adjusted years of life.

A 23% VAT is already levied on e-cigarettes, but there are ongoing discussions in the Department of Finance and at EU level of a new excise category that would force up the price of these alternatives to tobacco.

Released recently, the Tax Strategy Group report highlights the Public Health England review which found them to be at least 95% safer than smoking, and also references an advisory from the Revenue Commissioners that ”increases in excise may not lead to increased yields, as consumers are further incentivized to exit the tobacco products market in Ireland.”

A report produced the IVVA using Irish Government data suggests a worst case scenario of Irish citizens losing almost 250,000 (quality adjusted) years of life. This is based on modest estimates of the numbers of people who will return to tobacco cigarettes in response to a new tax – and also of the numbers who will continue smoking rather than begin ‘vaping’.

Click here to read the full report

According to the Dept of Health, half of tobacco cigarette users die of a smoking-related disease, resulting in 19 smoking-related deaths a day in Ireland. Each admission to hospital with a tobacco related disease costs our health system an average of €7,700.

Proposals for a new e-cigarette tax risk reversing progress made as some vapers return to smoking, either because the cost benefits have disappeared or because their supplier closes, no longer able to operate in the sector. There is also a risk that a new tax would be viewed by Ireland’s vapers as evidence for the false view that the harm from tobacco and e-cigarettes is the same – so it makes no difference whether they smoke or vape.

An estimated 70,000 vapers in Ireland no longer smoke.  The academic evidence is that each person who quits smoking gains an average of between 0.99 and 2.58 years of life, quality adjusted (ie QALYs).

Quality Adjusted Life Years – QALYs – are years of life, adjusted for quality, such that 10 years of life in perfect health equates to 10 QALYs while the same 10 years of life at 50% quality of life would equate to 5 QALYs.

If 20% of Ireland’s vapers return to cigarettes, between 13,860 and 36,120 quality adjusted years of life would be lost.

There is also the risk that existing smokers who would otherwise have switched decide against doing so.

If 10% of existing smokers would otherwise have quit, that means 82,700 more smokers and a consequent loss of an extra 81,873 – 213,366 quality adjusted life years.

An e-cigarettes tax would have greatest negative impact on Irish citizens aged 25 to 34 and the most deprived areas of the country, as smoking rates are highest among these groups.

If the government wish to reduce the number of people who die from smoking, they should be doing everything in their power to protect the attractiveness of these products to current smokers and also promoting their use through policy change and public awareness campaigns of their relative risk.

If the government here continues down the road of applying tax to e-liquids, this may appear to the public as merely a punishment on ex-smokers for lost revenue on cigarettes.

Surely that’s not Minister Noonan’s intention?

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[vc_row][vc_column][vc_empty_space][vc_single_image image=”1336″ img_size=”medium” align=”vc_align_center”][vc_empty_space][vc_column_text]Today we’d like to talk about action.
In recent years, quite a few things have happened to see the debate on vaping move forward. This list may not be exhaustive, but it includes as many as we think may illustrate our point.

Public health groups have reviewed the evidence and concluded that vaping products are about 95% safer than smoking lit tobacco.

Twelve health and public health and anti-smoking charities publicly endorsed this evidence review.

Health service clinical guidelines have said that tobacco harm reduction should be recognised.

Anti smoking group ASH have endorsed their use as part of a quit attempt.

Stop smoking services have become ”e-cig friendly” and welcomed smokers who wish to give vaping a try with encouragement and advice.

A study has begun, looking at the role their possible benefits might be for lung cancer patients who still smoke and can’t seem to otherwise quit.

A study trialing their effectiveness for smoking cessation vs traditional methods in the stop smoking clinic setting has been ongoing now for a year.

There has been a concerted effort to counter some of the still pervasive myths about nicotine in order to educate smokers and the public.

Local councils have teamed up with researchers and local vape shops to bring awareness to the fact they’re a positive tool for smokers looking to reduce their risk.

There has been public endorsement by the prime minister in Parliament.

Anti smoking group ASH, tobacco control experts and researchers have all cautioned against their taxation in order that they remain attractive to smokers so more will make the switch to their use, and suggesting that such an excise tax would be disastrous for public health.

There has been a debate including users on vaping should be considered within workplace smoking policies.

A public lecture on harm reduction spoke about how e-cigarette manufacturers, vape shops and vapers themselves are the new front-line in smoking cessation, and praised how this new technology is a cost saving for the state.

Smoking cessation service trainers engaged with users and experts in order to produce a comprehensive briefing on how best smoking cessation service providers should talk to smokers about their use, with practical and empathetic advice all backed up by evidence.

Public health leaders are suggesting frameworks of how their use can be integrated into existing policy strategies.

Hospitals are rolling back their campus usage bans as they correctly identify that their use poses no discernible risk to bystanders and their use on hospital grounds is a boon for patients, public health, and staff.

There have been seminars, conferences, summits, cross party parliamentary group meetings all discussing a variety of things like the implications of policy, what the currently available evidence tells us, and user and industry engagement can inform debate.

There has been a landmark review of evidence that concluded with a report and a recommendation that they be widely recommended to smokers.

This same report drew attention to some of the negative aspects of the incoming EU TPD regulations – namely taxation, advertising bans, warning labels and caps on nicotine strength.

Scientists, researchers and veteran leaders within tobacco control have gone public refuting widely exaggerated scare stories in the media so that smokers aren’t put off trying them and so there is better public understanding about the products themselves, and their relative risk to smoking.

There has been a debate in the upper house of Parliament where attention was drawn to the most egregious measures of the tobacco products directive as it pertains to these products, those involved who use these products spoke in detail about how unscientific and arbitrary these measures are, and even questioned why vaping products were ever included in a tobacco products directive at all.

The enforcement body tasked with deciphering what may possibly be the least harmonising EU directive they’ve seen has consulted with manufacturers, importers and retailers throughout the implementation process and kept them fully informed of updates along the way.

That’s quite the list, isn’t it?

Lots of action around this disruptive technology that represents a real and viable alternative to smoking and has the potential to be one of the most important things to happen to public health in generations.

So it’s regrettable that none of the above is happening in Ireland.

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[vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1324″ img_size=”medium” align=”vc_align_center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The Irish Vape Vendors Association have expressed their exasperation that with only seven days until the EU Tobacco Products Directive comes into force, the government is at risk of not meeting the deadline to implement it, and their members still do not have full details on what they need to do in order to fully comply.

Their spokesperson Gillian Golden said today that although some details have been forthcoming, with only seven working days until the EU directive must be transposed into Irish law, the government does not have a fully implemented regulation for the directive in place, the Department of Health has issued no guidelines on notification fees or compliance, and there has been an unwillingness by the department to even consult with their members on how they are to become compliant.

Last year Public Health England released a report that found e-cigarettes to be 95% less harmful than tobacco cigarettes, with no discernible harm to bystanders. The body that provides training to smoking cessation centre workers in the UK issued a guideline in January on how to advise smokers to use e-cigarettes as part of a quit attempt.

Since then there have been some policy changes in the areas in the UK such as use on some NHS hospital grounds, their role in stop-smoking clinics, and wider public health messaging.

Just last month, the Royal College of Physicians in London issued a report in which they urged doctors to widely recommend their use by smokers as a way of reducing smoking prevalence, as a harm reduction measure. Aspects of the Tobacco Products Directive were highlighted in the RCP report as having a possible negative effect on public health, as e-cigarette companies will no longer be able to advertise that their products are safer than smoking, warning labels may put smokers off trying them, and restrictions on higher nicotine levels in the products may not satisfy those who now smoke heavily and they may relapse to smoking.

A debate took place at Westminster yesterday in the House of Lords, in which Conservative peer Charles Cathcart said:

‘’To my mind, restricting nicotine strength to 2% will be particularly damaging, but I would say that, as I still use the 2.4%—as do about a quarter of e-cigarette users. By taking up vaping, I hope to keep ​the grim reaper at bay for a little longer. I hope that when I run out of my 2.4% nicotine supply and I am forced to use the weaker nicotine, I do not switch back to smoking. That is the danger for many e-cigarette users. Perhaps by the time I run out of my 2.4% nicotine supply, stronger nicotine may be available on the black market, with all the dangers that that will entail.’’

‘’Something that represents such a massive positive public health opportunity needs sound policies, based on good evidence,’’ said Golden, ‘’sadly, what we actually have is this European legislation based on a risk averse interpretation of the science that was available more than two years ago – and we don’t even have all the details of Ireland’s implementation of that. With a week until the law commences, we really need to know what it will require.’’
‘’Government figures tell us there are over 5,800 people every year dying from a smoking related illness, they should be doing everything they can to introduce policies that help smokers and reduce that terrible statistic.’’

Ends.

Public Health England Report – https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review
NCSCT Guidelines: http://www.ncsct.co.uk/publication_electronic_cigarette_briefing.php

Royal College of Physicians Report: https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0

House of Lords Debate transcript: https://hansard.parliament.uk/Lords/2016-05-10/debates/16051044000179/TobaccoAndRelatedProductsRegulations2016

Dept of Health statistics on number of smoking related deaths annually: http://health.gov.ie/healthy-ireland/tobacco/

Glasgow hospitals roll back vaping ban: http://www.bbc.com/news/uk-scotland-glasgow-west-36084268[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1076″ img_size=”medium” align=”vc_align_center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Irish Vape Vendors Association welcomes new report from Royal College of Physicians, London

A new report published today by the Tobacco Advisory Group of The Royal College of Physicians in London re-iterates that vaping is safer than smoking and concludes that the greater use of e-cigarettes as a substitute to smoking would benefit public health.

The report, titled ‘Nicotine without smoke: Tobacco harm reduction’, outlines the need for current tobacco control policy to include harm reduction principles. Because the consumption of nicotine through smoking is so harmful to health, nicotine use by smokers in an e-cigarette removes the by-products of combustion like tar and carbon monoxide and thus pose very little risk compared to smoking.

Welcoming the report, Gillian Golden of the Irish Vape Vendors Association, which represents independently owned retailers of vaping products said ‘’It’s bittersweet however, in that Irish smokers don’t see the same positive endorsement here, which reflects the wealth of international evidence that these products are a viable and acceptable alternative to smoking.’’

”Our members hear some horror stories from their customers, like doctors telling them that vaping isn’t any safer than smoking. Luckily, they’re able to point them to the research that reassures them otherwise. This new report will add to that re-assurance”, she said.

Also included in the report is some criticism of how the Tobacco Products Directive which comes into force on the 20th of May may negatively affect the uptake and availability of e-cigarettes. Mentioned is the 20 milligram per ml cap on nicotine levels in liquid refills which may hinder uptake by heavier smokers, and the requirement for products to carry such strongly worded health warnings when medicinally licensed products do not. It also states that to keep the products economically attractive to smokers, they be excluded from tobacco-like taxes.

The Irish Vape Vendors Association are now calling for Ireland to follow the UK’s lead.

‘’The UK’s Office of National Statistics data from earlier this year put the number of smokers there that have already switched from smoking to vaping at 849,000. That’s greater than the number of smokers identified in the most recent Healthy Ireland Survey. If Irish health bodies were to similarly endorse the use of lower risk nicotine products, imagine what this could do for Irish smoking rates,’’ said Golden.

Ends.[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_separator][vc_single_image image=”1309″ img_size=”medium” align=”vc_align_center”][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]On Thursday last, April 14th, the EU Commission finally clarified the implementing decision on technical standards for the refill mechanism of electronic cigarettes.

Today, we have received notification from the Department of Health that this will be transposed into Irish regulations.

The full text of the decision is as follows:

1. Member States shall ensure that refillable electronic cigarettes and refill containers are only placed on the market if the mechanism by which the electronic cigarettes are refilled meets one of the following conditions:

(a)

it entails the use of a refill container possessing a securely attached nozzle at least 9 mm long, which is narrower than and slots comfortably into the opening of the tank of the electronic cigarette with which it is used and possessing a flow control mechanism that emits no more than 20 drops of refill liquid per minute when placed vertically and subjected to atmospheric pressure alone at 20 °C ± 5 °C;

(b)

it operates by means of a docking system which only releases refill liquids into the tank of the electronic cigarette when the electronic cigarette and refill container are connected.

2. Member States shall ensure that refillable electronic cigarettes and refill containers include appropriate instructions for refilling, including diagrams, as part of the instructions for use required by Article 20(4)(a)(i) of Directive 2014/40/EU.

Refillable electronic cigarettes and refill containers with a refill mechanism of the type referred to in paragraph 1(a) shall indicate the width of the nozzle or width of the opening of the tank in the instructions for use in a manner that enables consumers to identify the compatibility of refill containers and electronic cigarettes.

Refillable electronic cigarettes and refill containers with a refill mechanism of the type referred to in paragraph 1(b) shall specify, in the instructions for use, the types of docking system with which such electronic cigarettes and refill containers are compatible.

The original can be found here: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv:OJ.L_.2016.101.01.0015.01.ENG&toc=OJ:L:2016:101:TOC

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The Irish Department of Health, through the Alcohol and Tobacco Unit, have today issued their second industry update on requirements under the Tobacco Products Directive for vaping products.

