Difference between revisions of "E-cigarettes"
Revision as of 11:42, 16 May 2019
This introductory page explains what e-cigarettes are and briefly summarises the main public health discussions around them. It does not include recent research developments on the safety of e-cigarettes.
Since the remit of TobaccoTactics.org is to monitor the tobacco industry and those involved with it, we will report on tobacco company developed brands and acquisitions of once independent brands and present information on related issues such as marketing and marketing rules, e-cigarette regulation and lobbying.
- See the list of all pages on e-cigarettes.
Use of E-cigarettes in the UK
According to a series of surveys involving more than 12,000 adult smokers, the number of people who use electronic cigarettes in the UK has tripled over the past two years to 2.1 million. Among those currently using electronic cigarettes, around 700,000 are ex-smokers and 1.3 million are using them alongside normal cigarettes or tobacco. The survey revealed that use of e-cigarettes among people who have never smoked remains small, at only 1%.
Current smokers using e-cigarettes regularly have risen from 2.7% in 2010 to 17.7% in 2014. When asked why they used electronic cigarettes, 71% of the ex-smokers said they wanted help giving up smoking. Among current smokers, 48% replied they wanted to reduce the amount of tobacco they smoked and 37% said they used e-cigarettes to save money.
These series of surveys commissioned by Action on Smoking and Health (ASH) and those conducted by the Smoking Toolkit Study are the only statistics available on the use of e-cigarettes in the UK. Even the Medicines and Healthcare Products Regulatory Agency (MRHA) of the Department of Health refers to a 2012 report by ASH and to statistics delivered by “Smoking in England”, which is a portal providing key information about smoking and smoking cessation patterns in England based on surveys by the Smoking Toolkit Study.
The UK Parliamentary Office of Science and Technology (POST) referred to the updated January 2014 ASH briefing when stating that the use of e-cigarettes (‘vaping’) is widespread in the UK:
- an estimated 1.3m people use e-cigarettes
- 35% of tobacco smokers have tried an e-cigarette and 11% currently use them
- use is confined almost entirely to current or ex-smokers
- among children, e-cigarette use appears confined to older children and those who have already used tobacco
- 30-38% of those who try e-cigarettes use them again, but only 14% become daily users.
- Awareness of e-cigarettes is highest among younger white smokers with higher incomes and there is no gender difference.
- Less data are available on how e-cigarettes are used (quitting or partial substitution) and duration of use.
The use of e-cigarettes is changing very fast. In early 2014, ASH estimated that perhaps as many as 400,000 people have replaced smoking with e-cigarette use. These numbers have gone up significantly in the past few years. In late 2012, Martin Dockrell et al concluded that e-cigarettes "remain something of a niche product." Although awareness had increased, the research had found that the proportion of smokers who were aware of e-cigarettes but had not tried them remained at just more than 50%. However, according to more recent surveys, this is changing rapidly:
- While 3% of smokers reported using e-cigarettes in 2010, this proportion increased to 7% in 2012 and 11% in 2013.
- The number of people reported having tried e-cigarettes went from 9% in 2010 to 22% in 2012 and 35% in 2013.
Statistics from SmokinginEngland.info confirmed the increase of e-cigarette use by smokers and people who intend to stop. Based on data collected during monthly household surveys (which involved a new representative sample of approximtely 1800 respondents each month), researchers estimated that between May 2011 and November 2013, the percentage of smokers using e-cigarettes rose from 2% to 15%. Similarly, the percentage of people using e-cigarettes in an attempt to quit smoking increased from about 1% to 12% in the same period. Dr Jamie Brown of Smoking in England concluded: "There are 8.5 million smokers in England (42.5 million people in England and about 20% smoking), and if 16% of all smokers use e-cigarretes, that equals 1.36 million current users."
A “Threat and Opportunity” for the Tobacco Industry
E-cigarettes are the “biggest potential threat and opportunity the industry has had for a long time,” according to James Bushnell, a tobacco analyst. “The only thing that’s fundamentally changed in cigarettes since the 1960s is that they put a filter in.” Bonnie Herzog, a tobacco market analyst at Wells Fargo predicted that demand for the smokeless devices in the US and Europe would surpass that of traditional cigarettes in the next decade. Although not everybody shares this optimism, the e-cigarette business is expanding quickly nonetheless. The market for e-cigarettes has grown from several thousand users in 2006 to several million worldwide, and users now have more than 200 brands to choose from. E-cigarette sales were projected to double to $2 billion in 2013 compared to the previous year, and top $10 billion by 2017.
Meanwhile, the tobacco industry reported that in 2013, the total volume of real cigarette sales was down by 4.5%, driven by volume displacement to e-cigarettes. Annual overall growth was 20%, but with 31% more shelf space being devoted to e-cigarettes.
Investment advisors at Merrill Lynch agree that e-cigarettes are likely to remain a “hot topic” in 2014, expecting the robust growth to continue amidst lack of overall regulation and taxes. Despite these predictions, the outlook for e-cigarettes in the US and Europe remains somewhat uncertain- in early 2014, e-cigarettes only accounted for 1%-2% of the total cigarette market.
