Catherine Conlon: Time to tackle vaping with strong legislation

Medical research all points one way — we must pass laws to ban disposable vapes, limit flavours, and mandate plain packaging

Bright colours, shiny packaging, and a variety of flavours add to the popularity of vapes among young people — policy makers must aim to diminish the power of these attractors. Picture: iStock

Recent years have seen the practice of vaping explode, particularly among young people, with bright colours, shiny packaging, and a variety of flavours  adding to their burgeoning popularity.

However, there is growing concern about the potential for long-term health impacts, particularly among the younger cohort who have ‘never smoked’ and consider vaping a more attractive and healthier option.

Is it possible that we can learn from past mistakes and introduce timely and robust legislation to curtail the potential for vapes to have serious long-term impacts on the health of teenagers and young adults in the coming decades?

New research from the Royal College of Surgeons in Ireland (RSCI) published in Scientific Reports recently has uncovered the potentially harmful substances that are produced when e-liquids in vaping devices are heated for inhalation.

What is exciting about this research in RCSI’s Department of Chemistry is the use of artificial intelligence to simulate the effects of heating e-liquid flavour chemicals found in nicotine vapes. 

The researchers included 180 known e-liquid flavour chemicals, predicting the new compounds formed when these substances are heated within a vaping device immediately prior to inhalation.

The analysis identified the formation of 127 hazardous chemicals, classified as ‘acute toxic’, 153 as ‘health hazards’, and 225 as irritants.

These included a group of chemicals called volatile carbonyls (VCs) that are known to pose health risks.

The AI machine predicted that these VCs would form in the fruit-, candy- and dessert-flavoured products — typically the flavours that young people zone in on. 

Young people don't consider long-term risks 

Lead author Donal O’Shea, professor of chemistry and head of the department, described the findings as “very concerning”.

“Our findings indicate a significantly different profile of chemical hazards compared to what we are familiar with from traditional tobacco smoking," Prof O’Shea said.

It is plausible that we are on the cusp of a new wave of chronic diseases that will emerge 15 to 20 years from now, due to these exposures.

However, young people don’t think about health risks that far into the future.

They may worry about how they are going to get home safely after a night out or the risks of giving their personal details to complete strangers but the risks of potentially hazardous chemicals causing cancer or heart disease two decades into the future is not on their radar. 

That is why robust legislation is so vital.

Ban on selling vapes to under-18s

A new law banning the sale of nicotine-inhaling products such as e-cigarettes, to people under 18 came into effect just before Christmas last year, after Health Minister Stephen Donnelly commenced the relevant section of the Public Health (Tobacco Products and Nicotine Inhaling Products) Bill 2023.

Further measures under the bill will come into effect in September, including a ban on the sale of tobacco products or nicotine-inhaling products at events aimed at children, and a ban on advertising for such products around cinema films for children, on public service vehicles, at stops or stations, and within 200m of a school.

A consultation process on further measures to decrease the appeal of nicotine-inhaling products to young people concluded in January. 

According to Dr O’Shea, the huge array of flavours available in vaping products is what makes their chemistry so challenging compared with traditional cigarette smoke.

“This cocktail of chemicals derived from the food industry where they have a good safety record for specific uses in flavoured drinks, pastries, and sweets — were never intended to be heated to high temperatures for inhalation.”

Legislation to curb the rising trend of vaping, particularly among young people must be a priority.

What are other countries doing?

According to the WHO, by July 2023, vapes were banned in 34 countries, including Brazil, India, Thailand and Iran. But enforcing a ban is challenging as they frequently become available on the black market.

In Australia, vapes are available on prescription only.  Since March, it has been illegal to import any type of vape not approved as ‘therapeutic’ by the Australian medical regulator.

New Zealand has had an effective ban in place since August, with new rules to protect young people, including a lower level of nicotine, duller flavour names, and a ban on vape shops near schools.

China, the world’s biggest producer of vapes, introduced a slew of laws in 2021 controlling their use, including banning flavoured products that many of the manufacturers continue to send overseas.

Not good enough for Chinese citizens but okay to bolster economic growth.

Vape manufacturers in the United States must get authorisation from the Food and Drug Administration (FDA) to sell their products. It has yet to approve a vape flavour other than tobacco. However, the laws are poorly enforced, with disposable products widely available.

The UK is the latest country to announce a ban on disposable vapes. The new regulations will limit the variety of flavours, implement plain packaging, and alter the way vapes are presented in stories to minimise their appeal to children.

A bill to ban the use of disposable vapes has been approved in France and could come into effect in September next year.

Germany also intends to take action, while some ecologists, including the Green federal environment minister Steffi Lemke, have gone one step further, calling on the EU to ban them altogether.

RCPI supports strong regulation  

The Royal College of Physicians of Ireland (RCPI) Faculty of Paediatrics, in a position paper last October, strongly supported laws to ban vapes to protect the health and wellbeing of children and young people who are using them in alarming numbers. The environmental damage vapes cause is also a concern.

A key concern of paediatricians is the targeting of young people.

“Clever campaigns on TikTok and Instagram, and the array of flavours and colours are making disposable vapes more desirable for young people,” said consultant in paediatric and respiratory medicine, Des Cox.

“We must adopt stronger legislation on the advertising and marketing of vapes and ban the use of flavours other than tobacco,” said Professor Cox.

Ireland has provided a global template for legislation around the sale of tobacco and, more recently, alcohol, with significant benefits to public health that are being copied across the world.

Isn’t it time we introduced similar robust legislation around the sale of vapes in Ireland? 

The most recent research compounds what we already know. We need to urgently prioritise legislation to ban disposable vapes, limit vape flavours, and implement plain packaging — all to curtail both the environmental impacts and the immediate and long-term health impacts to children and young adults in decades to come.

• Catherine Conlon is a public health doctor in Cork and former director of human health and nutrition, Safefood