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Opinion E-cigarettes are not part of the solution to a tobacco free Ireland

Professor Des Cox says it’s tempting to see e-cigarettes as a solution to smoking but he says that’s just not the case.

LAST WEEK, THE JOURNAL published the opinion article “why are we waging war on e-cigarettes when they help smokers quit”. I have been given the opportunity to explain why this is a war that should be pursued.

In 2013, the government launched a bold plan for Ireland to become Tobacco Free by reducing the prevalence of tobacco smoking to 5% by 2025. As of 2021, 18% of the Irish adult population are current smokers so we will not meet this ambitious target.

The opinion piece last week argued that Ireland needs to embrace e-cigarettes as a way to help more people quit tobacco but is there evidence to support such an approach?

Recently, the Oireachtas Health Committee published its report on the Public Health (Tobacco and Inhaled Nicotine Products) bill. In addition to recommending a ban on the sale of e-cigarettes to children under 18 years of age, the committee has also recommended a ban on the sale of all flavours except tobacco flavours, the introduction of plain packaging and the prohibition of all forms of advertising for e-cigarettes.

This has restarted the conversation on where e-cigarettes fit into Ireland’s tobacco control policy. In medicine, rather than looking at the findings of one paper on a topic, we need to examine systematic reviews and meta-analyses which identify and critically appraise many papers on a topic. These types of reviews offer a more robust scientific analysis of a particular issue and several systematic reviews have been published on e-cigarettes in recent years.   

Adolescents

The first point to address is e-cigarettes and adolescent use. The findings from the European Schools Project on Alcohol and other drugs (ESPAD) published by the TobacccoFree Research Institute in 2020, reported a 50% rise in e-cigarette current use in adolescents aged 16-17 years, since the previous study in 2015.

Nearly four in 10 (39%) adolescents have tried them and one in 5 (18%) were found to be current users. The ASH UK survey on vaping in adolescents was recently published and found that ever use of e-cigarettes in 11- to 17-year-olds rose from 11.2% in 2021 to 15.7% in 2022.

Worryingly, this rise in e-cigarette use coincided with a significant rise in the use of disposable vape products among adolescents. The report found a seven-fold increase in the use of disposable vapes in this age group between 2020 and 2022. Almost half of the adolescents surveyed who reported seeing e-cigarettes being promoted saw them on Tiktok. Increased regulations on the marketing of e-cigarettes are urgently required, particularly online marketing.   

The article last week raised the concern that a ban on e-cigarette flavourings will result in an increase in the number of smokers in Ireland. There is no published evidence stating a ban on e-cigarette flavours will lead to increased tobacco smoking prevalence. However, there is substantial evidence that flavours attract young people to the products and make them perceive vaping to be a harmless activity.

While adults may also be attracted to flavours, the risks of e-cigarette initiation in adolescents and young adults are likely to outweigh the benefits of ex-smokers using flavoured e-cigarettes. 

Gateway?

While no one argues that the sale of e-cigarettes should be banned for children under 18 years of age, the article last week claimed that e-cigarettes are not a gateway to tobacco smoking. A systematic review on the topic found that adolescents who ever used e-cigarettes are between 3 and 5 times more likely to start smoking compared with adolescents who have never used e-cigarettes.

The evidence is now irrefutable that we must protect children against the dangers of both tobacco smoking and e-cigarettes. Passing the proposed Public Health bill by just banning the sale of e-cigarettes to children under the age of 18 would not go far enough and government officials need to take on board the Oireachtas Committee’s recommendations on the bill.

We are proposing, based on current evidence, that the packaging, advertising and marketing of e-cigarettes are restricted in the same way that tobacco products are and that only tobacco flavoured should be made available in Ireland. This would allow ex-smokers continued access to tobacco-flavoured e-cigarettes and curb their use in adolescents and young adults.

With respect to whether e-cigarettes are an effective stop-smoking tool, a systematic review published last year examined ten randomised controlled trials and found there was no evidence that e-cigarettes were any better at helping smokers quit when compared to approved and regulated nicotine replacement therapy (NRT).

