Today we are launching our Challenging Prohibition campaign to oppose vaping bans. Read on to find out why, and how you can help.
Vaping bans send out the wrong message
Vaping is not covered by UK anti-smoking legislation yet every day brings more news of vaping being subjected to the same prohibitions as smoking.
Vaping bans are not just inconvenient for e-cigarette users, they are dangerous and cost lives.
Treating vaping as smoking feeds the widely-held misconception that vaping is just as harmful and deters people from switching to the far safer alternative.
Vaping policies need to be carefully considered
We aren’t arguing that vaping should be permitted everywhere but we do want employers and managers to carefully consider their policies around vaping, instead of imposing the knee jerk blanket bans which are becoming all too common.
We want Public Health England to take a stronger lead in guiding employers and managers to craft vaping policies appropriate for their circumstances.
We want an end to no-smoking signs which include vaping, especially those which refer to “smoking” an e-cigarette and those which falsely state that it’s illegal to vape on premises.
We want hospitals to at least follow the recommendations of the tobacco control plan, and not to include vaping in their “smoke free” regulations.
We want vaping to carry on working for people as it has for us - which means fostering an environment where vaping is at least tolerated - though not one where vaping is used as a stick to force smokers to switch.
We need your help to make this work.
Please look at our Challenging Prohibition pages, you can find them here.
The What you can do page includes actions you can take to challenge bans, such as writing to your local council, complaining to companies and helping to get positive vaping sign images into internet search results.
We have had some “vaping welcome” window stickers made up and we are selling them on eBay, here. Our Vaping welcome signs page has several sticker designs in various colours. which you can download and print or post on your social media accounts.
You may have already seen the video "a conversation about e-cigarettes". Here’s a short clip from it where Gerry Stimson, Chair of NNA, talks about why it makes no sense to ban vaping in public places, and how bans can be avoided by using simple common sense. Please share this video, where you can.
Four years ago, almost to the day, I was sat at the back of this room, vaping discreetly as requested, and trying as hard as I could to be invisible. I’d only been vaping for about 6 months but I was already an active participant in a massive consumer movement against EU regulations, which originally were medicinal in every way except in name.
Just a month before that first summit vapers had succeeded in overturning the impending regulation and they did it simply with their stories. Thousands of people wrote to their representatives in the EU parliament and told them about their switch from smoking to vaping, and the improvements that had made to their health and their lives.
In those days we felt as if we had few if any allies. Huge, multi-national industries with vested interests in either smoking or smoking cessation were lobbying against us. Vocal members of the public health community were denying the truth of our experiences and even our existence, things which we saw with our own eyes day after day.
And yet here I was, sat in a room with hundreds of others watching academics and other experts come up on this stage and say what we already knew, that vaping should be embraced, not feared and had the potential to change the lives of millions.
Passionate vapers are a diverse crowd but we all have some things in common. We want to share our experiences and protect something we love. We also want to ensure that other people will have the opportunity to make the choices that we made, when the time is right for them.
We want lawmakers to understand why that regulation they think is such a wonderful idea really isn’t. We understand this because we created this. It was vapers who took the original e-cigarette, pulled it apart and turned it into something that works. Through thousands of informal channels such as forums and YouTube reviews we pushed industry to improve designs and options and we still do so today.
The independent vaping industry has always been incredibly sensitive to the needs of consumers – and you know why? Because most of them are us. The only difference between us is the fact that their enthusiasm took them the extra step of setting up in business.
So when you see our rowdy revolution remember that what you’re seeing is people trying to stop you fucking it all up. In order to do that some of us have also had to take an extra step – to become almost full time advocates.
The challenges for consumer advocates in this area have been massive and often over-whelming. We are all ex-smokers and let me make this clear, we are resentful of the way that smokers are treated. We naturally rail against coercive methods of forcing smokers to quit, and detest the stigmatisation of smokers that always goes hand in hand with those methods.
And yet we congratulate and support those who make the switch from smoking to vaping, just as public health might anyone who successfully quits smoking. It could be said that our goals are the same – but our ideas about how we get there are often very different.
Because of these differences getting a seat at the table has often been difficult. In the UK NNA has been lucky to have the support of Public Health England, which has opened a great number of doors for us, but has also caused suspicion within the vaping community. In my time in advocacy I have been called a troll, tobacco shill and a brain damaged addict, and that’s just by people in public health, and at the same time been accused of being in cahoots with tobacco control by people on my own side of the fence. None of those things are true but it certainly makes life interesting..
Many consumer campaigns are libertarian and pro-choice in nature and vaping is certainly no exception. The phrase ‘just bugger off and leave us alone’ screams through my head on a regular basis. The freedom to choose what we want to do with our own bodies is vitally important to us, and it’s being eroded.
But vaping is more than just a pro-choice campaign. Whilst many vapers do regard it simply as a more pleasurable alternative to smoking, many others place more importance on the reduction in harm to their health, or the ability to use e-cigarettes to stop smoking. It’s not easy to represent all of these views without attracting criticism from one direction or another.
But these things are not mutually exclusive. If vaping is a pleasant alternative to smoking, people who choose to switch or take up vaping instead of smoking are minimising the harm they do to themselves, whether or not that was their intention.
And this is why engagement between vapers and public health is important for both sides. For public health vaping should be an important harm reduction tool. But like all tools, it won’t work unless you understand how and when to use it. And it won’t work for us if public health try to turn it into something that it isn’t. So what isn’t it?
The word ‘pleasure’ seems to be something of an anathema to some in public health. One of the biggest challenges for consumers is in getting regulators, and those who advise them, to understand that for a great many people vaping is not a medicine, or simply a smoking cessation intervention, it works precisely because it isn’t those things. It works because they enjoy it.
They love the personalisation that’s made possible by the diversity of the market in devices, and the thousands of flavours available. They enjoy the identity of being a vaper and the sense of community that that entails. They love that vaping is similar to smoking, but at the same time a million miles away from it.
But it’s important to remember that for many people vaping is purely functional. They can’t or don’t want spend much money on devices, aren’t interested in personalisation, or being part of a community. They just want something that works. To them all this choice can be a daunting prospect, and they may find the whole vape culture intimidating. Hell I do too sometimes.
For some of those people a good vape shop can make all the difference because they can try out products with the assistance of real world expertise and support. For others the answer may be the confidence an ecig friendly stop smoking service can offer, where they can receive impartial advice together with behavioural support.
If public health truly wants to maximise the benefits of vaping it must recognise all of these experiences as equally valid and equally valuable, as must industry. Both should be asking themselves ‘what can we add’, not ‘what can we restrict’. Start asking the right questions – not ‘does this work’ but ‘why does this work’ and how can we help more people to make it work for them.
