Over the past ten years, a substantial minority of cigarette smokers in many countries have turned to electronic (e-) cigarettes in an attempt to quit smoking or as an alternative to smoking some or all of the time. In 2013 around 600,000 Australian smokers had tried e-cigarettes, while there are currently around 2.6 million e-cigarette users in Great Britain.
These devices avoid burning tobacco and don’t produce smoke, tar and particulate matter. Instead they use an electronic system to produce a mist containing nicotine and propylene glycoland/or vegetable glycerine that can be inhaled much like tobacco smoke to deliver nicotine to the lungs.
E-cigarettes deliver much lower levels of toxins and carcinogens than cigarettes, and are 95% less harmful than cigarettes according to some proponents.
But Australia has banned the sale of e-cigarettes containing nicotine. Nicotine can only be imported for use in vaporisers on a medical prescription, but a spokesperson for the Royal Australasian College of Physicians would like to ban this too.
As we argue in the recent edition of the journal Addiction, the ban on e-cigarettes is ethically questionable. It’s a paternalistic policy that denies adult smokers the right to use a less harmful form of nicotine.
Banning a less harmful product (e-cigarettes) while allowing the most harmful (tobacco cigarettes) to be freely sold is an incoherent form of risk regulation. It also disadvantages smokers who may have difficulty quitting but want to reduce the risks of smoking.
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The ban has resulted in the black market of nicotineover the internet and “under the counter” and prevented any sensible regulation of e-cigarettes to reduce risks to consumers and others, including children.
Supporters of the ban argue it prevents the tobacco industry (which now owns some e-cigarette producers) from undermining smoke-free policies by encouraging smokers to keep smoking and use e-cigarettes only in areas where smoking is prohibited (this is known as dual use).
They argue a ban prevents e-cigarettes from “renormalising” smoking by increasing the public visibility of a behaviour that resembles smoking and limits promotion of e-cigarettes to adolescents and young adults.
Media coverage of the Australian ban often seems to suggest we only have two policy choices: either ban these products, or allow their unfettered and unregulated promotion, as is now happening in the United Kingdom and United States.