AVCA is truly a grassroots organization and our success depends completely on community involvement and support.  If you currently use smokeless alternatives to combustible tobacco, our goal is to ensure that these reduced harm alternatives become and remain available, affordable and effective.

Funding is utilised solely for the running of the charity, there are no salaries paid (all board members are volunteers) so all the money donated goes back into the community via our advocacy and outreach programs in the community.

Please consider making a one-time donation or set up an automatic monthly donation to help us help you.

AVCA is a charitable trust board meaning we are a non-profit organization. Contributions to AVCA can be receipted (upon request) for tax purposes.

We finally have a new government, including our new Minister of Health (David Clark) and two new associate Ministers of Health (Julie Ann Genter & Jenny Salesa).   We are pleased to see the choices include those whom have a track record of concern and empathy for the well being of all New Zealanders. It now their time to shine.  And ours too.

For far too long, those who had no voice were represented by those who used their plight to further their own vested professional and financial interests, and at times have quite openly, attempted to stifle (and attempt at times discredit) the self representation and determination of vaping consumers of New Zealand. 

AVCA, as most know by now, is run by volunteer vapers/former smokers whose whose sole interest is the self determination of their health and those around them by providing scientific evidence, sharing knowledge and providing support to all interested parties that is gleaned from real work experience as former smokers/current vapers.   We are an inclusive community, and have run numerous pilot programs countrywide through our VIF program, including a small cohort Mental Health patient VIF group, to assist smokers onto vape.  All of these programs have had high success rates (96% for standard VIF pilot, 80% for MH VIF small group).   We are proud of this work, and have much more to do.    

This is why the board of directors has agreed that the time has come to expand our VIF program to include local Councils, DHBs, PHO’s and community organisations to get the information to them in order to be able to make informed decisions surrounding the use of ELVs, the action of vaping in public and the benefits.    This has already begun informally in locations as far afield as Invercargill. There is an entire country that we represent and  who have and will benefit from what we know and what we do, as is shown from the consultations with the previous government where we have provided information, evidence and guidance.

We firmly believe in “nothing about us, without us” and it is hoped that the new government will also accept our offer of guidance and knowledge as they draft the legislation surrounding vapings’ place in the toolbox for a SmokeFree 2025.

Excelsior!    

Those interested in our new organisational VIF framework, please feel free to contact either Steve, Jan or Nancy.

Have to admit here that we are all still a bit in shock over todays’ announcement from the MP Nicky Wagner regarding the legalisation of e-cigarettes as we were not expecting anything that soon after our last meeting in early March where we were told nothing would be happening until after the election.   We are stoked, of course, but reservedly.

While everyone has been celebrating and/or questioning the veracity of the process, we have been discussing the situation and reviewing all the available information (ever pragmatic are we)…

Steve and I both agree there are a few points that absolutely need to be made at this point in time:

1. Everything up to this point has been a team effort from the community and its’ supporters – Marewa Glover started the discussion and then assisted with getting it moving by helping to get Aaron Biebert and “A Billion Lives” to launch the World Premiere here in Wellington.  The merry and loud band of vapers from the Wellington Vapers Group who decided to fight the Council on their inclusion of Vaping in their Smoke Free policy – which we was not won, however it made very clear that the vapers were not going to stand down from draconian policies initiated out of ignorance and prejudice.  The entire New Zealand community agreeing to and allowing for the formation of Aotearoa Vapers Community Advocacy (AVCA) to represent them on the national, and now international, level of consumer advocacy to the government and other stakeholders in the process, and lastly, but not least, the support of international experts when the time came for the government to open up a public consultation on e-cigarettes and nicotine e liquid for retail sale in New Zealand.

To all of you, we, the vapers of New Zealand say THANK YOU.

1. As was outlined in the Press Release (Press Release 29 Mar 17)  and the Q& A document (Q&A E Cigs)  we have “won” a big part of the battle to have nicotine e liquid made legal as a consumer product.  Not medicalised, not restricted to pharmacies only, but a consumer product with no tobacco excise.
2. All the foregoing aside, know that the valid concerns that are held by members of the community will be addressed in a further submission to the Ministry of Health as it related to “appropriate controls” and inclusion of vaping in the SFEA.   We had previously provided information and evidence for a suggested framework in our submission under the public consultation.  It is to that framework that we will be working towards, see (Consumer Bill of Rights/Vendor MoU)
3. We have been, and will continue to work with the members of VTANZ (www.vtanz.org.nz) towards providing information and consultation to the government as it relates to legislative and regulatory framework process.

