Japan: Alarming Spread of E-cigarettes Prompts Calls for Regulations

Source from:  Asahi Shimbum (jp)  07/02/2014

A pale fog filled the air of a small club in the trendsetting Harajuku district of Tokyo, where close to 50 men and women had gathered for a party.

A table of five or six men at a table tucked away in a nook of the venue were all smoking electronic cigarettes containing nicotine. And they all acknowledged they have taken advantage of the various loopholes and gray areas of Japanese laws to support their habit.

"E-cigarettes are better because they involve less thirst for nicotine than tobacco," one of the men said. "My nicotine intake has fallen."

E-cigarette use is rising in Japan, and authorities have yet to even define the product and its accessories, leaving gaping questions about regulations on sales and age limits for users.

The Pharmaceutical Affairs Law prohibits unauthorized sales and transfers of nicotine, which it defines as a "drug." But the men at the Harajuku club said they import the nicotine solution used in e-cigarettes from overseas dealers in a private capacity to bypass the legal regulations.

They added that they usually buy vaporizers in Japan because they are not covered by law.

An e-cigarettes is designed to receive a solution in the vaporizer, heat it with a coil heater and generate white vapor for inhalation. Users can mix in nicotine, agents with flavors of cakes or fruits, glycerin to increase the amount of vapor, propylene glycol to smooth passage in the throat and other ingredients into the solution.

The health ministry has said in a notification to prefectural governments based on the Pharmaceutical Affairs Law that an individual can import up to one month's dosage of nicotine solution for personal usage, or 120 milliliters, at one time.

One dealer of vaporizers said that volume of Western-made nicotine solution is available for around 12,000 yen ($118), whereas a vaporizer can be bought for several thousand yen to several tens of thousands of yen.

The dealer said sales in Japan have soared sharply since about a year ago.

The party at the Harajuku club on April 26 was organized by a 35-year-old man who had just opened up his own dealership. He sold nearly 50 vaporizers at the venue.

A number of dealers said e-cigarettes without nicotine became fashionable in Japan when tobacco taxes were raised four years ago and people wanted to quit smoking.

While the current boom represents a second wave, many users are inhaling nicotine through their e-cigarettes, the dealers said.

The men at the table in Harajuku said they got to know each other through an online bulletin board, and had switched from conventional tobacco two or three years ago. For one man, e-cigarettes have done little to stop him from smoking.

"The end of a burning tobacco cigarette gives you a reason to go back to work," he said. "With e-cigarettes, however, you just keep on smoking."

AN AGE-OLD PROBLEM

In Mito, the capital of Ibaraki Prefecture, e-cigarette vaporizers and related goods were on display in a corner of a tea leaf shop housed in an old wooden building facing a prefectural highway.

Nariaki Numata, the 39-year-old shopkeeper, started the business in July 2010. He said he has monthly sales of 8 million yen, mostly from online retailing, a tenfold increase year on year.

Exquisitely designed vaporizers were previously in vogue in Western countries. Numata said he started receiving a flood of orders after he began importing products in May 2013 to significantly expand his shop lineup.

He said a long-distance truck driver came all the way from Hokkaido to shop at his place.

But there are reasons to be worried, he added.

A group of boys in school uniforms arrived one evening during a holiday period and asked Numata's mother, who was tending the shop, to sell them e-cigarette vaporizers.

Numata's mother declined the boys' requests, telling them that vaporizers are intended for adult users. However, there is no legal ground for banning minors from using them.

"I only want to sell goods within the confines of the rules," Numata said. "I want laws to be developed against use by minors."

CALLS FOR REGULATIONS

The Law on Prohibition of Smoking by Minors bans those aged under 20 from lighting up. But the National Police Agency said there is no consensus on whether e-cigarettes with nicotine should be legally classified as tobacco products.

The Finance Ministry, which oversees the tobacco industry, said e-cigarettes with nicotine do not represent tobacco products. Health ministry officials said they can do nothing unless the Finance Ministry changes its stance.

The U.S. Centers for Disease Control and Prevention estimated that 20 percent of adult smokers and 10 percent of high school students have used e-cigarettes in the United States, where e-cigarettes with nicotine are available on the market.

Experts have differing opinions on whether e-cigarettes represent a less-harmful alternative to tobacco.

"There's no doubt that (e-cigarettes) have fewer risks than the real thing," said Michael Siegel, a professor of community health sciences at the Boston University School of Public Health. "The available therapies, such as nicotine patches and gum, only address the pharmacologic aspect of the addiction. But by simulating smoking, e-cigarettes also address all of the other behavioral aspects of the addiction. That is why these innovative products have such a potential to change the tobacco market landscape."

He said tobacco smoke is known to contain about 250 toxic ingredients, such as tar and carbon monoxide, whereas e-cigarettes contain fewer chemicals and pose lower health risks than tobacco.

"Regulations that treat e-cigarettes exactly the same as tobacco cigarettes will actually serve to protect the existing cigarette market and to preclude the possibility of a major transition from combustible products to noncombustible substitutes," Siegel added.

But Stanton Glantz, a medicine professor with the University of California, and his colleagues said 10 chemicals have already been identified in mainstream or sidestream e-cigarette vapor that are known in the state of California to cause cancer, birth defects or other reproductive harm.

"E-cigarettes do not deliver 'pure nicotine' and 'harmless water vapor,'" Glantz emphasized.

The World Health Organization also maintains that neither the safety of e-cigarettes, nor their efficacy for helping people to quit smoking, has been scientifically proven. It said the electronic devices could even entice consumers with its illusive safety and end up getting them addicted to nicotine.

The U.S. Food and Drug Administration on April 24 proposed a rule that would define e-cigarettes as tobacco products, ban their sale to minors under 18, and require FDA approval for their sale.

A New York City ban on the use of e-cigarettes in public places took effect on April 29. The state of Minnesota has been levying tobacco taxes on e-cigarettes since 2010.

Yumiko Mochizuki, chief of the Division of Tobacco Policy Research with the National Cancer Center in Tokyo, said Japan should take immediate action to pre-empt an uncontrolled spread of e-cigarettes.

"Governments of the world have helped reduce smoking rates through bans on smoking in public places, bans on advertisements, higher taxes and other measures since the United States became the first country to officially recognize the negative health impact of smoking 50 years ago," Mochizuki said. "E-cigarettes have emerged through gaps of those measures and spread rapidly across the world.

"Many countries are being slow in regulating them and are leaving them readily available to minors. Japan should address the problem promptly before e-cigarettes gain full currency." Enditem