Talk to vapers. Listen to and learn from their experiences. Get a better understanding of what motivates people to smoke and to vape (here's a hint: it’s not all, or evenly mostly, about addiction). Talk to smokers and find out what the barriers are to switching, and work out how to help them overcome them, if that’s what they want to do.
There are already researchers working in these areas, but their voices are being lost in the cacophony of politicised junk science press releases that grab the headlines every day.
One area where public health really does need to up its game is public perception, and I don’t just mean on relative risk. Tobacco Control policies have led to the stigmatisation of smokers on a scale that would not be accepted against any other minority.
The public hates smokers, and now it hates vapers – not because they believe the vapour is harmful, but because to them vapers are just those awful smokers getting around the rules. They’re vaping where they shouldn’t be and they’re not even getting horrible diseases to punish them for their bad habits.
This sort of prejudice has led to wide spread restrictions on vaping despite the fact that there is no statutory ban in this country. Many vapers don’t want the public’s sympathy just as people who have, or are trying to give up smoking. We’re used to the fact that the public has no sympathy for smokers, ex or otherwise. What vapers want is a lot more tolerance of something that barely affects anyone else.
Vapers are, on the whole, perfectly capable of working out where vaping is, and isn’t appropriate, and also of being considerate. But why should they have any respect for organisations such as the numerous NHS Trusts who, despite the fact that they apparently supported the recent Stoptober campaign which included e-cigarettes as an option, place a blanket ban on vaping, even in outside areas.
Don’t even get me started on local authorities, you can read about their abysmal efforts in a new report out two days ago from the Freedom Association.
What message do these policies send to smokers? Why should they believe that vaping is any less harmful than smoking if vaping is treated in the same way? Why would any smoker consider switching from one restricted and despised activity to another one? They may as well carry on smoking.
One of the biggest divisions between consumers and public health, and also within public health itself is the play off between reducing harm for current and ex smokers and preventing a new generation of nicotine users.
All too often it is clear that the choices which adults may make, whether that be for reasons of health, wealth or pleasure are considered less important than theoretical and most likely minimal risks to theoretical future children who theoretically may take up vaping.
Many consumers would question why a new generation of nicotine users is even a problem, seeing as there is no credible evidence that a gateway effect exists, and the world doesn’t seem to have a problem with new uptake of similar stimulants such as caffeine.
Of course, in absolute health terms it's likely to better to not inhale anything other than good clean mountain air. Or drink anything other than spring water, or eat anything other than a perfectly balanced diet which probably involves kale smoothies. But out here in the real world many of us don’t want to live like that – we want to enjoy what time we’ve got.
We want to enjoy enjoy a nice chilled glass of Sauvignon Blanc without thinking about breast cancer. We want to be able to take our kids to see the spectacle of the big red lorry at Xmas without being branded irresponsible parents. We want to be able to make our own choices based on accurate information and we want public health messaging to stop sucking the enjoyment out of everything that for us, makes life a little less dull.
But there’s more to this story. In every area I’ve just mentioned there are people whose ultimate goal is not to inform, or educate the public, or even to nudge them into making better choices. There are people in influential positions in tobacco control who are so determined to destroy the tobacco industry rather than allow it to evolve or adapt they’ll do it at any cost – including the health and wellbeing of those who might otherwise turn to safer alternatives.
No doubt the tobacco industry is deserving of its reputation, but fighting their lies with your own lies leaves only consumers as collateral damage. Don’t for one minute think you are doing smokers any favours if you lie about the safer alternatives just because the tobacco industry sells them.
All of the major tobacco companies are now investing in Harm reduced products and yes, I know that they’re still selling cigarettes and fighting tobacco control efforts around the world. But change, especially in an organisation as large and as complex as the tobacco industry, with its share holders to answer to, takes time.
Never forget that it's not just the industry who would have to transition to safer products, its smokers too. And for harm reduction to be successful on the scale that public health would like to see, smokers have to want to – as America will find out if it continues on its current course, you can’t force them. Nor should you.
So if you must fight the tobacco industry, fight them with truth. Make sure that their customers know that a safer alternative is available and where their customers go they will have to follow.
Hold them to account. If they say they want their business to transition to safer products make sure they continue in that direction. But be pragmatic. This won’t happen over night and it won’t happen at all if you continually block them simply because of who they are.
So is it possible to engage at any level with the tobacco industry and remain credible? All too often we see good people with valuable alternative views dismissed not because there is anything wrong with what they say, but with the use of smears and innuendo concerning tobacco industry influence.
Earlier this year Derek Yach announced the formation of the Smokefree Foundation, an organisation which would, basically, take a billion dollars of PMIs money and use it to fund independent research into harm reduced products. Predictably, as we heard earlier from Professor Etter, the idea has been panned by many in tobacco control. Also predictably, the idea of PMI funding a push for a ‘smokefree world’ hasn’t gone down well with pro-smoker groups.
The suspicion and antipathy on both sides is completely understandable and it’s right to be cautious, but if the foundation fails it is, once again, the consumer who loses out. Well funded studies with proper independent oversight are vital in empowering consumers to make an informed decision. They might also go a long way to counter the deluge of junk science that is constantly hitting the headlines.
Whilst giants like the FDA, the World Health organisation and even the EU Commission are sinking huge amounts of resources into funding science to support their restrictive policies on harm reduced products, other Funders, like Cancer Research UK, do seem to be asking the right questions and in the coming years we should see some really good science come through. But for many people this will be too little, too late. The damage in terms of policy and public perception will already have been done.
Consumers are impatient for good quality science and frankly, many of us don’t care who pays for it – for us, tobacco control hasn’t proven itself any more trustworthy in that area than the tobacco industry. Just think on that for a minute.
And what of the media’s schizophrenic treatment of e-cigarettes – where does that come from? Is it any surprise that the public is confused about the risk posed by e-cigarettes when almost on a daily basis they alternate between miracle cure and the work of the devil.
All too often the reason for this seems to stem from two things: policy based evidence making and research impact scores. Combine those two things with the fact that journalists rarely have time to look beyond the press release and bad news sells newspapers better than good news and you have all the ingredients for a public health balls up on a monumental scale.
But where is the accountability? When will someone pay for the harm the scaremongering is causing by denying consumers a balanced and accurate view.
Many countries, some of which are leaders in drug harm reduction, seem to struggle with the concept when it comes to tobacco. Similarly, the World Health Organisation, despite the fact that it supposedly embraces harm reduction, certainly doesn’t embrace e-cigarettes or any other tobacco harm reduction product I can identify.