Stay tuned, things are getting interesting to say the least!

Government Subsidies for Smokers to make the Switch to Vaping for Harm Reduction

AVCA was greatly pleased to see MP Marama Fox state in an interview with NewsHub that she would like to see the government assist smokers switch to vaping for cessation purposes.  Her support of our programs, specifically the Vape It Forward program that has been trialled and wildly successful in Wairarapa and our outreach and collaboration with the smoking cessation service providers, is priceless.  As is her acknowledgement and recognition that the vapers of New Zealand, through AVCA, as key stakeholders in the process of legalisation of nicotine e liquid.  We thank her and all those who are in support of vaping and e-cigarettes in government, healthcare and the Ministry of Health.

Whilst we do not know yet the exact particulars of the subsidies that MP Fox mentioned, we are sure that they will fit within the aims of helping assist Maori and all New Zealanders to become SmokeFree by 2025 by legalising nicotine e liquid as a consumer product, with no additional excises being applied to the liquid or equipment that is currently being used by thousands of New Zealanders to kick the habit of combustible smoking.

AVCA have been a strong supporter and voice of having regulation to legalise nicotine e liquid for retail sale in New Zealand, and have worked side by side with the members of the vendor association, VTANZ (www.vtanz.org.nz) to self regulate the industry for the benefit of consumers in terms of safety, well being and harm reduction.   We look forward to the government taking the next steps to increase accessiblility to everyone in New Zealand towards the technology that will get Aotearoa SmokeFree by 2025.

It is more than time for the Ministry of Health to prioritise the regulations to get nicotine e liquid legalised in New Zealand for access, accountability and the promotion of public health.

Currently, we have been dealing with various issues on the ground surrounding the easy & ready availability of nicotine e liquid of unknown provenance being available in dollar stores throughout the country – when questioned, the proprietors of these establishments have refused to acknowledge that they should a) not be selling this and b) definitely should not be selling this to children from an ethical standpoint even if it is not written in law.   

The reality, however, is the only law these shops are breaking is selling nicotine containing e-liquid, to anyone.

We have been contacted by a few health providers and by the parent of a student at one of the local colleges about students vaping both in town and on campus – with liquid and equipment purchased at the local dollar stores.   The college has been advised that it is not illegal to vape (they believed it was) and that their best course of action would be to contact AVCA.  Our stance on the matter is that they would need to include a no vaping on campus or in uniform clause in their student handbook to address the issue head on until there is some form of official guidance issued/regulation enacted by the government.

We at AVCA, and the wider vaping community in New Zealand,  believe and want that people can access the products they need for tobacco harm reduction, legally, with guarantee that what they are purchasing is of the highest quality, risk aversive and they are provided knowledgeable, experience support in their use.   If one utilises vaping for recreation, that is definitely an 18+ consumer product no different than any other age restricted adult consumer product.

This current situation is clearly unacceptable as we at AVCA, and our community of vapers in New Zealand.  E-cigarettes and nicotine e liquid should be legal and sold retail as an 18+ consumer product though a controlled scheme of registration of legitimate vape businesses with the government with enforcement.  

Our suggested framework was given in our submission to the government on the legalisation of nicotine e liquid.   A framework which was devised from the combination of existing regulation of products, scientific evidence and examples of practical application taken from the UK.   This framework is already in place as self regulation by the members of VTANZ  (www.vtanz.org.nz) and those who have applied to be part of the AVCA Approved Vendor Program.  

Harm Reduction and Harm Prevention go hand in hand in this context.  Do we want people to smoke because they cannot access an alternative therefore creating a barrier to harm reduction?  Do we want to cause harm by not addressing the issues outlined above and perhaps putting people at risk of harm?  

The liability and responsibility for any harm at this point in time, lays at the feet of those who are responsible for the law by lack of action on a known issue.  Addressing this in a timely, effective manner that will benefit the wider population is the correct answer to the questions raised herein.  