This outlines two key details:

Labelling

Article 20(4) of the Directive provides that each unit packet and any outside packaging of electronic cigarettes and refill containers must carry a health warning in both Irish and English. The following general warning must be used:

‘Cuimsíonn an táirge seo nicitín, ar substaint an-andúile é

This product contains nicotine which is a highly addictive substance’.

Transitional provision:

Electronic cigarettes or refill containers manufactured or released for free circulation before 20 November 2016 may continue to be placed on the market until 20 May 2017 provided they comply with other relevant legislation.

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[vc_row][vc_column][vc_separator][vc_single_image image=”1272″ img_size=”medium” align=”vc_align_center”][vc_column_text]The changes to the Advertising Standards Authority of Ireland (ASAI) code of standards for advertising and marketing communications in Ireland come into force today, March 1st.

Launched in September last year after a period of consultation, this is the 7th edition of the ASAI code, which for the first time now includes a set of rules for the advertising of vaping products.

In the guidance to the changes that were made to the previous edition, the ASAI include notes on two items:

17.2 For example, if an E-cigarette were to use a well-known tobacco label’s colouring together with font, this would be in breach of this code rule.

17.10 The concept of this rule is already used in the Alcohol Code rules. If a person who appears in an advertisement using an e-cigarette looks to the objective observer to be under 25, then this will be a breach of the Code, notwithstanding the fact that the actor/model is indeed over 25.

A downloadable PDF of the full code is available on the ASAI website, and we would advise all Irish vendors, manufacturers and advertising professionals to become familiar with it.

Marketing communications for e-cigarettes should be socially responsible.

Marketing communications should not contain anything which promotes any design, imagery or logo style that might reasonably be associated in the audience’s mind with a tobacco brand.

Marketing communications should contain nothing which promotes the use of a tobacco product or shows the use of a tobacco product in a positive light. This rule is not intended to prevent cigarette-like products being shown.

Marketing communications should make clear that the product is an e-cigarette and not a tobacco product.

Marketing communications should not contain health or medicinal claims unless the product is authorised for those purposes by the HPRA. E-cigarettes may be presented as an alternative to tobacco but advertisers should do nothing to undermine the message that quitting tobacco use is the best option for health.

Advertisers should not use health professionals or celebrities to endorse electronic cigarettes.

Marketing communications should state clearly if the product contains nicotine. They may include factual information about other product ingredients.

Marketing communications should not encourage non-smokers or nonnicotine-users to use e-cigarettes.

Marketing communications should not be likely to appeal particularly to
people under 18, especially by reflecting or being associated with youth culture. They should not feature or portray real or fictitious characters who are likely to appeal particularly to people under 18. People shown using e-cigarettes or playing a significant role should not be shown behaving in an adolescent or juvenile manner.

People shown using e-cigarettes or playing a significant role should neither be, nor seem to be, under 25. People under 25 may be shown in an incidental role but should be obviously not using e-cigarettes.

Marketing communications should not be directed at people under 18 through the selection of media or the context in which they appear. No medium should be used to advertise e-cigarettes if more than 25% of its audience is under 18 years of age.

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[vc_row][vc_column][vc_separator][vc_single_image image=”1254″ img_size=”medium” align=”vc_align_center”][vc_column_text]In what is a spectacular example of how bad science can go ‘viral’ with scaremongering and baseless headlines, today we’d like to talk about Hong Kong.

A story published yesterday in the South China Morning Post reports that researchers from Hong Kong’s Baptist university looked at 13 e-cigarette products which were available on the local market, and found polycyclic aromatic hydrocarbons (PAHs) at levels of 2.9 to 504.5 ng per mL (ng/mL).

Now, nowhere in the reporting does it mention the names of the brands of products, nowhere does it suggest where the research has been published,nowhere does it mention the methodology of the study, and nowhere in the story does it mention the levels of PAHs commonly found in outdoor air in Hong Kong.

It goes without saying then, that these headlines are unwarranted:

Once this story reached the shores of the UK and the desk of The Daily Mail, the headline got even more alarmist:

Dr Konstantinos Farsalinos has taken a look at the story and filled in some of the blanks in a blog post yesterday:

”First of all, the definition of PAHs is: “a class of environmental pollutants created primarily from incomplete combustion of various organic materials including tobacco”. We all know that there is no complete or incomplete combustion of any material in e-cigarettes, so I really doubt whether their findings are valid.”

Dr Farsalinos did a quick literature search to find the levels of PAHs in outdoor air in Hong Kong, and

”…found a paper from 1998, finding levels of PAHs up to 48 ng/m3 (cubic meter = 1,000,000 (million) mL) in Hong Kong. So, the levels in outdoor air are 48 ng per 1,000,000 mL. Obviously the scientist quoted in the media story compared mLs of air with mLs of e-liquid.

The average volume of air breathed daily by humans is 20m3 (=20,000,000 mLs). Contrary to that, an average vapers consumes 3mLs of liquid (according to our survey). Thus, the levels in outdoor air in Hong Kong would result in total daily exposure of 960 ng.

The levels of exposure from e-cigarette liquids (as tested by the Hong Kong university and assuming they are correct) are 9-1500 ng.

This is from 99% less up to 50% more than exposure to outdoor air (or, to express it differently, 100 times less to ½ time more).”

And his opinion on the statement asserted in the headlines?

1,000,000 times higher levels” is complete false.

He further discusses the other glaring error in the researchers’ study as it’s reported:

”First, tobacco cigarettes are solid, not liquids or gas. Thus, there is no mL of tobacco cigarettes, they should mention weight of tobacco. But here is the catch: tobacco cigarette smoke is known to contain about 1.6 ug PAHs per cigarette (that is, 1600 ng/cigarette).

But how can you compare mLs of inhaled tobacco cigarette smoke with mLs of e-liquid? It is simply a joke. The truth is that 1 tobacco cigarette contains by far more PAHs than what they reported they found in 1 mL of liquid (which is 1/3rd the daily consumption).”

In what on the surface looks like ”policy based evidence making”, Dr Chung Shan-shan, assistant professor in the university’s biology department is quoted as describing the situation ”worrying”.

The Hong Kong Council on Smoking and Health, which commissioned the study, is using the results of it to call for a ban on e-cigarettes – which seems to fly in the face of both the current existing evidence base, and also how to properly formulate policy on a product that is helping millions of people worldwide reduce their harm from smoking.

Dr Farsalinos’ opinion?

”…either the scientists have no idea about what they are talking about, or they are deliberately misinforming the public and the regulators.

Even worse, they are creating panic to vapers (the vast majority of whom are former smokers), with the risk of making them relapse to smoking. This is a typical case of gross misinformation and extremely poor science. Literally, a public health disgrace…

The reporters of this “study” (not authors, because there is no published study) need to immediately apologize to the public for creating this story out of nothing.”

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[vc_row][vc_column][vc_single_image image=”1210″ img_size=”medium” align=”vc_align_center”][vc_separator][vc_column_text]We have noted a number of reports in the media recently regarding damage to property or persons that were allegedly caused by e-cigarette batteries.

It should be mentioned at the outset that in incidences where a property is damaged and an investigation by fire officers is reported on, the use of incorrect chargers for the specific model of vaping device or leaving the battery to overcharge has frequently been the cause.

In some cases, the cause can be attributed to sub standard quality batteries where quality control has not been applied in the manufacturing process.

Always read instructions

Like all lithium ion batteries, such as those in laptops, mobile phones and tablets, the correct discharging, charging and storage of batteries ensures consumer safety.

Provided instructions should always be strictly adhered to. If none have been provided, contact your vendor for advice.

Never leave charging batteries unattended

In the case of smaller and ‘ego style’ batteries, only the corresponding charger with the correct amp rating for the battery should be used.

Batteries should never be left unattended while charging, and should never ever be left on charge overnight.

Always unplug the charger and remove the battery immediately after the battery has reached full charge.

Batteries should never be placed on soft furnishings or carpets while charging.

Charging bags are available that encase the charger and battery during re-charging and provide additional safety.

Use 3rd generation batteries and rebuildable atomisers safely

In the case of larger ‘3rd generation’ batteries, only high quality chargers with an automatic charging cut off should be used.

Batteries should never be discharged below 3.2 Volts or overcharged above 4.25 Volts.

If the battery is being used in a ‘mechanical’ device, only the correct atomiser resistance should be used for the amp rating of the particular battery.

An understanding of Ohm’s law is necessary to safely set up a ‘rebuildable’ atomiser.

Our members recommend these products are only used by experienced consumers who fully understand battery safety thresholds.

Batteries should always be stored safely, in plastic battery containers where the contacts cannot touch each other.

Never allow the contacts of batteries to come in to contact with metal keys or coins etc. This can lead to short circuits occurring and cause the battery gases to vent.

Never use a battery when the plastic covering is torn or damaged. Replace it instead

Lithium ion batteries, when used correctly and stored safely aren’t dangerous, and vaping is proven to be less dangerous for you than smoking.

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[vc_row][vc_column][vc_separator][vc_single_image image=”1223″ img_size=”medium” add_caption=”yes” align=”vc_align_center”][vc_column_text]The UK body that supports the delivery of services across local, NHS and Local Authority stop smoking services, published an updated briefing on e-cigarettes yesterday.

The National Centre for Smoking and Cessation Training (NCSCT) has taken an evidence based approach to the document, which has been reviewed by a number of public health researchers & experts, and – most notably – by current users (trustees of the UK charity New Nicotine Alliance).

Produced in conjunction with Public Health England, the 46 page document aims to arm stop service providers with helpful and practical information on what to advise people who choose to seek the help of a stop smoking service, but would like to try vaping – all the while backing it up with summaries of the currently available evidence.

To our mind, one of the most interesting and helpful aspects to the advice is the inclusion of common questions that smokers might have. It’s also encouraging to see that the NCSCT advocates that practitioners seek out experienced vapers and familiarise themselves with local vape shops if they themselves are not familiar with e-cigarettes.

Common questions smokers might have that are addressed include:

– In nicotine dangerous?

– Which e-cigarette should I start with?

– How often should I use my e-cigarette?

– Is it OK to smoke and vape at the same time?

– How will I know when to change the atomiser in my e-cigarette?

– How do I choose a flavour?

– What nicotine strength should I go for?

– Will I end up using more nicotine with my e-cigarette and overdosing?

– I’ve heard that e-cigarettes can produce harmful chemicals?

– Is secondhand vapour from e-cigarettes harmful?

Common concerns that practitioners may have are also addressed, accompanied by a comprehensive reference section that contains 135 citations. Some of these concerns include:

– Are e-cigarettes normalising smoking?

– Quality control

– Regulation

– Are there any adverse health effects?

As well as other tips for those who may be new to the idea of harm reduction products, or may be wary of giving incorrect advice:

The IVVA understands that the Dept of Health and the Health Service Executive do not currently endorse vaping in their tobacco control policies. We are hopeful this will change.

In the interim, this briefing may be useful in answering the questions which we regularly receive from Irish health care providers who either have patients that are already vapers, or who may be hesitant about making the switch from smoking.

As our members are all now ex-smokers, we all started with similar questions.

Should the relevant policy makers here decide to produce something similar, the IVVA feel it would be of enormous benefit, and we would warmly welcome it.

Images in this post are © 2016 National Centre for Smoking Cessation and Training (NCSCT)[/vc_column_text][/vc_column][/vc_row]

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Figures from the latest ONS survey of Adult Smoking Habits in Great Britain were released today and Hazel Cheeseman from ASH UK and Prof Peter Hajek from Queen Mary University of London were interviewed about the findings.

2.2 million people in the UK are now vaping, and this is the first time the figures on the use of e-cigarettes have been included in this survey.

Other highlights within the data are:

• 64% of current smokers have tried vaping, and 15% currently use vaping products
• More women vape than men (4.5% vs 4.2%)
• In men peak prevalence is among those aged between 55 and 64 (5.8%)
• In women this is younger at between 34 and 44 (6.7%)
• Only 23% of current vapers use ‘cig-a-like’ devices*

*(note it’s newer generations of products that are most likely to be adversely affected by the upcoming TPD regulations – in other words the remaining 77% of users will see a negative impact on their product choice post TPD implementation)

Prof Hajek’s comments are particularly insightful, and he correctly states three very important points that are highlighted time and time again by both consumers themselves, and the industry:

• that the figures of smokers taking up these far less harmful products may stall due to the number of negative media stories

• that some of the research being done on e-cigarettes fails to warrant the kind of headlines we’ve seen recently, and that’s often due to bad study design (we’ve written about the latest study on mice here)

• that the TPD is a hostile and misconceived move to regulate vapour products that are already regulated as consumer products :

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_video link=”https://www.youtube.com/watch?v=pSJ4Z4liass” el_width=”70″][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The data tables can be found here, and there’s overviews of the figures both here, and here in a slide share.

The less encouraging figures are that there is still large numbers of smokers and non smokers who don’t realise that the relative risk of these products is far, far less than smoking, and Clive Bates has touched on this in a post today.

