The great e-cigarette war

9th May 2016 Facebook Twitter LinkedIn Google+ News


E-cigarettes are far less harmful than tobacco and could be prescribed to help smokers quit, a report in England found. But the Welsh government wants to ban their use in public places. Why are approaches in the neighbouring countries so different?

Some look like traditional cigarettes, with a light to mimic the glow of burning ash. Others are more ornate – long metallic devices that more closely resemble pipes or even torches.

These days you don’t have to go very far to spot one.

Around 2.6 million adults in Britain have used e-cigarettes in the decade or so that they have been on the market. And there’s wide disagreement about the extent to which this is a good or a bad thing.

No-one is advising non-smokers to take them up, but a recent report by Public Health England and found they were 95% less harmful than tobacco and could be a “game changer” when it came to persuading people to quit cigarettes.

And yet while the report heralded the possibility of prescribing e-cigarettes to English smokers who want to stop, neighbouring Wales is taking quite a different approach.

The devolved government there is looking to ban them in enclosed public places – in common with 40 other countries that have already imposed similar restrictions. The World Health Organization also supports regulating them more stringently. Scotland has not gone as far as Wales, but e-cigarettes are currently forbidden in almost all Scottish hospital grounds, which the Holyrood government plans to put on a statutory footing.

E-cigarettes are not covered by the UK’s anti-smoking laws, and they are permitted in some pubs. But many businesses and organisations have imposed their own restrictions.

All Bar One, Caffe Nero, KFC and Starbucks are among the food chains that have banned them on their premises. Manchester City, Manchester United and Chelsea forbid using them in their stadia although Burnley FC has a “vaping zone”.

Pub chains Mitchell’s and Butlers, JD Wetherspoon and Fuller’s have all banned e-cigarette use on the premises, citing the possibility of confusion for customers and staff. Stonegate Pub Company said they were not allowed in non-smoking areas because of their “remarkable likeness” to cigarettes. Enterprise Inns leaves the decision down to its tenants and has done a deal with one brand of e-cigarettes to sell them.

The devices are forbidden on National Express coaches as well as on CrossCountry Trains, Northern, Thameslink and Virgin as well as all Transport for London routes. Many train stations ban their use even on open platforms as they can “unsettle passengers” and leave them thinking actual smoking is allowed.

Most airlines and airports ban them although London Heathrow permits their use up to the flight gate and Ryanair sells its own “smokeless” cigarettes, which aren’t electronic and work like nicotine inhalers. This year the industry body Oil and Gas UK advised companies not to allow e-cigarettes to be used offshore following a health and safety report.

Opinion is divided among UK public health professionals. The anti-smoking charity Ash strongly backed the PHE report’s recommendations and the Royal College of Physicians believes they could lead to “significant falls” in smoking. But the British Medical Association (BMA) supports banning their use in enclosed public places.

There is some consensus, however. The weight of evidence suggests that e-cigarettes – which heat liquid nicotine to form a vapour – are much less harmful to chronic smokers than conventional tobacco smoke, which has far higher levels of carcinogens and toxicants.