Organization : Ministry of Health
Type of Facility : Electronic Nicotine Delivery Systems (ENDS)
Country: New Zealand
Electronic Nicotine Delivery Systems (ENDS):
The World Health Organization defines electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems (ENDS) as:
“Electronic nicotine delivery systems (ENDS), of which electronic cigarettes are the most common prototype, are devices that do not burn or use tobacco leaves but instead vaporise a solution the user then inhales.
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The main constituents of the solution, in addition to nicotine when nicotine is present, are propylene glycol, with or without glycerol and flavouring agents. ENDS solutions and emissions contain other chemicals, some of them considered to be toxicants.
Although some e-cigarettes look like tobacco products (e.g. cigarettes, cigars, cigarillos, pipes, hookahs, or shishas), they may be produced in the form of everyday items such as pens, USB memory sticks or larger cylindrical or rectangular devices.”
Each device contains an electronic vaporization system, rechargeable batteries, electronic controls and cartridges of the liquid that is vaporized. The manufacturers report that the cartridges typically contain between 6 and 24 mg of nicotine, but sometimes can contain more than 100 mg. Nicotine is a psychoactive and addictive chemical that in excessive amounts (6.5-13.0 mg per kg of weight for adults and 0.1 mg/kg for children) can be lethal.
What is the Ministry of Health’s advice on using e-cigarettes?:
There is not enough evidence to be able to recommend e-cigarettes as an aid to quit smoking. The Ministry will be assessing new evidence as it arises, but in the meantime smokers should continue to use approved smoking cessation aids, such as patches, lozenges and gum, to help them quit smoking.
What is the current legal position on e-cigarettes?:
Medsafe has not approved any e-cigarette for sale in New Zealand. Therefore, it is illegal to sell an e-cigarette in New Zealand that contains nicotine. It is also illegal to sell an e-cigarette (with or without nicotine) that claims to help smokers quit, or an e-cigarette that looks like a tobacco product (or smoker’s pipe) to a person under 18 years old.
How does Medsafe categorise e-cigarettes?:
E-cigarettes are not an approved smoking cessation medication in New Zealand. Medsafe, the body that administers the Medicines legislation, has produced guidance on the legal status of e-cigarettes.
E-cigarettes are categorised depending on how they are presented for sale including the intended use claimed for the product by the supplier and whether this use has a therapeutic purpose as defined in the Medicines Act 1981.
** Electronic cigarettes are medicines when they are supplied for use as an aid to smoking cessation and with one or more cartridges.
** Electronic cigarettes are medicines when supplied with one or more cartridges containing nicotine even if they are not represented as aids to smoking cessation.
** Electronic cigarettes are medical devices when they are supplied for use as an aid to smoking cessation and without cartridges.
** Electronic cigarettes are not therapeutic products when they are supplied as a ‘gadget’ which consumers may choose to use as a social prop or as an item which is to be used interchangeably with cigarettes.
Medsafe has more information about the categorisation of electronic cigarettes on its website.
What is the World Health Organization’s advice on e-cigarettes?:
WHO has reviewed the existing evidence around ENDS, including electronic cigarettes. They also worked with national regulatory bodies to look at regularity options as well as toxicology experts to understand more about the impact ENDS may have on health.
On 27 August 2014, the WHO released a report based on this work. The report is on the agenda of the 6th Conference of the Parties to the WHO Framework Convention on Tobacco Control, which will be held on 13-18 October 2014 in Moscow. It sets out a number of issues and risks associated with ENDS, and recommends options for regulating the products.
You can find this report Electronic nicotine delivery systems (PDF, 228KB) on the WHO website.
The WHO report states that electronic cigarettes and similar devices are frequently marketed by manufacturers as aids to quit smoking, or as healthier alternatives to tobacco, and require global regulation in the interest of public health.
Among other conclusions, the document found there was currently insufficient evidence to conclude that e-cigarettes help users quit smoking or not. Therefore, WHO currently recommends that smokers should first be encouraged to quit smoking and nicotine addiction by using a combination of already-approved treatments.
In addition, existing evidence shows that e-cigarette aerosol is not merely “water vapour” as is often claimed in the marketing of these products. While they are likely to be less toxic than conventional cigarettes, e-cigarette use poses threats to adolescents and foetuses of pregnant mothers using these devices.
E-cigarettes also increase the exposure of non-smokers and bystanders to nicotine and a number of toxicants, the report says