It is extremely unfortunate that the industry is explicitly prohibited from promoting the use of vaping for cessation and harm reduction, while the Health Service Executive and anti smoking charities and bodies could – but do not. This is despite ever increasing evidence from elsewhere in the world, and particularly England, that this is exactly what they should be doing.

Failing to do so only increases the burden of smoking related illness not just on the Irish healthcare system, but also on ordinary people and their families.[/vc_column_text][/vc_column][/vc_row]

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*This post has been updated since first posting, below.

News of a new ‘study’ began to emerge on social media last night, with the sharing of headlines from The Independent, The Daily Mail and The Standard, among others.

We know from previous media stories which report on vaping research that it isn’t always the study itself that is being reported on – sometimes it’s just a direct re-post of the press release, and what’s contained in the press release isn’t always an accurate reflection of the actual findings of the study.

Commentators who work in the areas of public health, scientific research and even in the media itself, have described some of the media reporting on electronic cigarettes of late, as misleading.

Some have laid the blame at those who craft the PR on behalf of the researchers or the journal, which over states findings. Others have highlighted instances where researchers who conduct studies and experiments when either the study design shows a misunderstanding of real world conditions, ignorance of the products, or even that the research is merely ”policy based evidence” – research which may set out to find the answer to something but instead of merely reporting findings, goes beyond the remit of science to suggest a policy that might address it, or to in some way justify an existing policy where the evidence required to have justified it in the first place, is scant.

The study that has garnered such alarmist headlines as ”E-cigarettes may be just as harmful for pregnant women as tobacco” or that e-cigarettes ”could be worse for a baby’s health than tobacco smoke”’ deserves a closer look, however.

Smoking is a risk in pregnancy, and all risk should be weighed carefully in order that the best advice is given for the individual to make an informed choice for their own health.

If a pregnant woman, either through her own choice or on the advice of a health care practitioner has switched to vaping during her pregnancy in order to reduce her harm from smoking, and she or her health care practitioner sees these headlines, what might they think?

Would they think the headline was based on a sound study – with proper methodology and protocols, rigorously peer reviewed and published in an eminent journal? Would they think that the methodology of the experiments conducted were published so that the experiments can be reproduced from other research teams to see if they too came to the same conclusions?

Perhaps they might think that the researchers looked at pregnant women directly, after all they’re mentioned specifically in the headline aren’t they? They might even think that the journalist read the full text of the study to make sure that what was in the PR was correct, and the headline was chosen to best accurately describe what, within the study, is newsworthy.

The scientist involved in this study, Professor Judith Zelikoff, of New York University describes a study of pregnant lab mice as ”ground breaking research”, which slightly fudges the fact this seems (for now) to be in the form of a pre-published presentation at a conference.

(Study findings are often shared with other scientists at conferences in this manner, usually accompanied by careful caveats that clearly state whether the research itself or the paper is in its initial stages, or has gone through the peer review process already, or whether it’s been published etc. so that it’s clear where along the timeline the findings sit and no one is misled.)

Professor Judith Zelikoff, of New York University, said: ‘Women may be turning to these products as an alternative because they think they’re safe. Well, they’re not.’

Let’s for a moment focus on the not so small detail that no responsible party anywhere – manufacturer, retailer, medical professional, public health policy maker – describes vaping as ”safe”.

What it is, is safer.

Picking out this throwaway comment may seem pedantic, but it’s important. It’s a so called straw man argument often used to try and portray advocates of these products as in some way misleading the public.

So let’s be clear – the IVVA have never, nor will ever, describe e-cigarettes as safe, but we do share the view that the currently available evidence points to them being orders of magnitude safer.

So what of these media stories? Do any of them include a link to the study, or a link to the the journal in which it’s been published?

Not at the time of writing. Once we do have a link, this post will of course be updated.

Might this be because a commonality of some of the questionable research that we’ve seen recently seems to be to issue a press release before the paper is published – by which time they have free reign to say almost anything as by the time people can see the data in detail, the headline has been given ample time to be cemented as fact in the minds of the public?

Perhaps.

What do those who work in public health arena and who have an understanding of the product think of it?

Ms Salim-Sartoni works as a stop smoking specialist:

Prof McManus is head of public health policy for Hertfordshire:

Dr Glover works with low income smokers in New Zealand:

Tom Pruen, Chief Scientific Officer of ECITA put some quick thoughts down on paper in the form of responses (in blue, below) to some of the points in the PR:

Despite thinking to the contrary, tobacco/nicotine use exposure while pregnant remains a very real problem in the 21st century due primarily to the use of alternative tobacco/nicotine products such as hookah, smokeless tobacco and electronic nicotine delivery devices.

Wrong. The primary exposure to tobacco toxicants and nicotine during pregnancy is combusted cigarettes.

As a result of a variety of factors, including the Family Smoking Prevention and Tobacco Control Act (FSPTCA), indisputable evidence of the devastating health effects from use of conventional cigarettes, tobacco use is rapidly evolving and adolescent men and women of childbearing age appear to be the greatest consumers of these alternative tobacco products (ATPs) and nicotine delivery devices.

Wrong. The FSPTCA does not seem to have any effect on smoking prevalence. I’m not aware of any evidence that the primary users of e-cigs are adolescent men. The age range covered by “women of child-bearing age” is so broad as to be useless.

Despite the apparent surge of ATP use by adolescents worldwide, effects from new and emerging smoked and smokeless tobacco (ST) products, used with increasing frequency in the US, on reproductive health, pregnancy, or fetal development, are mostly unknown.

Broadly true, but beyond the already well known effect of nicotine (which is still better than the effects of smoking), there is little to suggest much reason for significant alarm.

While almost all anecdotal evidence suggests that ATP are “just as dangerous to your health as cigarettes”, there is a void of strong science upon which policy regarding the effects of alternative smoked and ST products can be made to protect the reproductive/ developmental health of already vulnerable populations.

True, but only because the scientific evidence runs counter to this anecdotal evidence, suggesting that it is total rubbish.

Toxicological studies from my laboratory demonstrate that like traditional cigarettes, exposure to a globally-relevant smokeless tobacco product decreases sperm counts while increasing sperm DNA damage in a mouse model.

Method? Dose? Exposure details? Anything to suggest this might be relevant to a human exposure?

Exposure of pregnant mice to the same smokeless product also reduces the incidence of pregnancy and increases the risk of fatty liver and cardiovascular risk factors in adult offspring.

Again, Method? Dose? Exposure details? Anything to suggest this might be relevant to a human exposure?

Our studies also show that exposure to vapor from electronic-cigarettes in utero and post-natally drastically reduce sperm counts and sperm mobility in juvenile offspring and brings about gene changes in the brain as well as altered behavior in adult male and female offspring.

Uh – sperm counts in juvenile offspring? Seems an odd measure.

Preliminary findings from this laboratory also suggest that inhaled hookah smoke can also impair sperm counts following in utero exposure.

Well, yes, it’s smoke. Given that the author has also published on the dangers of wood smoke, I can’t see this coming as a surprise.

While more studies are needed to better understand these effects, these translational studies suggest that early life exposure to alternative tobacco/nicotine products can adversely affect reproduction, development and long term health.

Unless we have a different definition of translational research, this seems to be a misuse of the term.

Though the “face” of tobacco and use of ATP in the US is changing rapidly, the science lags woefully behind.

Never have truer words been said.

Do animal studies always translate to being able to adequately quantify the same observed (or perceived) harm in humans?

No.

Does this study unequivocally prove that a pregnant woman is putting herself or her baby at risk if she continues to use vapour products?

No.

Might these headlines, ironically, have the unintended effect of sending pregnant smokers who have made the switch to a product that is less harmful, back to smoking?

Perhaps.

After all, if they’ve switched from smoking, are then told by newspapers they should be able to trust that vaping may be worse than smoking, it would seem plausible that a small number might go back to what they did before, incorrectly under the assumption that ”better the devil you know”.

Does this subject need more research?

Yes.

However, the studies would need to be designed in such manner as to be easily replicated, translate to real life conditions, and the findings communicated honestly and accurately in order for the knowledge base to grow.

What’s the takeaway message from this study, for now, until much more is known?

Pregnant mice probably shouldn’t vape.

*UPDATE:

Since we published this post, Prof McManus has written on his Linkdin blog:

The current study in the media is a conference presentation based on laboratory studies on mice by Prof Zelikoff. It suggests that chemicals in vapour can cause brain damage in mice. But that isn’t conclusive evidence of harm to babes in the womb.

What it does do is tell us we need to really do more and better research on this to get as near to a conclusive answer as we can so mums to be can be safe.  But the idea that vaping will cause the same level of danger as tobacco is a stretch not supported by the study and the conclusions have been overstated by some parts of the media.  It’s laudable to want to protect developing children and mums to be but this kind of scare tactic is not the way to do it.

You can read the full post here : https://www.linkedin.com/pulse/e-cigarettes-pregnancy-how-worried-should-we-jim-mcmanus

And Prof Peter Hajek, Director of Tobacco Dependence Research Unit at the Wolfson Institute of Preventive Medicine at Queen Mary University London has provided commentary to fact checking website Sense About Science:

”The story is based on an unpublished presentation and so the actual data cannot be checked, but in most such studies, animals are exposed to doses many times above any realistic human exposure and the results have little relevance for vapers. Most importantly though, no comparison with effects of cigarette smoke was made and so the conclusion that vaping could be worse than smoking has nothing to do with the study findings.”

See more here: http://www.senseaboutscience.org/for_the_record.php/218/response-to-stories-suggesting-that-e-cigarettes-are-as-dangerous-as-tobacco-or-worse-during-pregnan

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The IVVA welcomes the announcement yesterday that vaping products will be included in a report by HIQA to be delivered to the HSE and the Department of Health.

The HTA (health technology assessment) report is in response to a request by the DoH and will look at the range of products that are currently used to help people away from smoking tobacco.

Due to be concluded before the end of 2016, the Health Information & Quality Authority team working on the report will be aided by an expert advisory group, and a public consultation on the draft will take place before the findings and HIQA advice are presented to the Minister for Health and the Health Service Executive.

In our opinion, that HIQA have included vaping marks the start of an important phase in Irish health policy.

The Public Health England report published last August found that the current evidence points to vaping being 95% less harmful than smoking. UK Stop Smoking Clinics are embracing tobacco harm reduction and becoming ”e-cig friendly”. More NHS hospitals in Scotland are following the evidence that vaping does not impact on bystanders and are allowing their use on hospital grounds.

Vaping represents a gain for the state here in terms of there being no cost to the taxpayer, incoming VAT & tax returns to the exchequer, and the employment that the growing independent sector provides. There is also the huge positive public health impact of having so many thousands of people now switched to using these less harmful products who no longer smoke.

The clinical and economic value of all currently available cessation methods will be assessed and the findings will then go to inform future policy on reducing smoking rates in the coming years.

According to the HIQA website, the terms of reference for the HTA are to:

1. describe the range of smoking cessation therapies available
2. review the effectiveness and safety of the available smoking cessation interventions and their impact on long term quit rates
3. describe the epidemiology of smoking and smoking related-illness in Ireland
4. compare the cost-effectiveness of interventions that are associated with improved rates of smoking cessation and to estimate the costs associated with these interventions within the public health system in Ireland
5. examine any other relevant issues associated with potential changes to the provision of smoking cessation services by the HSE that may affect patients, staff or the organisation of existing services
6. advise on the optimal use of smoking cessation interventions by the HSE, based on this assessment.

It is to be welcomed that the Department of Health wishes to take a closer look at vaping products within these terms of reference, and we look forward to HIQA’s findings with interest.

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It is unfortunate that ‘negative’ media stories about vaping garner a lot more clicks and shares than ones which tend to be more balanced and accurately reported. One thing most casual readers would hope however, is that what is contained in the press release which gets sent out to journalists does indeed reflect the study findings, and that the data and its  implications have been communicated honestly and accurately.

So it certainly disappointing that a study which came to light on Tuesday has elicited some highly alarmist headlines. Although the research was conducted in November, its release this week seems to perfectly coincide with the exact time of year that many smokers will perhaps be thinking of looking for an alternative as part of their new resolutions.

‘Scientists warn e-cigarettes could cause cancer’

‘E-cigarettes may be ‘no better’ than smoking regular cigarettes, warn scientists’

‘E-cigarettes are not safe! They can cause cancer too’

‘E-cigarettes are ‘no better’ than traditional cigarettes, say scientists’

So what lies behind the headlines, what was the study looking at, and was the media frenzy warranted?

According to the press release,

…a lab team at the Veterans Affairs San Diego Healthcare System tested two products and found they damaged cells in ways that could lead to cancer. The damage occurred even with nicotine-free versions of the products.

“Our study strongly suggests that electronic cigarettes are not as safe as their marketing makes them appear to the public,” wrote the researchers, who published their findings in the journal Oral Oncology.

The researchers

…created an extract from the vapor of two popular brands of e-cigarettes and used it to treat human cells in Petri dishes. Compared with untreated cells, the treated cells were more likely to show DNA damage and die.

