E-cigarettes have rapidly risen in popularity in recent years and are now the subject of heated debate as to whether they are effective in helping smokers quit tobacco or whether they are actually making smoking attractive to young people. Are they a way for Big Tobacco to protect its profits in markets where smoking is declining and lure people back into nicotine addiction or are they just a fashion that will quickly lose its appeal?
Given that vaping has been around for barely a decade and studies into the long-term effects take time, we cannot answer these questions with certainty yet. The benefits of e-cigarettes' continue to be debated – and the potential risks to non-smokers and young people remain under-explored.
This makes it difficult to make recommendations, but politicians across the world are nonetheless having to decide what to do. The latest country to confront this question is Scotland, where the parliament has just voted to ban under-18s from using e-cigarettes. One of a raft of restrictions, this imposes the same age limit as for traditional cigarettes, bringing Scotland broadly into line with England and Wales. Was it the right thing to do?
Different countries have taken different approaches to vaping. Canada has technically made sales illegal, though regulation remains largely unenforced. While regulation across the US is mixed, San Francisco has just raised the minimum buying age from 18 to 21 years.
In some European countries, – among them Bulgaria, Ireland and Poland – sales and advertising are unregulated. In May, however, new EU regulations will impose standardised quality control on liquids and vaporisers across the union as well as requiring disclosure of ingredients in vaping liquids and child-proofing and tamper-proofing for liquid packaging. They will also restrict cross-border advertising. Wales meanwhile looks likely to extend its restrictions by introducing a ban on e-cigarettes in public places.
Health news in pictures
Health news in pictures
1/22 New online test predicts skin cancer risk
Health experts have created a new online tool which can predict a person’s risk of developing a common form of skin cancer. The tool uses the results of a 10-question-quiz to estimate the chance of a person aged 40 or over of having non-melanoma skin cancers within three years. Factors including the age, gender, smoking status, skin colour, tanning ability, freckling tendency, and other aspects of medical history are covered by the quiz
2/22 Multiple Sclerosis stem cell treatment 'helps patients walk again'
A new treatment for multiple sclerosis (MS) has enabled some patients to walk again by “rebooting” their immune systems. As part of a clinical trial at Sheffield's Royal Hallamshire Hospital involving around 20 patients, scientists used stem cells to carry out a bone marrow transplant. The method known as an autologous haematopoietic stem cell transplant (HSCT) works by using chemotherapy to destroy the area of the immune system which causes MS
3/22 Dementia patients left without painkillers and handcuffed to bed
Dementia patients experience a ‘shocking’ variation in the quality of hospital care they receive across England, a charity has warned. Staff using excessive force and not giving dementia patients the correct pain medication were among the findings outlined in a new report by The Alzheimer’s Society, to coincide with the launch of Fix Dementia Care campaign
4/22 Cancer risk 'increased' by drinking more than one glass of wine or pint of beer per day
Drinking more than one glass of wine or pint of beer a day increases the risk of developing cancer, according to medical experts. New guidelines for alcohol consumption by the UK published by chief medical officers warn that drinking any level of alcohol has been linked to a range of different cancers. The evidence from the Committee on Carcinogenicity (COC) overturns the oft-held view that a glass of red wine can have significant medical benefits for both men and women
5/22 Vaping 'no better' than smoking regular cigarettes
Vaping could be “no better” than smoking regular cigarettes and may be linked to cancer, scientists have found. The study which showed that vapour from e-cigarettes can damage or kill human cells was publsihed as the devices are to be rolled out by UK public health officials as an aid to quit smoking from 2016. An estimated 2.6 million people in the UK currently use e-cigarettes
6/22 Rat-bite fever
A teenager was hospitalised and left unable to move after she developed the rare rat-bite fever disease from her pet rodents which lived in her bedroom. The teenager, who has not been named, was taken to hospital after she complained of a pain in her right hip and lower back which later made her immobile, according to the online medical journal BMJ Case Reports. She suffered for two weeks with an intermittent fever, nausea and vomiting and had a pink rash on her hands and feet. The teenager, who had numerous pets including a dog, cat, horse and three pet rats, has since made a full recovery after undergoing a course of antibiotics. Blood tests showed that she was infected with for streptobacillus moniliformis – the most common cause of rat-bite fever. One of her three pet rats lay dead in her room for three weeks before her symptoms showed