Merrill Lynch does not think it is a foregone conclusion that e-cigarettes will replace tobacco within the next ten years, arguing that it is difficult to forecast how many people will switch to e-cigarettes entirely, and how many will use e-cigarettes only occasionally. The outlook for the industry will be driven by several factors including: 1) regulation; 2) taxes; and 3) product development and innovation.
Quitting Tool or Gateway to Smoking?
The debate over the use of e-cigarettes has become a major issue in public health. Some public health experts believe that e-cigarettes are an essential alternative to smoking tobacco that can help smokers quit. Others argue e-cigarettes could be a route into nicotine addiction and point out that their safety has not yet been proven. Those in between believe that e-cigarettes may offer public health benefits but that e-cigarettes should be regulated, particularly when it comes to the marketing of such products. One leading e-cigarette proponent and Emeritus Professor Gerry Stimson, argued that, “Electronic cigarettes are the big game changer, as they have the potential to help smokers transform their “health and welfare”.
In July 2013, the World Health Organisation (WHO) issued a statement stressing that the safety of e-cigarettes “has not been scientifically demonstrated”:
- "The potential risks they pose for the health of users remain undetermined. Furthermore, scientific testing indicates that the products vary widely in the amount of nicotine and other chemicals they deliver and there is no way for consumers to find out what is actually delivered by the product they have purchased."
The WHO also pointed out that "for smoking cessation products to be most effectively and safely used, they need to be used according to instructions developed for each product through scientific testing." As of yet, there are no scientifically proven instructions for using e-cigaretes as replacements for smoking or for smoking cessation.
Additionally, there are concerns that e-cigarettes could become a route to conventional cigarette addiction: “E-cigarettes must become an aid to quit smoking, not a tool to enlarge the number of smokers,” argues Jean-Louis Touraine, a Socialist lawmaker in France, doctor and expert on health-care policy. “They are becoming a fad, and many young people are being attracted to them.” Similar arguments are used in the legislative debate regardubg regulation and prohibition, as reflected in an EU Parliament Library briefing:
- "Arguments in favour of prohibition of e-cigarettes are that their safety is not proven, they can cause nicotine addiction and provide a ‘gateway’ to smoking.
- "Opponents consider prohibition as a 'smoke or die' approach that will drive nicotine addicts to smoking tobacco products. It may also lead to the emergence of a black market for e-cigarettes and e-liquids without any quality controls." 
- For more information on the human health effects of e-cigarettes see the overview of recent research on ASH Scotland's website (updated weekly from PubMed).
E-cigarettes At The Pharmacy
As of 24 February 2014, Boots, the high street chemist, sells the newly-created Puritane brand from Imperial Tobacco subsidiary Fontem Ventures. Puritane will be exclusively available at Boots. Likewise, in January 2014, LloydsPharmacy began stocking Vype e-cigarettes, manufactured by British American Tobacco subsidiary Nicoventures, in its 1,500 pharmacies. It is unclear whether these deals prohibition the selling of any other e-cigarette brands. PMI’s Nicocig and Nicolites sell in several pharmacy outlets across the UK and are also available from an online pharmacy.
- For more detail, see E-cigarettes: At The Pharmacy
Tobacco Industry Funding e-Cigarette Research
One of the first pieces of evidence perhaps backing the claim that e-cigarettes could help smokers quit resulted from a clinical trial at the University of Catania in Italy. The results, published in autumn 2011, sparked a heated discussion between people who believe in the benefits of e-cigarettes and those who advocate e-cigarette sales bans. According to the researchers, e-cigarettes were more effective for smoking cessation and for reducing daily cigarette consumption than nicotine replacement therapy. However, it must be noted that this research was funded by PMI, a multinational tobacco company who has invested in the e-cigarette market. Additionally, the principal investigator was involved in marketing the same e-cigarettes being tested. This raises a conflict of interest argument, and is an example of a frequently-employed industry tactic of commissioning research to suit its interests .
- For more on this research, see E-cigarettes: Mixing Research and Marketing.
