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Scenario

Counter assistant Mandy is talking to technician Vicky about the number of people she has seen in the pharmacy who are trying to give up smoking. €I know all the nicotine products we sell like the back of my hand now, but I get very confused when people start talking about electronic cigarettes. There seem to be so many types now €“ refillable, disposable, all the different generations €“ and I just haven't kept up. I know we don't stock them, but so many people are using them that I need to know what they are talking about.€

Answer

Electronic cigarettes (e-cigarettes) available in the UK fall into three categories: disposable, refillable and customisable, sometimes known as first, second and third generation respectively. All are battery operated devices that aim to simulate conventional cigarettes by heating nicotine into a vapour that is inhaled. Disposable e-cigarettes are widely available, and resemble normal cigarettes in appearance and usage, hence they are often referred to as 'cigalikes'.

Some can be recharged, and most have replaceable cartridges. While these are a good starting point for people wanting to use electronic cigarettes (which is commonly referred to as vaping), most people don't stay on them for long because the short battery life, poor vapour production and frequency with which cartridges and devices themselves have to be replaced makes them expensive. Refillable e-cigarettes are the preferred choice for many vapers, as the battery life is generally good, vapour is produced consistently and usually in greater volumes than their disposable counterparts, and the cartridges are refillable, making them a costeffective option in the medium- to long-term.

Second generation electronic cigarettes resemble pens, and a huge market has grown up around the e-liquid used to fill them, with hundreds of flavours available. Third generation models are much more complex, allowing users to choose from a range of batteries, atomisers, cartridges and tank systems to make their own modified device (which is often referred to as a mod or personal vapourizer). One of the more desirable components to have is a variable voltage battery, which the user can adjust to change the amount of vapour produced, among other features.

The bigger picture

Despite their prevalence nowadays, electronic cigarettes were only invented just over a decade ago, and didn't reach the UK until around 2007. The charity Action on Smoking and Health (ASH) estimates that over two million adults in Great Britain use electronic cigarettes, of whom 700,000 are ex-smokers and 1.3 million use the devices alongside tobacco products. ASH claims that there is little use among 'never smokers', and states that in 2014, just eight per cent of 11-18 year olds who were aware of e-cigarettes had tried one, and that use in this age group is closely linked to smoking behaviour, just as it is among adults.

Both the UK medicines regulator €“ the Medicines and Healthcare products Regulatory Agency (MHRA) €“ and the National Institute for Health and Care Excellence (NICE) have indicated that electronic cigarettes are less harmful than smoking due to the fact that they deliver nicotine without the many other chemicals present in cigarettes that account for smoking-related diseases. However, several organisations, including Public Health England, have voiced concerns about the extent and nature of the e-cigarette market, particularly the role of tobacco companies who are involved in manufacturing and promoting these devices while still selling conventional cigarettes. There are also concerns about how e-cigarettes are marketed, particularly in terms of how attractive they may be to children and non-smokers.

At the moment, current guidance for health professionals is to encourage smokers who want to quit the habit to use conventional nicotine replacement therapies, but to be mindful that for those who don't want to use such methods, e-cigarettes can be presented as a lower risk option than continuing to smoke tobacco.

Extend your learning

Electronic cigarettes are currently available in the UK as consumer goods, but this is set to change. Check your understanding of this here.

There are several countries in the world that have banned electronic cigarettes altogether. Have a look at the map here so that you are aware of the countries in which restrictions are in place.