This update merely restates what should arguably be the primary focus and role of any amendment intended to help NZ have healthy lungs.
Helping overcome nicotine addiction would be a major aim, not just replacing one toxic addictive product with another. Protocols for enabling this are not rocket science, and the government must simply be supportive for successful implementation. (eg see Mayo Clinic links below)
The government through the amendment should NOT, as the proposed amendment will ensure, keep NZ addicted and funding the primarily offshore tobacco/vape/HTP or SNU industries or short-term government coffers while NZ's future health and economic costs due to smoking and vaping soar.
My imperfect submission:
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Dear Committee
The Bill needs to address the UN Charter mandate requiring member states to 'achieve higher standards of living for their citizens, address economic, social, health and related problems'.
Currently New Zealand is in breach of this mandate.
- The New Zealand government allows widespread highly visible marketing of vape products both in store and online
- The major authoritative respiratory, cardiovascular and oncology clinical groups state that regular vaping places the user under serious health risks, along with the economic, social, educational and various other stressors
- The New Zealand government does not require health risks to be clearly stated to the user, only mention of nicotine addiction
- Means of overcoming addiction to nicotine, the addictive agent in vapes, are not adequately supported
I have for many years taught health sciences at tertiary level including in the cardio-thoracic specialty area and have some insight into the concerns of respiratory and oncology physicians regarding the impact of vaping on health.
Vaping is simply hazardous to health. However it is marketed in New Zealand essentially as candy for over 18s, and is easily accessed by those under 18. Is this justified by its potential to help tobacco smokers quit? Of course not.
Both tobacco and e- cigarettes are harmful, so one should not simply replace the other.
The proposed amendment will do nothing to curb vape use.
A government concerned about the health of New Zealanders would undertake a strategy including the following:
- Vapes would be out of sight to the public, and vape products availability tightly regulated, eg only in pharmacies. (Eventually they are likely to be banned outright as increasing awareness of their effects become better known.)
- A large public media campaign would be carried out, redressing the arguably criminal understatement to date of risk, and advising New Zealanders of what is in the vape aerosol, what the primary risks of vaping are, how to overcome vape and nicotine addiction and how to look after your lungs. It would include restating the risks of tobacco.
- Nicotine addiction centres would be set up around the country.
The proposed amendment tweaking at visibility, banning ‘disposables’ already got around by removable batteries, limiting some accessibility, etc would be utterly ineffectual in limiting vaping.
Those are the primary points. The following provides some underpinning material.
Currently the New Zealand Government supports liberal marketing of vape products from shops and online. It and the vape industry make billions from end users. Much of this money is going offshore of course. The product was allegedly introduced as a means of assisting tobacco smokers to quit. However there is now a New Zealand epidemic of vaping, including many who had never smoked or had given up tobacco. In its lack of regulation NZ is an outlier in first world countries, along with the UK, which also has a vape epidemic.
As a context:
1. The W.H.O. strongly recommends tight regulation or banning of vaping, and. N.Z. is one of the few outlier countries which is not following this advice.
2. New Zealand is second in the OECD in vape use per capita, with over 20% of 18 to 24 year olds and over 10% of 14-15 year olds vaping regularly.
3. Government advice in other countries, including the U.S. and Australia, includes clear easy-to-access statements of primary risk factors*, not just that of nicotine addiction which NZ states.
4. These countries also provide clear robust support for quitting both vaping and nicotine addiction. Until very recently NZ had no government support for quitting vaping, with Quitline just supporting quitting tobacco and strongly advised use of vaping to do so, with no mention of quitting nicotine addiction. The NZ government is still not providing decent support for vaping and nicotine addiction.
5. life insurance companies, such as in Australia, increase life insurance costs due to the insured being a vaper by the same amount as for tobacco smokers.
6. Vapes are still not approved by Medsafe, and thus as a measure to assist in quitting tobacco smoking legally are only permitted to be available on prescription.
7. The American Cancer Council states vaping is too dangerous even as a means of quitting tobacco smoking, the primary cause of lung cancer.
8. The US and Australian government provided lists like this below from the American Lung Association, clearly and simply about vaping, for their respective public.
*Australia:
https://www.health.gov.au/topics/smoking-vaping-and-tobacco/about-vaping or
US:
https://e-cigarettes.surgeongeneral.gov/knowtherisks.html#aerosol-exposure
The American Lung Association advises that the following toxic substances have been found in e-cigarette vapour at concentrations shown to cause harm.
