Irish and internati onal research on the risks of e-cigarett es

The latest Irish and international research on risks of e-cigarettes

AUTHOR: Priscilla Lynch

A new Health Research Board (HRB) review into e-cigarette use has found that e-cigarettes are associated with adolescents starting to smoke tobacco cigarettes; with adolescents who had ever used e-cigarettes between three and five times more likely to start smoking compared to those who never used e-cigarettes.

Key findings include:

 E-cigarettes are no more effective than approved and regulated nicotine replacement therapies (NRTs) to help people stop smoking. However, e-cigarettes as a smoking cessation device are not regulated or approved and their safety beyond 12 months is not yet known.  E-cigarettes acute effects include poisonings, burns, blast injuries, lung injury and asthmatic attacks. Some of the chemicals in e-cigarettes are thought to cause tissue and cell damage and some are agents that may cause cancer in the longterm. The long-term health effects beyond 24 months are not researched.  Dual use of both e-cigarettes and conventional tobacco cigarettes was not less harmful than smoking tobacco cigarettes alone, which raises questions about the smoking reduction benefit of e-cigarettes.

Dr Jean Long, Head of the Evidence Centre at the HRB said the findings would have to be considered as part of any smoking harm reduction strategy. “Our findings highlight that it is important more is done to promote NRT and protect the health of adolescents and vulnerable groups before considering the role of unregulated e-cigarettes as a harm reduction approach.”

Chief Executive of the HRB, Dr Mairéad O’Driscoll, said: “Independent and credible evidence is vital to help inform policy decisions. This HRB review is already

E-CIGARETTE USAGE IN IRELAND The Health Ireland survey* for 2019 shows that:

 5 per cent of the population use e-cigarettes and a further 12 per cent have tried them at some point.

 Use is higher in more deprived areas (7 per cent), than in more affluent areas (4 per cent).

 10 per cent of current smokers use e-cigarettes, with 13 per cent of ex-smokers using them.

 38 per cent of those who made an attempt to quit smoking used e-cigarettes during this attempt.

 25 per cent of those aged between 25 and 34 have tried e-cigarettes, with 8 per cent currently using them.  20 per cent of men have tried e-cigarettes compared to 14 per cent of women.

 5 per cent of men and 3 per cent of women currently use e-cigarettes.

A Health Behaviour in School Children survey found that e-cigarette use is about twice as common as tobacco smoking:

 More than one-in-five of 12 to 17-year-old children report that they have ever used e-cigarettes.

 Boys (one-in four or 26 per cent) are more likely than girls (under one-in-five or 18 per cent) to report that they have ever used e-cigarettes.

TOBACCO SMOKING IN IRELAND: PEOPLE AGED 15 YEARS AND OVER The results for 2019 Healthy Ireland survey* show that:

 Smoking has declined from 23 per cent in 2015 to 17 per cent in 2019.

 17 per cent of respondents are current smokers: 14 per cent smoke daily and 3 per cent smoke occasionally.

 Men are more likely to smoke than women:19 per cent of men are current smokers, compared to 16 per cent of women.

 Smoking rates are highest among those aged 25 to 34: 26 per cent of this age group are current smokers.

 Smoking rates are higher in more disadvantaged areas (24 per cent) than in more affluent areas (14 per cent).

 Smoking rates are also higher for those who are unemployed (40 per cent) and those with no third level education (20 per cent), than they are for those in employment (18 per cent) and those with degree level education (11 per cent).

 28 per cent of respondents are ex-smokers.

* The 2019 Healthy Ireland survey involved 7,413 interviews conducted with a representative sample of the population aged 15 and older living in Ireland

informing forthcoming HSE good practice guidelines to help people stop smoking and these will take into consideration the place of the e-cigarette when trying to stop smoking. The Department of Health have also prepared legislation, which will look at licensing of retail outlets and banning e-cigarettes for young people under 18 years of age.”

Meanwhile, separate research presented at the 2020 European Respiratory Society (ERS) International Congress found that flavourings combine with solvents in e-cigarettes to produce new toxic chemicals that irritate the airways, triggering reactions that can lead to breathing and heart and blood vessel problems.

Researchers consistently observed that the new chemicals formed from the flavours and e-liquid solvents were more toxic than either of their parent compounds.

The new chemicals also activated sensory irritant receptors in nerve endings in the bronchi called TRPV1 and TRPA1, which are responsible for a range of inflammatory responses. The researchers showed for the first time that even low concentrations of the newly-formed chemicals caused the cells lining the bronchi to die. 