We watch dumbfounded as this organisation lauds the actions of various notorious world dictators yet refuses to engage with the only stakeholders who matter – consumers.
To us, many policies around the world on e-cigarettes seem insane and to vapers in countries outside of the UK, UK vapers must seem very lucky – and maybe we seem ungrateful. Believe me we are not - but we worked hard for it.
We see what could have been. We see the choices that are taken away from people by the arbitrary and counterproductive restrictions on reduced risk products in the TPD. We see our smoking friends being put off of vaping by the appalling media coverage And where policies are formulated that would punish smokers into switching to vaping we see them becoming resentful and entrenched.
The UK is without doubt a world leader when it comes to e-cigarette policy but it has yet to get to grips with other harm reduced products. Snus is currently banned here and watching the regulators circle around heat not burn is like watching a very wary cat sizing up its prey.
There are other practically harmless nicotine products sold elsewhere in the world that are not sold here because the manufacturers fear that the regulators are hostile. The recreational nicotine landscape is shifting in favour of better public health, but the regulators are still resisting.
Whatever your view on Brexit, it may, depending on the deal we end up with, offer the UK the opportunity to revisit these regulations and replace them with something fit for purpose. Regulations which actually protect consumer safety whilst encouraging the innovation that will bring better and more attractive harm reduced products, whether those products are tobacco or pure nicotine based.
The UK could show the world how a policy of embracing and supporting private sector innovation through appropriate regulation can improve the lives of millions, but has it got the guts? It’s made a good start with the Tobacco Control Plan and the recent Stoptober campaign, but we are still shackled to the coercive policies of the past, and ideological resistance to harm reduction is still endemic in some areas.
This is the fifth e-cigarette summit. By the sixth I hope to see e-cigarettes as just one of a range of safer alternatives readily available to consumers, and I hope to see a lot more consumers finding them an attractive alternative to smoking. In order to achieve this though, there must be a greater acceptance of the (for some) uncomfortable truth that these products are first and foremost used by a great many consumers in the pursuit of enjoyment, and smoking cessation is a welcome by-product.
By all means reap those benefits for the goal of improving public health, but don’t expect a bountiful harvest if you ignore the the single most important factor in the success of vaping in creating ex smokers so far – pleasure.
Last November, the Freedom Association sent freedom of information requests to all UK councils requesting details of their policy towards e-cigarettes and produced a comprehensive report. The results were depressing but offered a snapshot of how council smoke-free policies were routinely including vaping along with smoking, despite guidance from Public Health England advising otherwise.
A year on, the Freedom Association has today released a follow-up report, based on the same questions as last year, to gain a sense of how things have changed in the intervening period. It is disappointing to note that, if anything, the overall environment for vapers working in local government has deteriorated rather than improved.
With evidence supporting vaping as a tobacco harm reduction tool accelerating in the past year, and with the government’s Tobacco Control Plan in July highlighting less harmful nicotine products as something to be embraced, it is puzzling that this information does not appear to be trickling down to authorities who are tasked with administering national public health strategies at a local level.
Public Health England guidance for all workplaces is that there is no health-based reason why vapers should be herded outdoors, let alone forced off the grounds of their employer or instructed to only use smoking shelters, yet this advice is not getting through.
Today’s report shows that there is a local authority information deficit surrounding e-cigarettes which is obstructing national efforts to increase awareness of their benefits. If the Tobacco Control Plan is to see results more widely, it is imperative that local authorities understand the beneficial role that vaping can provide for their public health obligations.
As NNA associate Clive Bates commented on reading today’s report:
“The message to councils is ‘think before you ban’. When people are vaping, it’s almost always because they’ve quit smoking, cut down or are trying to quit. Given it’s barely noticeable in most situations, maybe councils should stop treating vapers like pariahs, get behind their efforts to quit smoking, and consider the effect of forcing them back outside with the smokers."
Unfortunately, we can see from the survey of council policies on e-cigarettes that they are stuck in a punishment mindset and currently showing a lack of regard for the welfare of their staff who are choosing to switch from smoking to vaping. They need to realise that there is another, better, way that would make a significant proportion of their staff healthier, happier and maybe even more productive.
We would urge Public Health England and the Department of Health to redouble their efforts towards educating local authorities about the clear benefits of e-cigarette use, and urge local authorities to research the subject more thoroughly.
There is a plethora of positive evidence out there from well-respected organisations such as Cancer Research UK, Public Health England and The Royal College of Physicians, amongst others, that e-cigarettes are a good thing. Councils just need to be made familiar with it.
The consultation on the NICE draft guidance for Smoking cessation interventions and services is now open, you can find it here. The draft guidelines are concerned with stop smoking interventions in community settings and include recommendations on e-cigarettes. This guidance will have a huge influence on the advice which health practitioners give regarding e-cigarettes, so it’s crucial for vapers to make their views known.
Unfortunately, the consultation is open to registered stakeholders only. If you would like to comment on the consultation but are not eligible then NICE recommends you contact the stakeholder organisation that most closely represents your interests and pass your comments to them (the list of stakeholders is here).
We are looking forward to hearing from you.
Today the UK Government’s long awaited Tobacco Control Plan was published and is encouraging reading for those who, like us, have an interest in tobacco harm reduction. Although the plan is short on detail there is some emphasis on a pragmatic, harm reduction approach, rather than on further punitive measures intended to force smokers to quit - although those already in place are set to continue.
The plan sets out some ambitious targets, including the goal of reducing smoking prevalence in England from 15.5% to 12% (or less) by 2022. It concentrates on reducing prevalence in pregnancy, among mental health patients and on reducing variations among different regional or socio-economic groups.
The foreword to the report hails the UK’s success in reducing the prevalence, and thus the harms, of smoking. These achievements are attributed to “world leading public health measures”. However, there is one glaring omission in the list which follows - the fact that the UK is also a world leader in its pragmatic approach to vaping, a pragmatism which has led to very significant numbers of smokers in the U.K. switching to the much safer alternative. Perhaps the omission is because the U.K. Government doesn't deserve to make that claim yet, as it enthusiastically embraced the EU TPD, stands by silently whilst vape bans proliferate, and clings to the illogical ban on another risk reduced product, snus.
The latest Tobacco Control Plan though, gives us hope that at least some of these issues can be addressed. The government's commitment to review the TRPR, with a view to altering those provisions which relate to e-cigarettes, and the commitment to communicate accurate information about the relative risks of harm reduced products are, in particular, to be applauded. We hope to be heavily involved in that process.
