Is Scotland sleepwalking into a public health disaster over surge in vape use?
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An investigative piece by 17-year-old Highland News and Media reporter Iona MacDonald drew attention to how easy it is for children to buy e-cigarette vapes under the legal age. The story drew a lot of attention and prompted an invite to a round table discussion which heard a consultant paediatrician outline some alarming concerns. Amidst a Scottish Government consultation on a ban on disposable vapes, there was much to discuss.
Consultant paediatrician Dr Jonathan Coutts didn't mince his words when referring to an commonly-cited paper used by some to defend e-cigarettes or vapes – and it shocked a round table discussion involving politicians, health campaigners and environmentalists in the process.
Since my story was published, the Scottish Government has announced plans to hold a consultation on banning disposable vapes. There are dual concerns over underage vapers and the environmental impacts of the estimated five million disposable vapes being thrown away every week in the UK.
The Scottish Parliament round table I was invited was called by MSP Gillian Mackay, who has an ongoing campaigning to ban disposable vapes. It brought together MSPs, the CEO of Action on Smoking and Health, campaigner Less Waste Laura – and a presentation from Dr Jonathan Coutts.
He's a consultant paediatrician at Glasgow's Royal Hospital for Children and has warned of the cases where children have been hospitalised due to vaping.
There is conflicting evidence in the debate about vaping, but Dr Coutts believes there has been a spread of misinformation in a well-known statistic often used in the debate.
A paper published by Public Health England in 2015 said that vaping is 95 per cent safer than smoking the traditional cigarette. But it's not as simple as that, he says. When it says that vaping is 'safer', that includes external and environmental and not just health factors.
The reason cigarettes are cited as more dangerous than vapes and e-cigarettes includes factors such as deforestation, smuggling, and other external impacts.
Dr Coutts said: "In the paper they listed 14 harms, and nine of these are what you would call 'harm to the world', such as smuggling and deforestation. Only four of the harms listed were health-related. So it's not at all that they were investigating the health benefits of e-cigarettes to smoking."
When Dr Coutts revealed that the scientific paper had been sponsored by a cigarette company, the shock around the virtual table was palpable.
Such a clear conflict of interest and bias on a very factual subject is concerning, particularly when the study has been cited by the UK government.
"What they don't mention in the paper is that the whole meeting in a hotel was sponsored by a cigarette company" said Dr Coutts. "It's not a very good paper at all, the methodology isn't good, and it was created in 2014 – that was long before we recognised harms in e-cigarettes."
Dr Coutts also addressed concerns that a ban on disposable vapes would only result in more children turning to smoking traditional cigarettes.
He said: "Common sense suggests that's not the case. For the last 25 years, children haven't had access to vapes, and so traditional smoking amongst children and the general population has been going down.
"Compelling data evidence from Australia shows that two per cent of children aged 14-17 had tried traditional smoking. From 2020, when vapes have become more popular and accessible, instances of traditional smoking has also gone up to 12 per cent."
A central point of the vape debate is whether it really is 'safer' than cigarettes? This is what Dr Coutts had to say: "You get lung inflammation when you vape, which is very similar to what you see in people who develop COPD, and we are all aware that there is a massive problem with COPD in Scotland."
Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema, and chronic obstructive airways disease. According to Asthma and Lung UK, 140,000 people are diagnosed with COPD in Scotland, and more than 200,000 are estimated to be undiagnosed.
Dr Coutts continued: "COPD causes reduced lung function, which means you’re more likely to die earlier. Is it good to be promoting something that we know will cause lung inflammation, and cause COPD?
"We need to start thinking of this as a child protection issue. I believe the tobacco companies are interested in vaping because it leads to smoking, as shown in Australia. We should be very concerned that Scotland isn't sleep walking into a public health crisis."