AVCA is now officially registered as Charity in New Zealand.

Aotearoa Vapers Community Advocacy (AVCA) is pleased to announce that we have been approved and are now a registered New Zealand Charity (CC53899).  This development will allow us to continue the work we are currently doing and expand upon it to deliver our mission of Educate, Inform and Advocate throughout New Zealand.  This is what AVCA does – we educate the public and any interested party regarding e-cigarettes – what we do, why we do it and how to best utilise them to switch from combustible tobacco, as well as officially represent the vaping consumers of New Zealand in the international vaping community as a founding member of INNCO (innco.org).

Our most recent local efforts have been geared towards mentoring smokers towards vaping and  providing information, education and assistance to smoking cessation providers countrywide, free of charge.  We have also provided the government with scientific information, peer reviewed research and links to experts and recent, objective information on e-cigarettes and vaping.

Information is key.  Knowledge is power.  We are about empowering people to make choices based on recent, scientific information combined with the anecdotal experiences of those who have successfully made the switch from combustible tobacco to e-cigarettes.

Our charities registration will now allow us to reach a wider audience to further disseminate information and knowledge, as well as seek funding, accept koha/donations to begin new projects.  We are looking to expand our presence through the use of online seminars, training and info sessions for those providers who are not served by a local AVCA mentor/advocate as the majority of our work is in the community, building support networks and getting information on vaping to the people who want and need it and helping them.    As stated in our logo – Educate, Inform and Advocate in the community – the priorities are education, information and advocacy for everyone in Aotearoa New Zealand as it relates to vaping.  

Our Vape it Forward (VIF) program has had a 95% success rate (April – October 2016)  in switching people from tobacco to vaping.  We are looking forward to maintaining that success, sharing our knowledge and information on vaping and expanding our programs into the community.

As most here in NZ know by now, the Ministry of Health has updated their information on e-cigarettes for health care providers. (you can see that here).    Of course, we are thrilled that the information and documentation that we submitted to the MoH, Health Committee and MP Marama Fox was considered, utilised and made available to health care professionals in their daily care of patients.  Once again, we thank you for doing that.

In spite of the good news, there have been a few interviews and posts on social media that have taken a negative spin on this information, for whatever reason, that has caused some local controversy regarding the actual legalisation process and the future endgame with regards to e-cigarettes.    There seems to be quite a few people out there talking about the situation without actually having concrete validated information.

AVCA is about information, educating and advocating.   That is all we do, and as soon as we know things we advise.  We cannot force people to accept that advice, however it would be beneficial to all concerned to not spread misinformation and speculative opinions to create confusion.   It is not that the information is not available, it is that certain people have chosen to not acknowledge it for whatever reason.

So, to clarify on the MoH document regarding e-cigarettes issued this past week:

The document linked above does not mean that the MoH has approved e-cigs as a cessation device.   Nor does it mean that they recommend them as such.  What it DOES do is allow health care providers information and guidance should the issue arise during the course of their patient interaction and enable them to be able to discuss it intelligently and supportively.

As of this time, there are no standard e-cig setups (e liquid) that are before Medsafe for approval as a cessation device.  There is a heat-not-burn device in the pipeline, as well as inhaler devices but NO e-liquid vapouriser device.   We need to be clear about this.

We also need to be very clear that the current legalisation process involves making nicotine e-liquid for use in e-cigs as a CONSUMER RETAIL product.  Not a medical product.   As such, that means that the government will not be, at any time in the near future, considering suggesting or approving e-cigs as an official smoking cessation method or option.

And lastly, regarding the rumour that legalisation is only going to be a temporary measure – that the govt will legalise nicotine containing eliquid in the short term and then rescind that by initating a ban on it once the smoking levels have dipped below 5%.  No.  Just No.

Onto the WHO FCTC CoP7:

We have contacted the MoH regarding NZ’s participation, as a signatory to the FCTC, in the CoP7 in New Delhi in November.  In our correspondence we expressed our concerns that the official guidance document issued by WHO was lacking in current, valid information and was a step backwards with regards to the work currently in process here in New Zealand.  We strongly asked that the MoH not backtrack on the current processes in place to make ecigs and nicotine eliquid accessible on the retail market.

