Professor Des Cox:

They have probably been around for over 20 years but the explosion in the market occurred over the last ten years. That is down to technological advances with the products. We are on third or fourth generation devices now. That is one of the reasons there is confusion around the effects or impacts of e-cigarettes. Technology is evolving and medical science is constantly trying to catch up with it. That is why it is important not to look at one isolated study. We have to look at the bigger picture, involving large-scale population-based studies or collections where they have looked at a number of studies together. That is why people sometimes hear different messages about e-cigarettes.

There is enough evidence. I keep coming back to the HRB review but it is probably the best source of evidence we have. It was published in 2020 and the three main conclusions were that there is no evidence it is better than the standard treatments out there, that there is a three to five times increased chance of ending up using tobacco for those using e-cigarettes and that they are harmful rather than harmless. That is why the HSE in its new stop smoking guidelines has decided there is insufficient evidence to recommend them as quitting tools.

We may not learn the long-term effects for a while but there is evidence to suggest we should not hang our hat on such devices. If we are to get to a tobacco-free Ireland, we should push standard treatments and well-researched and evidence-based treatments, and support quit.ieand the people on the ground who help people quit tobacco. We should increase funding for them rather than looking to other devices.