Dr. Jessica Wang-Rodriquez, one of the lead researchers concludes:

“Based on the evidence to date,” she says, “I believe they are no better than smoking regular cigarettes.”

The study tells us that ”E-cigarette vapor was pulled through media using negative pressure, and the resulting extract was filter-sterilized with a 0.2µm pore-size filter before treating cell cultures.”

However, as Tom Pruen, Chief Scientific Officer for ECITA points out:

Here’s what is not described in the method:

1. Hardware – No mention is made of what hardware was used to generate the vapour. No mention of what design the hardware was, its resistance, or how much power was supplied to it.
2. Topography – How long were the puffs? How long between puffs? How many puffs were taken per cartomiser/tank? Was the number of puffs plausible for the design?
3. Were the emissions generated in a sensible, realistic way, or was there dry burning (leading to huge emissions of carcinogens – an effect described in the literature back in 2013)? This could have been easily established by conducting an analysis of the vapour condensate for carbonyls, but this was not done.

 

Effectively, this leaves us with no information at all on the sampling methods, making this research incomplete and unrepeatable. That is not how science is supposed to be conducted.

As regards the fact that this particular type of cell was used, there has been some criticism of the use of cell studies to look at whether results can be directly translated into similar effects in humans. Dr Farsalinos from the Onassis Cardiac Surgery Centre in Athens said when looking at a different study that: ”In the majority of cases, the protocols and experimental procedures are irrelevant to human effects.” 

So in comparing the effects of tobacco smoke and e-cigarette vapour, were the two protocols of exposure to the cell cultures comparable, so that an accurate comparison between the amount or rate of cell death observed could be made?

Not at all.

From the study itself:

“Treatment media was replaced every three days with 1% e-cigarette extract. Because of the high toxicity of cigarette smoke extract, cigarette-treated samples of each cell line could only be treated for 24 h.”

Tom Pruen looks at this more closely:

So the cells were being constantly exposed to the vapour condensate for periods of multiple days, with the solution refreshed every 3 days, but only for 24 hours to cigarette smoke condensate because it was too toxic.

Despite the massive difference in exposure, the cigarette smoke extract scored as high or higher on most of the measured outcomes:

This is reported as:

“Cigarette smoke extract led to the highest number of DSBs in HaCaT and HN30 cell lines, but were not significantly higher than V2 nic 1%.”

Except, of course that the exposures were completely different!

Paul Barnes, in his blog notes ”…the cell cultures were specifically chosen to “represent e-cig smokers that already have HNSCC (head and neck squamous cell carcinoma)” In other words, the cell strains specifically chosen for this study were already cancerous.

However, it’s hard to see if this would have mattered, given that, as quite succinctly put here, by clinical researcher and medical statistician Adam Jacobs:

All it tells us is that cigarettes do far more damage to cell cultures than e-cigarette vapour does. Because, and I can’t emphasise this point enough, THEY COULDN’T DO THE STUDY WITH EQUIVALENT DOSES OF CIGARETTE SMOKE BECAUSE IT KILLED ALL THE CELLS.

(Update)

Since first posting, Dr Farsalinos has added this comment on the methodological error of the experiment itself:

…when you want to look for effects such as inflammation or DNA beaks you need to have cells which have survived the exposure to the medium. In the case of tobacco cigarette smoke, it is so toxic that cells die so you cannot measure any effect. However, what you SHOULD DO is dilute the smoke extract to levels that are not cytotoxic (so that cells survive). Then, you should do the same with the e-cigarette aerosol extract. The problem (for the researchers) was that if they had done that they would see almost no adverse effect from e-cigarette aerosol exposure.

(This appears in full with more context on Clive Bates’ blog, here)

What has been missing from a lot of the reporting are these few statements that should have alerted any journalist to dig deeper and beyond the PR to find out if such salacious headlines were in fact factually accurate, or the scenario even possible:

She notes that cells in the lab are not completely comparable to cells within a living person.

The cells lines that scientists work with have been “immortalized because of certain cell changes,” she says. So it could be that e-cigarette vapor has different effects than those seen in the lab.

Also, her team didn’t seek to mimic the actual dose of vapor that an e-cigarette user would get.

“In this particular study, it was similar to someone smoking continuously for hours on end, so it’s a higher amount than would normally be delivered

For a scientist to outline the above, and then come to the conclusion that “based on the evidence to date, I believe they are no better than smoking regular cigarettes.” is nothing short of bizarre.

The press release suggests that ”the over arching question” is whether vaping products are any safer that tobacco cigarettes.

We would suggest that the more pertinent question might be the real life consequences of such bad science, should smokers be turned off moving to a less harmful alternative, or a vaper goes back to smoking.

The study and the manner in which the story was reported on the media has gained quite a lot of criticism.  Below is just a sample of that opinion expressed on social media yesterday from those working in tobacco control, and public health.

#withdrawpaper if ever there was a case for a journal to rectify an error this is it #ecigshttps://t.co/r1kR9JRc92

— Robert West (@robertjwest) December 30, 2015

This study does not support these conclusions & this erroneous message could cause deaths #badscience#irresponsiblehttps://t.co/aPpWyM99zC — Susan Michie (@SusanMichie) December 30, 2015

This paper should never have got through peer review. The conclusions are wrong. It should be withdrawn #ecigshttps://t.co/NeArE2tgOi — Susan Michie (@SusanMichie) December 30, 2015

A shockingly dishonest article on #ecigs in @Independent – ‘Vaping ‘no better’ than smoking regular cigarettes’ https://t.co/oxfnengX9o — Rick Lines (@LinesRick) December 30, 2015

.@jasperhamill – there’s *a lot* wrong with that #ecig coverage. It’s disturbing if you still can’t see that > https://t.co/zy9eZFhgOX

— Clive Bates (@Clive_Bates) December 30, 2015

What appalling reporting. Just read the final sentence. https://t.co/fRlgUUNRm6 — Peter English (@petermbenglish) December 30, 2015

@ianjmatt the cell study in the papers today? Please don’t be alarmed. This is not evidence that #ecigs are as harmful as smoking. — Linda Bauld (@LindaBauld) December 30, 2015

There seems to be a palpable sense of frustration among some of the tweets and exchanges that we have seen. Perhaps because they understand more than most that in order to keep people who are still smoking fully informed of all the options open to them, research and reporting like this isn’t useful. Those who still choose to smoke should be informed that the health risks involved in continuing to smoke are higher than the small amount of risk involved in using a vaping product.  

Public Health England re-iterated the importance of balanced risk communication so that smokers are not put off trying vaping:   

…provide the public with clear and accurate information on the relative harm of nicotine, e-cigarettes and smoked tobacco. Nearly half the population don’t realise e-cigarettes are safer than smoking, and studies have shown that some smokers have avoided switching in the belief that e-cigarettes are too dangerous.

As did this study looking at how the perceived relative risk of vaping can affect smokers and would-be switchers, which followed respondents over two years. When they found that the portion of people who accurately thought that vaping was safer than smoking had decreased, the authors speculated:  

…that this may be due to a predominance of reports and discussions focusing on the risks of e-cigarettes without comparison to the much greater risks posed by cigarettes.

Among a cohort of smokers and ex-smokers, accurately perceiving e-cigarettes as less harmful than smoking predicted subsequent e-cigarette use in never-users; this perception declined over time. Clear and balanced information on the relative harm of e-cigarettes and cigarettes is needed.

The IVVA stands by the position that more research on vaping products is needed and welcomed. But we are also going to publicly call for research to be conducted in a proper manner and that the science be communicated by the media in a way that responsibly informs the public, the industry and policy makers.            

For now, we’re going to leave the final words to Dr Michael Siegel:

“not only is this conclusion baseless, but it is damaging to the public’s health. It undermines decades of public education about the severe hazards of cigarette smoking. To declare that smoking is no more hazardous than using e-cigarettes, a non-tobacco-containing product is a false and irresponsible claim.”   One of Siegel’s chief concerns about the misrepresentation of e-cigarettes is many ex-smokers who took up vaping may switch back to regular cigarettes if they believe there is no difference between the two. “This will cause actual human health damage, not merely damage to some cells in a laboratory culture.”

and Professor Robert West:    

The study did not find this – not even remotely. Alas public health science is being dragged down by this nonsense https://t.co/uVX0MSBbnN — Robert West (@robertjwest) December 30, 2015

Further reading on this topic:

NNA UK

The Stats Guy

Clive Bates

Daily Caller

ECITA

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[vc_row][vc_column][vc_separator][vc_single_image image=”1108″ img_size=”medium” align=”vc_align_center”][vc_column_text]The following piece has been re-posted here with the kind permission of the New Nicotine Aliance UK. The original post can be found here.

A new study released in the January 2016 volume of Oral Oncology has garnered attention in the media. Unfortunately the attention it has garnered highlights several misleading points from the study leading to headlines in on-line media that will create a severely negative impression. After reading the study alongside the press releases, several things become abundantly clear.

Although cell studies have some value, presenting them with press statements making ridiculous claims about supposed findings and interpretations makes the whole issue look more like a joke. A wise comment from Dr Farsalinos from May 2015, however these “studies” keep getting churned out some with, and some without scary press releases. But as it is that time of year when folk are more likely to make a quit attempt either due to someone buying them a starter kit for Christmas, or they’ve made a resolution to “kick the habit” at the start of the year; you wouldn’t be surprised to see the useful idiots trumpeting all kinds of daft claims about “the dangers of e-cigarettes”.

Picked up via the Eureka Alert site, the headline of “Cell harm seen in lab tests of e-cigarettes” is one of those types of headlines that will get translated into something more sensationalised by the slathering copy & paste press “journalists”. Especially when you have a line in the press release that says:

Adding to growing evidence on the possible health risks of electronic cigarettes

Which will of course be interpreted as “more evidence that e-cigs cause harm” by journo hacks. You know how it works. So what exactly did this intrepid team of researchers do, and what did they find out?

• Cells in an artificial environment (in vitro)
• Two e-cig brands V2 and VaporFi (supposedly two of the most popular currently on the market)

These budding scientists sought to assess the contribution of e-cigs to the pathogenesis and progression of head and neck squamous cell carcinoma (HNSCC), a disease for which traditional cigarette smoking is a well-established risk factor yet the potential role of e-cigs has remained entirely unexplored. In other words, are e-cigs likely to cause cancer of the head or neck to the same degree that cigarette smoking is “well-known” for. So, stick some cells in a petri dish so they swim about in e-liquid “extract” and see if the cells “die”. In the words of the press release:

Her team created an extract from the vapor of two popular brands of e-cigarettes and used it to treat human cells in Petri dishes. Compared with untreated cells, the treated cells were more likely to show DNA damage and die.

Plus there’s this little nugget, which will no doubt create some scary headlines (emphasis mine):

The exposed cells showed several forms of damage, including DNA strand breaks. The familiar double helix that makes up DNA has two long strands of molecules that intertwine. When one or both of these strands break apart and the cellular repair process doesn’t work right, the stage is set for cancer.

Oh right, so if you drown your cells in e-liquid it’s going to cause irreparable damage to the double-helix setting the stage for cancer. Really? Oh, by the way I almost forgot to mention that the cells were swimming in the solution for up to eight weeks with the treatment media being replaced every three days. That’s 24 hours a day for up to eight weeks. But, as the lead author states:

her team didn’t seek to mimic the actual dose of vapor that an e-cigarette user would get.

So nothing to do with real world usage then. I doubt that this snippet will see the light of day:

She notes that cells in the lab are not completely comparable to cells within a living person. The cells lines that scientists work with have been “immortalized because of certain cell changes,” she says. So it could be that e-cigarette vapor has different effects than those seen in the lab.

Bit of a shortcoming there when combined with the lack of real world usage. It’s like bathing rat cells in liquid nicotine and extrapolating that effect to human cells. It doesn’t translate all that well.

“Based on the evidence to date,” she says, “I believe they are no better than smoking regular cigarettes.”

Cue the grandiose headlines claiming that e-cigs are no better than smokes! Bravo! Now here’s more grant money to find out more. What I did take away from reading this paper was that even though they did look at cigarette smoke, they didn’t always report the results and when they did it was only for comparison. Not to mention the cell cultures were specifically chosen to “represent e-cig smokers that already have HNSCC (head and neck squamous cell carcinoma)” Interestingly, the rate of “cell death” doesn’t vary that much between the two brands with or without nicotine.