7/22 Taking antidepressants in pregnancy ‘could double the risk of autism in toddlers’
Taking antidepressants during pregnancy could almost double the risk of a child being diagnosed with autism in the first years of life, a major study of nearly 150,000 pregnancies has suggested. Researchers have found a link between women in the later stages of pregnancy who were prescribed one of the most common types of antidepressant drugs, and autism diagnosed in children under seven years of age
8/22 Warning over Calpol
Parents have been warned that giving children paracetamol-based medicines such as Calpol and Disprol too often could lead to serious health issues later in life. Leading paediatrician and professor of general paediatrics at University College London, Alastair Sutcliffe, said parents were overusing paracetamol to treat mild fevers. As a result, the risk of developing asthma, as well as kidney, heart and liver damage is heightened
9/22 Fat loss from pancreas 'can reverse' effects of type-2 diabetes
Less than half a teaspoon of fat is all that it takes to turn someone into a type-2 diabetic according to a study that could overturn conventional wisdom on a disease affecting nearly 3 million people in Britain. Researchers have found it is not so much the overall body fat that is important in determining the onset of type-2 diabetes but the small amount of fat deposited in the pancreas, the endocrine organ responsible for insulin production
10/22 Potatoes reduce risk of stomach cancer
Scientists have found people who eat large amounts of white vegetables were a third less likely to contract stomach cancer. The study, undertaken by Chinese scientists at Zhejiang University, found eating cauliflower, potatoes and onions reduces the chance of contracting stomach cancer but that beer, spirits, salt and preserved foods increased a person’s risk of the cancer
11/22 Connections between brain cells destroyed in early stages of Alzheimer’s disease
Scientists have pinpointed how connections in the brain are destroyed in the early stages of Alzheimer’s disease, in a study which it is hoped will help in the development of treatments for the debilitating condition. At the early stages of the development of Alzheimer’s disease the synapses – which connect the neurons in the brain – are destroyed, according to researchers at the University of New South Wales, Australia. The synapses are vital for brain function, particularly learning and forming memories
12/22 Sugar tax
The Government should introduce a sugar tax to prevent an “obesity crisis” from crippling the NHS, a senior Conservative MP and former health minister has said. Dr Dan Poulter believes that the case for increased taxes on unhealthy sugary products was “increasingly compelling”
13/22 Cancer breakthrough offers new hope for survivors rendered infertile by chemotherapy
A potentially “phenomenal” scientific breakthrough has offered fresh hope to cancer patients rendered infertile by chemotherapy. For the first time, researchers managed to restore ovaries in mice affected by chemotherapy so that they were able to have offspring. The scientists now plan to begin clinical trials to see if the technique, which involves the use of stem cells, will also work in humans by using umbilical cord material and possibly stem cells taken from human embryos, if regulators agree
14/22 Take this NHS test to find out if you have a cancerous mole
An interactive test could help flag up whether you should seek advice from a health professional for one of the most common types of cancer. The test is available on the NHS Choices website and reveals whether you are at risk from the disease and recommends if you should seek help. The mole self-assessment factors in elements such as complexion, the number of times you have been severely sunburnt and whether skin cancer runs in your family. It also quizzes you on the number of moles you have and whether there have been any changes in appearance regarding size, shape and colour
15/22 Health apps approved by NHS 'may put users at risk of identity theft'
Experts have warned that some apps do not adequately protect personal information
16/22 A watchdog has said that care visits must last longer
The National Institute for Health and Care Excellence (Nice) said home help visits of less than 30 minutes were not acceptable unless part of a wider package of support
17/22 Pendle in Lancashire tops list of five most anxious places to live in the UK
Pendle in Lancashire has been named the most anxious place to live in the UK, while people living in Fermanagh and Omagh in Northern Ireland have been found to be the happiest
18/22 Ketamine could be used as anti-depressant
Researchers at the University of Auckland said monitoring the effects of the drug on the brain has revealed neural pathways that could aid the development of fast-acting medications. Ketamine is a synthetic compound used as an off anaesthetic and analgesic drug, but is commonly used illegally as a hallucinogenic party drug. Dr Suresh Muthukumaraswamy, a senior researcher at the university and a member of the institution’s Centre for Brain Research, used the latest technology in brain imaging to investigate what mechanisms ketamine uses to be active in the human brain