Other TobaccoTactics Resources
- S. Bond, Big Tobacco bets a packet on e-cigarettes, 6 June 2013
- Companieshouse, Nicoventures Holding Ltd, Webcheck, latest entry 21 January 2014, accessed January 2014
- Matthew Chapman, Boots to sell Puritane e-cigarettes from Imperial Tobacco subsidiary, Matthew Chapman, 19 February 2014, accessed February 2014
- R. Burrows, Speech by BAT's Chairman at its Annual General Meeting. 27 April 2016
- Lorillard, Lorillard, Inc. Reports First Quarter 2012 Results and Acquisition of blu ecigs, 25 April, accessed 27 April 2012
- PR Newswire, Lorillard, Inc. Acquires British-based SKYCIG, Expanding its Electronic Cigarette Business. Acquisition Marks First Major Step in Building the Company's Global e-Cigarette Business, 1 October 2013, accessed December 2013
- Skycig electronic cigarettes to become Blu ecigs, Convenience Store News, 21 March 2014
- M.J. De la Merced, C. Bray, To Compete With Altria, Reynolds American Is Buying Lorillard, The New York Times, 15 July 2014, accessed July 2014
- D. Robinson, Japan Tobacco joins rivals in e-cigarette market with E-lites buy. The Financial Times, 11 June 2014
- Brad Stone, Ploom's E-Cigarettes and Vaporizers Use Real Tobacco, BloombergBusinessweek, 21 November 2013, accessed December 2013
- Jiji, Japan Tobacco acquires rights to US firm Ploom brand,The Japan Times, 17 February 2015, accessed March 2015
- Matthew Chapman, Boots to sell Puritane e-cigarettes from Imperial Tobacco subsidiary, Marketing Magazine, 19 February 2014, accessed February 2014
- M.J. De la Merced, C. Bray, To Compete With Altria, Reynolds American Is Buying Lorillard, The New York Times, 15 July 2014, accessed July 2014
- M. Geller, Imperial Tobacco widens e-cigarette strategy with new brand, Reuters, 4 February 2015, accessed March 2015
- Andre Calantzopoulos, Philip Morris International Investor Day 26 June 2014, accessed June 2014
- Louise Banham, Philip Morris snaps up Nicolites, in BetterRetailing.com 26 June 2014, accessed June 2014
- Mike Esterl and John Kell, Altri to Enter E-Cigarette Market, Wall Street Journal, 25 April 2013, accessed 2 May 2013
- Reynolds American Inc, Reynolds American Quarterly Report, United States Securities and Exchange Commission, 23 April 2013, accessed 2 May 2013
- , Vuse Vapour Homepage, accessed October 2014
- Duncan Robinson and Shannon Bond, fires up e-cigarette legal battle, 10 march 2014, accessed May 2014
- Library of the European Parliament, Electronic Cigarettes, Library Briefing, 27 March 2013, accessed January 2013
- FDA, Regulation of e-Cigarettes, no date, accessed January 2014
- POSTnote, Electronic Cigarettes, Number 455 January 2014, accessed January 2014
- Wikipedia, Electronic Cigarettes, accessed January 2014
- Ash, Use of electronic cigarettes in Great Britain, Factsheet, April 2014, accessed April 2014
- BBC News, E-cigarette users in UK have 'tripled' since 2010, 27 April 2014, accessed April 2014
- Working group on Niotine Continging Products, Commission on Human Medicines, Current use of electronic cigarettes, MHRA, 2013, accessed February 2014
- funded by the DoH and Cancer Research UK. See: Smoking in England,About page, no date, accessed January 2014
- ASH, Electronic cigarettes, ASH Briefing, January 2014, accessed January 2014
- Martin Dockrell, Rory Morrison, Linda Bauld, Ann McNeill, E-Cigarettes: Prevalence and Attitudes in Great Britain, Nicotine & Tobacco Research, Volume 15, Number 10 (October 2013) 1737–1744, accessed February 2014
- The surveys have been running since November 2006 and have accumulated more than 150,000 respondents of whom more than 35,000 are ‘last-year smokers’. Robert West and Jamie Brown , Latest trends on smoking in England, Smoking Toolkit Study, 27 January 2014, accessed January 2014
- Jamie Brown, Email correspondence, 2 February 2014
- Albertina Torsoli and Makiko Kitamura, Future of E-Cigarettes in Question on European Crackdown, 14 June 2013, accessed December 2014
- Bonnie Herzog, "Tobacco Talk" - Q4 U.S. Retailer Survey – E-Vapor Products Continue to Take Combustible Cig Share Wells Fargo, 22 January 2014
- Merrill Lynch, Trial remains high; repeat usage lower, 6 January 2014, accessed January 2014
- Gerry V Stimson, David Dorn, Rick Lines, Re: E-cigarettes and the marketing push that surprised everyone, Letter to the British Medical Journal, 4 October 2013
- WHO, Questions and answers on electronic cigarettes or electronic nicotine delivery systems (ENDS), Statement, 9 July 2013
- Albertina Torsoli and Makiko Kitamura,Future of E-Cigarettes in Question on European Crackdown, 14 June 2013, accessed January 2014
- Nathan K. Cobb and David B. Abrams Perspective. E-Cigarette or Drug-Delivery Device? Regulating Novel Nicotine Products New England Journal of Medicine, 21 July 2011
- PJ Online, Boots and Lloydspharmacy join the vaping fold by selling e-cigarettes, Royal Pharmaceutical Society, 13 February 2014, accessed February 2014
- Weldricks Pharmacy, Product Search Nicocigs, undated, accessed June 2014
- R. Polosa et al, Effect of an Electronic Nicotine Delivery Device (e-Cigarette) on Smoking Reduction and Cessation: A Prospective 6-Month Pilot Study, BMC Public Health, 11 October 2011, accessed October 2011