These days, admitting you’re a smoker is like it would have been declaring you’re gay 15 years ago. People almost recoil, wonder how you could do that and say to their friends that they always had their suspicions anyway. However, now a smoker can become less of a pariah by switching to electronic (e-) cigarettes – demonstrating that almost everything is ‘e’ these days (or maybe ‘i’ if you are of the Apple persuasion). Apparently these may also be referred to as ‘electronic vaping devices’, ‘personal vaporizers’ (PVs), or ‘electronic nicotine delivery systems’ (ENDS). We’ll just refer to them as e-cigarettes.
E-cigarettes give you the nicotine fix without all the other toxic chemicals that go with the real thing. Tubular in shape and tending to look like a traditional cigarette (surely a missed opportunity?), they deliver a measured dose of nicotine for each inhalation. Take a drag and a nicotine solution in a cartridge is heated and vaporized by a battery-powered device. Simple: no smell, no tobacco breath and none of the sort of secondary smoking by people around you as occurs with traditional forms of tobacco use.
Are these things safe? Well for sure they avoid the toxicity of tobacco smoke. The solution that is vaporized contains propylene glycol and/or polyethylene glycol, the safety of which with long-term use is unclear. Thy are thought to be safe in small amounts, although propylene glycol is used too in things like hydraulic fluid and antifreeze.
How e-cigarettes are viewed by officialdom varies around the world. Generally they can be used legally, although regulations vary regarding advertising, sales to minors and use in public places. Notably Australia bans sales locally but permits its citizens to import from abroad. In the US the courts have resisted efforts by the FDA to bring e-cigarettes under its regulatory regime on the grounds that they are not therapeutic devices. The manufacturers argue anyway that their target audience is smokers and not those seeking to quit.
Nevertheless the medical community is pushing generally for tighter control of these products primarily on the grounds that the long-term effects are unknown. But doctors also point out there is no standardization of product information in terms of presentation and content, and there are marked variations in the quantity of the nicotine dose available.
Opinion is divided on whether e-cigarettes can be a significant part of the journey to giving up tobacco. The naysayers point out that the devices perpetuate the ‘held-in-hand, raised-to-mouth, etc’ routine of the classic cigarette. Others say they are a step in the right direction, and there are folk who say they have helped them quit. If you are a nicotine addict with some sort of chronic smoking-related health problem then ‘going e’ is surely better than persisting with the real thing.
There is also the view that smoking in any form encourages people, especially younger people, down the road to illicit drug use. This one is always going to run and run, but note that in most US states you don’t have to be 18 to buy e-cigarettes and that some of the products have candy flavouring, potentially increasing their attraction for younger age groups.
How should life insurers and their underwriters view e-cigarettes? They are not ‘tobacco products’ (they contain no tobacco) but they should fall into the same category as nicotine patches and gum. If you want to exclude users from your non-smoker insured group it worth checking that your definitions are up to the mark. Exclusion in this way does make sense in that users are most likely to be those with a history of tobacco use and who are at risk of reverting to traditional smoking. (But actually, will this always be the case? E-cigarettes might create a market of new users, maybe through kids liking the nicotine effect coupled with candy flavours… but then there may be a risk of ‘graduating’ to tobacco proper.)
How you handle e-cigarettes in the context of medical conditions, particularly respiratory and vascular disease and those risk factors predisposing to the latter, is down to what your underwriting manual says. On the face of it there is a case for a more lenient view that would otherwise have been the case, but it depends on how big that risk is of quitting ‘e’ and going back to simple burning of tobacco. This does need researching.
In fact the whole subject is worth keeping track of . In the meantime, we suspect that if you relish a pipeful of rich, pungent shag or enjoy relaxing of an evening with a Romeo y Julieta, vaping on an electronic nicotine delivery system won’t really do it for you.