The insider’s guide to vaping

Here we are today with the public barely acknowledging the potential risks of vaping

Back in 2014 – was it really only eight years ago? – I interviewed “the insider”.

It was hard not to imagine I was talking with a kind of Russell Crowe figure, and I was on the tip of my journalistic toes on that fuzzy Skype call.

Of course, the real Jeffrey Wigand was nothing like the one played by Kiwi actor Crowe in The Insider movie.

I’m sure this rings a few bells for readers but, if not, Dr Wigand was a research scientist for the forerunner of British American Tobacco and at great personal cost blew the whistle on the company over its minimising the harms of smoking.

For my article, he said tobacco companies were similarly working behind the scenes on e-cigarettes.

He literally called bullshit on our acceptance of e-cigarettes for smoking harm reduction, and advocated prompt regulation.

The companies need to capture young people by hooking them to nicotine, he said, and that’s easy to do by making e-cigarettes a cool new thing.

So cool, it turns out, that one US company, part-owned by tobacco interests, has just agreed to settle for its promotion of vaping to youth to the tune of US$438.5 million ($729 million).

The US experience has some unique features, including deaths from a condition dubbed e-cigarette or vaping use-associated lung injury. However, many ingredients of e-cigarettes generally were never intended for inhalation.

There are so many unknowns, including the pharmacokinetics of the carrier liquids (propylene glycol and vegetable glycerine) and their concentrations in the lungs and circulation after vaping. This is the view of the American Heart Association, which points out in a recent report that cardiovascular impacts have been shown from vaping and it is still too soon to understand the long-term effects.

New Zealand regulated e-cigarettes but we weren’t quick off the mark by Dr Wigand’s standards. It was not until the end of 2020 that the Government’s moves to restrict aspects of vaping began to come into force. Advertising and promotion were banned and sale to under-18s was prohibited.

Prior to this, though, Kiwis had had at least three years to get the message from a promotional blitz that largely targeted adolescents.

Our legislation on e-cigarettes had been delayed in part because Philip Morris took a court case against the Ministry of Health.

Although it’s all water under the bridge, here we are today with the public barely acknowledging the potential risks of vaping and young people, not unexpectedly, unmoved by them.

Under-18s are vaping in droves and the numbers keep rising.

The excellent Te Hā Ora: Asthma and Respiratory Foundation New Zealand last year reported on its 19,000-respondent survey of secondary school students. This found 27 per cent of participants were vaping.

Twenty per cent of total respondents said they vaped daily or several times a day, and the majority were vaping with high nicotine doses.

The young people mainly got their vape products from dairies.

So much for smoking cessation only: many people pick up vaping when they would not have chosen to smoke cigarettes.

The foundation has called for a limit to the nicotine content of vaping products. It also wants a new legal age (21) for purchasing them; a ban on storefront window advertising or product display by retailers; no sale of vaping products within 1km of any school; educational campaigns aimed at youth; and further surveys to investigate the regulations’ impact.

The RNZCGP has taken the opportunity of a smok­ing-related bill at select committee to put in its two cents’ worth. The college told MPs all retailers (not just specialist vape retailers) should be government-approved if they want to sell vapes, and approval should be suspended or cancelled if they are found selling vapes to under-18s.

The college, to its credit, appears just as concerned as Dr Wigand, the US cardiologists and the foundation about a social trend becoming entrenched while its unknown harms quietly build up in the background. As I am sure they will.