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Electronic cigarettes will remain on the kingdom’s banned list after health officials dismissed controversial research claims which have led to some experts supporting moves for them to be used as aids to stop smoking.
The Ministry of Health is determined to continue its crackdown and ban the import of the products because it believes the tobacco-free devices people use to inhale nicotine-laced vapour do more harm than good.
Cigarette smoking causes cancer, a host of other ailments and is a massive burden on health resources. Companies making and selling electronic cigarettes claim they help nicotine addicts snub out the habit but others fear they are simply a cool tool to entice the young into the nicotine trap.
Dr Ejlal AlAlawi, public health consultant and head of the anti-smoking group, explained the Bahrain government’s tough stance on the issue, and said: “The reason behind it is to reduce the tobacco products available in the market as much as we can; especially now that it has been proven that e-cigarettes are not a successful smoking cessation tool as claimed by manufacturers.
“A sample of nicotine-free e-cigarettes was sent to the Ministry of Interior’s laboratory and was found to have nicotine, contrary to what was claimed on the package. Also, it was found that the contents and emissions of e-cigarettes contain many carcinogens and was not harm-free.”
The devices may be banned from entry into the country but they are still finding a way of being distributed around the island. Classified websites advertise the purchase of e-cigs in Bahrain and local sellers are charging approximately double the price paid for the devices, additional filters and cartridges than in Europe. Consumers, however, ordering online find the packages confiscated by the Ministry of Interior’s Customs Affairs on arrival at the post office.
Others who try to stash the devices in their luggage after a holiday abroad often find them taken away during bag searches at the airport by custom officers carrying out health ministry instructions. The letters pages of local newspapers have recently been bombarded by e-cigarette supporters, buoyed by reports suggesting that these devices were around ‘95 per cent’ less harmful than tobacco and should be promoted as a tool to help smokers quit, according to a study by an agency of the UK’s Department of Health.
Up until then, despite e-cigarettes surging in popularity around the globe, health organisations had been wary of advocating them as a safer alternative to tobacco and governments from the US to India have tried to introduce bills to regulate their use more strictly.
“E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm,” claimed Professor Kevin Fenton from Public Health England, which carried out the study.
But there’s no smoke without fire. The study was swiftly criticised by the Lancet Medical Journal for relying on ‘flimsy’ evidence.
Dr Ejlal said: “This study was withdrawn as it was later revealed that it was done by a group of researchers that were indirectly connected to e-cigarette manufactures which renders its results questionable and invalid. Hence, the World Health Organisation did not change its recommendations in accordance with the study results.”
Apparently, the report relied on a 2014 study that was conducted by scientists in the pay of e-cigarette companies and the Lancet Medical Journal health experts accused the agency of falling short of its mission to protect public health.
The Lancet revealed that three of the 11 authors of the original study were paid advisors for the e-cigarette industry. The editors of the journal European Addiction Research even issued a warning alongside the article saying there was a ‘potential conflict of interest.’
So far, no electronic cigarette has been licensed by the Medicines and Healthcare Products Regulatory Agency or the National Institute for Health and Care Excellence in the US.
In fact, several studies have even found that the flavours used in e-cigarettes may cause respiratory problems and damage the immune system. Also, research published by the University of Southern California suggested that its usage could encourage youngsters to take up smoking in the future.
Dr Ejlal added: “Researchers found that e-cigarettes are popular among teenagers and adolescents and they promote using other types of tobacco products in the future. Also, some studies have also shown that some teens are replacing the filters and cartridges with other addictive substances.”
Most e-cigarettes consist of a cartridge, which holds a liquid solution containing varying amounts of nicotine, flavourings and other chemicals, a heating device (vaporiser) and a power source. When puffing the battery-powered device, it heats up the liquid thus vaporising it and resulting aerosol or vapour is then inhaled.
In the US, ‘vaping’ among young people exceeded smoking in 2014. Some states have banned the sale of e-cigarettes to minors, but they too found ways to get around it by ordering online. Easy availability, in addition to the wide array of cartridge flavours available, make them particularly appealing to the younger demographic, experts fear.
Many A-list celebrities and artists haven’t helped by regularly using the devices in music videos or putting images of themselves using them on social media accounts.
A recent study stated in the Journal of the American Medical Association by Nancy Rigotti, MD, showed that students who have used e-cigarettes by the time they started ninth grade (aged 14 and 15) were more likely than others to start smoking traditional cigarettes and other smokable products within the next year.
The battery-operated rechargeable e-cigarettes, also known as electronic nicotine delivery systems and vaporisers, are made to look like traditional tobacco cigarettes, cigars or pipes, or even everyday items like pens or USB memory sticks. There are more than 250 different brands available on the global market.
Since vaping was first introduced to the world in 2004, their usage has sky-rocketed. In 2009, His Majesty King Hamad issued an anti-smoking law banning the import of substances considered to be alternatives to the traditional tobacco products, even if they are nicotine-free.
In 2013, globally several millions were said to have caught on to the e-cig bug, netting a fortune for manufacturers, many of whom are now linked to cigarette makers.
Big tobacco companies were relatively slow to enter the e-cigarette market, but have made up for lost time using their size and financial firepower to take over a market that was reported by the Financial Times to be worth $3 billion globally. For example, Imperial Tobacco’s member company Fontem Ventures acquired Dragonite in August 2013, previously owned by Hon Lik, the Chinese pharmacist who claims he invented the e-cigarette.
Bahrain issued a ministerial decree banning the import and use of e-cigarettes based on the recommendations of the WHO which 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,” it said.
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-cigarettes as replacements for smoking or for smoking cessation.
Bahrain’s position has support. “E-cigarettes must become an aid to quit smoking, not a tool to enlarge the number of smokers,” argued Jean-Louis Touraine, a lawmaker in France, doctor and expert on health-care policy. “They are becoming a fad, and many young people are being attracted to them.”
