E-cigarettes and the potential impact on children in care

E-cigarettes and the potential impact on children in care

What is an electronic cigarette (e-cigarette)?

“An electronic cigarette is a battery-powered vaporizer which stimulates tobacco smoking by producing an aerosol that resembles smoke. It general uses a heating element known as an atomizer, that vaporizes a liquid solution known as e-liquid. E-liquids usually contain a mixture of propylene glycol, vegetable glycerine, nicotine and flavourings, whilst others release a flavoured vapour without nicotine”

(Wikipedia)

Current information and thinking around e-cigarettes

According to ASH- the charity, Action on Smoking and Health, it is estimated there are 1.3 million people who are currently using electronic cigarettes in the UK, although other figures have been quoted in excess of 2 million.  (www.ash.org.uk)

Research indicates that e-cigarettes have helped individuals cut down or give up smoking which is said to benefit health as they do not contain tobacco or the high levels of toxins found in traditional cigarettes. However, they are not yet regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and this will not happen until 2016.  This means, unlike approved nicotine replacement therapies such as patches and gum, they haven’t undergone all the rigorous tests needed to ensure their safety and effectiveness.

As e-cigarettes gain popularity, more agencies are beginning to realise the importance of having policies in place and health charities and agencies are becoming increasingly vocalised about the issues around the subject.  Shoosmiths (www.shoosmiths.com) who give guidance to employers about having an e-cigarette policy state “there is no conclusive medical opinion on the safety of e-cigarettes”. 

The British Medical Association (BMA) would like to see stronger controls used on e-cigarettes in line with traditional smoking. The World Heath Organisation (WHO) would like to ban e-cigarette use indoors, but Cancer Research UK states “there isn’t enough evidence to justify a ban on the use of e-cigarettes indoors”. (www.cancerresearchuk.org)  However, the charity agree there are still some questions about the safety of the chemicals that are in e-cigarettes, and say the current lack of regulation means there’s no way of verifying what’s actually in them, especially with so many different companies now entering the market.

The impact on children and young people in care

The Fostering Network (www.fostering.net) in association with ASH have produced a position statement about the use of e-cigarettes stating that it is “a shared policy position of those organisations working to protect the public’s health alongside those working to protect the welfare and interests of fostered and adopted children”. They conclude that whilst e-cigarettes produce a vapour, “there is no evidence to date that second hand vapour is harmful to human health”.  However, they do advise it is good practice not to use around children and young people until more evidence is gained about the effect of modelling smoking behaviour may have on young people.  

Protecting children from the dangers of smoking is a top priority for Cancer Research UK who says that in the UK alone, over 200,000 children under 16 start smoking.  They state “we need to find out more about whether e-cigarettes are attractive to children, particularly given the appealing flavours”.

The Child Accident Prevention Trust (CAPT) quote “Nicotine is highly toxic through ingestion, inhalation or skin contact, especially for young children. Ingestion of only a tiny amount can be fatal. A bulletin circulated to GPs and pharmacists in Northern Ireland in January stated that less than 2mls can be fatal for an adult, and warns that it is very likely to be even less than this for a child”. Furthermore they state there have been cases of children being poisoned, one fatally from liquid used for e-cigarettes (www.capt.org.uk ).

Finally, concerns have been raised about the safety of charging appliances in relation to e-cigarettes. The Electrical Safety Council (ESC) states “There have been a number of reported incidents involving e-cigarette chargers, with numerous reports of the chargers exploding whilst in use” and have listed some key points to reduce many of the dangers (www.electricalsafetyfirst.org).

Protecting children and young people in foster care
Dorset’s current policy on smoking does not include e-cigarettes and therefore, consideration should be given to whether this would be appropriate on the current information available.
It may be advisable to gather some information that gives a better idea as to how many foster carers or potential carers may use e-cigarettes. A provisional action plan to help protect children and young people in care is attached.

Conclusion
It is evident that the use of e-cigarettes in increasing and more companies are becoming involved with the marketing and production of the product. It is widely thought they can help to reduce or stop smoking traditional cigarettes which would beneficially impact on the health of the individuals.
No tobacco is used in an e-cigarette and therefore, it is seen as a safer option. However, agencies and charities are quick to point out that there has not been adequate research into the subject and it is uncertain exactly what is in the e-cigarette as they are not yet regulated. This is due to change in 2016 when they will be classified under the medicines and healthcare products.
Although it seems clear there is a risk to the health of children if they ingest liquids used from e-cigarettes, there is no current research to suggest the use of them per se is a concern to health. Fostering Network and the ASH organisation have jointly produced a position statement where they do not feel at this point that e-cigarettes should be banned in the fostering home. However, they recommend they are not used in front of children as they mimic smoking behaviour.  Their position will be reviewed in 12 months.
The ESC has also raised concerns that the paraphernalia used with e-cigarettes such as chargers can cause a fire risk in the home.

Advice for foster carers

We would ask you not to ‘use’ your e-cigarettes in front of children when at all possible.
The paraphernalia that charge electronic cigarettes can cause an increase in fire risk. You can avoid many of the dangers by following this simple advice:

• Follow the instructions provided by the manufacturer carefully – battery capacities and charging voltages vary according to manufacturer so it is important to check you are using the correct charger.

• Heed any warnings supplied with the product. Over-tightening of the screwed connection to the rechargeable battery can result in mechanical damage which can in turn create heat problems and possible failure.

• Ensure that e-cigarettes are not left charging for long periods of time

• Do not leave e-cigarettes plugged in overnight or whilst you are out of the house

• Look for the CE mark that indicates chargers comply with European Safety standards

• Please keep all e- cigarette paraphernalia out of the reach of children. The liquids used are dangerous and should be stored in the same way as prescription drugs.