Small regular donations from our Supporters could fund our work
NNA UK is now the go to organisation for tobacco harm reduction in the UK . With your support we are fighting back against excessive and crippling regulations and raising awareness about the use of harm reduced products - e-cigarettes in particular. We are campaigning hard against the TPD and we will also soon launch a campaign to educate and inform about vaping in public and work spaces. A tremendous amount of work is going into the battle to get the ban on snus sales overturned and the case is now with the European Court of Justice. A win for snus would be a win for vaping. Read more in our latest News update, here.
We need funds to do our work. We rely entirely on donations from individuals so, if you like what we do, please donate to NNA.
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Just £2 a month from our Supporters would fund our campaigning. You can set up a recurring payment with PayPal or standing order via our Donate page. Louise's suggestion of giving £5 a month would help us even more.
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NNA on eBay
We are now an eBay charity, find us here.
You can add a checkout donation to NNA when you pay for something you’ve won on eBay.
You can also choose to donate all or part of the proceeds of your listed items to us. Torchy has very generously done this by having these NNA battery wraps produced and by selling them on our behalf. Only £2 for 10 battery wraps. Stay safe - and support NNA. Buy them here.
We are very grateful to everyone who has donated to us in the past: without you we simply couldn't do what we do.
Following the release of ONS figures showing a record reduction in smoking prevalence in the UK, a good deal of health and tobacco control groups have been quick to claim that the effect has been caused by the UK's strict tobacco control policies such as high rates of tax, bans on smoking in public places, display and advertising bans, health warnings and even, bizarrely, standardised packaging, which was only fully implemented less than a month ago in the UK and which still isn't having any discernible effect in Australia, which has had it for 5 years. What they are not mentioning is the effect on those figures of vaping.
At the age of 85 many smokers would probably shrug their shoulders when told that stopping smoking would be a benefit to them. Many smokers who reach that age have been smoking, in one form or another, for decades and feel it is too late to stop.
As a smoker of 69 years, one man, after being diagnosed with borderline chronic obstructive pulmonary disease in 2010 decided to at least try to minimise the number of cigarettes he smoked. Over the course of two years, Terry Walker reduced his cigarette smoking from 10 per day to just 2.
The headline statistics from the annual ASH survey on vaping appear great at first glance. Vapers now number 2.9 million in the UK and for the first time ex smokers outnumber current smokers. Is this news really all it's cracked up to be though?
NNA will be at Vape Jam next weekend and we would love to see you there. You can find us at stand G58, along with INNCO and ViP. Dave Dorn (NNA) and Judy Gibson (INNCO) will be giving presentations so look out for those too.
The Vape Jam organisers, Amir Saeed and Maria Borissova, are, for the second year running, donating all the proceeds of the raffle to NNA. We will be selling the raffle tickets from our stand. We hope this will help to spread the word to a much wider audience, as well as raise much needed funds for the NNA. We are very thankful to Amir and Maria for their generosity.
We’ll be collecting NNA Supporter sign ups so please encourage anyone who hasn’t already signed up to come along and do so. The more supporters we have the louder our voice.
We are selling these silicone NNA branded 18650 battery sleeves / condoms from the stand: attractive, useful and consistent with the harm reduction theme! We have battery safety leaflets to hand out too; many thanks to e-cigarette direct for supplying those.
And these bags, perfect for carting about all the freebies you’ve picked up over the day:
And we'll be wearing these beautiful polo shirts, very kindly ordered and paid for by vapers.org.uk:
So, if you go to Vape Jam please do stop by for a chat and a sit down (no need to buy a raffle ticket, etc!). We’d really welcome an opportunity to discuss the issues we are all facing - that’s actually the whole point of us being there.
NNA has come a very long way in two short years and we have thoroughly earned our reputation as a “go to” organisation on tobacco harm reduction. Now we need your help to achieve even more. We have never asked for money before but we need to now.
We take every opportunity to represent the interests of those who seek safer methods of nicotine use. This includes working with the media, making submissions to governments here and abroad, responding to consultations, challenging rules that make life harder for consumers, speaking at events and working with scientists and regulators. All this costs money and we depend entirely on voluntary contributions. We would like to thank everyone who has given to us in the past, your support has enabled us to achieve remarkable things.
Our Trustees and Associates have worked really hard to get NNA this far and, until now, all of NNA’s work has been done by volunteers. We have recently appointed a part-time administrator to ease some of the pressure on our Trustees and to enable our charity to grow.
Every week there are new challenges: yet more questionable science, threats of creeping prohibition and individuals and organisations that want to sow doubts and fears. We need resources to counter these.
Guest blog from Rhydian Mann, NNA Associate and Welsh Campaign Manager at Vapers in Power
For all of you out there who know what my day job, is this piece won’t surprise you at all. For those who followed the development of the Tobacco Products Directive (TPD) 2014 into the UK’s transposed version, the Tobacco and Related Products Regulations (TRPR) 2016, this piece will be even less of a surprise.
For everyone else, well, this could be both an education and a shock!
Today, as part of my job, I met with two local Trading Standards Officers( aka TSO’s) in Swansea to discuss some of the“finer” points of TRPR compliance. Sorry, I can’t divulge the actual outcome because I could get fired BUT here are some of the knowledge bombs that came out of it:
1 Local Trading Standards have had no training in TRPR enforcement.
Yes, you read that right. I bluntly asked one of the TSOs if they have had any training or guidance on what to look for regarding compliant and non-compliant packaging for e-liquids. One of the senior TSOs said they have not received anything from the Chartered Trading Standards Institute, the body which provides training for TSOs across the country in any consumer product or consumer service provided to the public. I even rang the CTSI, earlier in the week, to see if they have any enforcement guidance and the best they could do was to pass my inquiry onto someone that specialises in “TOBACCO CONTROL”
This is a very scary thought indeed! This indicates that local TSO’s, when visiting an e-liquid manufacturer or a vape shop, are relying on the text of the TRPR itself and their own interpretation of it. Are the MHRA (the so called “competent authority”) and the Department of Health saying “just get on with it” to local council Trading Standards departments?
3 Interpretation = Confused.com
It’s been hard for manufacturers and retailers to get their heads around what the TRPR actually means. TSOs are probably going to have the same issue. As there is no guidance for enforcers, it is very likely that they will use the “Labelling”/”Product Presentation” requirements from Sections 37 and 38 of the TRPR as a checklist along with their interpretation.
I sense that term “harmonised enforcement” is a very comical thought. To put it bluntly, each local council TSO can have a different understanding of any line of the TRPR and hence enforce it differently. Here is an example of what I mean:
“(2) The unit packet and any container pack of the electronic cigarette or refill container may not include any element or feature falling within paragraph (3).
