1. What’s going on?
The Trimbos Institute has bundled several studies and has come to the conclusion that there is increasing evidence that the e-cigarette for young people is a ‘stepping stone’ to tobacco cigarettes.
“More and more studies show that children who use an e-cigarette, afterwards also start smoking regular cigarettes,” physician-epidemiologist Esther Croes of the Trimbos Institute tells RTL Nieuws.
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2. Is the use of e-cigarettes dangerous?
The tobacco industry and doctors disagree. Tobacco is burned with a regular cigarette. The substances that are released thereby cause (lung) cancer and cardiovascular disease. Electronic cigarettes, on the other hand, vaporize a liquid that usually contains nicotine and a flavoring agent.
An e-cigarette lacks many of the toxic combustion products of tobacco, but harmful substances such as nicotine and propylene glycol are released in the vapor, according to the Trimbos Institute. This vapor may contain traces of toxic and carcinogenic substances, which may have adverse health effects.
“You don’t want children to ingest carcinogenic substances,” says Wanda de Kanter, a pulmonologist at the Antoni van Leeuwenhoek Hospital and activist against the tobacco industry. “And you don’t want children getting addicted to nicotine either.”
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The problem is that we don’t know enough about the safety of e-cigarettes in the long term, says De Kanter. “The annoying thing is that there is something new on the market that you don’t know if you can cause heart and lung damage in the long term. Tobacco cigarettes also took twenty to thirty years to develop a lung cancer epidemic. “
In the United States, hundreds of people already suffer from an unknown lung disease that is probably related to the use of an e-cigarette. That does not mean that we should also be concerned: Europe has very strict standards when it comes to production. For example, the e-cigarettes they use in America contain much more nicotine.
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3. But, now everyone knows that e-cigarettes are also bad?
Most adults do, thinks Croes of the Trimbos Institute. “This is a completely different story for young people. They often think that they are not addicted or that it cannot be so unhealthy because of the fruity flavors.”
“These flavors give children the impression that it is a harmless product. They do not think that e-cigarettes still contain nicotine and that it is an addictive substance.”
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4. How many people smoke e-cigarettes?
Users of the e-cigarette are mainly adults who smoke, have smoked and / or want to quit, and young people. In 2018, 3.1 percent of adults in the Netherlands used an e-cigarette, according to figures from the Trimbos Institute. 4.3 percent said they were a former e-cigarette user.
More striking are the figures about young people. In 2017, 27.5 percent of students between the ages of 12 and 16 used an e-cigarette, and 44 percent of MBO and HBO students between the ages of 16 and 18. There are not (yet) precise figures about how many Dutch young people regularly use the e-cigarette.
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5. Why is the e-cigarette so popular among young people?
That is undoubtedly because of those flavors, says Croes. But also due to nicotine salt in some new models of e-cigarettes.
“Nicotine is dirty at first and causes a nasty itch in your throat,” says Croes. “But if you soften it with nicotine salt and a taste, you will no longer notice it.”
According to pulmonologist De Kanter, it also has everything to do with marketing. In the Netherlands, no (electronic) cigarettes may be advertised, but the tobacco industry finds creative solutions for this, says De Kanter. “Influencers pose with e-cigarettes on social media, for example. That marketing is entirely aimed at children.”
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6. What is already happening to discourage use among young people?
Shops may not sell (electronic) cigarettes to young people under the age of 18. The Dutch Food and Consumer Product Safety Authority (NVWA) regularly performs age checks by so-called mystery shoppers to deploy.
If shops do sell their products to young people under the age of 18, fines will follow. This starts with a fine of 450 euros, but can go up to 45,000 euros or closing the store.
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7. What else should be done?
According to De Kanter, there are also positive developments. For example, a majority in the House of Representatives supports a plan to reduce cigarette sales in petrol stations and supermarkets to zero next year.
“E-cigarettes may then only be sold in tobacconists. As a minor you will not get in that quickly and the number of points of sale will decrease drastically.”
Croes and De Kanter also believe that the fruity flavors should be banned. “Stricter legislation on flavors is important. I suggest banning flavors that young people like,” says Croes. But is that allowed just like that? “This has already been done with tobacco. Menthol will soon disappear, other flavors are already prohibited.”
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