Electronic cigarettes should be banned inside cafes, restaurants and workplaces, and should not be advertised to children and non-smokers, the World Health Organisation has said.
In a long-awaited report, the United Nations’ health agency resisted calls from many experts to soften their approach to e-cigarettes, recommending a raft of measures to curb their use, while also warning over the growing influence of the tobacco industry in the "e-cig" market.
The report also said that e-cigarettes which are flavoured to taste like fruit, sweets and alcoholic drinks should be banned, amid fears they encourage children to use the products.
Millions of people now use e-cigarettes worldwide, but public health experts remain divided over their potential harms and benefits. Studies have suggested that they help people to quit smoking, but the WHO said that there was currently “insufficient evidence” to prove their benefit.
The recommendations on indoor use in public places go further than existing regulations in most countries. The vapour produced by e-cigarettes is known to be considerably less harmful than tobacco smoke, but the WHO said there were still concerns over the nicotine and other toxicants produced.
The Department of Health said that no such ban was planned in England, but measures to curb e-cigarette use in public places are already under consideration in Wales, which has taken a harder line against the products. The UK Government already plans to ban e-cigarette sales to under 18s.
From 2016, changes to the way e-cigarettes are regulated will see some authorised as medicines if manufacturers can prove their therapeutic benefits. Some experts have called for them to made available free on the NHS as quit-smoking aids.
Tobacco companies which manufacture e-cigarettes, including British America Tobacco, are understood to be among the companies seeking medicines licencing from the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) - raising the possibility that NHS money could end up going to tobacco manufacturers.
In their report, the WHO issued a strong warning over the tobacco industry’s involvement in the e-cigarette market.
“No matter what role the tobacco industry plays in the production, distribution and sale of electronic nicotine delivery systems, this industry, its allies and front-groups can never be considered to be a legitimate public health partner or stakeholder while it continues to profit from tobacco and its products or represents the interests of the industry,” the report said.
While acknowledging that e-cigarettes carried “promise” in terms of controlling tobacco use, the WHO said that manufacturers should be banned from making health claims for their products until they had provided scientific evidence which had been approved by regulators.
In the UK, more than two million people are believed to be using e-cigarettes. A recent study by one of the UK’s leading smoking cessation experts suggested the products are more effective than nicotine patches and gum at helping people to quit smoking. Professor Robert West of University College London, said that the evidence did not support the WHO’s claims that e-cigarettes posed a significant risk to bystanders.
“These devices are not just a bit safer than smoking; there is good reason to believe they are much safer – and that is what smokers need to know,” he told The Independent.
Leading anti-smoking charity Action on Smoking and Health (ASH), has backed e-cigarettes’ use as quit-smoking aids. Hazel Cheeseman, the charity’s director of policy and research said that there was “no evidence” that e-cigarette vapour could harm bystanders and called for regulation to be “proportionate”.
“Smoking kills 100,000 people in the UK alone. Smokers who switch to using electronic cigarettes in whole or in part are likely to substantially reduce their health risks. Although we cannot be sure that electronic cigarettes are completely safe, as the WHO acknowledges, they are considerably less harmful than smoking tobacco and research suggests that they are already helping smokers to quit,” she said.
A Department of Health spokesperson said: "More and more people are using e-cigarettes and we want to make sure they are properly regulated so we can be sure of their safety.
“We have already set out our intention to change the law to ban the sale of e-cigarettes to children under 18. The UK has an existing licensing system for higher strength products and those that claim to help people quit. We are also bringing in new European rules to cover lower strength products which will ban most advertising, limit nicotine levels and set standards for ingredients, labelling and packaging.”