The “healthy” cell line (HaCat) shows consistently low “cell death” with an upper percentage of ~7-8%, even when exposed to cigarette smoke or to nicotine. Remember, the other two cultures (UMSCC10B and HN30) were deliberately chosen from head and neck squamous cell carcinoma cell lines. If you ignore the fact that cancerous cell lines were chosen, the graph can look pretty scary. The reality is, we know that vaping may carry some risk compared with cigarette smoking, and it’s a risk we are prepared to take, just as we did with smoking. All this study is highlighting is the fact that exposing already cancerous cells to cigarette smoke, nicotine or vapour may accelerate cell death, but of course only if you swim in it. So, the science is pretty clear if a little weird. After all, the first rule of toxicology is “the dose makes the poison” so drowning near-human cells in anything will have an effect, but you cannot specifically claim that it is “cancer causing” that is pure propaganda, not science. So the researchers writing statements like:

“Our study strongly suggests that electronic cigarettes are not as safe as their marketing makes them appear to the public”

Or like:

For now, we were able to at least identify that e-cigarettes on the whole have something to do with increased cell death

And finally:

I believe they are no better than smoking regular cigarettes

Diminishes what little value this research has, after all no credible researcher anywhere believes that, simply because it’s patently and inherently wrong. What we have here is yet another demonstration of science being distorted by personal bias and the results being mis-reported by so-called science journalists.

Provided with thanks from the following blog post.

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Today the Advocate General issued her opinion on the independent company Totally Wicked’s legal challenge to Article 20 of the TPD. It is important to emphasise that this is no more than an opinion. It does not constitute a judgement. This opinion will be considered alongside the opinions of other stakeholders early next year. These combined opinions will assist the CJEU judges in reaching a decision.

The IVVA hopes and expect that the CJEU judges will not blindly endorse this particular opinion. To do so would be to damage an emerging industry and, indirectly, to protect the position of the incumbent: tobacco. Though vaping is an imperfect alternative, it offers an exciting vista of new pathways away from cigarettes. To hamper vaping’s early development would be to stunt the growth of the most promising harm-reduction alternative to tobacco smoking.

The full press release from the CJEU can be found here, and comment from Managing Director of Totally Wicked, Fraser Cropper, can be found here.

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The deadline for the public consultation conducted by the Dept. of Health on the transposition of the Tobacco Products Directive passed yesterday.

While we fully welcome the Department’s call for submissions, we were disappointed by the manner in which the consultation was conducted. There was no draft legislation document or cost impact analysis included in the submission call. Additionally, there were only four questions that related to the non discretionary measures within Article 20, one of which did not present any opportunity for additional commenting, and as it was in the form of a SurveyMonkey link with strict character and word limits set, there was no opportunity to attach any supporting documentation.

We therefore felt that it was important that the additional comment section contained our views on the question relating to the mandatory labeling.

In addition, we felt that the consultation document somewhat excluded the opportunity to put forward views on the TPD as a whole, and so we welcome future stakeholder engagement as the transposition moves through the next stages.

Below is the IVVA response copied in full, and we are happy to note that an additional ten supporting but non member companies joined us in the submission.

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The Department of Health has today announced that it is seeking views on the transposition of the revised European Tobacco Products Directive (2014/40/EU).

The announcement can be found here, and the consultation document can be downloaded in PDF form here.

Rather disappointingly, the consultation documents do not contain any proposed text of the regulation, and the time frame for submissions to the consultation is merely a month. The consultation questions are rather vague, and from initial reading, it does not seem to take into account  how some of the more egregious details in the directive will impact the smaller businesses in this sector.

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The IVVA was contacted by a journalist from the Irish Independent yesterday. We were asked for a comment regarding the announcement of the new ASAI code of advertising, which we wrote about here.

Our short statement of comment was sent, the resulting piece has now been published, and the IVVA would like to address a few points raised in it. Continue reading →

The Advertising Standards Authority of Ireland (ASAI) have today announced a change to their advertising standards code, and this 7th edition of the code comes into effect in March of 2016.

We note that in the press release accompanying the announcement, they say ”New Code rules include that “marketing communications for e-cigarettes should be socially responsible and should contain nothing which promotes the use of a tobacco products or shows the use of a tobacco product in a positive light.”

Perhaps it’s worth emphasising that IVVA members are not part of the tobacco industry.  We do not sell tobacco products, but rather an alternative that carries a vastly lower risk. Our members therefore would have no interest in promoting our competitors’ products.

The new code can be viewed here, and the section the pertaining to e-cigarettes begins on page 105.

The ASAI state:

The majority of e-cigarettes are currently sold as consumer goods, however advertisers may seek a medicines licence for their product from the Health Products Regulatory Authority (HPRA). The rules in this Section also apply to marketing communications for electronic cigarettes which are authorised by the HPRA. For products authorised as medicines, the rules in Section 11: Health and Beauty also apply.

Depending on the formulation of their product and the means by which it is supplied, advertisers may have obligations relating to their advertising under chemical classification, labelling and packaging legislation. Advertisers are encouraged to take legal advice to ensure compliance with the law.

Among the measures included in the code are the following:

 Marketing communications for e-cigarettes should be socially responsible.

Marketing communications should make clear that the product is an e-cigarette and not a tobacco product.

Marketing communications should not encourage non-smokers or non-nicotine-users to use e-cigarettes.

Marketing communications should not be directed at people under 18 through the selection of media or the context in which they appear. No medium should be used to advertise e-cigarettes if more than 25% of its  audience is under 18 years of age.

Advertisers should not use health professionals or celebrities to endorse electronic cigarettes.

Marketing communications should state clearly if the product contains nicotine. They may include factual information about other product ingredients.

Marketing communications should not be likely to appeal particularly to people under 18, especially by reflecting or being associated with youth culture. They should not feature or portray real or fictitious characters who are likely to appeal particularly to people under 18. People shown using e-cigarettes or playing a significant role should not be shown behaving in an adolescent or juvenile manner.

The IVVA broadly welcomes the new code for advertising vaping products set out in the revised ASAI code.

E-cigarettes contain no tobacco, no tar, and involve no combustion of burning material.

In order to maintain the massive public health gains that these products offer in reducing the harm from smoking, it’s important that advertising restrictions be proportionate.

Reaching adult Irish smokers with socially responsible advertising of these alternative products that carry such a lower risk profile compared to tobacco cigarettes, is vital.

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Today brings the news that a court date has been set for the case being taken by Totally Wicked, one of the UK’s leading electronic cigarette manufacturers who are challenging the validity of the EU Tobacco Products Directive (TPD) at the Court of Justice of the EU (CJEU) in Luxembourg.

On the website dedicated to collecting signatures of support for the Article 20 challenge, Totally Wicked has said –

”This is great news, not just for us, but also for the wider industry and vapers across the whole of the EU… The TW court case is an historic opportunity to turn the tide away from bans and restrictions towards regulation that is proportionate, and genuinely risk based.”

Below is a video recorded earlier this year, in which the case is discussed with Mr Clive Bates of Counterfactual Consulting:

Totally Wicked’s challenge is based on its view that Article 20 of the TPD represents a disproportionate impediment to the free movement of goods and the free provision of services, places electronic cigarettes at an unjustified competitive disadvantage to tobacco products, fails to comply with the general EU principle of equality, and breaches the fundamental rights of electronic cigarette manufacturers.

Totally Wicked’s case is that e-cigarettes deliver to the consumer “clean” nicotine without the tar, carbon monoxide, and volatile hot gases of tobacco cigarettes. This “clean” nicotine contains only a fraction of the 7,000 chemicals contained in ordinary tobacco cigarettes. Delivery is through the act of vaping rather than through the combustion of tobacco and inhalation of smoke, as with conventional tobacco products.

Accordingly, Totally Wicked believes that e-cigarettes greatly reduce the risk of adverse health effects and death associated with smoking conventional tobacco. This risk reduction produces an obvious benefit to public health, whilst also satisfying a user’s strong desire for nicotine and the “behavioural” aspects of smoking.

Totally Wicked believes that the Article 20 restrictions will result in:

(a) less innovation in a demanding consumer market;

(b) fewer suppliers in the marketplace, as the remaining larger players will be tobacco or pharmaceutical companies, or be backed by them;

(c) a reduced product range for consumers, which will mean current tobacco and electronic vaporiser users may not find suitable strength products on general sale in the marketplace;

(d) regulatory burdens will increase product costs; and

(e) as a result, electronic cigarettes will become less available than, and less attractive than, conventional tobacco cigarettes and other tobacco products; this restriction on the availability to consumers of a healthier, alternative product to conventional tobacco will mean:

(i) a significant number of existing electronic cigarette users return to smoking conventional tobacco products;

(ii) a number of future and existing tobacco cigarette smokers will not have a readily available, attractive e-cigarette alternative which delivers nicotine to the bloodstream at anywhere near the level that conventional tobacco cigarettes do.

In addition, legitimate e-cigarette manufacturers and retailers in the EU will not only have to comply with the burdens imposed by TPD, but will have to compete with e-cigarettes continuing to be produced outside the EU, unburdened by the new regulatory regime, and also with “black market” e-cigarettes produced illegitimately within the EU.

The IVVA would like to publicly lend their support to, and sincerely thank Totally Wicked and their Managing Director Mr Fraser Cropper, in taking these steps that highlight the fact that Article 20 of the TPD is not the right legislation for vaping products.

Our members would also ask that you will join us by adding your name to the list of supporters. To do that, or find out more about the case, you can visit the Article 20 Challenge website.

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This post by Tom Pruen, Chief Scientific officer for the Electronic Cigarette Industry Trade Association was originally published here, and is posted below with the kind permission of ECITA.

An editorial in the Lancet  identifies that 3 (out of 11) contributors to a single point of research had previously been paid as consultants by various parts of the e-cig industry (and most would have been paid at some point by the pharmaceutical industry).

The Lancet rather bizarrely considers that this “raises serious questions not only about the conclusions of the PHE report, but also about the quality of the agency’s peer review process” [i]

This editorial resulted in dramatic stories in the Daily Mail and Telegraph :

As the pictures show, these stories were shared widely.

Do these stories accurately reflect the truth?

The answer is very simple: No.

While it is true that there were people on the panel who had been consultants for the e-cig industry, on unrelated work, the vast majority did not. The methodology of this work was also somewhat subjective (although, as Prof. Nutt points out , the same methodology has been used for Drugs of abuse, without comment, and indeed the report itself was not criticised at the time of publication).

As he also points out (and it should be noted that Prof Nutt is not one of the authors the Lancet alleges was conflicted):

“The expert group was chosen by members of the DrugScience scientific panel with the help of other UK experts to provide [sic] international expert group with expertise across the various disciplines of health, psychology, addiction, pharmacology, toxicology, neuroscience etc; the final panel was an impressive group. As is inevitable in such a field several had or had had ‘interests’ in aspects of nicotine and tobacco supply or harm reduction, and these were declared at the time.”

Nor is it clear why one of the author’s involvement with an Italian anti-smoking charity (LIAF) would be implied as a conflict of interest – this seems exceptionally bizarre!

But even if we ignore Prof. Nutt’s statement that:

 “… it is important to re-emphasise that the MCDA process is such that neither individuals nor even groups with particular biases can significantly influence the outcomes.”

and largely disregard this particular work, would it affect the conclusions of PHE?

Probably not.

As someone who is closely tied to the e-cig industry, I am not privy to the workings of PHE, but equally, as someone with a professional interest in the science surrounding the e-cig debate I am more than passingly familiar with the evidence.

There is a significant body of evidence – too much, in fact, to easily detail (although there’s a bit of list in this previous blog, which shows how little the debate has moved on).

All the evidence to date shows that, when used under real world conditions,  e-cigs generate somewhere between much less and none of the harmful constituents of smoke. One of the most cited studies on e-cig vapour described that levels were 20 to 450 times reduced compared to smoke.

Much of the evidence is in a similar vein, either known-to-be-harmful smoke constituents are completely absent, or present at less than 1/20^th of the levels in smoke.

If the highest levels of known-to-be-harmful chemicals are 1/20^th of those in smoke, that would make e-cigs much less than 95% of the risk of smoking.

There remains some uncertainty about the novel exposure to some of the ingredients in e-cigs (although all are considered to be safe at similar levels through other routes of exposure), so an estimate of only 95% safer, is actually quite conservative, and cautious (and almost certainly the estimate of residual risk at 5% is too high).

On the basis of this evidence, unless the unnamed author(s) of the Lancet article consider the authors of the PHE report to be either incompetent or dishonest, it is unclear to see how this attack on the conclusions of the PHE report can be justified.

The Lancet article would seem therefore to be yet another case of striking fear into smokers who might otherwise switch to e-cigs, something  that the PHE report raises concerns over:

“The ongoing negative media campaigns are a plausible explanation for the change in the perception of EC safety”.

“There is a need to publicise the current best estimate that using EC is around 95% safer than smoking.”

Similarly, ASH (an organisation that is ‘somewhat unlikely’ to have e-cig industry related conflicts of interest) raises concerns over the incorrect perception of harms :

“The number of ex-smokers who are staying off tobacco by using electronic cigarettes is growing, showing just what value they can have. But the number of people who wrongly believe that vaping is as harmful as smoking is worrying. The growth of this false perception risks discouraging many smokers from using electronic cigarettes to quit and keep them smoking instead which would be bad for their health and the health of those around them.”

ASH were also rather dismissive of the attack launched by the Lancet:

“To criticise Public Health England for quoting an estimate, contained in the expert review it commissioned, that e-cigarettes are 95% less harmful than tobacco on the basis that the methodology behind the estimate was weak is to miss the point.”

