Are e-cigarettes bad for you? WHO considers regulation 

 
       

  
  
   
       Credits:    Christopher Furlong/Getty Images     Alt Text:    E-cigarette      

  
 
      
    E-cigarettes could 'save millions of lives', say experts, but long-term effects are still unknown     
 
        Briefing  
    
    Thursday, May 29, 2014 - 3:57pm  
      Researchers and public health specialists have urged the World Health Organisation (WHO) to "resist the urge to control and suppress e-cigarettes", but health specialists remain divided on the issue. 
 A letter sent by 50 researchers said that the new device could turn out to be a "significant health innovation" and may help people quit smoking. "These products could be among the most significant health innovations of the 21st Century - perhaps saving hundreds of millions of lives," it said. 
 The public health community remains deeply divided over e-cigarettes. Some believe they may help people quit tobacco; others say that their long-term health effects are still unknown and they may actually serve to "re-normalise" smoking. 
 So what do we know about e-cigarettes, and should they be banned? 
  What are e-cigarettes? 
 E-cigarettes come in a range of shapes and sizes, but common to all of them is the way they work. A built-in battery powers a small electronic heating element located in the "atomiser", which draws liquid up from a cartridge and onto the element. The solution, usually a mixture of propylene, glycol, glycerine, flavourings, and – critically – nicotine, turns to vapour and is inhaled through the mouthpiece. 
 Some e-cigarettes look like a regular tobacco cigarette, others look more like the top of a hookah pipe. Others still have been made to look like a traditional pipe – the kind that Sherlock Holmes smoked. 
  Are they dangerous? 
 Anna Gilmore, director of the Tobacco Control Research Group at the University of Bath told  The Guardian : "E-cigarettes are certain to be way less harmful than cigarettes. Common sense would dictate that". But their long-term effects still remain unknown. 
 The  WHO  says that their safety is "illusive", noting that it is impossible to know what effect they may have on the body because "the chemicals used in electronic cigarettes have not been fully disclosed, and there are no adequate data on their emissions". 
 The British Medical Association (BMA) has also expressed concerns about the lack of adequate testing or controls. "The real truth," says Gilmore, "is that we just do not know. We cannot say e-cigarettes are risk-free. We cannot yet be sure what impact they will have on smoking rates or population health, whether they'll be the miracle product or not." 
  Should they be regulated? 
 Professor Robert West, of University College London told the  BBC  that e-cigarettes should be "regulated appropriate to what they are" and that they are "orders of magnitude safer" than tobacco cigarettes 
 He suggested "bespoke regulation" including banning sales for under-18s and controls on how the devices are advertised. 
 Dr Vivienne Nathanson, the British Medical Association's director of professional activities, told the BBC that there was evidence that children were beginning to use e-cigarettes as a direct result of marketing campaigns. 
 "Rather like cigarettes in the 50s and 60s, we really need to look at [advertising] and, I believe, ban it, to stop them advertising in a way that attracts children," she said. 
 Professor John Ashton, president of the UK's Faculty of Public Health, agreed that the possibility that advertising might impact on children was a cause for concern. 
 E-cigarettes are currently not regulated as medicines in the UK, the  Daily Telegraph  notes, but Britain's drug watchdog the MHRA wants to introduce new controls by 2016.  ·   
       Health & Science        E-cigarettes    World Health Organisation    British Medical Association