19/22 A prosthetic hand that lets people actually feel through
The technology lets paralysed people feel actual sensations when touching objects — including light taps on the mechanical finger — and could be a huge breakthrough for prosthetics, according to its makers. The tool was used to let a 28-year-old man who has been paralysed for more than a decade. While prosthetics have previously been able to be controlled directly from the brain, it is the first time that signals have been successfully sent the other way
20/22 The biggest cause of early death in the world is what you eat
Unhealthy eating has been named as the most common cause of premature death around the globe, new data has revealed. A poor diet – which involves eating too few vegetables, fruits, nuts and grains and too much red meat, salt and sugar - was shown to be a bigger killer than smoking and alcohol
21/22 Scientists develop blood test that estimates how quickly people age
Scientists believe it could be used to predict a person’s risk of developing Alzheimer’s disease as well as the “youthfulness” of donated organs for transplant operations. The test measures the vitality of certain genes which the researchers believe is an accurate indication of a person’s “biological age”, which may be younger or older than their actual chronological age
22/22 Aspirin could help boost therapies that fight cancer
The latest therapies that fight cancer could work better when combined with aspirin, research has suggested. Scientists from the Francis Crick Institute in London say the anti-inflammatory pain killer suppresses a cancer molecule that allows tumours to evade the body’s immune defences. Laboratory tests have shown that skin, breast and bowel cancer cells often generate large amounts of this molecule, called prostaglandin E2 (PGE2). But Aspirin is one of a family of drugs that sends messages to the brain to block production of PGE2 and this means cancer cells can be attacked by the body’s natural defences
The ayes and the noes
In the run up to the vote on the new Scottish Health Bill, opponents and supporters of e-cigarette regulations fiercely debated which approach was the most sensible. Opponents usually argue that vaping is less harmful than traditional cigarettes and effective in helping smokers to quit. They want minimal restrictions on availability and complete freedom for advertising, promotion and the use of e-cigarettes in public. Restrictions, they argue, might prevent smokers from switching to safer alternatives and reduce the chances of curbing tobacco consumption.
Supporters of regulation say that children and young people need to be protected from using products which imitate smoking and from developing nicotine addiction. They also favour regulation to ensure product safety and quality. They advocate a precautionary approach until there is evidence that e-cigarettes do not undermine our recent successes at controlling tobacco.
As well as banning sales to under-18s, the new Scottish laws require retailers to ask for proof of age when selling to someone that looks under 25 (similar to alcohol). They ban the sale of e-cigarettes from vending machines, make it an offence to buy on behalf of someone under 18, and require retailers to put their names on a product register. Scottish ministers will also have the power to further restrict or prohibit advertising and promotions in future.
Tighter shackles, please
While the evidence about the risks of e-cigarettes is likely to remain unclear for several years, the Scottish parliament can at least say it is doing what the country wants. A large majority of respondents backed regulation in the consultation of 2014, including representatives of health bodies, local authorities, charities, academics and members of the public. As well as supporting a ban on sales to under-18s or adults buying e-cigarettes on their behalf and preventing young people from seeing advertising and promotions, respondents also widely endorsed restricting the use of e-cigarettes in public places.
The Scottish public’s desire for these kinds of rules is also reflected in research I co-published that looked at debates about e-cigarettes in the UK media and found that supporters of regulation greatly outnumbered opponents. I have also been involved in a new study, which investigates the views of UK adolescents on regulation. We found they have a very sophisticated understanding of the advantages and disadvantages. While aware of the potential benefits of e-cigarettes to smokers – including those teenage smokers who want to quit – young people overwhelmingly support strong e-cigarette regulation. This includes restrictions on sales to minors, marketing and the use of e-cigarettes in public places.
The reality is that, until the jury returns, it makes sense to trust the public to reach a view from the best information on e-cigarettes that is available. Even if current regulations were to end up looking disproportionate in years to come, no one will be able to accuse the Scottish government of ignoring people’s concerns and taking public health issues lightly. In a situation where no one really knows what to do for the best, regulation which restricts access and promotion to young people looks like the best policy.