Last Wednesday, the All Party Parliamentary Group for E-Cigarettes convened in Committee Room 18 at the House of Commons and the NNA was represented.
The subject of discussion was a very promising proposal to change the policy towards risk-reduced products on the parliamentary estate. Namely, that parliament – in keeping with the goal to “maximise the availability of safer alternatives to smoking” in the government’s latest Tobacco Control Plan – should be setting an example to businesses up and down the country.
The proposals – hopefully to be inserted into the parliamentary handbook for all members and staff – were to permit vaping in all outside locations and all bars and cafeterias, as well as single use offices and other offices, dependent on the agreement of colleagues. It was emphasised in the supporting documents that vapers should be expected to be considerate and mindful of the concerns of others. A common-sense approach, and one that the NNA can heartily endorse.
The NNA was invited to give testimony and our representative for the day – one of four from different stakeholders - was Jessica Harding. Industry was represented by Dan Marchant of Vape Club and the British Beer and Pub Association (BBPA) also provided a spokesman to explain the current position in pubs up and down the country. The last of the panel was a union official who spoke with a UNISON hat on as well as commenting on behalf of the Trades Union Congress (TUC).
Jessica acquitted herself very well, being the NNA’s expert on workplace policies in her role developing the Challenging Prohibition campaign. The representative from the BBPA also contributed with some useful insights into how the UK’s hospitality industry estates view vaping and the varying rules that licensees apply.
Jessica emphasised to the BBPA that their insistence on licensees being responsible for their own policies on their properties is one on which we can readily agree. As our position statement makes clear on vaping bans, “we do not support the statutory prohibition of e-cigarette use in public spaces, enclosed or outdoors”, but that is not to say we do not agree that property owners should be entitled to set their own policy as they see fit. The proviso to that is that property owners should be informed enough to assess what their policies should look like based on objective evidence rather than scare stories. We highlighted that large chains could be better informed on the subject rather than pronouncing from board level when local knowledge of clientele might be better for both the business and consumers alike, and we were pleased that our suggestions were received with an open mind.
Sadly, this was not the case with the UNISON/TUC representative. Faced with a panel of MPs who had a good working knowledge of the vaping debate, all referrals to health authorities who are supportive of e-cigarette use in workplaces was met with a stock response of “The TUC disagrees”. Quite why the TUC is qualified to disagree with, for example, the Royal College of Physicians wasn’t explained.
In his defence, the representative may well – as he stated at the start of proceedings – not have the power to change TUC policy, but it seemed clear that he attended with a refusal to open his mind to the potential positives of permitting vaping in workplaces and feed it back to his unions.
Worse still, to back up his argument, he responded to every citation of reasoned research into vaping with much-debunked misinformation that could only have been gleaned from the pages of newspapers which revel in creating scare stories. Almost without exception, all were mentioned in support of the TUC’s policy that vaping should be treated exactly the same as smoking. Nicotine is a carcinogen; we don’t know what is in the vapour; it is a gateway to smoking for children; if you’ve seen an article fostering doubt, it was referenced.
We found this to be very disappointing, especially since most of the concerns that were mentioned would have been published on media with which TUC supporters might be expected to roundly disagree with, and even openly despise. Therefore, for an organisation which is set up to defend workers’ rights to exhibit a perpetually closed mind in front of MPs - who are attempting to facilitate an open and evidential discussion - with the only outcome being that vaping union members will be denied access to harm reduction by their employers on the basis of myths and ignorance, was unfortunate.
We can only hope that some of the wise interventions from MPs at the session were conveyed back to TUC headquarters. We would also hope that current poor TUC guidance – expressed in this blog which is high on the list of Google results when searching for workplace vaping policies – might be amended now that the stance of the British Medical Association, a doctors’ union, has recently changed for the better.
If we are to see positive changes in public health surrounding nicotine use, it is important that all parties are amenable to open discussions, and that this will also involve organisations availing themselves of information with an open mind. Burying heads in the sand might make for an easy life, but it doesn’t facilitate progress.
The start of 2018 has seen a flurry of activity in the tobacco harm reduction sphere, with many potentially significant events taking place in relation to several different products. In light of this, it is worth revisiting the NNA’s stated aims to reinforce why we are central to this debate and supportive of Tobacco Harm Reduction in all its forms.
As our About Us page states, the NNA seeks to encourage “a mature public and organisational understanding of the potential of safer nicotine products for reducing cigarette smoking, including their safety and efficacy”. This is as true for tobacco-based solutions as it is for vapour-based ones and extends to other novel harm reduction innovations currently in existence or yet to come to market.
It is important to highlight this because there have been some who have been puzzled, for example, as to why the NNA were instrumental in a case challenging the EU’s ban on snus. The NNA is not, and has never been, solely devoted to promoting e-cigarettes and vaping even though many of our most prominent advocates have been drawn from that avenue out of smoking.
We have provided many updates to the snus challenge and are still optimistic that – with the snus case being merely one part of our work - we may be part of a sea change in attitudes towards harm reduction, a concept which is not new or confined to nicotine and tobacco, but instead has a long history of saving lives in HIV prevention, safer drug delivery and road fatalities amongst other areas.
Harm reduction relies on rejecting binary thinking and argues that often the best solutions are those which – although perhaps counter-intuitive – will deliver optimal results without heed to ideology or blind groupthink.
Our support for snus – undeniably a tobacco product – is based on the fact that it has been proven in jurisdictions where sale is permitted to provide a safer alternative to smoking and therefore to save lives. To reduce harm, in other words.
By the same token, heated tobacco has also been in the spotlight recently and the NNA also supports this increased activity to assess its efficacy. Early research suggests that it offers another promising alternative for those who have chosen to reduce their exposure to the risks of smoking but may not take to NRT or vaping.
