SINGAPORE - We thank Dr Andy Ho for his commentary ("E-cigarettes: Better to regulate than ban them outright"; June 24).
Britain's Medicines and Healthcare Products Regulatory Agency (MHRA) has indicated its intention to regulate electronic cigarettes as medicinal products by 2016.
The British government has concerns about the safety of e-cigarettes and their effects on long-term health. The British Medical Journal on June 14 reported that it accepted the findings of the Commission on Human Medicines that e-cigarettes currently in the market do not meet appropriate standards of safety, quality and efficacy.
The MHRA has recommended that people do not use e-cigarettes currently in the market as their safety and quality are not assured.
Similarly, the Ministry of Health (MOH) and the Health Sciences Authority (HSA) are prepared to consider allowing e-cigarettes under appropriate regulation, should the manufacturers be able to demonstrate that their e-cigarettes meet the requisite standards for quality, safety and efficacy.
This has been the longstanding position for all products used for smoking cessation (that is, nicotine replacement therapy), which include the nicotine inhaler that is already approved for sale through a pharmacist or from a doctor.
In the meantime, until there is more substantive clinical evidence of their quality, safety and effectiveness, the MOH, Health Promotion Board (HPB) and HSA urge the public to refrain from using e-cigarettes and to discard any they have in their possession.
A study conducted by the HSA in 2011 also found poor consistency between actual nicotine content and the amount labelled among the different e-cigarette products.
The World Health Organisation has stated that it does not support e-cigarettes as a legitimate therapy to help smokers to quit as many of the marketing claims for e-cigarettes are not supported by evidence.
Smokers who would like to quit smoking should use methods that have been proven safe and effective, such as undergoing smoking cessation counselling, going cold turkey and using nicotine replacement therapy.
Additional advice can be obtained through a toll-free Quitline on 1800-438-2000 or at HPB's website www.hpb.gov.sg/smokefree
Lyn James (Dr)
Director of Epidemiology & Disease Control
Ministry of Health
Acting Director of the Tobacco Regulation Branch
Health Products Regulation Group
Health Sciences Authority
Chris Cheah (Dr)
Deputy Director (Substance Abuse) of the Adult Health Division
Health Promotion Board
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