“Public Health England has a statutory responsibility to ‘promote the health and wellbeing of the nation’. It has not fallen short. It has fulfilled its mission by putting the message out clearly – while electronic cigarettes are not risk free, they carry only a fraction of the harm caused by smoking”.

We have a view on this too:

Promoting doubt and fear over the safety of e-cigs is costing lives, and it needs to stop.

After this blog was drafted, the authors of the PHE report responded directly to the Lancet article, and this response is recommended reading.

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[vc_row][vc_column][vc_separator][vc_single_image image=”1191″ img_size=”medium” align=”vc_align_center”][vc_column_text]Headlines suggesting (and in some cases outright declaring) that smokers will be given e-cigarettes free on the NHS have emerged in the UK today. But is that the main point made by the report on which it’s based?

The report, commissioned by Public Health England and published today, is made up of two documents, and they can be downloaded in PDF form here:

E-cigarettes: an evidence update

E-cigarettes: a new foundation for evidence-based policy and practice

Nowhere does it explicitly say that e-cigarettes should or even will be given out ”free on the NHS”, but what the report does say is that

PHE looks forward to the arrival on the market of a choice of medicinally regulated products that can be made available to smokers by the NHS on prescription. This will provide assurance on the safety, quality and effectiveness to consumers who want to use these products as quitting aids.

This relates to the provision in the Tobacco Products Directive that if an e-cigarette company wishes to market their product as a smoking cessation device, it must first get its product medicinally licensed (in the UK, by the MHRA).

If the company does not wish to apply for and obtain a medicinal license, then the Tobacco Products Directive applies.

On the surface at least it appears this might be another case of a media headline frenzy that bears not very much relation to the actual report content.

But the report should be seen as a positive endorsement of vaping products, not least because it presents and summarizes evidence in a balanced manner, but it also lays out very clearly that vaping is already, and should be more so in the future, a positive thing for public health.

Here are some of the other key points contained within the two documents:

(The report in total consists of 117 pages, so this is by no means an exhaustive list. Also, due to the structure of the report, quotes below are taken from summary as well as chapter sections of the original documents.)

(Throughout most of the report, ‘EC’ is used as shorthand for ‘electronic cigarettes’.)

The report comments on the evidence that as e-cigarette use in England rises, both adult and youth smoking rates are declining. They find no evidence to date of any gateway
effect of youths using e-cigarettes and then moving on to more harmful tobacco cigarette use. The section in bold below (emphasis theirs) spells this out quite clearly indeed:

We strongly suggest that use of the gateway terminology be abandoned until it is clear how the theory can be tested in this field. Nevertheless, the use of EC and smoking requires careful surveillance in young people. The preferred option is that young people do not use EC but it would be preferable for a young person to use an EC instead of smoking, given the known relative risks of the EC and smoking cigarettes

Overall, the adult and youth data suggest that, despite some experimentation with EC among never smokers, EC are attracting few people who have never smoked into regular use.

…the vast majority of youth who regularly use EC are smokers.

Regular EC use in youth is rare.

 

These findings, to date, suggest that the advent of EC is not undermining, and may even be contributing to, the long-term decline in cigarette smoking.

The emphasis above is ours, simply because it is a statement that warrants repeating. If the numbers of vapers increases at the same time as the numbers of smokers is declining, then can e-cigarettes really continue to be seen as undermining a decline in smoking?

PHE makes it very clear that they have a role in making sure that the public is adequately informed of both the risk profile of e-cigarettes, and their positive potential:

It is important that the public be provided with balanced information on the risks of e-cigarettes, so that smokers understand the potential benefits of switching and so non-smokers understand the risks that taking up e-cigarettes might entail:

– when used as intended, e-cigarettes pose no risk of nicotine poisoning to users, but e-liquids should be in ‘childproof’ packaging. The accuracy of nicotine content labeling currently raises no major concerns

– the conclusion of Professor John Britton’s 2014 review for PHE, that while vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals present pose limited danger, remains valid. The current best estimate is that e-cigarette use is around 95% less harmful to health than smoking

– e-cigarettes release negligible levels of nicotine into ambient air with no identified health risks to bystanders

– over the last year, there has been an overall shift among adults and youth towards the inaccurate perception of e-cigarettes as at least as harmful as cigarettes

In the section relating to potential nicotine poisoning hazards, it is noted that:

Nicotine in the form of tobacco and more recently NRT has been available to thousands of millions of people and large numbers of them, including small children, have ingested considerable doses of nicotine. Fatal nicotine poisoning, however, is extremely rare. This fact strongly contradicts the often-repeated claim that an ingestion of 30-60mg of nicotine is fatal. The source of this claim proved difficult to locate – textbooks just cite
older textbooks. Eventually, the assertion was found to be based on dubious self-experiments conducted in the 1890s.

With the increase in EC use, there has been an increase in calls to poison centres following accidental exposures but these remain lower than calls following such exposure from tobacco and none resulted in any serious harm Serious nicotine poisoning seems normally prevented by the fact that relatively low doses of nicotine cause nausea and vomiting, which stops users from further intake.

E-liquid normally comes in 10ml bottles containing up to 360mg of nicotine. This poses no risk to vapers if used as intended. The liquid however should be in ‘childproof’ packaging to prevent small children, who may find the flavouring appealing,from drinking it. This seems to have been widely accepted by the EC industry. All e-liquids we have seen so far in the UK and globally were sold in child-resistant packaging.

This (10ml, 36mg nicotine strength) poses no risk of nicotine poisoning if used as intended. An overenthusiastic vaper, like someone who is over-smoking, receives a reliable warning via nausea. If the 10ml bottle of e-liquid was drunk, it would cause nausea and vomiting but would be unlikely to inflict serious harm.

Regulatory interventions should ensure optimal product safety but make sure EC are not regulated more strictly than cigarettes and can continue to evolve and improve their competitiveness against cigarettes.

If EC continue to improve in the speed of nicotine delivery, they are likely to appeal to more smokers, making the switch from smoking to vaping easier. It may be important in this context to note that if the smoking-associated risk is removed, nicotine use by itself, outside pregnancy, carries little health risk and in fact
conveys some benefits.

The report outlines the current UK policy framework on e-cigarettes, and correctly acknowledges that the Tobacco Products Directive will have a negative impact on the product choices that will be available to current smokers, and that aspects of the directive will negatively impact on smaller companies and product innovation:

The revised TPD will introduce new regulations for EC or refill containers which are not licensed by the MHRA. The cap on nicotine concentrations introduced by the TPD will take high nicotine EC and refill liquids off the market, potentially affecting heavier smokers seeking higher nicotine delivery products.

The fact that no licensed EC are yet on the market suggests that the licensing route to market is not commercially attractive. The absence of non-tobacco industry products going through the MHRA licensing process suggests that the process is inadvertently favouring larger manufacturers including the tobacco industry, which is likely to inhibit innovation in the prescription market.

The above point is also expanded on elsewhere:

This means that small manufacturers, particularly non-tobacco industry manufacturers, who may be producing a greater variety or more satisfying EC, will not compete with larger  corporations such as the tobacco industry in the prescriptions market.

There are several consequences of this which should be explored. These could include an inhibition of innovation and damage public health.

Alternatively, given the demand for prescribed EC products is as yet unknown, particularly in the population groups where smoking prevalence is elevated, the medicinal route may not impact public health.

The appeal of EC may rest in the fact that they are not medicines. A review of the MHRA licensing process for EC, and its likely impact, is recommended.

While Ireland’s plan to have reach ”endgame on tobacco” by reaching a smoking level of less than 5% by 2025, no where currently in that plan is there any mention of what role vaping products may have in helping to achieve it.

In direct comparison,

PHE’s ambition is to secure a tobacco-free generation by 2025. Based on the evidence, we believe e-cigarettes have the potential to make a significant contribution to the endgame for tobacco.
With opportunity comes risk, and a successful approach will be one that retains vigilance and manages these risks, while enabling a flourishing and innovative market with a range of safe and effective products that smokers want to use to help them quit.

They also recognise that, as is the case in Ireland, as smoking rates decline prevalence is becoming more concentrated in lower socioeconomic populations and specific groups, such as people with mental health issues or prisoners, and they see that e-cigarettes have a definite role in helping these smokers move away from tobacco smoking:

Smoking is increasingly concentrated in disadvantaged groups who tend to be more dependent. EC potentially offer a wide reach, low-cost intervention to reduce smoking and improve health in disadvantaged groups.

Some health trusts and prisons have banned the use of EC which may disproportionately affect more disadvantaged smokers. …The rationale for such prohibition is unclear.

…there is an opportunity for e-cigarettes to help tackle the high smoking rates among people with mental health problems, particularly in the context of creating smoke free mental health units.

EC should not routinely be treated in the same way as smoking. It is not appropriate to prohibit EC use in health trusts and prisons as part of smoke free policies unless there is a strong rationale to do so.

There are some questions that need to be asked though, and they are –

What effect if any might this report have on Ireland’s draft consultation of the Tobacco Products Directive implementation?

Have Irish smokers been dissuaded from trying e-cigarettes by the sometimes vague (and sometimes explicit) negative messages about vaping products from both those in political and public health circles here?

And once the Irish Department of Health has reviewed the current evidence, what might we expect to see published by them, the National Tobacco Control Office, or Healthy Ireland so that the Irish public can start to see a wider, more open discussion on tobacco harm reduction and vaping products?

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Do you operate an independent electronic cigarette retail business in Ireland?

This event is for you.

The Irish Vape Vendors Association
in association with the
Electronic Cigarette Industry Trade Association

would like to invite you

to an Irish electronic cigarette industry seminar

on Wednesday the 17th of June 2015
at Bewley’s Dublin Airport Hotel, Stockhole Lane, Swords, Co Dublin

The IVVA’s aims include:

• To promote and protect the business interests of vendors of vaping products in Ireland.
• To represent the views of Irish vendors on matters relating to this industry.
• To act as as advisory service with respect to legislation, industry changes, emerging scientific data, etc..
• To advocate for fair and appropriate legislation for the electronic cigarette industry which will keep businesses operating in it profitable.

For all electronic cigarette businesses operating in Ireland
to grow and survive the regulatory climate that
we’re both in now,
and facing in the future,
we need to remain informed and fore-armed.

The IVVA and Katherine Devlin, President of ECITA, have put together an outline of the most important issues affecting our industry, and although more speakers may be added before the day of the event, the topics that will be covered include:

– Industry engagement with national and international government bodies, and implementation of Tobacco Products Directive (TPD) into Member States (with an emphasis on Ireland)

– Requirements and restrictions under TPD

– Investigating the legal challenge at the European Court of Justice – what happens if it wins? If it loses?

– Overview of the wider regulatory climate in Ireland

– Creation of Standards: British Standards Institute PAS54115

– CEN (European Standards), and beyond

Download Draft Agenda (PDF)

Download Booking Form (DOC)

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A new study from a team of researchers led by cardiologist and e-cigarette researcher Dr Konstantinos Farsalinos was published in the journal Addiction today, and below is the press release that accompanied the publication.

The IVVA would re-iterate that in order for research to properly inform the understanding of these consumer products, the study needs to be properly designed in order to take into account real-world end user experiences.

The ‘dry puff phenomenon’ is something that was not taken into account in previous research looking at aldehyde content, and Dr Farsalinos and his colleagues should be commended for taking into account how vaping products are actually used by consumers when designing the protocol for the study.

New study challenges claims on aldehyde content of third generation e-cigarettes

In January 2015 a report published as a research letter to the New England Journal of Medicine (NEJM) (1) found that a 3rd generation e-cigarette (an e-cigarette with variable power settings) set to the maximum power and long puff duration generated levels of formaldehyde that, if inhaled in this way throughout the day, would several times exceed formaldehyde levels that smokers get from cigarettes.  Media worldwide accordingly reported this new health hazard of e-cigarettes.

A new study published online today in the scientific journal Addiction took a closer look at the NEJM findings in the context of real-world conditions.  It concluded that 3rd generation e-cigarettes can indeed produce high levels of aldehydes – but only under extreme conditions which human smokers can be expected to avoid because of the immediate unpleasant sensory effects.

The Addiction study, led by cardiologist Dr. Konstantinos Farsalinos, found that it was possible to get e-cigarettes to produce high levels of aldehydes, but only in what is known colloquially as ‘dry puff’ conditions.  As Farsalinos explains: “Our results verify previous observations that it is possible for e-cigarettes to generate high levels of aldehydes; however, this is observed only under dry puff conditions, which deliver a strong unpleasant taste that vapers detect and avoid, by reducing power levels and puff duration or by increasing inter-puff interval. Minimal amounts of aldehydes are released in normal vaping conditions, even if high power levels are used. In those normal-use conditions, aldehyde emissions are far lower than in tobacco cigarette smoke.”

To inhale more formaldehyde than that produced by a standard cigarette, a vaper would need deliberately and repeatedly to experience what one vaping blog (2) describes as ‘the dreaded dry puff’:  “Dry puffs, also known as ‘dry hits’, suck. They taste awful, can make you cough, and can also have the terrible side effect of leaving e-liquid in your mouth. Once you experience it, you’ll probably do all you can to prevent it from happening again!”