Nicotine - a highly addictive substance that affects adolescent brain development
Propylene glycol - a common additive in food and used to make products like paint solvents, antifreeze, artificial smoke in fog machines
Carcinogens - substances known to cause cancer, here including formaldehyde and acetaldehyde
Acrolein - a herbicide primarily used to kill weeds and can cause irreversible lung damage
Diacetyl - a chemical linked to a lung disease called bronchiolitis obliterans, aka 'popcorn lung' – in certain flavourings
Diethylene glycol - a toxic chemical used in antifreeze and linked to lung disease
Heavy metals such as nickel, tin and lead
Cadmium - a toxic chemical found in traditional cigarettes and which causes breathing problems and disease
Benzene - a volatile organic chemical (VOC) found in car exhaust
Ultrafine particles that can be inhaled deep into the lungs
*https://www.lung.org/quit-smoking/e-cigarettes-vaping/whats-in-an-e-cigarette
Propylene glycol is the agent which enables delivery of nicotine to the football field size surface area of the delicate air sacs where nicotine passes into the blood. This is where oxygen and carbon dioxide cross move between air and blood. Propylene glycol is an inflammatory agent, so and definitely not what you want in these tissues.
The following is a John Hopkins study of vape aerosol composition in popular brands, JUUL and Vuse.
9. The following studies show some very concerning mutations and other primary biological changes are the same for those who vape and for tobacco smokers
The 9 points above are just a sample of why vaping is a serious health risk and how the NZ government is not acting in a first world manner.
A government supporting the current protocol of highly visible widespread in-shop and online marketing without proper statement of risk or provision of quitting programmes for nicotine addiction is extremely irresponsible and arguably criminal.
What should the Coalition do?
Anything less than the strategy outlined above is not addressing the problem.
In not tightly regulating vaping the government appears to demonstrate the extraordinary hold which the tobacco-vape-HTP corps like Philip Morris have over NZ and it is also directly exploiting the unfortunate addicts as it makes 15% off each deal.
Note: The Department of Public Health is unfortunately ‘anaemic’ in addressing this area. Compare with its loud media reports about Covid. This weak response to the vaping epidemic, especially in youth, is extraordinary from a health perspective. It may result in part from it not being autonomous. It is part of a government, which has, whether manipulated or as a willing participant, and clearly not just the former, been very keen to endorse vapes as a great alternative to tobacco. In this it has followed the Philip Morris script where vaping is made out to be not entirely safe but strongly recommended for those who wish to quit smoking. Overcoming nicotine addiction has not been presented as a sensible option. This is tragic for obvious reasons. I hope the funding and control of research by Philip Morris is not occurring here, as it has been in Japan. Researchers there were advised to do limited ‘pretence at’ research, recommending tweaking of vape availability etc.
Other nicotine products discussed include HTPs and SNUs. HTPs are a lot like vapes but with other substances found in cigarette smoke and contributed to by the means of heating and delivery of the aerosol components to the lungs, so a terrible idea. They and SNUs, banned in most countries are toxic and addictive, and a dangerous way to cater to a nicotine addiction.
Counselling, cold turkey, patches, gum are safer, and cold turkey with appropriate social support the most successful. See Mayo clinic refs. After only 3 days even tobacco smokers report feeling that their lungs seem to function better and the nicotine cravings are much reduced.
The following link is about both tobacco smoking and vaping, and how to stop both by addressing nicotine addiction. It has some US-specific references but generally is applicable to NZ. Unlike the NZ Ministry of Health it does NOT recommend vaping as a method of stopping tobacco smoking.
A smoker's guide to quitting - Mayo Clinic Health System
https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/nicotine-craving/art-20045454
A government realistically addressing the health of the nation would rename the amendment with “Smokefree and Vapefree” in place of “Smokefree” and create protocols accordingly.
Note: Last year I witnessed colourful, appealing Vape Specialty Retail outlets popping up near schools, and the other vape marketing, and the associated deep concern amongst the public, physicians and high schools throughout the country. I created an online petition requesting tight regulation of vapes, for example by limiting availability to pharmacies, and have used this site to provide updates about the issue.
Petition · BAN VAPE SHOPS. Use plain packaging with health warnings and pharmacy outlet only - New Zealand · Change.org
Best wishes with your deliberations. I hope that health and the larger view of the economy are supported. Projected costs to the country of the vape epidemic would be devastating unless tight regulation is implemented now."
Image from Wikipedia.