(3) An element or feature falls within this paragraph if it—
(d) resembles a food or a cosmetic product; or…”
This line has already seen some enforcement in some areas of the UK, resulting in some products being seized. You might remember this photo being passed around social media last month:
Now this is where manufacturers have become confused. Does this mean that a bottle or box can’t look like something you’d find in a supermarket cereal aisle or like a bottle of your favourite perfume? More than likely! OR Does it mean that you can’t have a graphic of an apple to show that your e-liquid is apple flavoured? Who knows!
Actually this line crosses over with an existing piece of legislation known as The Food Imitations (Safety) Regulations 1989. This basically says that no product should look like (amongst other things) foodstuffs because it would be “likely to cause persons, in particular, children to confuse them with food.” So based on that line, having an apple, a marshmallow, a donut on your product packaging should not result in that product being seized by TSO’s. Yet the photo above suggests otherwise...
This a perfect example of where interpretation between different local TS can cause massive issues. Take my employer who supplies across the country: Swansea TS could give our packaging a thumbs up but a TSO in York, or anywhere else for that matter, could give the products a thumbs down. So how can this situation be avoided?
4 Let your Local Trading Standards handle it
Provided that you’ve followed the guidance from your own local TSOs on packaging, (mainly because the MHRA guidance is a smidge contradictory with the TRPR itself) continue to work with them. There is an agreement between a manufacturer or retailer and the local Trading Standards department under what is known as “Primary Authority”. This has a statutory basis and if your own trading standards gives a thumbs up but another doesn’t then the discussion on the possible non-compliance is held between the two different local Trading Standards departments. Another bonus is that, depending on the Trading Standards, you might have a dedicated TSO that will deal with your company. This is not a free service but I am sure that it will offer some solace amongst all the other stresses.
I hope for the sake of vapers in the UK that manufacturers AND retailers strike up a conversation with TSO’s and continue to talk to each other. I am sure that all vapers would love to see their favourite brands and flavours in shops. I am also sure that vaping businesses want to see their brands flourish as much as possible in what has now become some sort of level playing field. The only way that EVERYONE can be made happy is to work together to get through this.
Finally, remember that Trading Standards Officers are not just “spoil sports” or “clouds of doom” who remove non-compliant or dangerous items from sale but they can also be your “right hand man” or “right hand woman” for advice.
New Nicotine Alliance Sweden (NNA Sweden) is a brand new Swedish Tobacco Harm Reduction promoting civil society, started early in 2017. NNA Sweden is an affiliate of NNA UK and NNA AU, as well as a member organisation of the global network of consumer advocacy organisations for safer nicotine products, INNCO.org.
The public launch of NNA Sweden took place at the Swedish premiere of A Billion Lives on February 7th. The premiere sported Aaron Biebert, snus advocacy crowds, vaping advocacy crowds, politicians, health economists and decision makers from the Swedish tobacco control landscape. The initial board of trustees for NNA Sweden are Atakan Erik Befrits from policy research, Ms Jennie Gejel a veteran vaping expert and Mr Patrick Pihl who is a 25 year veteran of snus advocacy and covers snus science in Sweden.
NNA Sweden aims to give a valuable contribution to both Swedish tobacco control policy work and to the important international work being done to safeguard rights to harm reduction products and policy.
Please feel free to contact us at any time to discuss cooperative efforts, access to Swedish data and experience or just to say hello.
Jennie, Patrick and Atakan
One of the outstanding weaknesses in some recent research into e-cigarette use is the obvious lack of knowledge that some researchers and commentators have about the workings of vaping devices. indeed, whether by accident or design, some massive 'bloopers' have been made and those have had serious repercussions. How many smokers have disregarded alternative advice and have continued to smoke?
It is difficult for people who are in the front line: people who vape, to express their thoughts and counter the 'wittering's' of some experts. It is difficult for shopkeepers, hairdressers and used car salesmen to have their voices heard above the 'babble' of health professionals, politicians and media presenters all proclaiming loudly, this, that and the other.
Yet... Who are the experts when it comes to vaping? More importantly, are they really experts? Let us take a quick tour and have a look at what some 'experts' have said about vaping.
Let me start with what is to my mind, one of the 'daftest' ones. E-cigarettes may cause tuberculosis. That is correct, e-cigarettes may cause tuberculosis.
The following comment appeared in the Cape Bretton Post of 2nd January 2014. It was written by an 'expert.' (But not a medical expert)
“Now most of the e-cigarettes sold here are made in China, where there is very weak government regulation with respect to how they are made. The Canadian government does not know if Chinese workers making cigarettes wear masks. If they aren’t wearing masks, there are increased risks associated with tuberculosis.”
I spotted this at the time and wrote to the professor, pointing out that...
"This is just about one of the most ridiculous statements have ever come across. Pure, unsubstantiated scaremongering and an indication of the lack of care you have taken with your research.
There is a beautiful irony here. Some ‘idiot’ has reasoned that if there is tuberculosis in China, there must be a risk involved. You have decided to parrot this. And here is the irony! You see, the main ingredient in e juice is propylene glycol. Propylene glycol is a disinfectant. And, do you know what? It is used extensively in the war against… yes… come on now… Think! That’s it… Tuberculosis!"
Yes, I know, just because propylene glycol is a constituent in e-liquid does not mean it would prevent infection via vaping - but there again, there are, as far as I am aware, no cases of tuberculosis having been caused through vaping.
Anyway, I am not an expert. Oh! And you may have noticed that my propensity for using emotive terminology has not changed between my writing back then and now - I offer no apology even though scientists avoid doing this... or do they?
An emotive headline but did the researcher claim this? It would appear he did. “[Level of PAHs] in e-cigarettes is at least one million times more than roadside air in Hong Kong,” said Dr Chung Shan-shan, assistant professor in the university’s biology department." The study itself turned out to be 'pure garbage,' sorry, I must stop doing that. The study itself contained one or two weaknesses. No, back to my own style: It was not worth the paper it was written on, or perhaps I should say, the papers it was written in, because I am not sure if the research was ever published except in the world press.
It is not a one off... The New England Journal of Medicine [Published by Marvel Comics? I can say this because I am not an expert and have no ambition to have anything published in publications of disrepute] The New England Journal of Medicine published a report that started a media frenzy.
However, is was soon revealed that, once again there were major flaws.
Clive Bates said the following in his article, Spreading fear and confusion with misleading formaldehyde studies.
