UK embraces e- cigarettes as US bans them

LONDON — While the U.S. cracks down on vaping, Britain has embraced electronic cigarettes as a powerful tool to help smokers kick the habit.

The Royal College of Physicians explicitly tells doctors to promote e-cigarettes “as widely as possible” to people trying to quit. Public Health England’s advice is that vaping carries a small fraction of the risk of smoking.

U.S. public health officials have taken a more wary approach, and have been slow to regulate e-cigarettes. That caution turned to alarm, though, with an explosion in teen vaping, prompting the federal government and some states to take steps to ban fruit and minty flavors that appeal to youths.

And now, with hundreds of U.S. cases of a mysterious lung illness among vapers, the U.S. Centers for Disease Control and Prevention is recommending that people consider not using e-cigarettes, especially those with THC, the compound that gives pot its high.

The U.S. reaction is “complete madness,” said Dr. John Britton, director of the U.K. Center for Tobacco and Alcohol Studies at the University of Nottingham. “The reality with smoking is, if you tell people to stop vaping, they will go back to tobacco and tobacco kills.”

Regulations about e-cigarettes vary by country, making for a patchwork of policies. More than 30 countries ban e-cigarettes outright; India halted sales this month. Many European countries including Austria, Belgium, Germany and Italy classify e-cigarettes as tobacco products, subjecting them to strict controls. They are mostly sold as consumer products in Britain and France, under more lax rules.

6ince arriving in the 8.6. in 00 , e-cigarettes have been largely unregulated. The 8.6. )ood and rug Admin

istration didn’t get the power to do that until three years ago and is still working out the details. Black market versions, meanwhile, have flourished.

Appearing before &ongress last week, the 8.6. ) A’s acting commissioner was pressed to e plain the agency’s position. 6everal lawmakers suggested e-cigarettes should be completely removed from the market.

“:e do not consider these products safe, we think they have harm, said r. 1ed 6harpless. “:e do not think really anyone should be using them other than people using them in place of combustible tobacco.

In Britain, a review by 3ublic ealth (ngland, an agency similar to the & &, concluded that vaping is about less dangerous than smoking. A leading British anti-tobacco charity, Ash, even called for e-cigarettes to be licensed as medicines and provided free to smokers trying to Tuit by

Britain’s government-funded health system.

“:e need radical solutions to stop smoking and one option is providing smokers with e-cigarettes so they can get the nicotine they need without the tobacco smoke, said Britton. “:e have a much more rela ed attitude to people being addicted to nicotine on the basis that nicotine itself isn’t particularly ha ardous.

(-cigarettes and other vaping devices typically heat a solution containing nicotine into a vapor that’s inhaled. The amount of nicotine varies widely: 6ome countries set limits on the amount. There’s no cap in the 8.6. And the surge in 8.6. teen vaping brought warnings from health officials that nicotine can harm a teenager’s still developing brain.

“:hat’s right for (ngland might not be right for the 8.6., said 5yan .ennedy of the Institute for lobal Tobacco &ontrol at -ohns opkins Bloomberg 6chool of 3ublic

ealth.

&ompared to the 8nited 6tates, (ngland has had historically higher rates of tobacco use and a “deeper comfort with the idea of substituting a less harmful habit for a dangerous one, .ennedy said. British health officials have been able and willing to strictly regulate e-cigarettes while promoting them as a stop-smoking tool.

“It’s not very surprising that a place like (ngland has embraced e-cigarettes, .ennedy said. “A lot of things lined up to make sense to use these devices to help people transition away from cigarettes.

In the 8.6., meanwhile, the rapid rise in e-cigarettes’ popularity among teenagers, a thriving black market for vapes containing marijuana e tracts and the illness outbreak have muddied the public health message recently, .ennedy said.

“2bviously there are a lot of moving parts with this, he

said.

Another key difference is advertising. 8nlike in the 8.6., Britain has tight regulations on advertising vaping all T9, online and radio marketing is banned, e plained /inda Bauld, a public health professor at the 8niversity of (dinburgh.

“(-cigarettes are promoted to middle-aged smokers as a way to Tuit and the imaging from our annual Tuit campaign is usually all men with beards, so it looks pretty boring, she said.

2n )riday, the & & said it appears T & vaping products are playing a role in the pu ling 8.6. outbreak of lung injuries and deaths. The agency said many of the 00 people who got sick reported vaping T &. It said more information was needed on whether a single product, substance or brand is responsible. 6ome researchers suspect an ingredient used as a thickener in vaping oils, particularly in black market products.