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Vaping: How Ireland fought the nicotine nightmare

The Government is finally acting decisively, going from a laggard on tackling the issue to leapfrogging other countries

A new Irish study found 127 hazardous chemicals classified as 'acute toxic' in e-liquid flavours. Photograph: OK McCausland/The New York Times
Chris Macey
Sun Sept 15 2024 - 07:00

Strawberry Bubblegum. Caramel Lollipop. Gummy Bear. They sound like sweets. They’re packaged like sweets. But these are vape flavours that, just a few months ago, children were as legally entitled to buy here as a tube of Smarties. It was only in December that Ireland finally provided a sliver of protection for young people from the health risks masked by these sugar-coated names when we became one of the last countries in Europe to ban their sale to under-18s.

But in a single day this week, Minister for Health Stephen Donnelly and his Cabinet colleagues leapfrogged other governments also grappling with the question of what to do about the global explosion of youth vaping, putting forward safeguards potentially as strong as in any country that permits the sale of e-cigarettes. The collective assault on all the major tools used by the industry to target young people – disposable vapes, child-friendly flavours, bright, attractive packaging and the lifeblood of promotion, represents a serious act of political will. Only a handful of countries have imposed any one of these measures, let alone all of them simultaneously. This entails a huge commitment in terms of legislative bandwidth, overcoming legal complexities and facing down a big tobacco-led industry with deeper pockets than most sovereign states.

In truth, this is no knee-jerk response. It has been almost two years since a Minister of State, Ossian Smyth, first mooted a ban on disposable vapes – albeit on environmental grounds – while Donnelly has been engaged for a considerable time on the twin objectives of tackling youth vaping and, crucially, moving towards a tobacco-free Ireland.

This has been driven by a public clamour for action, fuelled by parents’ concerns over an epidemic that now has almost a quarter of 15-17 year-olds classified as current users according to a 2022 study on health behaviour in school-aged children at the University of Galway, and by young people themselves. About four in five 15-24-year-olds backed plain packaging in Ipsos MRBI polling that also recorded decisive majorities for disposable vape and flavours bans.

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The key issue for Ireland and all countries addressing this crisis is to find the right balance between minimising the health risks caused by a shameless exploitation of young people, and the benefits of vaping for long-term smokers unable to quit by other means. Current evidence suggests the Government has got it right. More than 30 countries including Brazil, Argentina and India have an outright ban on of e-cigarette sales. A big tobacco business model of capturing as many children as possible on the treadmill of long-term addiction doesn’t mean we should abandon the smokers for whom e-cigarettes could be a lifesaver.

There were more deaths caused by smoking during Covid than from Covid itself and, given this scale of devastation, only a timetable towards its ultimate elimination is enough

Based on its review of evidence, the HSE isn’t confident that vaping is a safe and effective way to quit smoking compared with nicotine replacement therapy, including gums and patches and prescription treatments. However, it’s also clear that a significant number of people are stopping smoking with the aid of e-cigarettes.

But that in no way requires the existence of disposable vapes, which are regarded as cool, fashionable and enticing by young people. Nor was there ever a need for child-friendly flavours or packs that make vaping more attractive to teens, but make no difference to adults. The notion that a hardened long-term smoker needs chocolate ice cream, buttered popcorn or rainbow milkshake vapes to quit is patent nonsense. And the proposition that it’s worth trapping young people into lifelong addiction to provide that option is nothing short of grotesque given what we know of the health risks.

Current research shows that vapes are considerably less harmful than cigarettes – but that’s a low bar given that tobacco kills up to half its users. Vapes can have a long-term negative impact on brain development among young people and are associated with increased risk of cardiovascular diseases, lung disorders and adverse effects on foetal development. The truth is we still don’t know the full extent of the harm they might inflict. A new Irish study found 127 hazardous chemicals classified as “acute toxic” in e-liquid flavours. It concluded this may lead to a whole new wave of chronic diseases emerging in the next 15-20 years.

[ Vaping: What are the Irish Government’s planned restrictions and will they succeed? ]

Meanwhile, an Institute of Public Health review showed “consistent evidence” of an increased risk of youth vaping resulting in subsequent cigarette use, following up studies concluding that teenagers who vape are up to five times more likely to smoke. After a generation of extraordinary reductions in youth smoking rates, this represents a nightmare scenario – the prospect of increasing smoking rates with all the death and misery that will perpetuate, coupled with the possibility that vaping could lead us to a whole new public health disaster.

In addressing this threat, it’s heartening that Donnelly hasn’t lost sight of the public health disaster we continue to face. There were more deaths caused by smoking during Covid than from Covid itself and, given this scale of devastation, only a timetable towards its ultimate elimination is enough. The increase in the legal age of sale of tobacco to 21 announced in June will reduce youth smoking and save lives. Most importantly, it’s a step towards the phasing out of smoking being pursued in the UK, a move supported by 83 per cent of the Irish public in a HSE poll.

There are many hurdles ahead – not least an upcoming general election that could delay or even derail the legislation. But we now have sight of real protection for children from vaping, the hope of e-cigarette sales being more focused on smoking cessation, and the beginning of the end for the tobacco industry.

Chris Macey is director of advocacy, Irish Heart Foundation