We did receive a response from MoH that they have taken our concerns on board and are proceeding with the current legalisation process and will be issuing their official statement on that process by the end of October.

As we said months ago, the process is ongoing and we are getting there slowly but surely.   We just have to keep on keeping on, sharing good validated information and supporting each other in the journey.

Thank you

Global Nicotine Consumer Advocacy Alliance Launches

AVCA is pleased to announce that the International Network of Nicotine Consumer Organisations (INNCO), an alliance of over 15 safer nicotine consumer advocacy organisations –  representing over 20 million former smokers worldwide, has launched.  INNCO  is a ground-breaking global consumer advocacy network that brings together leading advocacy organisations to pursue a set of common objectives. INNCO is the fruition of a meeting held with consumer advocates at the Global Forum on Nicotine in Warsaw, Poland in June 2016. INNCO’s mission is to make it easier for smokers to obtain safer alternatives to cigarettes, which are the leading preventable cause of disease and death in the world.

A full copy of the official INNCO press release can be found here.

AVCA, as a founding member, is humbled and honoured to be part of this global advocacy group from its inception and is looking forward to working with fellow consumer advocacy organisations to get the word out, spread the message and assist in “educating, informing and advocating” for safer alternatives to combustible tobacco and easy access and availability to harm reduction options on the global stage much the same as we do here in New Zealand.   

Some may be wondering why a Vapers Advocacy Group would be making a submission on the Drug Utensils Policy in New Zealand.

It’s very simple really…we made our submission to make it very clear to government that the equipment we use to vape are not drug utensils.  Some of the original documentation that was presented with the call for submissions did not differentiate between the equipment WE use and the equipment used with cannabis, meth “P”, and other illicit drugs.

For your review:  Drug Utensils Submission

At the beginning of August, Steve and I were invited down to Wellington to speak about AVCA, present copies of AVCA Policies and Procedures and answer questions as presented to us with regards to electronic cigarettes, nicotine e-liquid and ENDS use.

We were told that we were invited because of the work in our Vape It Forward Program, as well as a recommendation that came from the community to the minister that we were community advocates, helping to educate not just individuals but also smoking cessation providers in the area and were “onto it” when it came to explaining what vaping was and how we are involved in our local communities.

The minister was impressed that we were not affiliated with the industry and as an all volunteer organisation that has no vested financial interest in vaping.   The minister was impressed that we were willing to share our information, knowledge and assist in collaborating in the legalisation process for no other reason than we feel it is the the right thing to do, and that knowledge, information and experience is to be shared for the benefit of the whole community.

Below, please find a copy of the document that we were asked to create to submit to MP Coleman and the Health Committee as it relates to the “big three” concerns that are/were held at the time of our meeting;  Nicotine toxicity/carcinogenicity; youth gateway effect and second hand vape exposure.

INTRODUCTION:

The policy document states the objectives that the Ministry of Health hopes that the submission phase of the process towards legalising nicotine containing e-liquid will help to clarify.  The main emphasis is how there may be reduction from harm from tobacco smoking through the use of nicotine containing e-cigarettes (ENDS).

From perusal of the policy document and a consultation with a minister in Wellington,  the “big three” concerns held by the Ministry of Health were outlined as: the toxicity of nicotine, the effect of the use of ENDS on youth smoking and exposure – aka “The Gateway Effect” and the effects of ENDS on others.

BACKGROUND:

In order to review the science that is available, one must first understand about science and scientific method and then be aware of the source of the funding of the scientific research.

With regards to science and scientific method, I am going to make three presumptions:  the first that it is common knowledge that Science is “a systematic and logical approach to discovering how things in the universe work. It is also the body of knowledge accumulated through the discoveries about all the things in the universe.”; the second  we know the word “science” is derived from the Latin word scientia, which is knowledge based on demonstrable and reproducible data and, lastly that the scientific method is utilised to “collect measurable, empirical evidence in an experiment related to a hypothesis (often in the form of an if/then statement), the results aiming to support or contradict a theory.” (1)

The scientific method:

1. Make an observation or observations; ask questions about the observations and gather information;
2. Form a hypothesis — a tentative description of what’s been observed, and make predictions based on that hypothesis;
3. Test the hypothesis and predictions in an experiment that can be reproduced;
4. Analyze the data and draw conclusions; accept or reject the hypothesis or modify the hypothesis if necessary;
5. Reproduce the experiment until there are no discrepancies between observations and theory.