"This experiment, published in the New England Journal of Medicine, operated the vaping device at a such a high temperature that it produced thermal breakdown products (so-called dry puff conditions), but no user would ever be able to use it this way – the vapour would be too acrid. They went on to calculate human cancer risk from these unrealistic machine measurements and presented the data in way that was bound to mislead, which it duly did and created a world-wide media storm. This was irresponsible science, careless publishing, and credulous journalism adversely changing the perceptions of the relative risks of smoking and vaping in a way that will cause harm. The paper should be retracted in its entirety".
And on and on and on. 'Experts,' media, spouting crap, anything to demonise this perceived threat - and not necessarily a threat to the vaping consumer. Lipoid Pneumonia, Tuberculosis, cancer, gateway,However, thank goodness, there are real experts out there. [Note, no inverted commas].
And now we come to the present day, yesterday in fact. Yesterday I read an article by Sofia Carlsson, Associate Professor, Institute of Environmental Medicine, Karolinska Institute, and Cecilia Magnusson, Professor, Department of Public Health Sciences, Karolinska Institute, here. [You may have to use translate]
They discuss a paper purporting to show a connection between heavy snus use and diabetes type 2. Before saying anything about this, in the above [linked] article they stress, and stress it more than once, that we should not jump to conclusions as there may be confounding factors - how very refreshing...
They also state as a fact: "Smoking is an established risk factor for diabetes, and a new problem in previous studies has been to separate snuff effects from smoking as inter use is common."
This comment started warning bells ringing. So I Googled (five minutes' worth) and the very first thing I came up with was... (page 250)
"Then there are quirky findings. In the Sweden study, researchers also looked at the risks associated with using "snus."... In this study, and in contrast to smoking cigarettes, the use of this nicotine containing product did not significantly increase the risk of diabetes."
Oh aye! But it is the next paragraph I find really interesting.
"The Hopkins' study also had an unexpected finding. Although cigarette smoking was clearly linked to type 2 diabetes, stopping smoking led to higher short term risk. highest in the first three years after cessation with a hazard ratio of 1.9.
The last finding is a head scratcher. A report from the University of Oxford, England, involved 1,919 patients followed over 6 years. Of these subjects, 1,216 were initially free of retinopathy
Hang on a second, what on earth is retinopathy? I am not an expert you see. Right, Google: 'Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye'
and 22% developed the pathology over the next 6 years. Of the 703 persons with retinopathy at the onset of the study, 29% progressed with 2 scale steps or more... Not smoking had an unfavourable effect on the development or progression of retinopathy.
A head scratcher right enough.
Sofia Carlsson, and Cecilia Magnusson, rightly emphasise that there may be many confounding factors but also state that, they, "have also, insofar as possible, taken into account other risk factors for type 2 diabetes such as overweight, physical inactivity, heredity, alcohol consumption, and education level." Did they? I do not have access to the research and even if I did, I doubt that I would understand much of it. It just seems to me to be an echo of previous, dubious e-cigarette studies. It just seems to me that not enough attention has been paid to the lifestyles of the participants... For example, is it the case that, like so many heavy smokers, heavy snus users are concentrated within specific society groupings, that they tend to be less active: that their diets are poorer; they belong to a particular ethnic group. (Some racial, ethnic groups continue smoking cigarettes at higher rates) Whatever...
It seems dubious to me that just because diabetes is higher in heavy snus users that it is the snus which is the cause? The researchers welcome any discussion - so do I.
And please take into account https://www.accessdata.fda.gov/Static/widgets/tobacco/MRTP/18%20appendix-6a-environ-snus-monograph-2013.pdf
Pay particular attention to the sections dealing with diabetes.... and you say that there has been little research. Hmmm!
But why do so many researchers publish materials that that are so far from the truth? What can it be that motivates them to go down this road? Michael Siegel, Professor in the Department of Community Health Sciences at Boston University School of Public Health gives us an insight into the world of Tobacco Control. He paints a picture of a world where individuals are indoctrinated and controlled. A world which will broke no contradiction; suffer any criticism.
He says, in an article, containing a great deal more...
"...if I conduct a study and it fails to show a significant relationship between second hand smoke and chronic disease, then all of the sudden, I have automatically become an illegitimate scientist."
"If it fails to show." Is this why so many 'studies' risk ridicule; a combination of induced blindness and fear?
"I was able to overcome my "brainwashing," but it took a lot of courage to do so, and a lot of risk to my career. I paid a heavy price for breaking out of the mould into which I had been cast. It shattered my career in tobacco control. But at least it didn't shatter me, and the person who I really am."
How many experts show this kind of courage, and the answer, surprisingly, is quite a few... these are the experts, the genuine ones, and their number is growing.
The edifice which is Tobacco Control is crumbling. Soon it will be gone.
New Nicotine Alliance would like to offer our thanks to Robert Innes for this guest blog entry. He can be reached on Twitter at @brainyfurball
The EU consultation on excise duties applied to manufactured tobacco ends on 16th February and includes proposals to tax reduced risk nicotine products. It’s vital that nicotine consumers respond to make their feelings known. If the EU permits taxation on reduced risk products the prices will go up and many people will be discouraged from switching. It’s simple and quick to respond to the consultation - it only takes around 15 minutes. Vapers in Power has done a useful guide to it, here. The Clive Bates/NNA briefing is here.
If you have already responded then please make it your goal to get three other people to respond too.
Here's a repost of NNA's "EU Tax policy - harmful to health - our briefing", in case you missed it the first time round:
The EU Commission is currently consulting on a revision to the Tobacco Excise Directive, which could see reduced risk products such as e-cigarettes being included. Our associate Clive Bates has written an in depth briefing together with NNA which details why this is a very bad idea. The full briefing can be read here. The consultation can be found here.
There is no case on principled or practical grounds to apply excise duties to vaping products and other products that offer a much safer alternative to smoking. The value to health and wellbeing associated with switching from smoking to vaping will exceed any benefits arising from revenue collection.
Just as it was with the Tobacco Products Directive, the inclusion of products which do not contain tobacco in the Tobacco Excise Directive is unhelpful and risks creating confusion in the minds of consumers.
If vapour and other reduced risk products are to be included in the directive then our view is as follows:
Our recommendations for low risk non combustible products are as follows:
We urge the European Commission, European Council and member state tax authorities to take great care in striking the balance between public health, revenue raising and administrative costs. The institutions involved should conduct thorough impact assessments, take a hard look at the risks of causing harm to health and then think again about imposing excise duties on products that are already helping millions of Europeans to improve their health and wellbeing and have the potential to help millions more.
Please do read the full briefing and have your say. Make sure your MP also understands your concerns.
