National Drug Strategy
National Drug Strategy

Public Submission by Australian Tobacco Alternatives Consumer Association

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Title: Mr
Name: Sana Nolan

Is your submission on behalf of an organisation or professional association ?

If yes, which organisation or professional association ?
Australian Tobacco Alternatives Consumer Association

What is your position in the organisation ?
Public Officer

Are you or your organisation in any way associated or affiliated with the tobacco industry, or receive funds or resources from the tobacco industry ?

The goal, as outlined in the draft for consultation is, “To improve the health of all Australians by reducing the prevalence of smoking and its associated health, social and economic costs, and the inequalities it causes.”

The key here is smoking. The vast majority of the health and social costs of tobacco usage, including the 4000-10,000 harmful chemicals are created during the combustion process. If Australians can stop SMOKING this risk disappears. The solution already exists in the form of Swedish Snus and electronic cigarettes.

Starting with Swedish Snus, we know have over 30 years’ worth of research and data to show that Snus usage is “safe” (by the commonly accepted definition). The increased risk in any cancer type is nothing more than statistical background noise.

“ We were unable to confirm any excess of oral or lung cancer in snus users.”
For more information please visit : The Lancet website

“Current smokers who switch to using snus rather than continuing to smoke can realise substantial health gains. Snus could produce a net benefit to health at the population level if it is adopted in sufficient numbers by inveterate smokers. Relaxing current restrictions on the sale of snus is more likely to produce a net benefit than harm, with the size of the benefit dependent on how many inveterate smokers switch to snus.”
For more information please visit : The Lancet website

“If, in the fight against tobacco-related ill health, we adopt a puritanical view, rejecting all nicotine use, we shall see snus as part of the problem. But if we adopt a pragmatic view, seeking to exploit all means of possible reduction of these health risks, we might well see snus as part of the solution.”
For more information please visit : Wiley Online Library website

“Switching to ST compares very favorably with pharmaceutical nicotine as a quit-smoking aid among American men, despite the fact that few smokers know that the switch provides almost all of the health benefits of complete tobacco abstinence. The results of this study show that tobacco harm reduction is a viable cessation option for American smokers.”
For more information please visit : Biomedcentral website

The biggest problem with Swedish Snus is Australia is that the local retail sale as already been banned. Although reversing this decision would have a net health gain to the community I can understand the difficulty in doing so. This is where electronic cigarettes come in.

“There is a need to better understand the potential risks and/or benefits of these products and determine whether there is a need to increase restrictions on their availability and use and identify the most appropriate policy approach for Australia.”

Electronic cigarettes vaporize a propylene glycol and/or vegetable glycerine solution that may or may not contain nicotine. Both of these base substances have been used for over 60 years in theatrical fog machines, in IV solutions and were even tested as a germicide in the 40’s with no health risks shown.

“There was no indication of histopathological effects in the kidneys of either species, and there were no hematological effects. No treatment-related effects were found in either rats or rabbits exposed to 300 or 1000 ppm.”
For more information please visit : Science Direct website

"General Toxicity Observations
Upon reviewing the available toxicity information, the Agency has concluded that there are no endpoints of concern for oral, dermal, or inhalation exposure to propylene glycol and dipropylene glycol.”
For more information please visit : Environmental Protection Agency website

"The report of the 3 years' study of the clinical application of the disinfection of air by glycol vapors in a children's convalescent home showed a marked reduction in the number of acute respiratory infections occurring in the wards treated with both propylene and triethylene glycols. Whereas in the control wards 132 infections occurred during the course of the three winters, there were only 13 such instances in the glycol wards during the same period."
For more information please visit : American Public Health Association website

So we know that the base ingredients are safe. What about the nicotine? Again, the data clearly shows that nicotine inhalation outside of tobacco smoke to have no major health risks:

“In conclusion, our study does not indicate any harmful effect of nicotine when given in its pure form by inhalation”
For more information please visit : The National Center for Biotechnology Information website

Concerns have been raised over the addictive potential of nicotine. There is available data that heavily suggests that nicotine by itself (again, outside of tobacco smoke) is nowhere near as addictive as many would believe.

“Craving for cigarettes is more to do with the mind than the addictive influence of nicotine. In other words, it is the psychological element of smoking that makes one addicted to cigarettes, a new study conducted by Israeli scientists has revealed.”

“Therefore, the craving effect is produced by psychological reasons rather than by the physiological effects of nicotine deprivation.”
For more information please visit : Medical Daily website

This would seem to be reinforced by the fact that although addiction to NRT products does occur, the incidence is miniscule compared to tobacco smoking addiction.

All of this would suggest that not only does the usage of electronic cigarettes completely remove the risk of second hand smoke (since nothing is burnt) but also present no risk to either the user nor bystanders. But do they work as a cessation aid?

“The primary finding was that the 6-month point prevalence of smoking abstinence among the e-cigarette users in the sample was 31.0% (95% CI=24.8%, 37.2%). A large percentage of respondents reported a reduction in the number of cigarettes they smoked (66.8%) and almost half reported abstinence from smoking for a period of time (48.8%). Those respondents using e-cigarettes more than 20 times per day had a quit rate of 70.0%. Of respondents who were not smoking at 6 months, 34.3% were not using e-cigarettes or any nicotine-containing products at the time.”
For more information please visit : Science Direct website

“Ecigarettes were used mainly to quit smoking, and may be helpful for this purpose…”
For more information please visit : BioMedCentral website

“We conclude that electronic cigarettes show tremendous promise in the fight against tobacco-related morbidity and mortality. By dramatically expanding the potential for harm reduction strategies to achieve substantial health gains, they may fundamentally alter the tobacco harm reduction debate.”
For more information please visit :Palgrave Macmillan Journals website

“The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit”
For more information please visit : BioMedCentral website

In summary, the electronic cigarettes are clearly “safe” by the common usage of the word and although further studies would benefit, initial research also shows them to be far more effective as a cessation aid than ANY currently recommended method.

The only question remaining is the flavouring ingredients used. These flavours are all currently used in a variety of food products with no known negative health effects. Some components (such as diacetyl) which are known to have adverse effects when inhaled are not used by any reputable electronic cigarette solution manufacturer. The inclusion of these products into existing Food Safety guidelines would ensure that Australians could continue to use these products with confidence.

I will end this submission with a quote from the testing done on Ruyan electronic cigarette products by Health NZ:

“Electronic Cigarette Mist – harmless inhaled or exhaled”
For more information please visit : Health New zealand website

And another from cardiologist Konstantinos Farsalinos:

"It would be an ethical crime to ban e-cigarettes and make ex-smokers (vapers) start smoking again"

Thank you for your time.
Sana Nolan
Australian Tobacco Alternatives Consumer Association
Australian Tobacco Alternatives Consumer Association website

Page currency, Latest update: 13 March, 2013