It is of paramount importance to keep the concept of “good science” in mind when deciding which studies are best for evidence to address the concerns that are presented by the Ministry of Health in the policy surrounding nicotine e-liquid and nicotine containing ENDS.  A review of the policy document leads us to believe that this particular document has taken some of its guidance from the FDA Deeming regulations and the TPD from the EU.

How and why Research is Funded in the US & EU – The simple version:

Most of the “first tier” medical research projects and longitudinal studies that are funded in the United States come through the National Institutes of Health and their various subsections (NCI, NIDDK, NIMH, etc. – for the specific area of the human body that the research relates to) and are funded by their priority on the federal register and public health concerns (Put simply, diabetes research will be funded to prevent diabetes – some projects may focus on obesity and endocrinology, some diabetes research will focus on obesity and dietary factors, some diabetes research will focus on genetic factors & causes.)  .  The projects are given priority according to federal public health priorities but the funding itself comes from the health budget targets, private donations/foundations and taxes on “public health harms” such as those excises on tobacco, alcohol and “sugar tax” on food products.

“Second tier” funding comes from the “charities” that receive funding from their sponsors (American Cancer Society, American Lung Association, etc.) who have a specific bias towards preventing the diseases that they are affiliated with.  Funding comes from donations from the public as well as donations from private corporations (including tobacco and pharmaceutical companies as “alms” for the harms their products can cause in the former case, and for the discovery of new products that may perhaps benefit to their profit margins in the latter case should a marketable discovery be made.)

“Third tier” funding is that which is funded through private foundations setup for philanthropic causes that are near and dear to the founders of said foundation.

None of the foregoing is an indictment on the researchers who apply for funding, but they do know which way to go (1^st,2^nd,3^rd tier) and which organisation to apply to for the best chance of funding. (Most new researchers start with 3^rd and work their way up to 1^st).  They also know how to present their hypothesis & methods to suit the particular funders requirements.  Some of those requirements are in “black and white” and others are more “between the lines.”  In academic research, as I am sure Dr. Coleman knows, it truly is a matter of “publish or perish”, so funding is a priority.

Where research Happens in the United States & EU:

Most research happens in the bigger Universities – both public and private.   Some also occurs in the bigger privately funded “think tanks” and “foundations.”   Researchers at these institutions are usually hired because they fit the “research game plan” for the particular institution and then need to keep in mind the mission statement and goals of the particular institution they work for.   As well, those mission statements and goals need to be in line with the local prevailing public health goals and focus that the Dean of Medicine chooses for the research.  Again, keeping in mind the “publish or perish” scenario, the “sexy science focii” are those topical areas of interest within the parameters set by the people who run the medical school/research facilities.

1. Negative Bias in Research as it relates specifically to Electronic Cigarettes:

Assessing all the foregoing, it is easy to see that any scientific research coming out of the United States is going to be institutionally biased towards the tobacco and pharmaceutical industries.   Electronic cigarettes/ENDS are a “disruptive technology” as they disrupt the status quo and the processes by which revenue and profits are generated and therefore, are a threat to that same status quo.   Hence the most effected concerns see ENDS as a threat.  Part of the reason is the revenue and profits that are generated from the products produced by the tobacco and pharmaceutical industries that contribute to the federal and local economies in the United States.    As more people switch to vaping from combustible tobacco smoking, there is a major loss of revenue to government tax bases and lack of funding towards those projects that require that money to continue. As far as the pharmaceutical industry is concerned, they too are losing profits as more people switch to vaping in lieu of their products for smoking cessation – patches, gum, lozenges and medicinal compounds such as Zyban, Champix, etc.  It is believed that the foregoing were the reasons for the push by the FDA to initiate and implement the Deeming Regulations regarding ENDS – to protect tax revenue and corporate profits, NOT in the interests of public health, referencing biased science to prove their case.

