Hong Kong is moving rapidly to join others in snuffing out the e-cigarette craze, as new, local research reveals the smoking alternatives contain toxic chemicals. Sylvia Chang reports.

Latest research, undertaken by Hong Kong Baptist University reveals that electronic cigarettes, marketed as the safer alternative to tobacco, are not safe at all. Studies of 13 randomly selected brands of electronic cigarettes contain formaldehyde, polycyclic aromatic hydrocarbons (PAH), and polybrominated diphenyl ethers (PBDEs), flame retardants used on furniture, automobile interiors, textiles and plastic products. Health risks include a list of maladies ranging from impaired fetal development to cancers

The research findings are clear validation of the administration's determination to play it safe on the subject of e-cigarettes. Of equal concern was the fear that e-cigarettes might be seen as chic, fashionable and stylish, and could undermine years of effort to make Hong Kong one among the most smoke-free cities in the world.

The final verdict on the health hazards associated with e-cigarettes remains in abeyance as scientific tests are carried out around the world. The question of whether or not to sell has been whirling around for a few years and is now the subject of a heated controversy. People have been arrested, puffing on e-cigarettes at sites where smoking is prohibited by law, all the while protesting that they are not smoking, but "vaping".

The battery powered e-cigarettes create a vapor from replaceable cartridges, offering an experience similar to smoking. Sales of e-cigarettes hit $3 billion globally in 2013, according to figures produced by the World Health Organization. Market projections anticipate retail sales will be seven times that amount by 2030.

The School of Public Health at the University of Hong Kong covered e-cigarettes for the first time in its annual household survey of smoking patterns, released in early February.

The survey revealed that among 41,000 students from 92 secondary schools surveyed, nine percent said they had smoked e-cigarettes when they are not even legally on sale in the SAR. Researchers interpreted the finding as a "red alert" to health authorities and urged greater efforts to raise awareness of the potential risks of e-cigarettes.

Catch 'em young

Teenagers are prone to smoking addiction. By the time they've smoked about 100 cigarettes, they are hooked as life-long smokers, says anti-tobacco advocate Judith Mackay, director of the Asian Consultancy on Tobacco Control. Mackay is also a senior policy adviser to the World Health Organization.

Many e-cigarettes contain nicotine, the same addictive substance found in normal cigarettes, but in lowered concentrations. Many other brands claim their products contain no nicotine. Another argument in favor of e-cigarettes is that they produce vapor instead of highly toxic smoke. Still, latest studies show that both "vaping" and smoking suppress the normal function of 53 genes of the body's immune system. Alarmingly, 305 more immune genes were shown to have mutated under exposure to e-cigarettes, leading many researchers to believe that e-cigarettes pose serious, long-term health hazards.

That study was presented on Feb 12 at the annual conference of the American Association for the Advancement of Science in Washington. Lead researcher Ilona Jaspers of the University of North Carolina at Chapel Hill was quoted by Ars Technica as saying that it was still unclear whether the changed immune response will lead to more infection risks or other immunological diseases.

Despite all these findings, even experts seem a bit ambivalent about the issue. "If all smokers changed to smoking e-cigarettes, it would mean a lot of lives being saved. But it's not as simple as that," Mackay told China Daily. "Only in the next three or five years will we have a clear understanding of the effects of e-cigarettes."

Health authorities fear that non-smokers, mistakenly believing e-cigarettes are safe, will be enthused to take up the habit and that people who have quit smoking may pick up the vaping habit, exposing themselves to the same sort of Pandora's Box that can afflict regular smokers. This is a matter for the social sciences, and as Mackay explained, there have been no definitive studies as to how e-cigarettes will affect the market if they were to become fashionable.

Fashion statement

With their attractive design and multiplicity of flavors, e-cigarettes are targeted at the youth market. There are more than 8,000 e-cigarette flavors available in the global market, with approximately 200 new flavors being added every month.

The majority of e-cigarette manufacturers have argued their products contain no nicotine at all and thus shouldn't even require licensing or the levying of any "sin tax". The selling price is usually 60 percent less than that of normal cigarettes, another way to attract young people.

Also there are several instances of batteries exploding during recharging, and getting inside the clothes of e-cigarette smokers, raising dangers of serious burns or fire outbreaks.

As the debate goes on, the tobacco industry already is moving in, buying e-cigarette manufacturing companies, recalling days gone by when smoking was portrayed as sexy, cool, refreshing and sophisticated. As medical evidence condemning tobacco piled up, the tobacco industry changed tactics promoting "better filters", "low tar and nicotine", and commissioned spurious research aimed at undermining the influence of serious scientific findings.

In 2012, a US Federal Court judge ordered that tobacco companies publicly confess to lying to consumers in their efforts to minimize health concerns.

Mackay supported the Hong Kong government's adoption of a "precocious principle"-to ban e-cigarettes completely. "When we don't know, when we're not sure, it's better to be really careful, and to get more science before allowing them to go market," Mackay emphasized.

Under Secretary for Food and Health Sophia Chan Siu-chee said that the department will finalize an initial amendment on e-cigarettes by the end of the year for presentation to the Legislative Council for approval. The prohibition is expected to cover importing and manufacturing, selling, distributing and advertising.

Under the current law, only e-cigarettes cartridges containing nicotine are banned. The new rule seeks to ban all cartridges, even those containing no nicotine.

Contact the writer at sylvia@chinadailyhk.com

(HK Edition 03/01/2016 page11)