A number of studies have shown that regular cigarettes are harmful to health. After this there was the worldwide trend of quitting smoking. Electronic cigarettes have recently emerged as a band-aid solution to regular cigarettes. However, some countries are restricting electronic tobacco because a lot of studies have proved that the electronic cigarette is unhealthy. Let’s check out how other countries deal with electronic cigarettes and how Korea does comparing to those countries.

Current situation of the electronic cigarette

The global electronic cigarette market is growing rapidly. According to the market analyst Euromonitor, the global sales of electronic cigarette exceeded $ 10 billion (about 7.3 trillion won) in 2017 from $ 7 billion (about 1.1 trillion won) in 2014. The World Health Organization (WHO) predicts that by 2030, the market size will reach 51 billion dollars (about 52.9 trillion won) a year. The portion of Philip Morris’s "IQOS" in the Japanese tobacco market jumped from 0.8 % in 2016 to 13.9 % in the fourth quarter of 2017, and also increased to 16.3 % in January 2018. This percentage is expected to continue to increase in the future. Currently, there are 18 million electronic cigarette smokers in the United States (14 percent of smokers) and 480,000 electronic cigarette smokers die annually. There is an economic loss of about 300 billion dollars (approximately 320 trillion won) per year because of the loss of life balance and the diseases caused by smoking cigarettes and electronic cigarettes.

Reasons of the spread of the electronic tobacco

The first is, the promotion of companies using people’s perceptions. Electronic cigarettes provide nicotine without burning tobacco leaves, so you can avoid cancer-causing agent from drying or burning cigarettes. The thing is you can still get satisfaction just like you would with smoking normal cigarettes. Unlike normal cigarettes, which produce nitrosamine which is a cancer-causing agent, and other carcinogens, electronic cigarettes only contain nicotine and harmless organic solvents (a kind of liquid organic chemical that can melt a substance). Companies promote electronic cigarettes with using these wrong perceptions of the public. The companies said that electronic cigarettes are non-carcinogenic, so they marketed and recommended electronic cigarettes as a substitute for regular cigarettes. But many studies have shown that this argument is wrong. The Korean Society for Research on Nicotine and Tobacco also pointed out that consumers often have the wrong perception about electronic cigarettes. In 2018, the Society refuted through a statement of position which shows that it is not true that electronic cigarettes are less harmful than regular cigarettes. 

Second reason is the various options of the scent. In 2017, the number of electronic tobacco smokers in the United States reached 18 million and 16 percent of them are high school students. The increase in the rate of smoking electronic cigarette among teenagers seems like it was caused by the indirect experience through adults around the students. About 39 percent of teenagers said that they smoked because of their family or friends. 33 percent of the students said that they started smoking electronic cigarette because of the variety of its smell, such as mint, candy, fruit, chocolate and so on. This smell makes it easy for teens to be attracted to electronic cigarettes. “The use of electronic cigarette products among teenagers is increasing because of the fragrant ingredients contained in the cigarettes," said executive director of the New York Tobacco Center. He also said, "The research of the different scents used in electronic cigarettes shows that the scents make more harmful effect on users”. In fact, after studying 145 electronic cigarettes, benzaldehyde, a respiratory stimulus substance, was 43 times higher than regular cigarettes (70.3μg). 

And the finally, public health is the reason of using the electric tobacco. Some people argued that the reason why electronic cigarettes are spreading especially in Korea and Japan is because of public morals for not to harm others around them. The companies promoted to Japanese, who value the consideration towards others, saying that the electronic cigarettes do not smell very much and the second-hand smoke of electronic cigarettes is not too bad for their health. Smokers are losing smoking spaces as the number of non-smoking areas continues to increase in Japan. Electronic cigarettes that do not smell as strong as the ordinary are popular because people can smoke outside of the smoking area. 

The consumption of the electronic cigarettes is increasing due to the positive image of the electronic cigarettes, but studies have proven that the electronic cigarettes are not good for health and related accidents are happening.