The evidence for e-cigarettes as a stop-smoking tool is mixed at best and healthcare professionals should be recommending the tried and trusted methods such as NRT over e-cigarettes. In January, Ireland’s first National Stop Smoking guideline was published and made no recommendation in relation to e-cigarettes as a stop-smoking tool due to insufficient evidence and substantial uncertainties with these products.

Best advice

In addition, to recommending effective treatments, healthcare professionals need to be confident that the care they recommend to patients is safe. The Health Research Board published a review of over 361 studies on the harms and benefits of e-cigarettes in 2020 and found that e-cigarettes have negative effects on the heart and lungs.

Some proponents of e-cigarette use as a stop-smoking tool say they are 95% safer than tobacco products. This statement has no scientific basis and is derived from the opinions of a small group of doctors back in 2013 when we knew little about the harmful effects of e-cigarettes. While it is important to acknowledge that e-cigarettes are less harmful than tobacco products, they are not harmless and the public needs to be aware of this fact.  

The harm reduction argument for e-cigarettes is belittled by the fact that they’re not any more effective than proven treatments and there are too many uncertainties about their long-term safety profile. Also, research shows us that many e-cigarette users continue to smoke. The Healthy Ireland survey from 2018 demonstrated that for every ten adults who use e-cigarettes, four also use tobacco.

For e-cigarettes to be a viable option in the harm reduction strategy, they would have to demonstrate that they are safe products which help people quit smoking that are regulated by the Health Products Regulatory Authority (HPRA). This has not been done.
 
In conclusion, the evidence as it stands in 2022 does not support the argument for the use of e-cigarettes as a stop-smoking tool. There remain significant concerns regarding their long-term safety and they have now been proven to be a gateway to tobacco smoking for adolescents.

Until clearer research emerges, healthcare professionals should promote safe and effective stop-smoking methods such as NRT above unproven methods such as e-cigarettes. Most smokers want to quit and the good news is that there is help is out there. The HSE www.quit.ie service offers proven stop-smoking assistance given by experienced trained professionals. 

Professor Des Cox is Chair of the Royal College of Physicians in Ireland policy group on tobacco and consultant in respiratory medicine at Children’s Health Ireland, Crumlin.

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    Mute Mick Tobin
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    Jul 30th 2022, 9:17 AM

    It’s not that hard. Vaping doesn’t have tar, and just by not having that it’s likely to be way safer. But it *is* very obviously part of a tobacco-free Ireland as there’s no tobacco in there in the first place.

    That selling it to kids should be illegal is similarly obvious. But that kids might use it is no reason to ban it outright.

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    Mute Nick Nolan
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    Jul 30th 2022, 9:26 AM

    @Mick Tobin: I think he means nicotine-free Ireland. As in nicotine the chemical that’s so poisonous it’s used as a weed killer.

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    Mute Mick Tobin
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    Jul 30th 2022, 9:33 AM

    @Nick Nolan: Yes I figured he probably meant that. But it’s tobacco smoke that’s chiefly annoying as well as potentially harmful to others, which isn’t the case with vapours except of course for those maxi-pluming hipsters, but they should be deported to the North Pole anyway.

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    Mute l
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    Jul 30th 2022, 9:42 AM

    @Nick Nolan: same with pure alcohol isn’t it..

    32
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    Mute Gary Kearney
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    Jul 30th 2022, 2:30 PM

    @Nick Nolan: Yet not as deadly as alcohol which is freely sold everywhere.

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    Mute Tom Gleeson
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    Jul 30th 2022, 2:45 PM

    @Nick Nolan: Nicotine is used as an insectoid, not a weed killer. However, I am not an insect and it would take a huge amount of nicotine to kill me. I need to ingest over 1000 mg before death was a certainty.

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    Mute William Croke
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    Jul 30th 2022, 5:07 PM

    @Tom Gleeson: closer to 100mg but you could have put an extra 0 by accident

    https://en.m.wikipedia.org/wiki/Nicotine_poisoning

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    Mute Ian Hoey
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    Jul 30th 2022, 10:14 PM

    @Nick Nolan: The doses used in e-cigs or regular cigarettes is harm less and is no more addictive than caffeine.

