Young adults and e-cigarettes: a qualitative exploration of awareness, experience and attitudes

11 Regulation of e-cigarettes

11.1 This project did not specifically aim to explore the views of young adults on the regulation of e-cigarettes, but this was a subject which came up spontaneously in a number of early focus groups and so was covered more proactively in later groups. Given the timing of the fieldwork for this study (December 2015-February 2016), participants may have been aware of recent changes in legislation in England and Wales, proposals to regulate e-cigarette sales in Scotland, and the planned introduction (at an EU level) of the Tobacco Products Directive - all of which received some media attention in autumn 2015.

11.2 This chapter begins with a discussion of general attitudes and awareness relating to regulation. However, the individual aspects of regulation which came up most often in discussion were: use of e-cigarettes in enclosed public places; sales to and use by children; product safety and consumer protection; and taxation. Each of these is addressed in turn in the sections below. ^[19]

General attitudes towards, and awareness of, regulation of e-cigarettes

11.3 Comments from participants indicated a broad level of support for regulation of e-cigarettes in principle, whether that was in terms of product regulation, or regulation of sales and use. Young adults expressed concerns about a range of issues such as product safety and health implications, use of e-cigarettes in public places and use of e-cigarettes by children and young teenagers, and often commented on the apparent absence of current regulation. Across all the groups, some compared e-cigarettes with cigarettes and felt a similar regulatory framework should be in place.

11.4 While there was a general consensus on the need for regulation relating to product safety and age restrictions, views were more mixed with regard to regulation of use in enclosed public spaces. In addition, some participants queried the feasibility of regulation, given the prevalence of online and non- UK suppliers, and home-made or modified devices and e-liquids.

11.5 Those who expressed reservations about regulation in general tended to be younger participants who were concerned that e-cigarettes might be 'banned'.

11.6 There was, however, a degree of uncertainty amongst participants with regard to the current regulatory framework covering e-cigarettes. In general, participants appeared to believe that the sale of e-cigarettes to those under the age of 18 was illegal, ^[20] and that using e-cigarettes in enclosed public places was at the discretion of owners or managers. However, not everyone was confident in their knowledge and some asked for clarification of the law on, for example, age-restrictions on the sale of e-cigarettes, whether using e-cigarettes in cars with children was permitted and whether e-cigarette use was 'technically' banned in pubs.

11.7 One participant (a smoker-vaper) indicated during the discussion that he thought that statutory regulation of e-cigarettes was due to be introduced in the UK - specifically in relation to restrictions on cartridge sizes and the amount of e-liquid that could be purchased. ^[21] This information was offered spontaneously, and was not asked systematically of all participants.

Using e-cigarettes in (enclosed) public places

11.8 Using e-cigarettes in (enclosed) public places was an issue of some debate in the discussion groups, with a range of views expressed. There was some confusion about what was allowed, but most commonly participants believed (correctly) that restrictions were at the discretion of individual owners and operators of premises.

11.9 E-cigarette users reported varied experiences of using the devices in public places. Most commonly they had used them on public transport and in the workplace and pubs and clubs. Other places people had vaped included ice rinks, cinemas, football grounds, shops and shopping centres, and school/college. However, people reported that they had encountered a range of different rules and regulations with regard to indoor use, and there was also a clear view that change was underway, with e-cigarette use being banned in an increasing number of places. Participants were, though, often aware of 'vape-friendly' venues. They also reported rules being regularly disregarded with little apparent consequence, and in some cases admitted doing this themselves, for example, in a pub or using an e-cigarette discreetly at work.

11.10 There appeared to be a general acceptance of restrictions on e-cigarette use: e-cigarette users often expected to have to ask if vaping was permitted in a particular place, and accepted the need to respect the views of others. There was also a degree of 'self-regulation' with regard to e-cigarette use: this included not vaping in the presence of non-vapers and non-smokers; asking permission to vape; choosing to vape outside for social reasons or because they enjoyed the ritual of 'going for a fag'. Vaping enthusiasts were amongst those who advocated self-regulation - this appeared to be associated with promoting a positive image of e-cigarette use.

11.11 Some smokers and vapers offered a slightly different rationale for supporting restrictions on using e-cigarettes in enclosed public spaces, arguing that it could be seen as unfair if vapers were treated more favourably than smokers.

