No doubt about harmful effects of e-cigarettes

The harmful effects of e-cigarettes and vaporisers are beyond doubt. Responsible public health authorities, including the World Health Organisation (WHO) and US Centres for Disease Control, recognise this.

E-cigarettes and vaporisers harm users and non-users as they contain toxins such as nicotine, cancer-causing chemicals such as formaldehyde, and fine PM2.5 particulate matter.

E-cigarettes can lead to nicotine addiction and are a potential gateway to cigarette use.

Youth are particularly susceptible. Many authoritative scientific studies in the United States, United Kingdom and Canada have shown that youth who use e-cigarettes were more likely to move on to conventional cigarettes.

Some writers argue that e-cigarettes may be used to help smokers quit. However, according to the WHO and a study by the US National Academies of Sciences, Engineering and Medicine, there is no conclusive scientific evidence on the safety and efficacy of e-cigarettes as smoking cessation aids.

Dr Tan Kok Kuan (Time to change tack in fight against smoking; Feb 8) suggested that the legalisation of e-cigarettes in the UK and New Zealand has reduced smoking prevalence. This is inaccurate.

The declining trend in smoking prevalence started long before the introduction of e-cigarettes.

Between 2012 and 2016, the UK also enhanced its tobacco control measures, including annual tobacco tax increases above the rate of inflation, a point-of -sale display ban and standardised packaging of tobacco products.

New Zealand has not legalised e-cigarettes and hence, the decline in its smoking prevalence cannot be attributed to e-cigarettes.

New Zealand has also acknowledged there is insufficient evidence to recommend e-cigarettes confidently for smoking cessation, and has instead advised the use of approved nicotine replacement therapies (which do not currently include e-cigarettes).

In Singapore, smokers who wish to quit should use proven nicotine replacement therapies which have been evaluated for safety and efficacy by the Health Sciences Authority (HSA), and which are already available in Singapore.

We are open to reviewing the evidence on the safety and efficacy of e-cigarettes as a smoking cessation aid.

E-cigarette manufacturers may submit their application and scientific evidence to HSA to register their devices as therapeutic products for smoking cessation purposes.

To date, none have done so.

Lim Siok Peng (Ms)

Director, Corporate Communications

Ministry of Health

A version of this article appeared in the print edition of The Straits Times on February 27, 2018, with the headline 'No doubt about harmful effects of e-cigarettes'. Subscribe