Paidamoyo Chipunza Senior Health Reporter
Just like fruits, they come in different flavours. They have no smoke, no smell and no ash but only vapour. Pink bubble gum, peach, watermelon, maple, banana, strawberry and vanilla are some of the more than 7 700 flavours that come with e-cigarettes – a modern fashion statement among young tobacco users across the globe.

Some of the flavours such as vanilla, bubble gum, banana are appealing to children while others appeal to youths and women.
Invented around the 2000s, e-cigarettes have taken the world by storm and are being marketed as smarter compared to traditional cigarettes.

According to local distributors, e-cigarettes are also cheaper in the long term and can be smoked anywhere since they do not produce smoke hence address fears of second hand smoking.

In Zimbabwe, the Public Health Act Chapter 15:09 of 1996 and Statutory Instrument 264 of 2002 stipulates that smoking in public places such as halls, public offices, buses, schools and commuter omnibuses is prohibited.

The Forestry Act Section 81 actually makes it a criminal offence to smoke in public.
E-cigarettes cost between US$25 and US$50 in Harare while traditional cigarettes cost an average of US$1,50 a pack of 20.
With traditional cigarettes, a chain smoker can take an average of 10 a day.

The monetary advantage of e-cigarettes is that some of them are rechargeable.
Zimbabwe has not been left behind in this new trend.

Since their introduction on the local market last year, e-cigarettes are now a common feature in some supermarkets and night clubs.
The e-cigarette comprises a plastic cartridge that serves as a mouthpiece and a reservoir for liquid, an “atomiser” that vapourises the liquid and a battery.
While electronic cigarettes do not actually burn any tobacco, they are designed in such a way that when the smoker inhales, they activate a “flow censor” which releases a water vapour containing nicotine, propylene glycol, and a scent that stimulates the flavour of tobacco.

While proponents of e-cigarettes argue that cancer causing agents found in traditional cigarettes such as tar, glue, and other additives and hydrocarbons are absent in e-cigarettes, health experts feel there has not been enough research to consider them safe.

“We certainly do not yet have all the answers as to their long-term health impact, but what we do know is that they are much safer than cigarettes,” Professor Ann McNeill, lead author of the National Addictions Centre, said.

Speaking to journalists at a recent lung health workshop organised by the National Press Foundation under its J2J programme in Barcelona, Spain, the Union Against Tuberculosis and Lung Disease technical advisor for tobacco control, Mrs Myra Wisotzky said the main challenge of e-cigarettes is that they have not been on the market for so long hence there are few studies on their long term health effects.

Ms Wisotzky said although they are being marketed as a step in the direction to quitting smoking, these claims are not scientifically proven.
“They deliver lower levels of some of the toxins found in cigarettes but the long-term effects of exposure to e-cigarette vapour and to nicotine in the cartridge is unknown,” she said.

She added that the only few studies available showed that propylene glycol in the e-cigarettes vapour can cause eye and respiratory irritation.
Nicotine, she added, is the main culprit of addictive smoking in the traditional cigarettes and can impact negatively on foetuses in pregnancy, lead to heart diseases and can promote growth of tumours.

It is, however, believed that the nicotine in e-cigarettes is much lower than that used in traditional cigarettes.
“In some brands, the level of some cancer causing agents is high as in the smoke produced by some cigarettes,” she said.

While they say vapouring an electronic cigarette is almost similar to smoking a traditional cigarette, Mr Charles Gotora of Harare – who once used the e-cigarettes – said he did not have much confidence in the products.

He said he vapoured the cigarette for at least two weeks last year after their introduction and did not like its sensation, which he believed triggered a cough thereafter.

“When these products were introduced on the market, as a smoker I said why not give it a try, which I did.
“The vapour came with an irritating sensation on my throat, which then triggered a cough.

“I tried it again and I had the same experience until I dropped them. In a way I think they may have health implications,” said Mr Gotora.
The world now is divided on the use of e-cigarettes. Some experts welcome their use as a pathway to the reduction of tobacco smoking but others characterise them as products that could undermine efforts to de-normalise tobacco use.

According to the union, e-cigarettes therefore represent an evolving frontier, filled with promise and threat for tobacco control.
“Long-term health effects are unknown at this time because e-cigarettes have not been in widespread use long enough for assessment,” said Dr Christopher Zishiri, Zimbabwe country for the Union Against Tuberculosis and Lung Disease.

The Union therefore strongly supports regulation of e-cigarettes preferably as medicines or ban advertising, promotion and sponsorship, prohibit their use for tobacco cessation.

According to the Zimbabwe Demographic Health Survey 2006, 12 percent of Zimbabweans smoke, a majority of whom are males.
The Zimbabwe Global Youth Tobacco Survey (2008) further notes that at least one in 10 students use any tobacco products and 3,2 percent smoke cigarettes.
It also supports the position that prohibits their sale in retail stores, sale to minors, prohibit flavours appealing to children such as bubble gum, vanilla candy.
It also said although they do not produce smoke they should be prohibited from use in public places and workplaces just like traditional cigarettes.
The Union also calls for setting of consumer safety standards for the cartridges, packaging and labeling consistent with those for medicines and inclusion of clear information and warnings on the products’ proven health risks, ingredients and usage.

The World Health Organisation (WHO) adopted a decision at its Conference of Parties Framework Convention on Tobacco Control held in October this year that efforts should be made to prevent initiating e-cigarettes use by non-smokers and youths.

In its resolutions, the WHO also agreed to minimise potential health risks to e-cigarettes users and protect non-users from exposure to their emissions.
It also banned the use of unproven health claims from being made about these products.

WHO also urges parties to consider banning or restricting advertising, promotion and sponsorship of e-cigarettes.
WHO’s resolutions came after it was realized that while the products are banned by some countries such as Brazil, Hong Kong and Malasia others such as UK, New Zealand and Sweden treat them as medicines while the use of e-cigarettes in countries such as USA, Egypt, India and Ireland is unregulated.
WHO director general Margaret Chan said: “One company used this year’s World No Tobacco Day to call on WHO, and call on all of your governments, to promote electronic cigarettes as a way of protecting some of the lives that they themselves are killing with the other products they sell.”
According to the Zimbabwe Demographic Health Survey 2006, 12 percent of Zimbabweans smoke, a majority of whom are males.

The Zimbabwe Global Youth Tobacco Survey (2008) further notes that at least one in 10 students use any tobacco products and 3,2 percent smoke cigarettes.
The global tobacco epidemic kills nearly six million people each year, of which more than 600 000 are people exposed to second hand smoke, also known as passive smoking. WHO estimates that about 8 million people would have died by 2030 due to tobacco unless action is taken.

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