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    Mute Daniel Nevin
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    Aug 2nd 2022, 7:03 AM

    @Nick Nolan: Water, in excessive amounts, can be just as deleterious to health. I appreciate your point in context, but its inherently incorrect.

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    Mute Brian McDonnell
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    Jul 30th 2022, 9:43 AM

    I vape, I tried patches, gums, inhalers and even hypnosis, to quit the cancer sticks, the only thing that has worked is the vapes, and I have reduced and reduced down the nicotine content to the point where I now have to mix my own as you can’t buy that low a content.
    I am fully aware that not using e-cigs would be better for me, and I have no problem with any and all products containing nicotine being aged restricted, and heavy fines for those caught selling or buying for anyone deemed under age

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    Mute Marc Mc Donald
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    Jul 30th 2022, 11:57 AM

    @Brian McDonnell: Try CBD vape without any nicotine or CBD food supplement. May help even better with cessation.

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    Mute pistachio 32
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    Jul 30th 2022, 12:01 PM

    @Brian McDonnell: im 3 weeks off the smokes today Brian. I’ve quit multiple times. It’s only hard for 1 week. You’ll have all sorts of agitation, anger, restless leg syndrome and short temperedness. Just get through that first week. It goes fairly quickly. Ya just have to get through that 1 week

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    Mute Aido
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    Jul 30th 2022, 1:52 PM

    @pistachio 32: Oh yeah, like smokers havent already tried. It sounded easy for you, not as easy for the rest of us

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    Mute Gary Kearney
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    Jul 30th 2022, 2:33 PM

    @Brian McDonnell: I found exactly the same thing, I have medical issues which means the withdrawl is very dangerous for me. My brain chemistry gets completely messed up. I canniot handle that as I have brain injuries.
    Vapeing got me off cigarettes and my health is considerably better for it,

    19
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    Mute Brian McDonnell
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    Jul 30th 2022, 3:43 PM

    @pistachio 32: I have gone cold turkey a good few times and it never lasted. Each person seems to have their own way, and what ever works for each person to quit the cigs should be encouraged, not banned.

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    Mute Michael Legris
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    Jul 30th 2022, 8:43 PM

    @Brian McDonnell: Smoked a full pack for 25 years and only thanks to the eCig i became out of the tobacco (not the nicotine).
    There is a French website that delivers in Ireland where you can make your own mix and gradually use less nicotine: Le Petit Vapoteur.
    After 2 years of vape, i am now free for the past two months

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    Mute Ian Hoey
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    Jul 30th 2022, 10:21 PM

    @Michael Legris: There are Irish websites too.

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    Mute Tom Kelly
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    Jul 30th 2022, 9:55 AM

    I was a smoker for 30 years.
    E cigarettes for 5 years, and I loved them.
    I gave up by reducing level of nicotine every 3 months, eventually down to zero.
    That lasted 3 months too.
    Never ever noticed at any stage.
    Haven’t smoked in over two years now.
    Can’t do that with normal cigarettes.

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    Mute tottkingham
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    Jul 30th 2022, 10:45 AM

    @Tom Kelly: I was a 20yr + smoker, tried all the usual remedies, hypnosis, patches, books, cold turkey, acupuncture etc. Only vapes got me off the sticks and I’m currently working on getting off these. Using it less and less now. I’ve not smoked a cigarette in years….. So, they say there’s no evidence that e cigs don’t work, WE are the evidence that it does!

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    Mute Ivan Genockey
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    Jul 30th 2022, 10:20 AM

    At the end of the day, the only reason they want to ban vaping is because they are in the pockets of the big pharma.
    They are losing billions because people are vaping to try give up cigarettes and not buying patches, gum and other products.

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    Mute FrustratedASDMum
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    Jul 30th 2022, 12:11 PM

    @Ivan Genockey: I’m no conspiracy theorist by any stretch of the imagination but I remember when governments and other groups started making a fuss about vaping and e-cigarettes many years back, I wondered how much of this was pushed by pharmaceutical and tobacco companies having a tantrum over the profits they were losing as a result. Particularly in the likes of the US where these industries are huge contributors to political parties.

