Vapes contain toxic levels of heavy metals

There are growing calls to clamp down on the underage sale and branding of e-cigarettes. A BBC investigation found that vapes confiscated from school pupils contained dangerously high levels of lead, nickel and chromium. Health officials are concerned. Linda Bauld is a leading public health expert and a social policy advisor to the Scottish government.

Linda - It's not terribly surprising to me because we always know with age-restricted products you're going to have an illicit trade. And when you have an illicit market you can have constituents in the products which can be harmful. The three things that have been identified in the lab. So lead obviously has a detrimental effect on the brain. That's why we've banned lead in pipes and lead in petrol. In relation to nickel and chromium as well, those are class A carcinogens. And nickel, we know in particular, the effects on lung health can be serious. And then chromium of course can be used in small amounts, trace amounts as a supplement for people with diabetes and pre-diabetes. But at the higher levels they've found here. We also know there are effects on the liver and a number of potential health harms. So I think an acute exposure to the levels they've identified in the lab is probably not going to cause irreparable harm to young people, but chronic exposures would do and that's a worry. So cracking down on illicit trade is a priority.

Chris - We seem to be in a difficult position with this, don't we? Because on the one hand we've got positive health messaging around vaping. This is much better for you in terms of health threats than smoking. But on the other hand, it's being pushed at youngsters to addict to the next generation of people who might have smoked, but instead they're turning into vapers.

Linda - Yes, and we always knew this was a risk. I mean, we've been monitoring youth vaping from the beginning of the products being rolled out and we were surprised that we didn't see a rise in youth vaping over the years because the US and others had expressed more concern about it. There was quite a bit of experimentation, but regular use was not going up. But then we saw this big shift really during the pandemic period and with the new advent of these disposable devices, which are used by 69% of young people aged 11 to 17 compared to 7% in 2021, they've clearly driven a big uptick. And the reasons for that are that they're cheap. The main disposables were about £2.99. You can get them for even cheaper. They're really bright. There's loads of flavours. They're marketed at the point of sale because we've removed the tobacco displays. So vaping products are very visible and they're also discreet. So what we've seen is this rise. The rise in young people who've used vaping once or twice is now up to 11.6%. That was 7% just in 2022. Current use, so people who say they're vaping at the moment, jumped up to about 8% last year and it sort of stayed at that level and that was a rise from the year before.

Chris - We seem to be very slow off the mark on this though, because I was having a look at what other countries are doing because other countries have also experienced a big increase like we have. You mentioned America earlier, I know Australia have, New Zealand have seen a tripling in the number of kids who vape in recent years. Their regulations and legislations appear to be far more stringent than ours though. Even in China where many of these products are made and then shipped here for our kids to consume, they're completely illegal there. So why are we so slow to react?

Linda - It's actually not that we've been slow, it's that we had a different paradigm. So most of these countries have a fear of nicotine. They don't prescribe nicotine replacement therapy to pregnant women, to people with coronary heart disease, to young people. If you know, you can get NRT on prescription if you're age 12 or above in the UK. The priority is to get adult smokers to quit because we had the highest rates of smoking back in the fifties and sixties and it's taken us decades to get down to lower levels. The priority is the smokers. We thought that other countries were panicking about the youth and imposed too stringent measures. But now the chickens have come home to roost. We're now faced with a rise in youth. So I think the policy approach that we took, which was to prioritize harm reduction and smoking cessation, we're now going to need to shift.

Chris - The genie is really well and truly out of the bottle, isn't it? Can we get it back in though? What can we do now so that these very significant numbers of young people who, many of them openly admit that they are consumers of nicotine because they're addicted. What can we do now to try to stop this getting any worse?

Linda - I'm confident we can put the genie back in the bottle because we did it with tobacco. So we need to apply the same regulatory tools and basically you impose policy so you could do the extreme and you could ban this category of products, disposable vapes, also on environmental grounds. They're thrown in the street, they're hugely damaging to the environment, incredibly difficult to recycle. Or you could be a little more subtle and say, okay, what we're going to do is we're going to increase the price. Increasing prices is a big driver for young people not to buy a product. But then you'd also need measures for the illicit trade because that can be an unintended consequence. You can do things about point of sales, not making them as visible or accessible in shops. You can also take action on the labeling, the packaging, the colours, the flavours, the four P's. I always go back to - product, place, price and promotion.