If you think the ban on the sale of e-cigarettes to under-18s is the silver bullet to break vaping’s growing stranglehold on our children’s future health, the industry’s enthusiastic response to the measure should give you pause for thought.
Vape brands deny that they target children, insisting that it is the needs of veteran smokers trying to quit that are being catered for with flavours like gummy bear or pink lemonade, wrapped in sweet product-style packaging. As with Big Tobacco – which dominates the global vaping market – the real objective is profit.
The potential long-term health damage to children seems to be relevant mostly for the risk of regulation it carries.
So the multinational vape companies take the hit on the portion of child market that will be lost to the ban, and continue the pursuit of large numbers of children for whom illegal sales are not a deterrent, using child-friendly flavours and packaging. The UK offers an insight into the effectiveness of banning sales to under-18s: eight years after its ban, it is gripped by a teenage vaping epidemic.
The response to such mendacity should be to focus on the policy actions the vaping lobbyists oppose, not the ones they welcome. What the industry fears most – as is clear from the concerted campaign now being waged – is a ban on e-cigarette flavours. This is the real battleground that will determine the scale of industry profits and child addiction rates into the future.
US research shows that almost 80 per cent of youth users gave the availability of flavours as the reason they vape. US Food and Drug Administration research also found that 97 per cent of youth vapers had used a flavoured e-cigarette in the past month. Our own teenage focus groups were equally conclusive. They agreed unanimously that sweet and fruity flavours, along with bright, colourful packaging, were designed specifically to target young people.
A growing list of European countries – including even war-torn Ukraine – have recognised the danger and imposed flavour bans. In the Netherlands and Finland, plain packaging is also required. In Ireland, Tánaiste Micheál Martin’s tough anti-vape rhetoric does not hide the reality that we’re lagging far behind with a policy response essentially limited to us being among the last EU countries to ban vape sales to children.
At least the Department of the Environment, Climate and Communications is stepping in to the void left by health policymakers through the newly-announced consultation on banning disposable vapes. This is a crucial step given these devices, which are cheaper and easier to conceal from parents than standard vapes, have probably fuelled a further explosion in vaping. Statistics show that 37 per cent of 15-16 year-olds have used vapes and 18 per cent are regular users.
These measures are being proposed on environmental grounds, so it’s worth spelling out the health impact of e-cigarettes on young people. The full extent of the damage won’t be known for years, but already Irish research shows acute effects may include poisonings, burns, lung injuries and asthmatic attacks. Other studies found they may be linked to stress to the brain, heart and lungs. Even more worrying is evidence of a gateway effect that suggests teenage vape users are up to five times more to start smoking than non-users.
Sadly, our limp policy response to e-cigarettes is accompanied by a deeper malaise within tobacco control in Ireland which has badly lost its way due to lack of political priority. The flagship national policy of a tobacco-free Ireland with smoking rates below 5 per cent has failed – with a rate almost four times higher and rising. This won’t be remedied by the legislation before the Oireachtas that is regarded as badly out of date.
Of greatest concern is that, for the first time in a quarter of a century, teenage smoking rates are rising. It is not much of a leap to conclude this is due to e-cigarettes. The appalling vista that now confronts us is the loss of the hard-won gains of reducing smoking rates among 15-16 year-olds and the addiction of new generations of children to tobacco.
There is an obvious roadmap to reverse this decline and re-establish Ireland as a global tobacco control leader. First, in addition to removing disposable vapes from sale, children must be protected from e-cigarettes through a ban on all flavours except tobacco; plain packaging of vapes; and measures to prevent flouting of online marketing restrictions, particularly by social media influencers.
These are defensive measures to halt the slide back to high rates of nicotine addiction among young people. Further action is needed to reach the targets set for a tobacco-free Ireland.
The next logical step is to follow the US by increasing the legal age of sale of tobacco products from 18 to 21, which has resulted in substantial reductions in smoking rates in that age group. This should be accompanied by a national debate on the introduction of New Zealand-style measures banning the sale of tobacco products for life to those born after a certain date.
The public appears to be way in advance of policymakers on the issue, with a recent HSE poll finding that 83 per cent of adults support the phasing out of tobacco in Ireland, including almost three-quarters of smokers. Given their inertia on the issue, this suggests the political guardians of the tobacco-free Ireland policy may require more convincing on taking action to achieve it than the rest of us.
Chris Macey is director of advocacy and patient support at the Irish Heart Foundation