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    Mute Gary Kearney
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    Jul 30th 2022, 2:37 PM

    @FrustratedASDMum: Theuy sponsored it all and when Big Tobacco realised they were losing, they then bought into the vape business and are very strong into it now.
    Same with hemp, it can replace so much plastic and other material and it is cheap to grow, big business hate it as it takes their profits.
    The US ban that started the worldwide ban was paid for DuPont, the plastics multinational.

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    Mute Tom Gleeson
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    Jul 30th 2022, 2:41 PM

    @Gary Kearney: IIRC hemp was banned to protect the cotton industry in the US,

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    Mute Gary Kearney
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    Jul 30th 2022, 7:12 PM

    @Tom Gleeson: And the plastics industry, DuPont paid for a lot of the politicians and the rest were good old southern boys, Also a bit if racism thrown in for good measure. A fascinating story.

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    Mute Paul
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    Jul 30th 2022, 9:39 AM

    They above article in my opinion lacks certain disclosures.
    For example, I would like to hear statistics based on how many people are being treated for health related problems from tobacco users versus vape users.
    Why a widely advertised product/s on tv promotes its use as an aid to quit smoking and yet contains nicotine?

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    Mute Mick Tobin
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    Jul 30th 2022, 9:46 AM

    @Paul: Because if you vape you don’t smoke; it’s basically a way of giving in to nicotine addiction if all else’s failed. To be fair they might want to communicate that point more succinctly.

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    Mute barry moore
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    Jul 30th 2022, 9:54 AM

    @Paul: have to agree. I was smoking 30 major a day, changed to vape in an attempt to stop. My misses got worried as after 2 weeks using vape I sounded like I was drowning in my sleep. I taught it was because my lungs had started to clear what tar they could. Got worse over the next month or so. Turns out it was the oils mixing with the moisture in my lungs and building up. Ended up back on major for a few months then went cold turkey. Smoke free now 6 years.

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    Mute Jumanji
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    Jul 30th 2022, 1:29 PM

    @barry moore: you’re not supposed to drink the vape juice

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    Mute Gary Kearney
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    Jul 30th 2022, 2:34 PM

    @barry moore: I sounded a bit odd as my lungs cleared too but now they are like I never smoked.

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    Mute Ian Hoey
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    Jul 30th 2022, 10:26 PM

    @barry moore: There’s no oil in eliquid.

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    Mute Marianne Sherlock
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    Jul 30th 2022, 10:42 AM

    They absolutely do help people give up smoking

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    Mute Peter
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    Jul 30th 2022, 9:58 AM

    I’m all in favour for the banning under 18’s and for restrictions on advertising as well as the change to packaging and the banning of the disposable e cigarettes but I can not and will never support the banning of the flavours. That part makes no sense to me. If the other parts are implemented and enforced correctly then the banning of flavours becomes a moot point. Why not try doing the restrictions and removal of disposable for a year and see what happens. If force to use non flavoured liquid I might as well go back to smoking the real things. For me the flavour is part of what keeps me off cigarettes and I suspect that the same would be true for a fair few others.

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    Mute Gavin Conran
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    Jul 30th 2022, 12:32 PM

    @Peter: I’m in the exact same boat mate.

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    Mute John Madden
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    Jul 30th 2022, 11:21 AM

    Most adults who vape prefer flavours. Banning them will increase smoking rates and be totally counterproductive. This was proved in San Francisco. There are far too many anti tobacco activists whose careers are at risk due to the success of vaping as by far the most effective way of quitting smoking.

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    Mute Dick Puddlecote
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    Aug 1st 2022, 1:50 PM

    @John Madden: Yep, Dr Cox senses a gravy train coming to a screeching halt.

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    Mute John Smith
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    Jul 30th 2022, 9:03 AM

    Why not just ban tobacco?

    53
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    Mute Tony Harris
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    Jul 30th 2022, 9:32 AM

    @John Smith: And alcohol. Don’t forget sugar. Oh, aerosols, don’t forget them. C’mon Nanny, let’s start the list……

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    Mute G man
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    Jul 30th 2022, 10:10 AM

    @John Smith: prohibition only drives it underground, the black market would be booming.

