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Press Release: Tobacco Control Research and Knowledge Management Center (TRC) On 28 April 2014, Tobacco Control Research and Knowledge Management Center (TRC), Mahidol University, together with the Thai Health Promotion Alliance Against Tobacco supported by the Thai Health Promotion Foundation (ThaiHealth) held a press conference entitled: Alert: The Electronic Cigarette is a Cancer Risk at the Medical Association of Thailand.

Asst. Prof. Dr. Srirat Loeisamut, Faculty of Communication Arts, Rangsit University, reported on electronic cigarette consumption by adolescents aged 13 18. Nowadays, electronic tobacco products in Thailand are categorized into 3 types which are: (1) Electronic cigarette, (2) Electronic Baraku, and (3) Electronic cigar. Products of the electronic cigarette are currently very popular and available through social networks, in market areas, and at locations in front of shopping malls. The electronic cigarette is also available through social networks in all media such as on websites, Facebook, IG, Line and Whatsapp, especially on LINE with 1,300 IDs found selling electronic tobacco products. Electronic tobacco products are the most common products advertised via social networks such as VDO clips and introductions to smoke via Youtube, which gives viewers false/incomplete information on electronic cigarettes. The research results of a tobacco market of Pangrangconsisting of a sample group of adolescents aged 13 18 (2,426 persons) studying at high school level indicates that 78% of the sample group know about the electronic Baraku, 44% smoke the electronic Baraku, 12% smoke the electronic cigarette, while 42% smoke conventional cigarettes. 32% know about the electronic Baraku through various social networks, 67% buy it directly themselves and 18% buy it via social networks. Reasons for smoking are often based on wrong information and mistaken knowledge plus the deceptive appearance of electronic tobacco products which appear to be attractive products and mistaken beliefs that smoking electronic tobacco products is easier and safer than conventional cigarettes with no chance of addiction.

Dr. Katha Bantitanukul (Pharmacist), of the Smoke Free Pharmacy Network, discussed the topic, Does the electronic cigarette help one to quit smoking Currently, there are claims that the electronic cigarette is safer than the conventional cigarette since the conventional cigarette contains over 6,000 toxic substances while the electronic cigarette contains only nicotine. For this reason, more and more smokers switch to smoke electronic cigarettes. However, research results show that the electronic cigarette contains more concentrated nicotine than the conventional cigarette, and it becomes easy to become addicted. Smoking the electronic cigarette requires one to drop nicotine liquid into an electronic tube and it is difficult to control the concentrate of nicotine. For this reason, it is very dangerous to smokers who may be obtaining high doses of nicotine to the body. Nicotine is dangerous to the body because it causes acceleration in heart rate and may cause high blood pressure. Moreover, it has been found that burning propylene glycol in the electronic cigarette produces residues that may cause cancer. Commercial advertising suggests that the electronic cigarette is helpful in quitting smoking. However, academic review and opinions from relevant sectors indicate that the electronic cigarette has a low capability of helping smokers to quit smoking. This is not clearly stated since there is little research comparing the effectiveness of using electronic cigarettes versus using the Nicotine patch in helping people quit smoking. According to one research review, some studies are not reliable; sample sizes of smokers are quite small, and some people withdraw from the study during the research. For this reason, much of current research cannot be used in making a conclusion. Although there is research has showing that using the electronic cigarettes can help one quit smoking, it is a result of decreasing the smoking of conventional cigarette. However, smokers require larger amounts of smoking the electronic cigarette to do so, and this simply demonstrates an addiction to smoking the electronic cigarette.

Asst. Prof. Dr. Suthat Runanghirunya, Faculty of Medicine, Srinakharinwirot University, discussed the health effects resulting from electronic cigarette smoking according to recent research results. Research results indicate that the electronic cigarette is not safe for the health of users as quoted in current interactive marketing. Although found less toxic/dangerous to health than the conventional cigarette, the electronic cigarette contains several carcinogens (such as Diethaylene Glycol, Lead, Manganese, Zinc, Mercury, Arsenic and Cadmium) in amounts that can be dangerous to the body with continual use. Moreover, studies also found that smoking of the electronic cigarette can reduce lung function and breathing the same as with smoking the conventional cigarette. Recent research conducted through the collaboration of researchers from several major universities in the United States also found that after exposure to electronic cigarettes for only 5 minutes, human cells can have genetic changes and become cancer cells similar to changes when smoking conventional cigarettes. In addition, smoke of the electronic cigarette can also stick to surfaces of various materials including human skin, and there can be continual reaction with other toxics and other pollutants in the air resulting in these combinations becoming carcinogenic in the end. For long term effects on human health, these potential dangers are under study. So, it is clear that the electronic cigarette is not really safe as stated in its advertisements because there is not yet enough evidence about its possible harms.

Khun Soranee Chularsarekul, Mission Development Group, Department of Disease Control, Ministry of Public Health said that there are measures to control the electronic cigarette in Thailand since electronic cigarettes are against several laws. For this reason, the Department of Disease Control collaborates with the Custom Department, the Office of the Consumer Protection Board (OCPB), the Excise Department, the Royal Thai Police Headquarters, and relevant sectors uses processes of import of electronic cigarettes entering the country to control the prevalence of electronic cigarette use through indirect methods. These include controls using the following existing legal provisions: (1) import or taking products without tax paid, or to take limited products, prohibited products, banned products or products not having legally passed through the Customs Department into the country according to Section 27 of the Customs Act B.E. 2469 (1926), (2) help, hide, distribute, take, buy, pledge or receive in a secretive manner products known to have unpaid tax, prohibited products, banned products, imported to the country without passing through the Customs Department or that have avoided paying tax according to Section 27 of the Customs Act B.E. 2469 (1926), (3) having direct business without registering according to Section 54 of the Direct Sale and Direct Marketing Act B.E. 2545 (2002) for selling through websites, and (4) selling controlled label products without having labels or having incorrect labels according to Sections 30, 31 of the Consumer Protection Act, B.E. 2522 (1979). However, the Department of Disease Control and relevant sectors are trying to obtain solutions to modify the law to cover electronic cigarette through additional means.

Besides, Assoc. Prof. Nithat Sirichotiratana, Faculty of Public Health, Mahidol University, said that some electronic cigarettes produced or distributed in the market imitated models of cigarettes which is considered a violation of Section 10 of the Tobacco Product Control Act B.E. 2535 (1992).It states that no person shall be allowed to manufacture, import for sale or general distribution or advertise any other goods having such an appearance as to be understood as an imitation of such tobacco products as cigarettes or cigars under the law on tobacco or of the package of the said products.Violation is punishable by a fine not exceeding 20,000 baht.

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Coordinator: Haris Taweewatana, Tel., 0-2354-5346, 089-6627-917, Fax: 0-2354-5347 E-mail: haris.taw@trc.or.th