In Europe, as it relates to the TPD, it is a well known fact that there were representatives on the committee that devised and implemented those regulations – specifically Pfizer Glaxo Smith Kline (GSK) and they had major influence on the proceedings as can be seen here.

Finishing with the reality that there are ethical issues within the scientific community as well – some associated with the “publish or perish” mantra and others associated with undue influence from funding sources/sponsor.   In one study done overseas that reviewed and surveys researchers globally, one in seven scientists said that they are aware of colleagues having seriously breached acceptable conduct by inventing results. And around 46 per cent say that they have observed fellow scientists engage in “questionable practices”, such as presenting data selectively or changing the conclusions of a study in response to pressure from a funding source.  Interestingly,  misconduct was far more frequently admitted by medical or pharmacological researchers than others, supporting fears that the field of medical research is being biased by commercial interests.  (2)

Summarised:  Research on ENDS that comes from the United States and the EU, especially from the former –  needs to be approached cautiously for its veracity and its ethical underpinnings.  This is not to say that research should not be considered from the United States particularly, but that research from there may be unduly influenced by commercial interests and profits – the protection thereof, as well as professional investment (scientists, some not all) and government revenue (protection of same) are the driving force behind much of the “science” as it relates to ENDS.  There are quite a few researchers in both the United States (Michael Siegel, PhD from Boston University) and the EU (Konstantinos Farsolinos, MD and his team at the Onassis Research institute in Athens) that not only conduct their own research, but review the research from around the world for its validity based on scientific method, ethical standards and process of funding.

NEW ZEALAND MINISTRY OF HEALTH CONCERNS – The Big Three

DISCUSSION: 

Nicotine – carcinogenicity, toxicity and harms:  Nicotine is a widely used addictive substance, which has a psychoactive effect and can be lethal in large quantities.  On the other hand, the long-term use of small quantities of nicotine in approved nicotine replacement therapy (NRT) products (such as gum, patches or lozenges) is considered to be safe.

The reference utilised by MoH to the justify above statement comes from a journal article that was a review of previous scientific articles with an emphasis on, as is in the title “dubious self-experiments in the nineteenth century.”  Accordingly, In the policy document, MoH references that  “The medium lethal dose is estimated to range between 6.5 and 13 mg/kg.” ^(6).  Current science disproves these figures and results, as discussed below. 

Nicotine is no more addictive than that of the caffeine contained in coffee and tea. ^(9). Although nicotine is the main psychoactive agent in tobacco, it has relatively minor health effects –  It is not a carcinogen, does not cause respiratory disease and has only minor cardiovascular effects. ⁽³⁾ Also, the nicotine used in ENDS, while it may contain small amounts of other chemicals including volatile organic compounds, carbonyls, aldehydes, tobacco-specific nitrosamines (TSNAs) and metal particles, research indicates that they are present at much lower levels than in cigarette smoke. ⁽⁴⁾  In normal conditions of use, toxin levels in inhaled ENDS aerosol are below prescribed threshold limit values for occupational exposure, in which case significant long-term harm is unlikely. ⁽⁵⁾

Lethal overdose of nicotine is rare as nicotine itself is an emetic and any ingestion of liquid nicotine diluent, such as that used for ENDS would result in vomiting. ^(7,8,9).  This also coincides with the issues the ministry holds regarding “dual use” of ENDS with combustible tobacco, that it may cause harm does not take into account the concept of “reduced harm”  There is no evidence of increased nicotine intake from dual use.  Smokers regulate their smoking behaviour in order to maintain the blood concentrations of nicotine within a comfortable range.  If those levels get too high, symptoms of nicotine toxicity – such as nausea, headache and dizziness can occur and smoking is then reduced.   A recent study found that smokers using ENDS maintain their intake of nicotine, but reduce their smoke and toxin intake, which results in an overall health benefit, therefore reducing harm through reducing exposure to the toxicants in combustible tobacco ^(10).  It is extremely difficult for someone to have a fatal overdose of nicotine through either ENDS use or through ingesting nicotine containing e-liquid due to nicotine’s inherent emetic qualities.

Promotion to young people:  Overseas evidence shows that promotion of e-cigarettes targeting young people through flavours, packaging may appeal to young people.   Local evidence that there is an increase in New Zealand youth trying e-cigarettes from studies in 2014 that DID NOT NOTE whether said use was with nicotine containing e-liquid or non-nicotine e-liquid.

