Electronic cigarette interview with Dr Adrian Payne

Photo of Dr Adrian PayneDr Adrian Payne is the Managing Director of Tobacco Horizons, a Tobacco Harm Reduction Consulting Agency. During a post-doctoral career spanning more than thirty years, he has worked for both tobacco and pharmecutical companies, often in the field of Tobacco Harm Reduction.

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ECD: How harmful is the electronic cigarette when compared to a regular cigarette?

Adrian: Based on the safety profiling data on E-cigarettes that has been published so far, I think it’s reasonable to say that they are probably at least two, if not three, orders of magnitude less harmful than regular cigarettes. The key reason for this huge difference is that E-cigarettes don’t generate harmful tobacco smoke. But it’s important to understand that ‘no smoke’ doesn’t necessarily translate into ‘no harm’; it’s possible that some risks might emerge from studies into their long-term use.

However, it’s hard to imagine that any such risks would even begin to approach those of smoking cigarettes. Indeed, probably the issue of main concern with E-cigarettes is that children might ingest the E-cigarette cartridges. So along with the necessary internal quality control checks, it would seem sensible for the various manufacturers to use childproof packaging as a design feature.

 

ECD: Do we have any idea of the effect of heating up nicotine prior to inhaling it? How is the heating of nicotine by the electronic cigarette different to setting fire to tobacco and inhaling the resultant smoke?

Adrian: The end result of tobacco combustion and nicotine vaporisation is basically the same, i.e. generation of a nicotine-containing aerosol that can then be inhaled by the user. Both processes involve heat, but they are otherwise very different in that the aerosol generated by the E-cigarette does not contain within it the thousands of other chemicals, many of which are thought to be extremely harmful, that result from the combustion of tobacco. It’s true that concerns have been expressed about possible harmful effects of some of the chemical components other than nicotine in the E-cigarette aerosol, for example propylene-glycol. But based on current knowledge, these concerns seem vastly overplayed when compared to the risks of cigarette smoking.

 

ECD. One criticism that has been leveled at the e-cigarette is that it could encourage youngsters and other non-smokers to take up smoking. Are young people more likely to take up smoking with an electronic cigarette than with a regular cigarette?

I’m not aware of any evidence of adult non-smokers using either E-cigarettes ...in any number as a gateway to smoking – if there were I’m sure we would have heard of it by now. Bad news travels fast!

Adrian: As a parent myself, I understand concerns that young people might be attracted to E-cigarettes and then move on to conventional cigarettes. But I’m not aware of any evidence that this is, or is even likely to be, the case. In the first place, E-cigarettes are not ‘pocket-money’ devices. Secondly, I don’t think anyone has raised the same concerns about pharmaceutical nicotine inhalators which, in the UK at least, are available over the counter. Similarly I’m not aware of any evidence of adult non-smokers using either E-cigarettes or pharmaceutical nicotine inhalators in any number as a gateway to smoking – if there were I’m sure we would have heard of it by now. Bad news travels fast!

 

ECD: You have worked with both the tobacco industries and the pharmaceutical industries. Do you think there is any justification in e-smokers’ beliefs that Philip Morris is interested in snuffing out alternatives to cigarettes via the Tobacco Bill it supports in the US? And are large pharmaceutical companies encouraging public health groups in America to campaign against the devices?

Adrian: To my knowledge, Philip Morris was involved in discussions on the Tobacco Bill it supports in the US long before the advent of E-smoking so I don’t think that these beliefs are justified in the case of E-cigarettes. But what I think are justified are the widely-held beliefs that if this Tobacco Bill is signed into law as currently drafted, E-cigarettes along with other innovative products would face an almost impossible task to get regulatory approval and would therefore be banned.

"E-cigarettes are at risk of being caught in a regulatory trap, with consumers being denied the choice of a far safer product than regular cigarettes..."

This would in effect freeze the market and divide it between regular cigarettes (for those who either want to smoke or partake in the quasi-smoking experience which E-cigarettes provide), smokeless tobacco products (less harmful than cigarettes, but a completely different consumer experience) and pharmaceutical nicotine products (for those want to quit smoking entirely or at minimum cut-down their consumption). So E-cigarettes are at risk of being caught in a regulatory trap, with consumers being denied the choice of a far safer product than regular cigarettes that might meet their smoking abstinence needs better than either smokeless tobacco or pharmaceutical nicotine products.

It would make a lot more sense if a separate regulatory category were to be carved out for cross-over products like E-cigarettes and I’d like to see the manufacturers of these products being more pro-active in this regard. I’m certain such a move would find support from those members of the public health community who see E-cigarettes as potential life-savers rather than as regulatory upstarts. Development and application of an appropriate regulatory package wouldn’t have to be done all at once; it could be incremental, thereby allowing the products to stay on the market in the meantime.

Certainly large pharmaceutical companies with interests in stop-smoking medicines provide very substantial financial support to some of the public health groups that are calling for E-cigarettes to be banned. Incidentally these are the very same public health groups that support the Tobacco Bill backed by Philip Morris. But I’m not aware of any evidence of specific encouragement from these pharmaceutical companies for those groups to take such an antagonistic position. Nor have I seen any position statements on E-cigarettes from the companies themselves. That doesn’t mean to say of course that they are not keeping a close eye on what is happening on the E-cigarette front – I’m sure they are!

 

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