On the day that NNA was in the High Court asking for permission to join the effort to overturn the ludicrous ban on snus, and Hertfordshire County Council were holding their very successful 'e-cigarette masterclass', at which delegates learned about vaping, and sensible vaping policy, Public Health Wales issued their new position on e-cigarettes. https://www.wales.nhs.uk/sitesplus/888/news/43873
It is difficult to imagine the machinations that must have gone on within PHW whilst coming to this position. Seemingly realising that a failure to admit that e-cigarettes are very much safer than smoking tobacco cigarettes is now akin to being an anti-vaxxer, they grudgingly advise that anyone who is unwilling or unable to stop smoking should switch to vaping instead. Quite why anyone would want to do so given the rest of the PHW statement is anyone's guess.
Cherry picking from the US Surgeon General report, and of course the World Health Organisation, we are told that:
There are no benefits to children or young people using e-cigarettes.
No one wants to see young people initiate nicotine use via any method, but for those who have or will take up smoking there are definite benefits.
'Confectionary-like' (sic) flavours of e-liquid should not be permitted, in order to reduce the appeal of ENDS to children and young people.
How many times do we have to point out that the majority of adults prefer candy and fruit flavours. Certainly these flavours should be marketed responsibly, but in light of the fact that there is no evidence that 'confectionary-like' flavours, or indeed any other flavours, cause young people to take up regular vaping, all that this policy would achieve is to make e-cigarettes less appealing to those adult smokers who, as PHW admits, would benefit from switching.
Until a more definitive risk assessment can be completed, voluntary restrictions on the use of ENDS in enclosed public spaces should continue.
No doubt PHW would have preferred to push for legislative bans, but given what happened last time they tried, they settle for telling Welsh businesses to do that job for them. Contrary to PHW's carefully selected 'evidence' on this issue, there is no evidence at all of a risk of harm to bystanders, or that vaping renormalises smoking.
Additional 'factoids' in the statement include:
"Use of e-cigs may reduce the likelihood of smokers quitting by displacing scientifically proven methods to help people quit."
"The use of ENDS will act as a gateway to tobacco use."
Needless to say there is no evidence to suggest that either of the above concerns are happening in the real world.
In summary, whilst PHW's assertion that for a smoker, switching to e-cigarettes will significantly reduce the risk of harm to health is welcome, this statement is completely outweighed by the very negative comments which follow. We can all guess what this information will look like:
"Public Health Wales will include information on ENDS alongside other aids to stopping smoking in all information materials and in Stop Smoking Wales support services. Information on all products will be presented to support smokers in making an informed choice about the best way to quit for them."
NNA associates attended a debate at London South Bank University on Tuesday evening entitled “A way forward – How e-cigarettes could and should affect public health” which, sadly, only resulted in conveying an entirely misleading message to the approximately 50 people in the auditorium along with many more who logged on to watch a live stream of the event on Facebook.
Unfortunately, most of the panel did public health a significant disservice by repeating almost all the ill-informed canards that their more enlightened colleagues have sought to dispel over the past few years about vaping.
For example, Faculty of Public Health board member Patrick Saunders began the evening stating confidently that there is evidence that e-cigarettes inhibit smoking cessation rather than help smokers switch to vaping – which is quite wrong - and followed up later by dramatically declaring e-cigarettes to be “designed to mimic smoking, are intended to mimic smoking” with no recognition that this might be a positive attraction for smokers wishing to quit. He also said that it was “encouraging to see most places ban smoking and vaping” without a care that Public Health England has rightly identified the public health advantages of vaping being permitted where smoking isn’t.
Professor Andy Parrott of Swansea University – when not advocating for public information films showing tumours and gore to be shown on CBeebies – added that “nicotine is the ideal training drug for addiction” leading to addiction to harder drugs; an idea entirely unsupported by any science, and said that he would recommend nicotine patches over e-cigarettes despite research proving the latter to be more effective.
Dr Helen Walters of the National Institute of Health Research, while mildly supportive of vaping, also appeared to be singing from the vape-sceptic hymn sheet by declaring that she was happy that evidence shows e-cigarettes not to be a gateway into smoking for children in the UK, but that it is a different situation in the US despite youth smoking rates plummeting across the Atlantic too.
It was quite clear that some panellists possessed scant knowledge of the research conducted on e-cigarette health effects and usage, while in amongst all this was Professor Peter Hajek attempting to share the real evidence but being largely ignored in favour of falsehoods spread by other ‘experts’ on the panel.
If that was disappointing, it only deteriorated further once discussion was opened to the floor. One by one all the lazy myths about vaping came tumbling out, and there was precious little pushback from the panel to correct them.
The oft-repeated misconception was advanced that a former smoker used his vaping equipment far more often – thereby implying he was self-administering more harm - without anyone pointing out that e-cigarette nicotine delivery is more dilute and tempered compared with smoking so this is a normal occurrence. Public health officers were forthright in condemning e-cigarettes for “substituting one addiction for another” without being educated that nicotine is on a par with caffeine, while another public health professional asserted boldly that “nicotine doesn’t break any kind of habit”, which any e-cigarette user will be able to tell you is not the case.
As for the idea that people might actually enjoy using nicotine and that the safer it is delivered, the better, the wholly clinical approach to the subject matter meant that the very premise was not up for discussion. Although it is encouraging that a London university decided to schedule an event on vaping, it was not so much a debate as a kangaroo court whereby vapers were offered no real defence.
If these misconceptions are to be addressed, and assuming the public health community truly wants to properly understand the attraction of vaping and its potential for public health, it is essential that this kind of event includes people who can do exactly that. Not, as was the case on Tuesday, in the audience with the chance of a minute or two at most to counter the untruths, but on the panel with a microphone given equal prominence and respect. The NNA can boast dozens of citizen experts who are qualified by their experience to talk about the subject and who are far more knowledgeable than many of those on display at South Bank University.
If those entrusted with advising parliamentarians and policy-makers wish to make a positive contribution to public health in the UK, they simply cannot preach ignorantly from their privileged pulpit like this. On Tuesday, they sent a cohort of local authority public health officers and interested students out into the chilly London air with negative, incorrect and evidence-free opinions about vaping to share with their friends and colleagues. They had been informed by ‘experts’, after all.
The way this event was structured may have been well-meaning, but in practice it has caused harm by effectively disparaging a technology which carries huge beneficial potential for population health in the UK and beyond. Health debates like this must include consumer advocates to offer a differing – and informed – view in the future; to not do so is nothing short of ideological public health vandalism.
Andrew Hall may not be the most competent vaper on the planet, but he’s not solely to blame.
You may have seen the media stories today about the Idaho man whose e-cigarette exploded. It seems he was using a hybrid mod. The vast majority of e-cig users use regulated mods containing inbuilt electronic safety features which mechanical and hybrid mods do not have. No reputable vendor will sell a hybrid or mechanical mod to a non advanced user.