The main issue with youth is harm reduction.  One cannot, in an unequivocal manner state that they can prevent youth from uptake or experimentation with any harmful substance of behaviour with 100% guarantee. “Common Liability”, as discussed by Bell and Keane, as it relates to the “gateway theory” defines this as the association between youth who are more risk takers and attracted to experimentation and more likely to try anything that seems to be “taboo” be it ENDS, alcohol, drugs, etc. ^(11).

With regards to the uptake of “vaping” in previously non-smoking youth, the available evidence does not support the “gateway hypothesis” that ENDS encourages nicotine addiction or uptake by youth.  In the UK, daily ENDS use in youth is almost exclusively confined to those who already use combustible tobacco daily and regularly.  Less than .2% of youth who have never smoked combustible tobacco have taken up vaping and there is no evidence of progression to smoking in this cohort. ^(12,13)

Keeping this in mind, as far as harm reduction and youth:  nicotine dependence in youth develops rapidly and over 50% of those youth who smoke daily are already nicotine dependent.   Young people who are already smoking can reduce their harm by switching to ENDS by 95%, as was shown in the Public Health UK Report.

Impact of vaping on others:   “vaping clouds may be a nuisance to others, especially in enclosed spaces” and “could have negative health impacts.”

With regards to second hand exposure concerns, the ministry needs to look again at the Public Health UK report that they referenced in their policy document.  Contained therein is a review that passive exposure to vapour have generally concluded that the risk to bystanders is very small and that Public Health England found that “ENDS release negligible levels of nicotine into ambient air with no health risks to bystanders.”^(14,15)­

As far as the argument that “vaping clouds could be a nuisance to others especially in enclosed spaces”, unless the government also wishes to regulate the use of body sprays, perfumes, and deodorants which are also a nuisance – and can be a health hazard to those who have respiratory difficulties and disease (unlike second hand vapour which has NO health harms associated with it ^(15,16) therefore this argument is not valid.

CONCLUSION:

his document we have covered the process of ENDS research as it is conducted in the United States and in Europe, outlining the questions that need to be asked of any science on this topic due to the insidious influence of both tobacco and pharmaceutical concerns on the subject.   In the environment of academic research, there still exists the “publish or perish” mentality which means that at times, researchers must approach their hypotheses and research methods to coincide with the funding providers point of view and/or their institutions mission statements and funding sources.   This is a reality at all research institutions worldwide, regardless of the topic.

When looking at the research and information on ENDS from a Public Health perspective, one needs to weigh the same five criteria that the Ministry utilised in their Drug Utensils policy document:  Harm Prevention, Harm Reduction, Proportionality, Ease of Implementation and Cost Effectiveness.   It is in the spirit of this point of view that we at AVCA have addressed the foregoing and will be utilising in our submission on Nicotine E Liquid and ENDS products submission that we will make in September in response to the Ministry.

Thank you for the opportunity to provide you with this information and should you require more in depth information or explanation, please do not hesitate to contact us as we wish to work with the Ministry on this process.

REFERENCES/BIBLIOGRAPHY:

1. Bradford, A. (2015, March 30). Science & the Scientific Method: A Definition. Retrieved August 08, 2016, from http://www.livescience.com/20896-science-scientific-method.html

2. Fanelli, D. (2009, May 29). How Many Scientists Fabricate and Falsify Research? A Systematic Review and Meta-Analysis of Survey Data. Retrieved August 08, 2016, from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0005738

3. Bell K, Keane H. All gates lead to smoking: the ‘gateway theory’, e-cigarettes and the remaking of nicotine. Soc Sci Med. 2014;119:45-52.

4. Zwar N, Bell J, Peters M, Christie M, Mendelsohn C. Nicotine and nicotine replacement therapy – the facts. Australian Pharmacist. 2006;25(12):969-73

5. Goniewicz ML, Knysak J, Gawron M et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014;23(2):133-9

6. Burstyn I. Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks. BMC Public Health. 2014;14(1):18

7. Mayer B. How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century. Arch Toxicol. 2014;88(1):5-7

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