E-cigarettes set to be banned on all hospital campuses

First they were banned on buses and trains and now e-cigarettes are being ruled out of order on all hospital campuses, as Irish regulators grapple with a new front in the war on tobacco.

The decision by the HSE to prohibit e-cigarettes in its facilities from next week coincided yesterday with the first move towards regulation by the US Food and Drugs Administration (FDA), which has proposed a ban on sales to those aged under 18.

You’d have to be living on another planet not to have noticed the boom in sales of e-cigarettes over the past two years. In my own part of Dublin, three new shops dedicated to “vaping” have opened in the past six months. Not since headshops has Irish retail seen such a boom.

This growth has happened in a legal and regulatory vacuum, as e-cigarettes are not subject to any of the traditional controls applying to regular cigarettes. They don’t contain tobacco, and don’t emit smoke; instead, these battery-powered gadgets heat up liquid nicotine, which turns into a vapour – hence “vaping” – that smokers inhale.

Dismissed initially as a fad from China, where they were invented, e-cigarettes have taken off in a serious way. The global market grew from $2 billion in 2012 to $3 billion last year. This is small compared to the $700 billion value of tobacco sales, but that market is in terminal decline. “Big tobacco”, seeing the writing on the wall, has begun to snap up some of the small firms that pioneered e-cigarettes.

Here, health advocates have looked on in confusion and even horror at this trend. Ireland led the way internationally with the workplace smoking ban a decade ago, and extensive plans are in train to build on the success of this initiative by driving down smoking rates further. However, the proliferation of e-smoking threatens this progress by “normalising” a behaviour that seemed to be dying out.

“We have smoke-free policies in operations on 92 per cent of health campuses, but the fact that some people were smoking e-cigarettes was making these policies more difficult to implement,” says HSE director of health Dr Stephanie O’Keeffe.

Individual smokers have said e-cigarettes help them kick the habit, but the World Health Organisation says their efficacy in helping people to quit has not been scientifically demonstrated.

Irish regulators, taking their cue from the WHO, have focused on product safety issues, such as would arise with any new product. Questions have been raised about the amount of nicotine in the product, which can vary greatly, the presence of other, toxic chemicals and the fire risks. A number of children have been harmed by exposure to e-cigarettes liquids and the HSE has highlighted the risks that can arise from the use of e-cigarettes close to hospital oxygen supplies.

The WHO says that until e-cigarettes are deemed safe by a regulatory body, consumers should avoid them. But as Dr O’Keefe admits, the bans may yet have to be revisited.