What you need to know
Hundreds of fallen sick from vaping in the U.S. this summer and New York has just become the first state to ban e-cigarettes. But in Taiwan, e-cigarettes and Heated Tobacco Products were never legalized.
Translator: Andrew Maxey
Infographic: Yu Cheng-ying
New York banned flavored e-cigarettes on September 17 after hundreds of vaping-related breathing illnesses surfaced in the United States this summer.
In Taiwan, about 24,000 smokers die from smoking every year and nearly 2,600 non-smokers died from secondhand smoke. On average, one person loses his or her life every 20 minutes due to the harmful effects of smoking. Measures to reduce smoking have continuously been a focus of Taiwan's domestic policy, but in the wake of continuous innovation in e-cigarette and T-vapor technology, it seems that a solution is forever out of reach.
After implementing the Tobacco Hazards Prevention Act over a period from 1997 to 2009, Taiwan now prohibits smoking in most indoor places and mandates the printing of warning labels on tobacco product packaging, while promoting various efforts to help people to quit smoking. According to the Health Promotion Administration statistics, the adult smoking rate fell from 21.9 percent in 2008 to 14.5 percent in 2017.
However, there is a different trend among teenagers. Rates of e-cigarette usage among middle- and high-schoolers have shot up from 2 percent and 2.1 percent respectively in 2014 to 3.7 percent and 4.8 percent in 2016, nearly a double. Among adolescents who smoke e-cigarettes, the majority will go on to smoke cigarettes in adulthood. It is estimated that 52,000 of Taiwan’s youth currently use e-cigarettes, but there is currently no appropriate regulation in place.
Many people still believe things like “vaping isn’t smoking" or “vaping helps to quit smoking.” The News Lens is going to break down the components of these nicotine products and
- Contents: Tobacco + Combustion Agent + Various Additives
- Smoke Production: Burning Tobacco
To make traditional cigarettes, tobacco is dried, shredded, and then rolled into a cylinder with paper. When smoked, one end is lit while the mouth inhales the smoke created by its incomplete combustion at the other end. In the burning process, over 7,000 different chemicals are created, including nicotine, tar, nitrosamine, arsenic, and formaldehyde. Of these chemicals, at least 250 are known to be harmful, and more than 70 are known carcinogens. The carbohydrate in tobacco that hasn’t been fully burnt also produces tar, which contains a large amount of carcinogens.
A pack of cigarettes contains about 20mg of nicotine. In addition, not only is secondhand smoke generated by smoking a primary carcinogen, but even “thirdhand smoke,” the residue left on walls, furniture, and clothes, contains substances harmful to the body.
Secondhand smoke, also known as “involuntary smoking,” is a form of passive smoking. Thirdhand smoke refers to the contaminants left by smoking on the surface of objects and in dust. They can adhere to things like hair, carpets, window curtains, clothing, and food, but even if these invisible particles are dispersed, they will still be present in the environment.
Electronic Cigarettes and Vaporizers (Vapes)
- Contents: E-liquid + Flavoring + Nicotine. Different juices have different compositions, and there are more than 8,000 different flavors on the market today.
- Smoke Production: Heating E-liquid
As defined by the World Health Organization (WHO), the e-cigarette is a type of device that does not use combustion or contain tobacco but instead uses a rechargeable lithium polymer battery to power an atomizer that heats e-liquid (without burning it). This mixture of nicotine, propylene glycol, other chemicals, and heavy metals is boiled, creating vapor for the user to inhale. Due to the large variety of flavors, models, and functions, e-cigarettes have been very popular in recent years with young people worldwide.
Compared with the other harmful substances produced by burning tobacco, such as tar and carbon monoxide, the composition of e-juice is relatively healthier. However, the vapor contains high concentrations of toxic chemicals like propylene glycol, formaldehyde, acetaldehyde, and heavy metals such as cadmium. It can also be a carrier for illicit drugs such as methamphetamine or marijuana. Typically, a disposable e-cigarette can contain about 24 mg of nicotine.
Heated Tobacco Products (HTPs) or Heat-Not-Burn (HNB)
- Contents: Tobacco + Flavored additives
- Smoke Production: Heating, Not Burning Tobacco
HTPs are generally composed of three parts: a Heatstick filled with tobacco, a structural support, and a battery charger. Users would have to place the tobacco into the structural support and then heating it to a high temperature for inhalation. HTPs are something between regular cigarettes and e-cigarettes.
Philip Morris, the world’s largest tobacco company, claims that the technology in their iQOS product heats the tobacco to no more than 350°C, releasing nicotine in an aerosol form, which is different from the smoke created at 700°C and above by cigarettes. The company also claims that HTPs reduce the original amount of harmful or potentially harmful substances by 90 to 95 percent.
But some researchers stated that HTPs will produce an acutely toxic substance during their normal heating process — formaldehyde cyanohydrin — which is toxic even in low concentrations. And a study in Japan has also found the emissions of harmful compounds in HTPs to be similar to that of traditional cigarettes.
As Long As There’s Nicotine, Addiction Will Follow
Whether it’s traditional cigarettes, c-cigarettes, or HTPs, all of them contain nicotine, and they will not stop nicotine addiction.
Nicotine is an addictive substance that is naturally present in tobacco. When inhaled, nicotine will enter the bloodstream through the lungs, and can reach the brain in 10 to 20 seconds. It then stimulates the brain’s “pleasure center” through chemical processes.
Additionally, although HTPs and e-cigarettes are all classified as “non-combustion smoking products,” they do still reduce the amount of harmful substances in second- and third-hand smoke.
The U.S. Food and Drug Administration (FDA) has emphasized that no smoking products are safe. E-cigarettes, menthol cigarettes, smokeless cigarettes, cigars all contain chemicals harmful to the body.
In terms of Taiwanese regulation, cigarettes fall under the Tobacco and Alcohol Administration Act and Tobacco Hazards Prevention Act. E-cigarettes are considered "prohibited items" in Taiwan and HTPs are also presumably prohibited.
Taiwan currently bans e-cigarette sales. The Ministry of Health and Welfare interprets that due to e-liquid containing artificially added nicotine or other chemicals, it does not fall under the legal definition of tobacco products as “entirely or partly made of tobacco or its substitute as raw material.” Instead, the Ministry handles e-liquid containing nicotine as medicine.
If a type of medicine does not comply with the Pharmaceutical Affairs Act and is manufactured or imported without first obtaining a permit, it is classified as either a "counterfeit drug" or a “harmful drug.” According to the law, people who import or manufacture banned medicine can face up to 10 years of imprisonment.
Although some Taiwanese legislators wanted to loosen the regulation, they have not been able to amend the laws. The Ministry of Health has also pointed out that bringing electronic cigarettes into the country is not legal, and the products will be confiscated if found.
TNL Editor: Daphne K. Lee (@thenewslensintl)
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