Professor Peter Hajek, director of the Tobacco Dependence Research Unit at Barts and The London School of Medicine and Dentistry, UK, says of the Addiction study: “These findings emphasise the importance of making clear the conditions in which tests of this kind are undertaken and avoiding sweeping assertions that can mislead the public. Vapers are not exposed to dangerous levels of aldehydes. My reading of the evidence is that e-cigarettes are at least 95% safer than smoking. Smokers should be encouraged to switch to vaping.”

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In reply to the announcement of the findings of a survey conducted by the Irish Cancer Society today, the IVVA have issued the following press release:

The Irish Vape Vendors Association have noted a statement released by the Irish Cancer Society today, which calls for the regulation of electronic cigarettes as medicines.

”There are now thousands of Irish people who are tobacco free thanks to electronic cigarettes, but the IVVA see a number of conclusions reached by the Irish Cancer Society  which unfortunately may have the result in turning smokers away from trying them,” said Gillian Golden, administrator of the IVVA.

”The study data they refer to in their statement found that some users of electronic cigarettes are also using tobacco cigarettes, and the Irish Cancer Society incorrectly make the claim that this points to e-cigarettes cutting down a smoker’s chance of quitting”.

In trying an electronic cigarette for the first time, many smokers experience a transitional period whereby they may begin by replacing some of their usual smoking with e-cigarette use, and then gradually increase that use to a point whereby they no longer feel the need to smoke. The cross sectional data referred to by the Irish Cancer Society does not acknowledge this.

”The NRT treatments that prove to be successful for some smokers may not work for others. And those are often the very people that have great success with switching from combustible tobacco to electronic cigarettes as a way of reducing their exposure to harm. If smokers are unnecessarily warned away from these products, they may well just continue to smoke.”

The Irish Cancer Society also claim that there are currently no regulations covering electronic cigarettes, however the IVVA feel this is somewhat misleading the Irish consumer. As it stands today they are covered by a number of EU consumer product regulations, in such areas as chemical safety, electrical safety, weights and measures, packaging and labeling, commercial practice and data protection.

”A product that the scientific researchers can agree on being between 95% and 99% safer than tobacco smoking should be encouraged, not prohibited by medicinal regulation, and given the positive study results that similar public health bodies and charities have found in the UK, the position of the Irish Cancer Society is puzzling. Any policy that goes to regulating these products in Ireland must be science and not ideologically based.” said Golden.

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A new bill the proposing regulations for electronic cigarettes was announced recently by Senators Averil Power and John Crown that will subject vaping products ”to the same regulation as tobacco products. No more, no less.”

From the press release on Senator Powers’ website, the suggested bill aims to include a number of measures :

– A ban on the sale of electronic-cigarettes to those under 18 years of age;

– A ban on the consumption of electronic-cigarettes in bars, restaurants and other places of work

-A ban on the advertising of electronic cigarettes,

– A ban on sponsorship by manufacturers and importers of electronic-cigarettes, and

– A ban on the consumption of electronic-cigarettes in vehicles where persons under 18 years of age are present.

– Standardised packaging of electronic-cigarettes and the fitting of child safety caps on liquid nicotine bottles.

From the outset, the Irish Vape Vendors Association welcomes regulation, and we strongly welcome age restrictions on sales and proper childproof packaging.

Good regulation for this emerging industry maintains standards, fosters competition and innovation, and safeguards both industry  growth and the safety of consumers. Good regulation will keep the product an affordable and viable alternative for adult smokers wishing to find an alternative to smoking combustible tobacco.

But we also have to make it very clear that we feel this bill is over reaching and some of the proposed measures may have a negative effect on the public health of Irish citizens.

It should not be the government’s aim to over ride a business owners’ own personal or commercial choice on allowing the use of electronic cigarettes on their private premises. There is no evidence arising from correctly-conducted research that ‘second hand’ vapour is of any danger to bystanders, and in broader terms, to treat a harm reduction tool to exactly the same regulations as tobacco cigarettes flies in the face of logic. This reduced harm product will be put at a disadvantage to the more harmful product it replaces.

The IVVA hopes that both industry and consumers will be consulted during the bill’s progress, as there must be leave given along the way for the truth surrounding the positive research on these products to be made public.

The press release issued by the IVVA regarding this new bill can be found below.

Trade association cautiously welcomes e-cigarette regulations announced by senators.

The Irish Vape Vendors Association have cautiously welcomed the announcement of a bill that will regulate e-cigarettes in Ireland, announced last Friday by Senators Averil Power and John Crown. The bill will cover a number areas such as a ban on sale to people under 18, childproof caps on e-liquid bottles and product advertising. They claim, however, to have concerns that the bill may be too far reaching.

”We will obviously have to wait for the final wording, but the bill actually covers issues like safety caps on liquids and underage sales that are already written into our code of conduct”, said Gillian Golden, the IVVA’s administrator. ”Electronic cigarettes have proved a viable alternative for thousands of Irish smokers who would otherwise still be smoking, and we welcome this initiative that will keep them safely out of the hands of minors”.

The regulations would also seek a ban on using electronic cigarettes in public places like bars and workplaces, bringing them in line with existing regulations on tobacco cigarettes.

”There is however, a danger that regulations can go too far,” said Golden, ”and we would urge that the raft of research data that finds no significant risk to bystanders be considered, before these regulations are finalised. The only research that Senator Power has even made mention to in her announcement last week, has been flawed studies done with little understanding of how these products work, studies that have been debunked by international experts as misleading to the public.”

Senator Power has also claimed that electronic cigarette vapour gives off ‘toxic chemicals’ and ‘toxins damaging to bystanders’. But the IVVA say this is a misleading presentation of the scientific research that has been done over the last number of years into these devices. They say claims of toxic emissions have to take into account that in toxicology terms, ‘the dose makes the poison’. They explain that when you compare the levels of toxins found in electronic cigarette vapour, in terms of parts per million, any toxins that ARE found are at such low levels both in comparison to tobacco cigarettes, and in comparison to occupational safety limits, they are negligible. In some cases, the toxins are actually similar to the levels found in nicotine inhalers.

Igor Burstyn, from the Department of Environmental and Occupational Health, at Drexel University in Boston is one such scientist. When he conducted a systematic review of the vapour produced by electronic cigarettes, he found ”..that there is no evidence that vaping produces inhalable exposures to these contaminants at a level that would prompt measures to reduce exposure by the standards that are used to ensure safety of workplaces.”

This is an important discovery, which must have caught the attention of British MPs, who recently decided to allow people working at the houses of parliament in London to vape their electronic cigarettes in certain parts of the Palaces of Westminster, including the bar on the parliament campus. It begs the question, if the UK have come to the conclusion that using electronic cigarettes in public is safe enough for members of their government, why isn’t that science being looked at in the same light here?

”From the moment of the bill’s announcement, we’ve seen a lot of misinformation and scaremongering in the media.” Golden continues.  ”We would hate to see adult smokers turned off this fantastic harm reduction tool because of catchy soundbites that have little basis in science and that aren’t backed up by research. Let’s not forget that recently 137 medical professionals from areas like tobacco research, public health, cardiology, and toxicology have all agreed with the findings that e-cigarettes are between 95% and 99% safer than smoking combustible tobacco.”

The association also claims that a number of measures suggested in this bill are unnecessary, given that work on a central European quality standard for the manufacture of e-cigarette products has already begun. Other measures, they say, may prove harmful to consumers, such as the plan to restrict the products to plain packaging. ”If we subject a harm reduction product such as e-cigarettes to the the same rules as the more harmful product they’re replacing, it makes them less attractive to the adult smokers who are looking for an alternative to smoking tobacco.”

ENDS.

About the IVVA: The Irish Vape Vendors Association represents independently owned Irish retailers specialising in e-cigarette products, and aims to safeguard both the advancement of the industry and consumer peace of mind. For more information you can visit their website at www.ivva.ie

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An article by Professor Robert West*, Editor-in-Chief of the journal Addiction, titled ”Electronic cigarettes: getting the science right and communicating it accurately” has caught the IVVA’s attention. In this post we’d like to share and expand on some of the points raised.
The article begins:

”Electronic cigarettes are being used by millions of people worldwide, mostly in an attempt to reduce smoking or stop altogether. Policy makers, smokers, clinicians and the public in general need accurate information on their safety and potential for reducing smoking rates. Unfortunately in some notable cases the science is being misused, with findings being distorted, misinterpreted or misrepresented. Interestingly, up until now this appears to be mainly (though not exclusively) by those who are opposed to electronic cigarettes. Addiction’s goal in this debate is to present evidence as dispassionately as possible whatever it shows, and to correct misinformation where it appears.”

Professor West then identifies some of the ways scientific research is misused:

Failure to quantify

Such as saying ”electronic cigarettes contains many toxins”. This is misleading; it’s an incomplete fact, because it doesn’t say anything about the type of toxins, what amount of toxins are found to be present, or at what levels.

The IVVA would suggest that a failure to compare results with tobacco cigarettes, also constitutes a failure to quantify. Electronic cigarette products are a harm reduction alternative to smoking tobacco cigarettes, and therefore we would share the view with the many researchers who maintain that comparisons with the harm from tobacco cigarettes should always be presented.

Dr Konstantinos Farsalinos from the Department of Pharmacology, University of Patras, & The Onassis Cardiac Surgery Center, Athens  is one of the most-published scientists on electronic cigarette research. He outlines an example of this, regarding a study conducted in 2013:

”Over the past month, a series of articles was published in a consumer magazine in France, presenting the results of a chemical study on e-cigarettes that was conducted on their behalf. The initial article mentioned that some e-cigarettes emit more toxic chemicals compared to tobacco cigarettes. However, there was no mention on the methodology or the results in detail. That article sparked worldwide media frenzy, with respected news-media reproducing the news with titles such as: “E-cigarettes are as harmful as cigarettes and could cause cancer” (Daily Mail), or “Cancer from e-cigarettes” (Greek newspaper). Obviously, no one cared about the true results of the study, it was the headline (and its distortion) that was “selling” to readers.

When the results were released (at first the range of findings was reported and subsequently a table with findings per sample tested), it was evident that the initial statement was not true. Chemicals like aldehydes (formaldehyde, acetaldehyde and acrolein) were indeed found, but the levels were similar to those found by Goniewicz and coworkers. In his study, Goniewicz concluded that the levels of such chemicals were 9-450 times lower in e-cigarettes compared to tobacco.”

Failure to account for confounding and reverse causality

The example Prof Wests uses is a statement like ”e-cigarettes reduces a smokers’ chance of quitting”. This is misleading, he maintains, because in cross-sectional surveys of smokers, ”the prevalence of e-cigarette use is higher in smokers than in recent ex-smokers.”

We’ve already seen an example of this in the Irish Cancer Society’s position paper on electronic cigarettes, and as we have already pointed out, presenting data using smokers who are already engaging in harm reduction by using electronic cigarettes to replace some of their daily smoking, and going on to accuse this ”dual use” of being of more harm is not only misleading. It’s frankly illogical.

Selective reporting

We know the types of headlines that are written to garner clicks and shares in this digital age, and so often in reporting on electronic cigarettes. The body of evidence that does not show harm, or shows a reduction is rarely if ever quoted to give balance, and so the public is often left with negative-only spin.

Professor West has himself been quoted only this week in an article on the Mirror Online: “Bad studies on e-cigarettes are easy to do and easy to get into top journals, which are hungry for publicity. Good studies are hard to do and are difficult to get into top journals if they do not lead to scare stories.”

The IVVA strongly believe that scare stories do nothing to add to such a serious debate as tobacco harm reduction.

Misrepresentation of outcome measures

West writes ”Claiming that e-cigarette use is prevalent among youth by using data on the proportion who have ever tried and creating the misleading impression that they are all current e-cigarette users.”

The most prevalent example of this can be seen in the US Centre for disease Control, where the misleading headlines covered up the fact that the level of current users amongst never-before-users was merely 0.3%.

The same can be seen here in Ireland too, with the statistic from Tobacco Research Institute, where Prof Luke Clancy’s figures were 1 respondent from the 900+ surveyed, yet headlines would rather have us believe is that this figure constitutes widespread youth uptake. When in fact it does nothing of the sort.

Double standards in what is accepted as evidence

For example, reporting on findings that have major issues in the scope of the protocol design or testing methods used, simply because their results suggest harm, while ignoring studies that show positive results, and where the protocols were better designed and the testing methods were more in keeping with how products are used in real life by consumers.

The ”formaldehyde study” that was recently written about in an article in the New England of Medicine is a prime example of this, and one we’ll be writing about in more depth in a future post. Although both the study itself, and the conclusions headline writers came to, have been repeatedly discounted as flawed here, here, here, here, here, and here, we’re unfortunately going to see lawmakers and policy makers continue to quote it as accurate. Why? Because public fear seems to feed into over-zealous regulatory agendas. Forgotten of course, in the public’s mind, is the small fact that when the tested devices were used correctly, no formaldehyde releasing compounds were found.