11.12 Those opposed to restrictions on using e-cigarettes in enclosed public places were generally vapers (although one non-smoker also expressed this view), and they offered two main arguments: (i) there was no scientific evidence that the vapour was harmful and a ban was therefore not justified on public health grounds; and (ii) being able to use e-cigarettes indoors was one of their attractions and removing this option could reduce the incentive to switch from tobacco cigarettes (this second argument was also recognised to some extent by non-smokers). Some highlighted the irony of vapers sharing outdoor shelters with smokers. (There was one example provided of a workplace providing separate shelters for vapers and smokers.)

11.13 Non-smokers expressed mixed views on the use of e-cigarettes indoors. Some did not like it when people vaped around them, some were happy to tolerate it in moderation, and others said they were 'not bothered' by it. The balance of opinion in these groups, though, was in favour of restrictions on where e-cigarettes could be used - some thought this was needed for health reasons, some for courtesy reasons, and others wished to see consistency with smoking restrictions.

Product safety and consumer protection

11.14 Chapter 8 discussed participants' views on health and safety concerns. Some had suffered minor injuries or knew of others being injured as a result of using an e-cigarette. It was also common for participants to express concerns about the possible long-term health effects of e-cigarette use. In this context, they often commented on what they perceived as poor or inadequate existing regulation of devices and e-liquids. There was strong support for the introduction of greater controls to ensure products were safe, both in the short term and with regard to long-term health impacts. Participants were particularly keen to see greater regulation of the contents of e-liquids.

Children and e-cigarettes

11.15 The research identified a range of concerns about the use of e-cigarettes by children and young teenagers.

11.16 As discussed in Chapter 7, participants across all groups had seen children using e-cigarettes and expressed concern about this. Younger research participants reported e-cigarettes having been used at school, and some said they had seen e-cigarettes being used by children as young as 10. In most cases, people were concerned about children being exposed to possible unknown health risks, given that e-cigarettes were such new products. Very occasionally, participants said they knew of young teenagers who had progressed from e-cigarettes to tobacco cigarettes.

11.17 Participants also expressed concern about young people being impressionable, and vulnerable to advertising campaigns and promotions. Indeed, as discussed in Chapter 5, participants who used - or had experimented with - e-cigarettes reported being attracted to them because they thought they looked 'cool', or by flavours such as bubble gum and Irn Bru.

11.18 Given these concerns, there was a clear view expressed by participants that there should be age-restrictions on the sale of e-cigarettes to deter and prevent use by children. Discussions suggested that participants generally believed there were already restrictions in place at the time of the research, although some, including vapers, were uncertain about this.

11.19 Although younger participants were most likely to have been given their first e-cigarette by someone else (usually an older relative) most also had experience of buying e-cigarettes, and did not report significant difficulties in doing so. Just two participants mentioned being asked for ID when buying e-cigarettes; one of these participants thought it was harder to buy e-cigarettes than tobacco cigarettes which he thought somewhat ironic given the use of e-cigarettes as a smoking cessation aid.

11.20 Although there was strong support for steps to be taken to discourage e-cigarette use amongst children, there was also an alternative view that e-cigarette use by teenagers may, in fact, be useful if it prevented them from taking up smoking - a counter argument to concerns about the 'gateway theory'. (See Chapter 7.)

Taxation

11.21 The issue of taxation occasionally arose in discussions with smokers and vapers groups. Those who offered views were concerned about the possibility of e-cigarettes being taxed or were cynical about the government's possible motives in considering this option. Participants were concerned that taxing e-cigarettes would increase the price and deter use; they thought this would be counterproductive, given that e-cigarettes were mainly being used as smoking cessation aids. Some participants thought that the government might consider taxing e-cigarettes as a way of making money out of people's addictions, or as a way of compensating for revenue being lost as a result of reduced tobacco sales as people switched to e-cigarettes.

Advertising

11.22 Participants occasionally commented on advertising of e-cigarettes. Those that did indicated a growing awareness of e-cigarette advertising, and an impression that it depicted e-cigarettes in a favourable light. Some smokers and vapers thought that e-cigarette marketing should be subject to the same kind of regulation as tobacco cigarette advertising.