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Obesity is currently the bête noire of the public health agenda, but smoking isn’t lagging that far behind.

How policy and regulation on e-cigarettes should evolve is a core element of the smoking debate – and regulators and policy makers are all too aware of their need to play catch up with this fast-maturing market and get a handle on the complex policy and regulatory challenges e-cigarettes pose.

Last week the Science and Technology Committee in the House of Commons questioned academics representing four tobacco companies on their research into the health effects of e-cigarettes, as part of the inquiry it launched last autumn on the topic. We were also presented with new research from Action on Smoking and Health (ASH) warning of a potential ‘revolving door’ between experimenting with e-cigarettes and smoking amongst young people.

Public Health England (PHE) had of course already fanned the flames of the e-cigarette debate earlier in February when, following the publication of updated independent evidence, it stated its desire for e-cigarettes to be prescribed on the NHS within the next few years, and also called for ‘an easier route’ for manufacturers to get a medicinal licence from the Medicines and Healthcare products Regulatory Agency (MHRA).

However, while PHE has been emphatic in its support for the use of e-cigarettes amongst smokers – stating that e-cigarettes are 95% safer than tobacco and are helping thousands of smokers to quit and stay smoke free – encouraging the use of e-cigarettes continues to divide opinion.

Irrespective of the broader debate on the social and ethical concerns surrounding e-cigarettes and the increasing influence of tobacco companies in the market, it’s argued that we’re still some years away from knowing exactly what additional risks e-cigarettes pose on people’s health over the longer term. The tobacco companies’ academics quizzed in last week’s committee session conceded that current judgements on where e-cigarettes sit on the continuum of risk between traditional cigarettes and nicotine replacement therapies are only ‘educated conjecture’ at present.

ASH has emphasised that further research is also needed to better understand how vaping and smoking behaviours are influenced. While they stress that vaping amongst ‘never smokers’ remains rare, the potential ‘revolving door’ they highlight will no doubt give policymakers pause for thought.

PHE has already said that over the coming years it wants to see investigations into the way e-cigarettes are being used in the community (including trials of e-cigarettes as quitting aids), long-term studies looking at cardiovascular disease, as well as further assessments of potential risks from less well studied chemicals in e-cigarette vapour such as the many flavourings and some metals.

In the face of increasing scrutiny, efforts to ensure research integrity and tackle the existing communications challenge around the health risks and benefits of e-cigarettes will be key focuses for the industry. Navigating the evolving NHS landscape poses a separate challenge for the industry to grapple with if e-cigarettes are to be prescribed on the NHS in the future.

The Science and Technology Committee is accepting written evidence to its inquiry into the topic for some weeks yet as it continues to hold further hearings, which provides a key opportunity for stakeholders to inform the debate on how the UK’s policy and regulatory approach to e-cigarettes should evolve.

However, the market isn’t standing still. The industry is already looking at the next generation of vaping products, which makes the challenge for policymakers and regulators to take steps to adequately address concerns over manufacturing and safety standards, as well as marketing and advertising practices, even more complex.

It’s clear that striking the balance between proportionate regulation of e-cigarettes which, on the one hand ensures product safety and enables and encourages smokers to switch to less harmful alternatives, whilst on the other also detects and prevents effects that counter the overall goals of supporting smokers to stop smoking completely and reducing smoking related death and disease, remains a formidable task.