Dr Garrett McGovern, a GP specializing in addiction medicine at the Priority Medical Clinic in Dundrum, Ireland, recently wrote about vaping.

He argued that banning e-cigarette flavors would increase the harm and death of smoking and would not protect young people.

The Irish Joint Commission on Health released its report this week on a pre-legislative review of the Public Health (Tobacco and Nicotine Inhalation Products) Bill 2019. Several recommendations were made, including banning all flavors (except tobacco flavors) in e-cigarettes.

The rationale given was that flavors would appeal to young people, while removing their availability would be less appealing to teens, which would reduce their use.

The report also noted that tobacco costs Ireland's coffers 10.6 billion euros a year and 6,000 people die each year from smoking. No one can argue with these dizzying statistics that every effort should be made to reduce the harm that smoking is doing to all of our citizens.

Additionally, one of the goals of the bill is to ensure that young people growing up today have a smoke-free future and to help smokers who want to quit their lifelong addictions. The goal is to achieve a smoke-free Ireland by 2037. We have been making steady progress in reducing the overall number of people smoking. In 2015, 23% of the population smoked. By 2022, that number will be less than 20%.

progress made

There is no doubt that we need to do more, but the statistics are moving in the right direction. This has largely been achieved by giving smokers more options for quitting over the past decade or so.

One of the increasingly popular interventions is e-cigarettes. A device that delivers nicotine via vapor without burning tobacco (e-cigarettes contain no tobacco at all). It's the burnt, inhaled tobacco from which nearly all of the harms of smoking come from.

In Ireland, around 200,000 people use e-cigarettes. Almost all were smokers or ex-smokers trying to quit. International research shows that less than 1% of people who vape would otherwise not smoke. In other words, e-cigarettes are a smoking cessation tool that is roughly twice as effective as any other smoking cessation tool, including nicotine replacement therapy, NRT.

The Royal College of Physicians and Public Health England estimate that e-cigarettes are at least 95% safer than smoking. The core of smokers trying to use e-cigarettes to quit smoking is the use of flavors.

Despite these compelling statistics, the Joint Commission has shifted its focus away from smokers and towards younger users of e-cigarettes. It is estimated that less than 20% of people under the age of 18 have used e-cigarettes, but the vast majority use them irregularly or experimentally. Only 4% use e-cigarettes regularly (i.e. daily or almost daily). This is equivalent to less than 1% of the total population under the age of 18.

Is vaping harmful?

Even among those who vaped regularly, there appeared to be little evidence of significant harm. In my own work, I have not encountered or treated any vaping-related illnesses in clinical practice. In fact, I haven't even heard of a single case of vaping-related harm. In nicotine replacement therapy (NRT) formulations, regular use of nicotine appears to be very safe. Nicotine also appears to be safe in e-cigarettes.

Which begs the question: Why are we waging a 15-year war on a product (e-cigarette) that helps many smokers break free from a habit (smoking) that is causing incalculable harm to them and reducing life expectancy by 10 years, in an effort to reduce 1% of the teen population, who are unlikely to cause major harm anyway.

Of course, reducing youth initiation of e-cigarettes is important, but the more important goal is to reduce the number of young people who start smoking. E-cigarettes are not a gateway to smoking (as is often claimed). They are the gateway to quitting smoking, the pathway to a longer, healthier life.

Incredibly, there will be no age limit for e-cigarette use in Ireland in 2022. The New Nicotine Alliance (NNA) Ireland and trade groups have been calling for an age limit for years, but the regulation should have been enacted long ago. In my opinion, banning flavors (the vaping ingredient that attracts smokers) in favor of pure tobacco flavors (the ones smokers are trying to get rid of) is a mind-numbingly short-sighted policy that could increase the number of smokers in this country and with it of all hazards.

I also think it will threaten the viability of the 400 or so well-known e-cigarette retailers who are experts in advising smokers trying to quit. Flavor bans are de facto vaping bans, and since tobacco flavors attract so few people, most vaping retail units are likely to close. It would be shortsighted for the Joint Commission to exclude people who actually use e-cigarettes from these hearings, as they are important stakeholders in this debate.

I urge the government to ignore the proposal to ban vaping flavors. Such a policy would be disastrous and lead to more smoking-related injuries and deaths.