E-cigarettes should not be advertised — we don't even know how dangerous they are

A young woman in an evening dress looks into the camera and, as she runs her hand seductively over her body, says: “You know that feeling you get when something’s great. You can touch it, hold it, even see it. Well now you can taste it”. She then places an object in her mouth, inhales, holds it briefly, before exhaling a white cloud.

In fact, the object she describes is not a cigarette but rather an electronic nicotine delivery system (ENDS), commonly marketed as an e-cigarette. The white cloud is not smoke but rather vapour containing nicotine and flavouring. It’s easy to be fooled. So easy that the advertising company that created it – Peppermint Soda – described it on twitter as “the first smoking advert to be shown for half a century”.

The broadcasting of this advert confirmed the worst fears of those who are concerned about the massive marketing push behind ENDS, with tens of millions of dollars spent in the US in recent years. As a report from a group of US Senators concluded: “e-cigarette manufacturers are aggressively promoting their products using techniques and venues that appeal to youth.”

Their report described many examples of highly sexualised imagery being used to promote ENDS including a now notorious advert in Sports Illustrated, in which the logo of the Blu brand, owned by Imperial Tobacco, is emblazoned on the front of a bikini bottom.

The advocates of ENDS seem unperturbed by these developments. They argue that everyone who uses an ENDS instead of a cigarette is reducing their risk of death. Well, maybe. But it isn’t that simple. First, it assumes that the only people who are affected by these adverts are hardened smokers who would otherwise be unaware of any benefits purported to be associated with ENDS.

Yet surveys show that 90% or more of smokers are aware of these products. The information they want from an advert is whether it is safe and effective, which these adverts definitely do not give them. Nor can they, because the evidence that ENDS are any better than nicotine replacement therapy, itself of only limited effectiveness, simply does not exist. And we don’t have any idea what the effects of inhaling nicotine, now known to promote tumour growth, or any of a large number of food additives for 30 or 40 years.

The only conceivable rationale for these advertisements is to promote the imagery of using ENDS as cool, just like the way that movie stars in the 1950s, many paid by the tobacco companies, would slowly blow smoke into the air. The tobacco industry knows that such imagery encourages smoking among children, with its now internal documents demonstrating the cynicism with which it exploits the power of the moving image. The US campaign Smoke Free Movies catalogues its methods in great detail.

The likely consequences of these adverts are well recognised. Within two years they will be illegal, as the European Union’s Tobacco Products Directive is implemented. One of the greatest successes of the public health movement is to show the true imagery of tobacco, with diseases lungs and users dying unpleasant premature deaths. Unfortunately, by using ENDS as a Trojan Horse, the tobacco industry is undoing the good work.

Martin McKee is Professor of European Public Health as London School of Hygiene and Tropical Medicine