E-cigarettes an evidence update A report commissioned by Public Health England

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E-cigarettes: an evidence update2) The official reporting statistics for the UK [155] do not specifically report EC as acause of fire. There were 2,360 accidental fires between April 2013 and March 2014where the source of ignition was “smokers’ materials” causing 80 fatalities and 673 nonfatalcasualties. Additionally, there were 3,700 fires from faulty appliances and electricalleads causing 19 fatalities and 820 non-fatal casualties. It is not clear what proportion ofthese were caused by EC.Regulations covering chargers and quality standards of production could help reducethe risk of fire and explosion in EC. An unpublished Department for Business,Innovation and Skills (BIS) funded market surveillance exercise in 2013/14 found thatsix out of 17 EC had no instructions for charging, and that eight out of 17 EC did nothave a charging cut-off device and therefore did not meet the requirements of BS EN62133:2013 'Safety requirements for portable sealed secondary cells and batteries foruse in portable devices' 4 . It seems likely that the risk of fire and electrical fault is similarto other domestic electrical products, indicating that EC should be subject to the sameguidelines and safety mechanisms.Summary of findingsThere is a risk of fire from the electrical elements of EC and a risk of poisoning fromingestion of e-liquids. These risks appear to be comparable to similar electrical goodsand potentially poisonous household substances.Policy implicationsoooThe risks from fire or poisoning could be controlled through standard regulations forsimilar types of products, such as childproof containers (contained within the TPDbut which are now emerging as an industry standard) and instructions about theimportance of using the correct charger.Current products should comply with current British Standard operating standards.Records of EC incidents could be systematically recorded by fire services.4 BIS Funded Market Surveillance Exercise 2013/14. The Electrical Safety of Electronic Cigarettes and the Labelling of E-liquids. Lancashire County Council. Unpublished report.84
E-cigarettes: an evidence update12. International perspectivesOverviewInternationally, countries have taken a wide variety of approaches to regulating EC[156]. Current approaches range from complete bans on the sale of any EC, to applyingexisting laws on other products to EC (poison, nicotine, and/or tobacco laws), toallowing EC to be sold under general consumer product regulations. Similarly, withincountries, different laws have also been applied at the state/provincial level, along withmunicipal by-laws, extending into areas including taxes on EC, and bans on use inplaces where smoking is banned. Furthermore, several nuances in laws exist, making itdifficult to make broad statements about the regulations in a given country. This sectionfocuses on presenting (1) studies that have compared the use of EC internationallyacross countries using representative samples and comparable methods, (2) a briefreview of adolescent surveys internationally, and (3) the cases of Australia and Canada,two countries that have very similar tobacco control policies to the UK but very differentpolicies relating to EC.Use of e-cigarettes among adults internationallyThree studies have compared the use of EC internationally: (1) International TobaccoControl Project (described in the Methodology section), (2) Eurobarometer study and (3)Global Adult Tobacco Survey.The International Tobacco Control Project compared EC use (use defined as less thanmonthly or more often) among smokers and ex-smokers across 10 countries [157].Gravely et al., 2014 found significant variability in use across countries, but data weregathered across different years. Gravely et al., 2014 concluded that the study providedevidence of the rapid progression of EC use globally, and that variability was due partlyto the year the survey was conducted, but also market factors, including differentregulations on EC. Notably, EC use was highest in Malaysia at 14%, where a ban onEC was in place.Two studies using secondary data from the 2012 Eurobarometer 385 survey haveexamined EC use. Vardavas, et al., 2014 [158] examined ever use (tried once or twice)of EC among smokers, ex-smokers and never smokers aged 15 years and over across27 EU countries. The study found wide variation in ever EC use among smokers andnon-smokers, with ever use varying from 20.3% among smokers, 4.4% among exsmokers,and 1.1% among never smokers. Of those who had tried, 69.9% reportedusing EC once or twice, and 21.1% and 9% reported ever using or currently usingoccasionally or regularly (use or used regularly or occasionally). It is important to notethat the question asked about ever using or currently using occasionally or regularly,85
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E-cigarettes an evidence update A report commissioned by Public Health England

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