E-cigarettes: The debate gets cloudier

Smoking an e-cigarette Image copyright Thinkstock
Image caption Researchers say national policies need to be made once all evidence is reviewed

What will be legal in Cheltenham will not be across the River Severn in Chepstow. Drivers pulling in for a break on the M4 at Magor services will find they can't do what they could back at Membury. That will be the reality if the Welsh government's Public Health Bill, with its plans to ban the use of e-cigarettes in public places, becomes law.

Some will say this is a good example of devolution in action. Welsh health officials and legislators have decided that the potential risks of e-cigarettes require them to be treated in the same way as tobacco smoking with a ban on their use in the workplace, pubs, restaurants and other public amenities. Their counterparts in England, Scotland and Northern Ireland do not feel the same way. That's the nature of devolved government and national democracy within the UK.

Consumers however, may feel confused. If it's permitted in much of the UK, why does one nation decree that the use of e-cigarettes is harmful enough to ban usage other than on private property? Will smokers be less likely to try to kick their habit by switching to vaping if there are conflicting messages from public health administrations?

The Welsh government accepts that the evidence on any harm caused by e-cigarettes is inconclusive. But officials argue that the priority is try to ensure that smoking is not "renormalised". Any possibility that children attracted to e-cigarettes might be more likely to take up smoking, officials in Cardiff argue, should be enough to justify a ban on their use in public places. Better, they say, to relax the law in a few years' time once more research has been done than to do nothing now and be criticised in the future.

Strong opinions

Malta, Belgium and Spain have already imposed bans on the use of e-cigarettes in public spaces. Welsh officials believe that by following those precedents it can take a lead within the UK. But there is no suggestion that this is likely to happen any time soon in England, Scotland or Northern Ireland. A Scottish Health Bill unveiled last week included plans to bar the sale of non-medical e-cigarettes to under-18s and to restrict certain types of advertising. But there was no proposal to ban their use.

The health argument around e-cigarettes generates strong opinions. The Faculty of Public Health said the Welsh move was "very welcome" because of concerns that vaping might promote nicotine addiction in young people and increase numbers starting to smoke lit cigarettes. The faculty says there are doubts about whether smokers using e-cigarettes really do kick their habit as opposed to using both.

But Prof Robert West of University College London had strong words for the Welsh government, accusing it of being misled by the "barrage of anti e-cigarette propaganda coming from public health activists with little knowledge or understanding of the evidence". Prof West recently authored a study which suggested that people trying to giving up smoking without professional help were 60% more likely to succeed by using e-cigarettes than by other means.

Public Health England is currently working on a major evaluation of e-cigarettes which will be published later this year. A report last year by PHE suggested the organisation was well disposed to the arguments in favour. It concluded that electronic cigarettes and other nicotine devices offered " vast potential health benefits" while noting the need for careful monitoring and risk management.

The e-cigarette debate will run and run. Wales is taking its own step which may prove to be further than other nations in the UK wish to go. It raises big questions over the role of the state in protecting public health and restricting individual freedoms. The jury will remain out until a greater body of evidence is gathered.

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