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    Mute Una Ni Mhathuna
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    Jul 30th 2022, 4:03 PM

    @John Smith: Tell that to the patients in a psychiatric hospital already proved fatal

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    Mute Chris Sorochin
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    Aug 2nd 2022, 5:39 PM

    @John Smith: See “Alcohol Prohibition, USA 1920-1933″

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    Mute Noel_Random
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    Jul 30th 2022, 12:38 PM

    This article is nonsense. Vaping absolutely helps people quit smoking and is far more effective than the expensive and sometimes dangerous (Champix) NRT that the HSE and medics continue to push at great expense to tax payer. The real problem is the crazy level of anti vaping misinformation being pushed by the likes of Bloomberg which is having a global influence on government policy. This article boils down to the usual “will nobody think of the children” nonsense. There will always be teenagers who experiment and take risks. They’ll try vaping, alcohol and tobacco. You should not base national policy on that cohort. It’s time that people like the author put their focus on the adult smoker and their need to quit. Flavour is critical to vaping success for adults.

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    Mute Shane Nolan
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    Jul 30th 2022, 12:47 PM

    That’s funny because it was the e cigarettes that helped me give up.. I had set rules, vape only when drinking and a flavour I liked but not fond of.. decreased the strength over time and after good few months I was off!!!

    Haven’t looked back since! You have to want to give up, these were the best aid I ever had, better than the patches!

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    Mute John Smith
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    Jul 30th 2022, 1:57 PM

    @Shane Nolan: same as that, without them I’d probably still be a smoker .

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    Mute James Gorman
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    Jul 30th 2022, 1:59 PM

    Vaping has saved lots of people who couldnt quit otherwise.
    Its not just the nicotine addiction.A nicotine patch doesn’t replace the comfort people get from what is effectively an adult pacifier.

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    Mute Gary Kearney
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    Jul 30th 2022, 2:43 PM

    people like to vape and there are nicotine free vapes available.
    Does vaping stop people smoking , yes it does I dont know what planet this doctor is living on.
    My new doctor cannot believe I smoked for almost 25 years as my lungs are that of a non smoker.
    This from a person that would get at least four chest infections a year.
    It took 3 weeks to switch from cigarettes to vaping and I lost my vape, and rushed to get a new one. Why? easy I am addicted to nicotine but dont want to smoke. Now I can do that.
    Why some group want vaping banned is not a health issue, it is a personal crusade for these people.

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    Mute James Mc Sherry
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    Aug 1st 2022, 3:55 PM

    @Gary Kearney: 100% agree on personal crusade element. Isn’t there enough restrictions in place re tobacco (pricing, packaging etc). Also, teenagers have and will always experiment. Can’t we achieve some kind of balance, live and let live? Always ban, ban, ban here. They just can’t stop

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    Mute Margaret Doyle
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    Jul 30th 2022, 12:13 PM

    While thousands of new heroine, coke and other addicts are destroying their own lives I don’t think it’s even appropriate to tackle cigarette smoking. Maybe when all drug pushers and drug gangs are locked up for life – which will never happen we can begin to tackle cigarettes.

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    Mute Tom Gleeson
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    Jul 30th 2022, 2:37 PM

    I remember when in 2013 Ireland proposed a plan to be smoke-free, there was no mention of tobacco-free then. Des claims there is no published evidence stating a ban on e-cigarette flavors will lead to increased tobacco smoking prevalence, He’s careful with his words because he says ‘will’ when in fact there are several studies showing flavor bans ‘have increased smoking.
    He uses one systematic review to show vaping is not an effective stop-smoking tool and ignores Chochran’s systematic reviews (plural) which show it is. I guess if theirs only one cherry worth picking you have only one cherry to use. As to the mythical gateway to smoking? Des? where are all the new smokers? If vaping leads to smoking, why don’t we see huge numbers of new smokers? In the US where Des tells us they had an epidemic of youth vaping, the smoking rate among youth is under 2% the lowest it’s ever been. here in Ireland where Des and co have fought bravely against vaping it’s 14% Slow clap for the great work Des and co are doing. BTW what ever happened to Action on Smoking and Health Ireland? Could it be the word smoking in the title has gotten them relegated to back room busy work?