NNA trustee David Dorn explains more below:
If you are not aware that Facebook managed to bring the notion of battery and mech mod safety to the fore on January 16th 2017, then you’ve missed a watershed moment in vaping circles.
Before the Deeming rules came into force in the USA, Andrew, apparently, was using a mechanical mod (that is to say a battery unit with no electronics to protect or regulate the power of the device). It seems to have been a hybrid mod. A hybrid has no 510 connector as we all know it, but simply has a thread to attach a dripper or tank, and relies on the centre post of the dripper (we’ll say) contacting the positive terminal of the battery cell when it’s pushed up by the bottom button.
Such a device is inherently unsafe unless a number of criteria are met:
1: The tank or dripper - the atomising device - MUST have a protruding centre contact.
2: The contact cannot be sprung or articulated in any way that would allow the battery’s positive terminal to make contact with the threaded section
3: No matter how far the atomising device is screwed into the hybrid connector, it must never make contact with the positive terminal of the battery unless the button has been pressed
4: Each and every battery used in the device can have no splits, tears or cracks
And that’s just the tube itself. If any one of those criteria are not met, there is a very much increased chance of a short circuit scenario occurring, and when a battery cell is short circuited, then thermal runaway is highly likely.
As I said, that’s just the battery tube.
Resistance is not futile
The next weak link is the coil itself. Generally speaking, in a regulated device, the resistance of the coil(s) is matterless. As long as said resistance falls into the range that the mod can handle, it will deliver regulated power at the user’s chosen level without any issues. If the resistance of the atomiser setup is too low, the electrnics therein will prevent any current from flowing.
Not so with a mech or hybrid. There is no intelligence.
Reports suggest that Andrew was using a 0.06ohm coil - and although this is far from confirmed, such resistances in coils are not unusual. And that would be fine if, and only if, the battery cell in the device was capable of handling the currents generated when the setup is powered up. In this case, Andrew was expecting an 18650 battery to produce something over 50 Amps (bordering on 200 watts).
Without wishing to alarm too many people (just the right ones) there is no 18650 on the market which will produce that much power safely and reliably. Many will do exactly what his did and vent/blow up.
In the scenario where a hybrid mod is used and the connector on the atomising device is either flush or recessed, a dead short will occur. In this case, the resistance of the coil is matterless - there is no resistance to the current, and thermal runaway can be almost instant, with little or no notice. It looks awfully likely that that is what happened in this case.
Yes - this kind of thing is totally avoidable. The generality of users, as with all generally available stuff, ought not to need to know Ohm’s law in order to use an ecig safely. That it is not only possible, but also very easy to buy a battery unit which is fully protected, can produce high power and massive clouds, and will not allow you to put yourself in danger by mismatching bits of the setup. Not only that, but such mods will very often be considerably cheaper than boutique hybrids and mechs - it’s not difficult to choose a battery unit that will produce exactly what you need in terms of safely generated power - there are many on the market.
So where next?
This is the controversial bit. Look, there are folks out there who are unwittingly lead into purchasing hybrids and mechs. They are, frankly, sexy, “scene”, used by the top echelon of trick vapers and there is a level of kudos applied to users of the most sought-after units. I get that.
But they should NOT be the default “next step” in a vaper’s journey. Indeed, were it up to me, I’d be asking vendors not to display them or advertise them. The vast bulk of mainstream vapers are not competent to use them safely. (That’s not to say that those vapers are in any way second class or deficient. For instance, I am not competent to service a motorcycle - it’s not because I’m thick, it’s because I don’t have either the necessary skills or training to do so safely - and when it comes to hybrids, particularly, mistakes are all too easy to make).
So, my plea to vape shops”
1: don’t display hybrids and mechs - those vapers who understand them and know them will know you have them. Let them ask.
2: should someone wander into your shop with an ego or an iStick and ask for a mech or hybrid, ask the right questions to determine whether they know what they’re doing. The first one is “WHY?” the answer to that tells you everything you need to know.
3: If a customer constantly comes in for you to re-coil a mech or hybrid device, do your very best to take their setup in part ex for something regulated and safe. Please.
Think about it.
This unfortunate happening has resulted in massive publicity, has certainly resulted in people dumping their ecigs and going back to smoking, and that is, in fact, a net lowering of your customer base.
We have to do everything we can to prevent such things happening again. If we don’t “they” will, and regulations no-one wants will ensue.
Researchers based in North Carolina have discovered that if you lie to smokers about the amount of harmful chemicals in e-cigarettes compared to traditional cigarettes you will put them off using the products. In a study entitled 'How hearing about harmful chemicals affects smokers' interest in dual use of cigarettes and e-cigarettes', Pepper et al present smokers with four scenarios and then analyse their attitude towards dual use of the products with smoking. The four scenarios were:
That cigarettes and e-cigarettes had the same amount of harmful chemicals
That cigarettes contained 10x more harmful chemicals than e-cigarettes
That cigarettes contained 100x more harmful chemicals than e-cigarettes
That cigarettes contained harmful chemicals and e-cigarettes contained none
Unsurprisingly, in the scenarios where e-cigarettes contained less or no harmful chemicals participants indicated that they would be more likely to initiate or increase dual use of cigarettes and e-cigarettes.
What isn't immediately obvious from the publicly available abstract, but is noted in the limitations section of the full paper hidden behind a paywall, is the fact that the study concentrated on those smokers who said they would start or increase their use of e-cigarettes without stopping smoking. So smokers who indicated that they would completely switch to the safer product were excluded.
Astonishingly, the authors concluded that this apparent encouragement of dual use created by giving smokers accurate information on the relative numbers of harmful chemicals in the products would lead to a harmful continuation of smoking, and that therefore e-cigarettes "may not be able to be approved as a modified risk tobacco product on the basis of reduced chemical exposure alone because the public views information about lower chemical amounts as inherently related to reduced health harms". Paracelsus must be turning in his grave. The underlying suggestion in the conclusion to this study is that the FDA should consider hiding the the fact that e-cigarettes contain vastly reduced numbers and amounts of harmful chemicals when compared to smoking combustible cigarettes.
It is deeply concerning, but unfortunately not surprising to those of us who regularly read the bilge coming out of certain parts of the world, that researchers should feel comfortable suggesting that lying to smokers about the relative risk of products would be a viable public health policy. The obvious consequence of such a policy is that some people who might otherwise have switched to a safer alternative will continue to smoke. It is unfortunate that these researchers appear to have completely ignored them. Whatever happened to ethics?