The World Health Organisation (WHO) has called for a ban on the use of e-cigarettes in public places and in workplaces as recent reports estimate that there are now some two million users in the UK. 

E-cigarettes contain liquid nicotine which is heated inside the device to release vapour that the smoker then inhales or 'vapes'.  The devices are not a medical product or a foodstuff and are not categorised legally in the same bracket as traditional cigarettes.  As a result, they are not subject to the same regulations and there is a lot of debate over the risks. 

While there is widespread agreement that e-cigarettes are less harmful than traditional cigarettes because they contain fewer toxins, there is only very limited research on their effects, particularly over the long-term.  Nicotine itself is a toxin and e-cigarettes are not harmless.  Much controversy has surrounded the sale of popcorn or confectionary-flavoured e-cigarettes as these may become an entry point  for younger users to move on to smoking tobacco products. 

A report published by the Good Hope Hospital in Birmingham highlights the very real risks of nicotine as a substance.  A 2½–year old girl was treated in A&E at the hospital after licking liquid nicotine from an e-cigarette refill cartridge bottle.  She vomited shortly afterwards and appears to have recovered but the case is a clear warning that nicotine is poisonous and can be fatal. 

Andrew Clayton, a senior associate in Penningtons Manches' clinical negligence team expresses his concerns: "E-cigarettes potentially have a role to help tobacco smokers to cut down and quit harmful smoking , with clear benefits to their own health and reducing the burden on the NHS.  As Cancer Research UK warns that the demands on NHS cancer services are now at "tipping point", anything that reduces that burden would be welcomed. 

"But e-cigarettes are not without risks and far more research is needed to establish what those risks are, particularly over the longer term.  As the devices were invented only recently,  there are no available statistics on their effects on health beyond a few years.  Research is also needed to investigate how much e-cigarettes are being used to reduce tobacco smoking among those who were already using traditional cigarettes, rather than being taken up by 'new' smokers.  In the meantime, the case in Birmingham highlights the real dangers associated with liquid nicotine and e-cigarettes.  Tighter regulation is needed together with greater public awareness of the known dangers."