Everyone is familiar with the warning that smoking is hazardous to health. However, in recent years, electronic cigarettes (e-cigarettes) with their claims that they are non-addictive and that they can help smokers quit smoking, along with various flavours, attractive packaging and diverse smoking devices, mean that smoking e-cigarette is hailed as a fashionable trend for the young smokers. The Consumer Council is deeply concerned about the impact of e-cigarettes on consumers, especially young people, leading them to fall victim to this sugarcoated trap. Not only has the increasing popularity of vaping caused the already declining smoking population in Hong Kong to enjoy a resurgence, but vaping may also cause the age group of smokers to become younger. The Council calls on the Government and the Legislative Council to pass and implement as soon as possible the legislation for a full ban of e-cigarettes, heat-not-burn (HNB) cigarettes and all such new tobacco products, prohibiting the import, manufacture, sale, distribution and advertisement of e-cigarettes and other new smoking products in order to protect the next generation from the harmful effects of smoking.
Last month, Council’s staff carried out a survey on the sale of e-cigarettes and heating devices for HNB cigarettes in malls selling trendy novelties, mobile phones and computer products. Site visits were made to 20 shopping malls in 5 districts, namely Wan Chai, Causeway Bay, Mong Kok, Yau Ma Tei and Sham Shui Po. Of the malls visited, half of them (10) have some shops selling these products. In one of the relatively smaller malls which has 44 shops, over 10% (5 shops) of the shops were found to be selling e-cigarettes or heating devices for HNB cigarettes; while for the remaining 9 malls, the number of shops which sold these products ranged from 0.5% to 5.7%.
The investigation further revealed that some shops would set up their own websites or social media platforms to facilitate consumers to make purchases online. As pointed out by staff members at the shops, their websites provide more comprehensive information on the types of e-cigarettes available for sale and consumers can select the product models online, place their purchase order by phone, then once the merchandise is available, they could go to the shops to pay and collect their ordered goods. This method of selection and purchase not only makes it more convenient for young people, but it also means that the shops can be more discreet, bypassing the need to display a large quantity of such products inside the shop, which in turn makes the work harder of combatting the sales and the control of these e-cigarettes and HBN.
According to the information provided by the Hong Kong Council on Smoking and Health, some specialist e-cigarette shops in Hong Kong offer “trial smoking” to consumers inside their premises. Apart from potentially violating the Smoking (Public Health) Ordinance, this also greatly increases the chance of young people getting in contact and smoking e-cigarette. The Council warns that both local and international medical reports point out that e-cigarettes and HNB cigarettes can release different harmful substances which can become a health hazard. In recent years, many international research also cast doubt on the claim of the correlation between smoking e-cigarette and quitting smoking.
As stipulated by the Pharmacy and Poisons Ordinance, e-cigarette and liquids containing nicotine must be registered as pharmaceuticals in order to comply with the requirements of safety, quality and efficacy. In addition, license has to be obtained from the Pharmacies and Poisons Board of Hong Kong before traders or suppliers are allowed to possess or sell these products. However, according to current record, there are no e-cigarette products containing nicotine registered as pharmaceutical products in Hong Kong. In other words, the sale of e-cigarette and liquids with nicotine content in the market is illegal.
Furthermore, under the Dutiable Commodities Ordinance, tobacco (including products containing tobacco) is a type of dutiable commodities, and the sales of tobacco products in Hong Kong must comply with the Smoking (Public Health) Ordinance in displaying the statutory health warning in the prescribed form and manner on its sales packaging.
E-cigarettes and HNB cigarettes both release harmful substances
Despite the claims of tobacco traders that the health impact from either e-cigarettes or HNB cigarettes is less harmful to health than traditional cigarettes, local studies have discovered the presence of harmful substances such as formaldehyde, heavy metals and nicotine in the aerosol emitted from e-cigarettes. Furthermore, overseas reports found that nicotine concentrations in different brands of e-cigarette and liquid products varied widely; nicotine was even detected in some e-cigarette products which claim to be nicotine-free. Also products labeled with the same level of nicotine concentration were found to vary in their nicotine content by as much as 3 times.
Notwithstanding the attractive and fashionable packaging of HNB cigarettes, similar to traditional cigarettes, the principle is still to use a built-in heater to heat the tobacco and although there is no combustion, addictive nicotine and other harmful substances are still being released in the fumes. Tobacco traders claim that since the tobacco in HNB products heats at a lower temperature, less harmful substances are released compared to traditional cigarettes, and therefore, the impact on smokers’ health is relatively lowered. Whether these claims are true require further study and research.
As there are currently no safety levels for toxic or carcinogenic substances released by some of the HNB cigarettes such as PAH (polycyclic aromatic hydrocarbons) which can be used as a reference point, any amount inhaled is still considered harmful to health. Earlier in 2018, the Korean Ministry of Food and Drug Safety issued a report indicating that the amount of tar released in HNB cigarettes is similar to traditional cigarettes, and so is the nicotine content. In addition, the report said that HBN cigarettes also release carcinogenic substances commonly found in tobacco.
As HNB cigarettes may not offer the same level of satisfaction to smokers as traditional cigarettes, HNB cigarette smokers may tend to increase their smoking frequency, resulting in an increase in their exposure to more nicotine.
Recent research revealed that the high temperature of e-cigarettes could produce a new form of formaldehyde, which, when combined with the particles from e-cigarettes, could lead to deposits in lungs, causing more serious health problem than vapourised formaldehyde. It was also found that the heating coil inside the e-cigarette device could be a source of heavy metals release. Research showed that copper content released by e-cigarettes is 6 times more than traditional cigarettes; and the aluminium content in a room could double after smoking e-cigarettes.
The Council wants to stress that currently, there is no scientific evidence to prove that e-cigarettes and HNB cigarettes could effectively help smokers quit smoking. Various studies have shown that after 1 year of smoking e-cigarette, most smokers have not changed their smoking habits or reduced the number of traditional cigarettes they smoke a day in any significant way. In order to protect your health, the Council recommends that smokers should quit smoking completely under the guidance of healthcare professional by choosing to use registered nicotine replacement therapy products such as nicotine gum, lozenges, patches, etc. which have been proven to help smokers quit smoking safely and effectively.
Currently, around 30 countries or regions in the world have banned the sale of e-cigarettes, including Singapore, Thailand, Brazil and Macau etc. The Government is urged to follow suit to implement a full ban on e-cigarettes and other new smoking products without further delay, and in addition, strengthen anti-smoking education among the young, ensuring that the next generation would not be tempted into becoming habitual smokers by trying out new tobacco products.
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