 Some problems of the electronic cigarettes

The first problem is harmfulness of the electronic cigarettes. " Electronic cigarettes contain carcinogens up to 82 percent of the ordinary cigarettes, " explains a research team from the University of Bern in Switzerland. Also, the researcher Orelly Berthett warned that electronic smoking releases grade 1 carcinogens. The team of Dr. Berthett measured the concentration of VOCs in the smoke produced by the electronic cigarettes and found that they contain nicotine, carbon monoxide, the 1st grade carcinogens like benzopyrene, and cancer-causing substances. In electronic cigarettes, formaldehyde, a first-grade carcinogens, was detected at an average rate of 3.2μg(microgram, one-thousandth of a million grams) per cigarette, which is less than the normal cigarettes(4.3㎍) but there is no significant difference (74.4 percent of the ordinary cigarette). The concentration of nicotine causing addiction was also 301㎍, but it was found to be similar to that of a normal cigarette(361㎍). Researchers at the University of New York's medical school found that mice which were exposed to electronic tobacco had much worse damage to their heart, lungs and bladder than mice exposed to the clean air. In addition, mice which were exposed to electronic smoking seemed their DNA recovery capacity declined, and certain DNA recovery proteins have significantly decreased in their lungs. Similar results were found in humans. The lung and bladder culture cells of the person exposed to electronic tobacco have more severe mutations and changes in tumor incidence than those of those who are not. These experiments show that although smoking electronic cigarette is less cancer-causing than smoking an ordinary one, electronic cigarette smokers may have a greater possibility of getting a lung cancer, bladder cancer or heart disease than non-smokers.

The danger of explosion is another problem. In May 2018, a 35-year-old man died in a fire caused by an electronic cigarette explosion in Florida. Investigators said that the accident caused burns to 80 percent of man's body, but the direct cause of death was the injuries from two chips of electronic cigarette stuck in his head. The exact cause of the explosion so far has been unknown, but it is assumed that the battery explosion inside the electronic cigarette is possible. According to the report by the U.S. fire Department, between 2009 and 2016, there were 195 fires involved in electronic cigarette, and there has been a steady explosion of electronic cigarette in the United States. In 2017, a man in Idaho, U.S., smoked an electronic cigarette and his teeth were damaged by an explosion in his mouth. In 2016, an electronic cigarette in a man's pocket exploded and burned his nails at Grand Central Terminal in New York City.  In Korea, three fires caused by electronic cigarette occurred in 2015, one in 2016, and two in 2017.

Regulations on electronic cigarettes in foreign countries

The World Health Organization(WHO) urges the electronic tobacco to be regulated just like regular tobacco products. Let's find out how other countries regulate the electronic cigarettes.

There are a lot of countries that have regulations for the electronic cigarettes. The first country is America. There is no regulation for electronic smoking to minors in the United States. Beginning in April 2018, the U.S. Food and Drug Administration (FDA) issued a measure to ban convenience stores and retailers from selling electronic cigarettes to minors. According to NBC News on April 25, the FDA has issued an electronic smoking sales warning to teenagers under 18 in 40 stores across the United States, including convenience stores, retailers and gas stations. The FDA also called on eBay, an online auction house known to sell a lot of electronic cigarettes, to remove some of the electronic cigarettes listed on its website. The FDA also asked ‘Juul’, the company which takes possession of more than 54 percent of the electronic cigarette market, to come up with marketing research and data to analyze why electronic cigarette is a trend among teenagers. In May 2018, the New Jersey State Government pushed ahead with a plan to increase the tax on electronic cigarettes by a large margin. The governor Phil Murphy's administrative budget included a 59 million dollar increase in taxes on tobacco products such as electronic tobacco for a year. According to this, the plan is to apply up to 75 percent of the tax on electronic cigarettes, also the tax on other tobacco products will be raised from the current 30 % to 68 %.

