Written evidence submitted by the
Royal College of Physicians of Edinburgh (ECG0025)

1. The Royal College of Physicians of Edinburgh (“the College”) was founded in 1681. We support and educate doctors in the hospital sector throughout the UK and the world with over 12,000 Fellows and Members in 91 countries, covering 30 medical specialties. 50% of our UK Fellows and Members work in the NHS in England, and we welcome the opportunity to submit evidence to the Science and Technology Committee on e-cigarettes.

On health:

The impact on human health of e-cigarettes—themselves and relative to ‘conventional’ smoking—and any gaps in the science knowledge-base in this area.

2. The College recently signed a consensus statement[i] with a number of other organisations, clarifying perceptions about the harms and benefits of using e-cigarettes and supporting the current evidence that vaping e-cigarettes is less harmful than smoking tobacco. However, for public health and health service purposes, e-cigarettes are only useful as a potential route towards stopping smoking. Access to e-cigarettes must be controlled carefully and there remains much that we do not know.  The statement makes it clear they are not risk free and the College notes that considerable research in this area is required.

The benefits and risks of e-cigarettes as a ‘stop smoking’ tool, any gaps in the knowledge-base on this, and whether any approaches are needed to tackle e-cigarette addiction.
The uptake of e-cigarettes among young people and evidence on whether e-cigarettes play a role in ‘re-normalising’ smoking.

3. There is now agreement based on the current evidence that vaping e-cigarettes is definitely less harmful than smoking tobacco. Although most e-cigarettes contain nicotine, which is addictive, vaping carries less risk than smoking tobacco. Thus, it would be a good thing if smokers used them instead of tobacco. Using e-cigarettes without stopping smoking (dual use) does not provide health benefits.

4. The College also has concerns about those devices currently available which do not deliver nicotine but do deliver a variety of flavoured liquids. These devices could be very attractive to under 18’s and there is currently little evidence on whether or not this could lead on to nicotine use either in e-cigs or real cigarettes in due course. In view of the lack of knowledge and evidence about the effects of vaping even with non-nicotine solutions, there is a case for reviewing the sale of these devices in addition to nicotine inhaling products. A paper published by the American Industrial Hygiene Association “White paper; Electronic Cigarettes in the Indoor Environment[ii]”   highlights a number of concerns, including the lack of regulation and quality control of the devices; chemical exposures to bystanders, and the lack of good evidence about exposure to many of the flavourings etc.

December 2017