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    Mute Tom Cullen
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    Jul 30th 2022, 10:49 AM

    Generally speaking, I’m all for decriminalisation and regulation of nearly all drugs to counter criminal networks, control quality and have proper oversight. Nicotine is the exception to the rule as pretty much every other illicit drug has physical or psychological effects to be chased and drive a black market. Nicotine is just pure addiction and there is no change in state of mind to chase. How about outright ban on tobacco with only e-cigs permitted from 2023. That’s tar eliminated in 1 year with nicotine cravings still being satisfied. Then every year after, reduce the eliquid nicotine maximum strength by 4mg until it hits zero. That target of of nicotine free Ireland could be hit by 2028. ( Current 3mg/0mg Ecig user and tobacco free for 7 years )

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    Mute Aido
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    Jul 30th 2022, 1:59 PM

    @Tom Cullen: OK Tom, let’s ban alcohol, sugar and caffeine while we’re at it. Prohibition has been proven to work in the past

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    Mute Heisen berg1
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    Jul 30th 2022, 9:45 AM

    I think we are getting to a tobacco free Ireland, it will take time and a lot more budgets, more and more taxes on tobacco products and soon the cost will just be two much.

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    Mute Andrew Redmond
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    Jul 30th 2022, 6:24 PM

    I’m shocked that doctors don’t want smokers to have a cheap and healthier alternative and instead are pushing people towards rip off nicotine replacement products. It’s a total scam and it’s pretty clear that these stop smoking advocatetes are thick as thieves with the likes of Nicorette

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    Mute William Croke
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    Jul 30th 2022, 5:22 PM

    Pretty bad article, allowing himself to see a connection between people who have tried vaping to those that have tried smoking is like comparing people who cycle to those who run. The fact you are willing to try one makes you more likely to try the other, sure, but you were probably more likely to try running if cycling was not an option when you decided to try to get fit.

    Many other major issues with the authors viewpoints expressed here.

    Vaping has proven to be a method of replacement for many people, it doesn’t work for everyone, but nor does any Nicotine Replacement Therapy.

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    Mute William Croke
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    Jul 30th 2022, 5:22 PM

    @William Croke: Personally, I found Champix great years ago until I couldn’t sleep due to a constant dream cycle brought on because it was originally earmarked as an antidepressant. I found nicotine patches good but never felt satisfied and found it impossible to wean myself off those either.

    When I eventually found vaping, I had initial problems with the taste (tobacco flavor is terrible), liquid leaking due to it being a cheap pen and other issues. I changed the device and liquids and found great success staying off cigarettes for the last 8 years. Initially I would have been on 24mg strength, working myself down to 3mg these days.

    Would I go back to using a tobacco flavor? I’d rather go back smoking cigarettes.

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    Jul 30th 2022, 11:05 AM

    Stale cigarette smoke from someone’s breath & clothes is the most vile smell known to mankind (along with stale BO & alcohol). Put those three together & you could knock someone unconscious if you get too close to them! :-)

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    Mute Leonard Barry
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    Jul 30th 2022, 1:13 PM

    @: You obviously were never unlucky enough to experience the smell of gangrene.

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    Mute John Mack
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    Jul 30th 2022, 2:44 PM

    A highly critical factor which needs to be born in mind in all of this rampaging debate is this : Once vaping become mainstream, the Government will ramp up the revenue element of the cost price as sure as night follows day because they just MUST get the revenue return akin to what’s being collected at present.

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    Mute Ian Hoey
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    Jul 30th 2022, 10:50 PM

    Quit smoking 11yrs ago through the use of e-cigs, which I still use today and have no intention of quitting. My advice to many family/friends, who have since quit smoking with the help of ecigs, has always been not to use tobacco flavours. Most people don’t actually like the taste of tobacco, your brain just associates it with it’s delivery of nicotine. Are ecigs saver than cigarettes, absolutely they are. Nothing is better than not smoking or vaping but ecigs are designed to help smokers quit or use a saver alternative. A non smoker should NEVER begin vaping. Absolutely ban the sale to under 18′s, this should have been done years ago. Introduce huge fines for any caught selling to under 18′s. Banning flavours is just a lazy way to stop kids vaping(which won’t work).

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    Mute Mark Howard
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    Jul 30th 2022, 4:46 PM

    @Majella Carew: Well at least she had her fags to back to after the breakup . . .

