Incoming regulations from the Ministry of Health on the promotion and sale of e-cigarettes and vaping products will be good news for everyone, says Asthma and Respiratory Foundation NZ Chief Executive Letitia Harding.

There are currently no legal regulations around safety standards and sale of e-cigarettes, e-liquids, or other vaping products in New Zealand, something set to change when the Government introduces legislation to regulate later this year. Legislation to set maximum nicotine levels, restrictions on branding that appeal to youth, and regulating the advertising of vaping products to align with other similar industries, is supported by the Foundation.

"Regulation is not the enemy of any reputable industry," says Letitia, "so creating legal restrictions on who these products can be sold to, and how, will not harm any business that is already operating in good faith."

Dr Stuart Jones, New Zealand President of the Thoracic Society of Australia and New Zealand (TSANZ), says that certain e-liquid flavoured products are aimed at youth, with some further health issues.

"We are particularly keen to see regulation of flavours and marketing designed to appeal to youth. Some marketing is clearly aimed at a younger audience, and we have seen the impacts of this overseas. There is also substantial evidence that vaping can act as a gateway to smoking, especially in youth, and it’s good to see the Ministry of Health’s Vaping Facts website now reflecting this.

"Some e-liquid flavourings create intense airway inflammation through the production of toxic metabolites. These flavours might be safe to add to food, but that doesn’t mean that they are safe to inhale, particularly when their chemical composition changes with the intense heat that occurs in the production of the vapour. Our airways are delicate, so we need to look after them."

Philip Pattemore, Associate Professor of Paediatrics and member of Paediatric Society of New Zealand (PSNZ), agrees that the introduction of a new potentially addictive product into the market, even as a smoking cessation device, requires careful regulation.

"The Paediatric Society welcomes appropriate regulations on the content, availability, and branding of e-cigarettes, to prevent them becoming a danger to children and young people. E-cigarettes come in thousands of flavours, and are marketed as recreational products. Tobacco companies also have a major share in the e-cigarette market; this is an obvious conflict of interest regarding using vaping as a tool to help smoking cessation, and preventing youth from taking up smoking."

These statements echo the July 2019 World Health Organisation (WHO) Report on the global tobacco epidemic, which states that electronic nicotine delivery systems (ENDS) regulation "should include minimising potential health risks to ENDS users and non-users, prohibit unproven health claims from being made about ENDS, and protect existing tobacco-control efforts from commercial and other vested interests of the tobacco industry".

The WHO report also states that "More evidence is still needed to inform a conclusive statement on their health impacts and potential as a cessation tool. Until then, there are a number of unknown factors which mean they cannot be safely recommended for consumption."

The Asthma and Respiratory Foundation is not fundamentally opposed to vaping being used as another tool for smoking cessation, but evidence suggests this still needs to be in conjunction with a behavioural support wraparound service. Letitia suggests that legislation could be put in place to monitor, track, and regulate the vaping industry, as is the case with other industries in New Zealand. Vaping is not a special case, she says, and shouldn’t be treated as one.

"Smoking, alcohol, and food have mandatory standards they must meet; we want to see these apply to vaping too. We want to see requirements for all ingredients in e-liquids to be listed, standards set on maximum nicotine levels, and addiction warning labels on products containing nicotine. All smoke-free areas should also be free of vapour, to avoid currently unknown effects from second-hand emissions, and to avoid renormalisation.

"While not necessarily something for legislation, we’d very much like to see vaping shops include Quitline information, and train their staff to discuss vaping as a smoking cessation tool. If the vaping industry is truly committed to helping people quit smoking, then this should be backed by regulation, safety standards, and appropriate training.

"Asthma and Respiratory Foundation NZ are ready and willing to work with both the Ministry of Health and the vaping industry in this space. Smokefree Aotearoa is our shared goal, but it won’t happen unless we work together."