Singapore also has regulations. Singapore Health Ministry revised the Tobacco Advertising and Sales Regulations Act in November 2017 and enforced it on February 1, 2018. The revised law completely prohibits the purchase, possession and use of cigarette-like products such as electronic cigarettes and water cigarettes. A fine of 2000 Singapore dollars(about 1.63 million won) should be imposed just by owning an electronic cigarette. Regulations for Seller have also been tightened. If the sellers be caught selling electronic cigarettes in Singapore, they will be asked for up to 6 months of the prison labor and a fine of 10,000 Singapore dollars(about 8.15 million won). If they were caught again, the penalty and fine would be doubled. 

The last country is Japan. It was said that the Japanese government would add electronic cigarettes to the list of passive smoking regulations. Japan's Ministry of Health, Labor and Welfare announced that they are thinking about making new regulations such as a fine on electronic cigarettes in order to strengthen the second-hand smoking policy, before the 2020 Tokyo Olympics and Paralympics. It was said that the Ministry of Health, Labor and Welfare will submit a revised law for the Promotion of Nation’s Health within 2018 to a regular session of the National Assembly, including new second-hand smoking counterplan. The Ministry also said that the impact of the smoke containing nicotine on health cannot be overlooked in the revision of electronic cigarette legislation. Hospitals and schools will ban electronic cigarette, and restaurants will ban the cigarette in principle. However, stores that have a system which separates the smoking and non-smoking areas said that they are considering not being regulated. Since it was judged that the government does not have sufficient data to determine health effects on electronic cigarette, the government decided to review the regulations again in the future when it has more data. 

 Electronic cigarettes in Korea

The domestic electronic cigarette market is growing rapidly as the electronic cigarette ‘IQOS’ began to be sold in Korea in May of 2017. Electronic cigarette sales surpassed 70 million packs in 2017 and 20 million packs were sold in January 2018. The domestic electronic tobacco market is expected to grow from 30 billion won in 2017 to 150 billion won in 2018 and 900 billion won in 2021. The total market share of the domestic electronic cigarette was 2.2 percent in 2017 and will be 12 percent in 2018 and 18 percent in 2019. In 2020, the electronic tobacco will account for more than 30 percent of the total domestic tobacco market and secure half of the smokers in the long run.

According to the Ministry of Health and Welfare, beginning in December 2018, all smoking warning pictures and phrases on cigarette packs will be replaced and the warning picture would also be attached to electronic cigarettes. It is the first time in the world that the warning picture is attached to the electronic cigarettes. It was analyzed that the smoking rate of adult males decreased to 39.3 % last year due to the impact of the smoking warning picture introduced in December 2016, so the government decided to apply this system to the electronic tobacco as well. 10 different types of warning pictures attached to existing cigarettes will be raised by adding pictures of teeth discoloration. But there is strong opposition from companies. The companies said that the government had no discussions with them when the regulation was made, also the government omitted the process of hearing public opinions guaranteed under the Administrative Procedure Act. The companies also claimed that the government didn’t communicate with tobacco retailers and smokers. Accordingly, KT&G, Philip Morris Korea, and BAT Korea have submitted their own objections to the Ministry of Health and Welfare regarding the strengthening policy of electronic cigarette warning images. They argue that although there are different opinions between the companies, the level of warning pictures should be set according to the harmfulness identified by the government's scientific investigation. According to the tobacco industry, a total of 6-7 companies and associations have submitted objections to the notice of administration of the Ministry of Health and Welfare's "information on warning signs on cigarette packs and etc". On June 7, the government released a study about the harmfulness of electronic cigarettes, which further contributed to the government’s decision to put warning pictures on electronic cigarettes.

The spread of smoking electronic cigarettes has been growing in recent years, with increasing studies which have proven the dangers of those. Other countries are increasingly setting electronic tobacco regulations. Therefore, it would be wise for Korea to regulate electronic smoking more actively for the health of its citizens.

황희원  sso03134@naver.com

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