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    Mute Majella Carew
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    Jul 30th 2022, 2:15 PM

    My ex GF, privileged, from a upper middle class detested smoking. When she got a stressful job though she picked it up. Glad I dumped the b—-

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    Mute Eric Ryan
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    Jul 30th 2022, 7:19 PM

    @Majella Carew: An excellent contribution to the debate!

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    Mute Mick Wall
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    Jul 31st 2022, 12:35 PM

    Interesting the facts you leave out “Use of e-cigarettes remains largely confined to current or former smokers. The overwhelming majority, 92.2% in total, of 11-17 year old never smokers have never used an e-cigarette”

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    Mute Dick Puddlecote
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    Aug 1st 2022, 1:55 PM

    @Mick Wall: Yes, he also leaves out “Of 11-17 year old never smokers … 0.5% use e-cigarettes more than once a week”. The overwhelming majority of underage vapers are current or former smokers. Strange that a doctor wouldn’t mention something so important.

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    Mute Paul O Meara
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    Aug 7th 2022, 3:48 PM

    I was person that vaped I had low oxygen in my blood after 17 years I’m a month off the vape and cigarette

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    Mute Mick Wall
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    Jul 31st 2022, 10:40 AM

    A ban for under 18’s is obvious and should be done. But how many of those teenagers that vape would have been smokers? Also, alcohol is also a problem with teens, it’s sale is banned to them, should we now make all alcoholic drinks taste the same to discourage its use? Perhaps we make all alcoholic drinks taste like tobacco ? That should do it.

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    Mute James Mc Sherry
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    Aug 1st 2022, 4:02 PM

    @Mick Wall: ‘should we now make all alcoholic drinks taste the same to discourage its use’ – exactly where this continuing logic keeps taking us. After they’ve finished with tobacco/nicotine, that’s the next thing. Plain packaging on alcohol? – this latest round of anti vaping stuff is selective with facts and ideology driven, and not proportional to the problem. Interesting that almost no comments here agree with the artcile

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    Mute Chris Sorochin
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    Aug 2nd 2022, 5:36 PM

    How about just a “free” Ireland, where people are allowed to decide for themselves how they’ll live their lives?

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    Mute Tom Gleeson
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    Jul 31st 2022, 8:49 AM

    “While no one argues that the sale of e-cigarettes should be banned for children under 18 years of age,” Des, that’s exactly what everyone and their mother is arguing for. An age restriction. You and tobacco control are the ones who failed to implement one.
    “For e-cigarettes to be a viable option in the harm reduction strategy, they would have to demonstrate that they are safe products which help people quit smoking that are regulated by the Health Products Regulatory Authority ” NO Des, that’s the bar for a cessation medication. You seem to not understand the principles of harm reduction or you stubbornly refuse to understand them.

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    Mute Dick Puddlecote
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    Aug 1st 2022, 1:58 PM

    Interesting that no-one in these comments agrees with the doctor. Credibility in the public health profession is plummeting due to clearly disingenuous and deliberately inaccurate articles like this.

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    Mute Dick Puddlecote
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    Aug 1st 2022, 1:45 PM

    “Some proponents of e-cigarette use as a stop-smoking tool say they are 95% safer than tobacco products. This statement has no scientific basis and is derived from the opinions of a small group of doctors back in 2013 when we knew little about the harmful effects of e-cigarettes.”

    This old nonsense again? No, it’s based on PHE’s review of 185 studies in 2015 (McNeill et al) of which the Nutt paper in 2013 was just one. PHE have since backed up their review in 2018 and 2021 and still come to the same conclusion. Your own colleagues at the UK Royal College of Physicians agreed with the estimate too in 2016. Google “Nicotine Without Smoke RCP” and enlighten yourself.

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    Mute Tom Gleeson
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    Dec 7th 2022, 3:50 PM

    And even as Des wrote this the ONS was compiling this data
    https://www.independent.co.uk/news/health/smoking-uk-number-lowest-level-b2239761.html

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    Mute James Johnson
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    Jul 30th 2022, 8:20 PM

    Less Tax intake for Government. Ad a smoker Ban the bloody Cigarettes

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