Discrediting the source

e.g., arguing that researchers who have received financial support from e-cigarette manufacturers (and even companies that do not manufacture e-cigarettes) are necessarily biased and their results untrustworthy, and presenting themselves as having no conflicts of interest when their professional and moral stance represents a substantial vested interest.

In closing, the IVVA would like to point out that we have many fine journalists and commentators on medical and public health matters here in Ireland. They should step up and present the research they’re reporting on, correctly. It is incumbent on them to report on the emerging research on electronic cigarettes in a responsible manner.

Catchy, negatively-spun headlines may sell more papers and get more clicks and likes, but the Irish public should not be mislead about the truth surrounding e-cigarette science.

*Robert West is Professor of Health Psychology at the Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London [/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_separator][vc_single_image image=”1180″ img_size=”medium” align=”vc_align_center”][vc_column_text]The IVVA have noted a new global initiative aimed at doctors, health professionals and scientists, called M.O.V.E.

Their website states ”In support of the initiative, the MOVE statement has been carefully written by leading scientists, doctors and international public health authorities appearing in the supporters list, to involve their colleagues in the importance of this debate.”

The statement then draws attention to the evidence for the following:

• It is the combustion of tobacco and the 4000 chemical substances that are produced when smoking cigarettes that are harmful to health of smokers, not the nicotine.
• The dangers of electronic cigarettes are considerably lower than those of tobacco. From analysis of the constituents of e-cigarette vapour, e-cigarettes can be expected to be at least 95 to 99% safer than smoking tobacco cigarettes in terms of long-term health risks.
• The vapour exhaled from e-cigarette users is highly unlikely to be harmful to bystanders; nicotine concentrations in exhaled vapour are too low to have pharmacological effects on bystanders.
• Randomised controlled trials show that e-cigarettes are effective in smoking cessation and studies of the use of e-cigarettes in real world settings show that they are more effective than other means for stopping smoking including Nicotine Replacement Therapy.
• It is estimated that for every one million people who switch from smoking to electronic cigarettes, some 6000 premature deaths a year would be averted.
• E-cigarettes do not ‘renormalise smoking’ – ‘vaping’ is not smoking. In many countries the rise in e-cigarette use has been accompanied by a continued decline in tobacco sales and prevalence of smoking.

The IVVA contacted one of the organisers, Carmen Escrig, for some more information:

Can you tell us how the idea for MOVE came about and who are the organisers?

The MOVE project emerged, like many other initiatives, as a distress signal from the EFVI Spain Platform, to deal with the constant attacks that eCigs have suffered in Spain. There has been an unprecedented misinformation campaign, orchestrated by major medical organizations funded by the pharmaceutical industry in the country; as a result, 95% of the Spanish electronic cigarette industry has been closed.

In our country, the medical-pharmaceutical sector has virtually unlimited powers and it has even gone so far as imposing sanctions on doctors who support electronic cigarettes as an alternative to smoking.

However we knew that, from the shadows, many doctors, scientists and healthcare workers were supporting us.

We realized that most real doctors and GPs, who really are in direct contact with patients, did not have the right knowledge about real progress in eCig science and its potential to save lives. Moreover, they were being bombarded daily with completely wrong information about this product.

We had to provide them with quality information. So we decided to perform an initiative based on the original idea of Dr. Philip Presles in France but extending it internationally.

What are your aims with the MOVE initiative?

Our main goal is to obtain and monitorize the global support of health professional community for electronic cigarettes; this way, we hope that the worldwide media, for the first time, releases real information about the electronic cigarette conflict.

Having 100 health professional supporters is significant, but having 1000 or 5000 would be an exceptional and unprecedented event. This fact could change the worldwide public opinion that has been systematically manipulated until now and will show that there is a scientifically based way to stop smoking by switching to this great harm reduction tool.

On the other hand, we want to create an ethical debate among the health professionals, about the importance of these devices as harm reduction tools and their potential to save lives.

Nobody had asked to health professionals about their opinion on vaping. They have not been objectively informed about the electronic cigarette potential impact on society. So MOVE tries to make them look at the large number of scientific studies that have been conducted up to now and invites them to actively learn and take part in the debate and to always compare the effects of electronic cigarettes with the tobacco smoking on health.

Another aim is to cause a political debate about the restrictive regulations such as the European Tobacco Products Directive. Legislators cannot continue looking the other way when a large proportion of health professionals are claiming for a fertile ground to the growth of this alternative.

Would you say that it’s important that the medical and healthcare community support it?

We need to find more supporters in the healthcare community, with criteria and scientific arguments, capable of defending electronic cigarettes as a tobacco harm reduction tool, and a way to save millions of lives.

We already have great scientists, doctors and public health authorities supporting us, but it is our commitment to call for the help of those who, although they’re secretly supporting us, are still afraid of possible reprisals if they express their public support. They only will lose that fear if they are supported by a large number of colleagues.

What could Irish doctors and healthcare professionals do to help spread awareness of electronic cigarettes as a harm reduction tool?

Mainly give their support to the initiative by reading the MOVE statement, filling in the form provided on the MOVE website  and, of course, sending the link to their colleagues to spread the word.

As physicians they know that tobacco smoking remains the most serious public health issue in the world. By supporting MOVE and spreading accurate information about the effects of electronic cigarettes compared to tobacco smoking on health, they can help save lives.

Carmen Escrig holds a PhD in Cellular Biology and Genetics and is EFVI Spain Platform Co-ordinator.[/vc_column_text][/vc_column][vc_column][/vc_column][/vc_row]

[vc_row][vc_column][vc_separator][vc_single_image image=”1213″ img_size=”medium” align=”vc_align_center”][vc_column_text]The IVVA would like to take this opportunity to address the position paper, published by the Irish Cancer Society on their website.

Whilst we acknowledge the Irish Cancer Society’s position in requesting the Department of Health to regulate vaping products as medicines, and while we would disagree on that point, the IVVA think it’s vitally important that some of the mis-information that this position paper presents to the Irish public be addressed.

According to the data presented by Amárach Research on behalf of the Irish Cancer Society, the figures which date from July 2014 clearly show that out of the respondents, 0% of non smokers surveyed currently use electronic cigarettes. Yet despite this, there seems to be a pervasive notion that we should fear this product.

We shouldn’t.

Electronic cigarettes are a tool for current adult smokers to transition themselves away from the harms of smoking tobacco. Nothing more, nothing less.

”The research has also shown that upwards of one third of current e-cigarette users continue to smoke tobacco cigarettes simultaneously.”

What the IVVA feel is a glaring omission in this point is that it doesn’t seem to include the timescales that respondents have been using electronic cigarettes.

What every electronic cigarette user will acknowledge is that there is usually a ‘transition period’ whereby some of the tobacco cigarettes that would usually be smoked throughout the day are replaced by the use of an electronic cigarette. As time continues those who successfully ‘make the switch’ find themselves smoking less and less, but this time scale varies from person to person.

Taking a response from a smoker during this transition period, when they are actively partaking in tobacco harm reduction and making it sound like they are doing themselves more harm, is not only misleading, it serves no purpose.

”Compared to smoking tobacco, e-cigarettes are deemed to be safer; however, there is no research into the long-term effects of their usage. The Irish Cancer Society cannot recommend the use of e-cigarettes without guarantees of their long-term safety.”

Frankly, this is just puzzling. We would wonder how the long term safety of any new disruptive technology can be deemed safe long term, unless it is used long term.

In reality, electronic cigarettes have been around for 11 years now, with the surge in use in Ireland happening around 2009/2010. In worldwide terms, no serious safety concerns have emerged in scientific data that would warrant the product being out rightly ‘banned’, so it seems rather strange that the Irish Cancer Society would make this ideological leap. Especially considering that some of the UK’s NHS-run ‘Stop Smoking Services’ are now taking the view that electronic cigarettes have a definite role in their programs.

”There have been recent media reports in Ireland and the UK of devices exploding
and of an increase in incidences of nicotine poisoning caused by e-cigarettes. In Ireland, there were as many incidents of nicotine poisoning in the first three months of 2014 as in the whole of 2013. 11 of these cases involved children less than six years of age. All were allegedly caused by the ingestion of liquid for e-cigarettes.”

As we have previously addressed on our blog post about battery safety, in all the media reports that have reported exploding where a fire officer investigation has taken place, the problem is not with the devices themselves, but with the improper use of battery charges.

The IVVA has a clear policy in our code of conduct on only supplying batteries with the correct safety marks, the proper advising of consumers not to mix brands of batteries and chargers, and the correct way to charge various types of batteries. For the Irish Cancer Society to confuse however, could be construed as merely fear-mongering. One would not expect calls for tight restrictions on mobile phones, for example, which also use lithium ion batteries simply because the misuse of chargers may cause batteries to fail.

As regards the claims of nicotine poisoning, the main thing of note is the word ”allegedly”.

In looking at the 2013 reports published by the National Poisons Information Centre, the first thing that is of note is that the calls to the centre don’t seem to be broken down into actual cases of harm versus a call inquiring for more information.

For example, if a parent were to leave an electronic cigarette on their coffee table, and found their child had picked it up, decided to call the poison information centre to ask if the child might be in any danger, there is the chance that the national poison centre included that as a call reporting an incident regarding electronic cigarettes.

More calls were made to the centre in relation to household cleaners, and the largest number of concern was over the counter medications such as paracetamol. Common sense would dictate that all such things be kept out of the reach of children to avoid accidental ingestion, and again the IVVA have written into our code of conduct that consumers are properly advised of the correct and safe storage of vaping products.

”The Irish Cancer Society wants to ensure marketing of e-cigarettes ‘denormalises’ smoking rather than renormalise it.”

This is a very popular stance from bodies that would rather express a fear, than actually back it up with data. On the face of it, it seems an understandable fear, but it’s merely an ideological one.

The increase in the use of a reduced harm alternative cannot conceivably result in an increased use of the more harmful product it replaces – it merely renormalises harm reduction.

There is no current evidence that electronic cigarettes renormalises smoking tobacco cigarettes, in exactly the same way as there is no current evidence that drinking water renormalises the drinking of vodka.

To conflate two such very dis-similar products in this manner is misleading.

”The Irish Cancer Society believes the workplace smoking ban should not be undermined and therefore supports employers who keep their workplaces free of e-cigarette use.”

Another puzzling one. One may be forgiven for thinking that the Irish Cancer Society know so little about the product, that they really do think that electronic cigarettes are exactly the same as smoking tobacco. We’re not sure how clearer we can state this, but electronic cigarettes contain no burning plant material, they do not contain tobacco, they do not produce smoke, because vaping is not smoking.

In closing, the IVVA do welcome regulation for this industry, but it needs to be the right regulation; based on fact and reality. And the reality is that vaping products are a harm reduction tool being used by thousands of Irish smokers, many of whom have not succeeded by any other means. We need to focus on the here and now facts, not mislead the public by inducing unnecessary fear.[/vc_column_text][/vc_column][/vc_row]

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The IVVA has noted a number of reports in the media recently regarding damage to property that were allegedly caused by electronic cigarette batteries. It is worth noting that in incidences where an investigation by fire officers is reported on, the use of incorrect chargers for the specific model of vaping device or leaving the battery to overcharge has frequently been the cause. In some cases, the cause can be attributed to sub standard quality batteries where quality control has not been applied in the manufacturing process.

Always read instructions

IVVA members strongly believe in the safety of vaping products. Therefore our members adhere to a strict guideline on advising customers on correct battery safety for their device. Like all lithium ion batteries, such as those in laptops, mobile phones and tablets, the correct discharging, charging and storage of batteries ensures consumer safety. Provided instructions should always be strictly adhered to. If none have been provided, contact your IVVA vendor for advice.

Never leave charging batteries unattended

In the case of smaller and ‘ego style’ batteries, only the corresponding charger with the correct amp rating for the battery should be used. Batteries should never be left unattended while charging, and should never ever be left on charge overnight. Always unplug the charger and remove the battery immediately after the battery has reached full charge. Batteries should never be placed on soft furnishings or carpets while charging. Charging bags are available that encase the charger and battery during re-charging and provide additional safety.

Use 3rd generation batteries and rebuildable atomisers safely

In the case of larger ‘3rd generation’ batteries, only high quality chargers with an automatic charging cut off should be used.

Batteries should never be discharged below 3.2 Volts or overcharged above 4.25 Volts.

If the battery is being used in a ‘mechanical’ device, only the correct atomiser resistance should be used for the amp rating of the particular battery.

An understanding of Ohm’s law is necessary to safely set up a ‘rebuildable’ atomiser.

IVVA members recommend these products are only used by experienced consumers who fully understand battery safety thresholds.

Batteries should always be stored safely, in plastic battery containers where the contacts cannot touch each other.

Never allow the contacts of batteries to come in to contact with metal keys or coins etc. This can lead to short circuits occurring and cause the battery gases to vent.[/vc_column_text][/vc_column][/vc_row]