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By Graham Satchell BBC News
The number of people using e-cigarettes in the UK is expected to reach a
million this year but but while some believe the electronic alternative to
tobacco could help save hundreds of thousands of lives others think they
normalise what looks like smoking and may be unsafe.
Anyone walking into a busy pub in Manchester may well be confronted with a
rather shocking sight.
At one table it looks like a group of friends are smoking, but there is no
smell in the air and no ashtrays on the table. What they are using are
e-cigarettes.
One of the women, Steph, says the e-cigarette has helped her to stop smoking.
"I've tried patches and inhalators," she says. "They're a lot better because
you feel like you're having a cigarette."
"They're a great idea," says another woman, Lisa. "You've got the health
benefits from it and it does taste like a cigarette."
The e-cigarette comes in two parts.
In one end there is liquid nicotine, in the other a rechargeable battery and an
atomiser. When the user sucks, the liquid nicotine is vaporised and absorbed
through the mouth. What looks like smoke is largely water vapour.
Because there is no tobacco in e-cigarettes, there is no tar and it is the tar
in ordinary cigarettes that kills.
Safety concerns
Start Quote
If all the smokers in Britain stopped smoking cigarettes and started smoking
e-cigarettes we would save 5 million deaths in people who are alive today
Professor John Britton Royal College of Physicians
The e-cigarette market is growing fast. A survey by the charity Action on
Smoking and Health (ASH) suggests 700,000 people in the UK were using
e-cigarettes last year.
The charity estimates that number will reach a million in 2013 and some medical
experts see huge potential benefits.
"Nicotine itself is not a particularly hazardous drug," says Professor John
Britton, who leads the tobacco advisory group for the Royal College of
Physicians.
"It's something on a par with the effects you get from caffeine.
"If all the smokers in Britain stopped smoking cigarettes and started smoking
e-cigarettes we would save 5 million deaths in people who are alive today. It's
a massive potential public health prize."
There are however concerns about the safety and regulation of e-cigarettes.
They can legally be sold to children. There are few restrictions on
advertising. Critics say some of the adverts glamorise something that looks
like smoking.
Unlike patches and gum, e-cigarettes are not regulated like medicines. It means
there are no rules for example about the purity of the nicotine in them.
Regulation call
So are e-cigarettes safe?
"The simple answer is we don't know," says Dr Vivienne Nathanson from the
British Medical Association (BMA).
"It's going to take some time before we do know because we need to see them in
use and study very carefully what the effects of e-cigarettes are."
The BMA is just one of the bodies to respond to a consultation on e-cigarettes
by the Medicines and Healthcare products Regulatory Agency. The agency is
deciding whether the e-cigarettes should be licensed as a medicine and more
tightly regulated. The BMA thinks they should.
Start Quote
I don't think there's any difference between going for a caffeine break and
having a nicotine break
Lawrence Jones UK Fast
"I would either take them off the shelves or I would very heavily regulate them
so that we know the contents of each e-cigarette were very fixed," says Dr
Nathanson.
E-cigarettes are currently classed as a general consumer product and regulated
by trading standards. It means they cannot contain hazardous chemicals, for
example, and that the battery in them must meet EU standards.
The trade association for e-cigarettes, the Electronic Cigarette Industry Trade
Association, says they make no medicinal claims for their product. It is sold
merely as an alternative to ordinary cigarettes.
Attempts to classify e-cigarettes as a medicinal product have been made in
Holland and Germany but the industry successfully overturned the decisions in
court.
Workplace etiquette
One UK based distributor, called VIP, says over stringent regulation could see
them go out of business. Nonetheless Andy Whitmore, the company's marketing
director, said it would "welcome regulation that ensures the product can't be
sold to anyone under the age of 18".
There are many other questions. For example, should using e-cigarettes be
allowed in a public place? At the offices of UK Fast - an internet storage
company - employees can use them at their desk.
"It's a tricky one," says the company's chief executive officer, Lawrence
Jones.
"It does look like smoking but could you stop someone from chewing a pencil or
biting their nails? I don't think there's any difference between going for a
caffeine break and having a nicotine break."
Other companies have banned it. But in theory electronic cigarettes can be used
anywhere - on planes, trains, in hospitals.
The BMA is worried that the more people start using e-cigarettes the more it
will normalise something that looks like smoking. They have called for the ban
on smoking in public places to be extended to e-cigarettes.
A decision on whether the regulation of electronic cigarettes should be
tightened will be made in a few weeks.