In September the Drug Foundation made submissions on two Ministry of Health consultation documents: Policy Options for the Regulation of Electronic Cigarettes and Review of Drug Utensils Regulation. An overview of key points is provided here, with the full submissions available for download. These were based on the Drug Foundation’s mandate to promote an evidence-based approach to policies aimed at reducing drug-related harm.
The main focus was on the evidence available in support of a stand-alone Act, regulation of certain ingredients and the prohibition of advertising at least until more is known about long term effects.
The international NGO community focusing on tobacco control appears to be divided on the issue of e-cigarettes. Research released by Public Health England indicates that e-cigarettes are less harmful than tobacco cigarettes by a wide margin. However, the rate of e-cigarette development means that research has not been able to keep pace with associated the health impacts. In particularly there has been insufficient time since e-cigarettes been available to determine the long-term impacts. Therefore e-cigarette regulation therefore needs to be agile, sensitive to this uncertainty, and responsive to new findings and innovation.
Despite emerging consensus that e-cigarettes are less harmful than regular cigarettes, their potential harm is not fully understood. Although various compounds found in e-cigarettes have been identified as food safe, or simply less harmful than in tobacco, substances used are subject to thermal degradation leading to inhalation of chemical that are toxic or even carcinogenic. Limited testing carried internationally has revealed wide variations in the toxicity of contents and emissions.
There is limited evidence on the effectiveness of e-cigarettes in reducing or replacing smoking of tobacco cigarettes. Use of e-cigs may perpetuate the habit of tobacco cigarette in existing smokers by continuing addiction to nicotine and there is potential for the new form of smoking to provide a ‘gateway’ for non-users by normalizing or entrenching smoking behavior.
The Drug Foundation suggested restricting the sale of e-cigarettes to those 18 years and older. And pointed out that given advertising is problematic therefore it warrants further consideration. Until a thorough investigation is completed, advertising of e-cigarettes should be prohibited.
A strong recommendation called for is the passage of a stand alone Act which focuses on the manufacturing, selling and advertising of e-cigarettes. Support was also expressed for the regulation of some e-cigarette ingredients such as nicotine.
A ban on drug utensils on harm minimization grounds is not supported due a lack of evidence. However, there is sufficient evidence, mainly from Canada and the UK, to highlight the importance of access to drug utensils and their correct use in reducing risk by people who choose to use drugs. The main utensils that are supported in the submission are vaporisers, bongs and crack kits.
The Drug Foundation endorsed the Ministry’s description of the current regulations as impractical and pointless. There is a wide range of normal household items that can be used for drug taking. Users shouldn’t be additionally penalized for the using traditional methods, especially when some utensils (e.g. vaporisers), have been shown to reduce harm to health.
The Ministry’s summation of the current regulation as neither proportionate nor compassionate is considered accurate. It is particularly concerning that the maximum penalty for possession a drug utensil is greater than that for possessing illegal drugs. Some utensils have the potential to reduce harm for drug users and having a conviction severely narrows opportunities such as finding employment, travelling and being granted credit.
The Law Commission’s recommendation to remove the offence of drug utensil possession is supported. There is no known evidence that this offence deters drug use or drug-related harm.
Drug-related harm results primarily from factors including types of drugs used, means and patterns of use, context of use and users’ personal characteristics. Prohibiting possession of drug utensils does not help address these important factors.
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95% of respondents reported positive effects, in a study that looked at both prescription and black market cannabis use.