In January, an application by PMI’s iQos for making a reduced risk claim was rejected by an FDA committee but it is expected that the right to market the product in the US will be approved. Market analysts are confident that claims of ‘heat not burn’ tobacco to be markedly less harmful than smoking will follow once the science has been evaluated, perhaps as soon as the end of this year.
Likewise, in keeping with the UK government’s commitment in its Tobacco Control Plan to assess evidence on novel nicotine delivery systems, the UK Committee on Toxicity reported at the turn of the year that heated tobacco is likely to be less risky than lit tobacco and exposes consumers to between 50-90% fewer harmful compounds. This is the essence of harm reduction which is why the NNA is supportive of further research to examine the potential in these products. Indeed, just last week the government’s Science and Technology Committee took evidence at Portcullis House about reduced risk products and included heated tobacco in its remit.
On the horizon are more opportunities for tobacco harm reduction, with novel products such as tobacco-free snus being available in some countries and rumours that these may be rolled out in the UK too. Other options such as dissolvables and nicotine films/strips may all contribute in the future to a diverse range of nicotine products which can deliver reduced harm while also satisfying what is a vast market for nicotine which is never going to go away.
The NNA exists to promote tobacco harm reduction - a term understood by governments, NGOs and even the WHO to describe ways of reducing harm from cigarette smoking without necessarily giving up the use of nicotine – and we will never shy away from that.
Anything from smoking fewer cigarettes through to total abstinence are harm reduction of varying degrees. There are no downsides if harm and risk are being reduced. To borrow a rhetorical turn of phrase from the Prime Minister, tobacco harm reduction means tobacco harm reduction, and the NNA is happy to add its support to anything which delivers that goal.
On 28th January, I was delighted to welcome friends up to Scotland to attend the Glasgow School of Vape in my home city. It was a lively event which attracted many keen vapers along with fellow NNA trustees, associates and supporters, plus a delegation from Cancer Research UK recruiting e-cigarette users for a study. However, the weekend was soured on hearing from those who flew in that Glasgow Airport has installed poor and misleading signage outside the arrivals terminal.
This is a ghastly message to send to new arrivals to my country and in direct contravention of guidance offered by Public Health England which states “it is never acceptable to require vapers to share the same outdoor space with smokers”. It is also, according to my guests, rigorously enforced by staff outside the terminal.
The signage at the airport is new so I asked to be contacted by the airport to talk to them about it. They called me, and I patiently listened while the representative explained their policy. I cannot be sure if he was having to defend it as part of his role or he was responsible for formulating it, but he insisted that he had read all the literature. I doubted that, so emphasised Public Health England’s guidance in case he was unaware of it. I could not understand why the airport authority believed it was proportionate to ban vaping in the open air and herd vapers into smoking sheds in the middle of a central reservation where the exhausts of diesel-powered buses were by far a more prevalent threat to health.
The airport’s representative assured me that vaping was permitted in some areas, such as the car parks and in the central reservation outside of the smoking shelter - which is still unreasonably precautionary - but their signage fails to communicate this. I asked if their signs could be altered to that effect or new signs be put up to make it clear, but they said this was “not practical”.
I found it baffling how the airport could spend a significant amount of money on signs which are misleading and could lead to adverse health outcomes but are unwilling to consider a small outlay to properly convey what they claim is true to their policy.
Lastly, I asked when their policy would be reviewed and if the NNA could be involved in giving advice. The response was that a review is slated for 18 months’ time but that consulting with us would be “a non-starter”.
This kind of blinkered and, sadly, ignorant policy-making is increasingly common which is why the NNA has recently committed to a campaign entitled “Challenging Prohibition”. Policies such as the one at Glasgow Airport are inadvertently sending a message that vaping is as harmful as smoking which has led to confusion and, subsequently, an increase in the mistaken perception that vaping should be avoided. Glasgow Airport may believe that they are doing the right thing, but they are unwittingly contributing to flawed understanding of risk reduced products which is arguably harming the public’s health.
It is true that Public Health England’s guidance is not necessarily transferable to Scotland, but NHS Scotland and ASH Scotland are both sympathetic to harm reduction policies and I’m sure would agree that Glasgow Airport’s policy is overly restrictive and not conducive to health, especially considering that Scottish hospitals are increasingly being more receptive to vaping by repealing blanket outdoor bans in their grounds.
It is also disappointing that the airport authority is not willing to revisit this flawed policy until a year and a half’s time. As tobacco control activists always tell us in relation to other measures, every day of delay before a control measure is adopted by government will result in hundreds or thousands of more young people taking up lit tobacco and more smokers continuing to smoke. The airport’s policy is irresponsible and should be reviewed as soon as possible, not in summer 2019.
The very last thing Glasgow Airport should be doing is forcing vapers into a smoking shelter, because they will be more likely to light up a cigarette. Yet that is exactly what their signage demands, and they appear stubbornly unwilling to correct it.
You can view our materials on Challenging Prohibition here, and we encourage NNA supporters to put these resources to good use by politely writing to establishments which have counterproductive policies such as that at Glasgow Airport.
Ringing in the changes Gerry Stimson has been chair of NNA since NNA was first registered as a charity in 2015 (and prior to that too) and so recently decided it was time to pass the baton to someone else. Under Gerry’s stewardship NNA has grown into a very successful advocacy organisation and running NNA now entails a considerable amount of work, so the Board of Trustees has decided to create the new position of Vice Chair, in addition to Chair. Please join us in welcoming Sarah Jakes as our new Chair and Kevin Molloy as Vice Chair. Sarah will be “the face” of NNA and Kevin will be taking on the day to day running of the organisation, both will be supported by our hard working trustees and by our administrator. We are delighted that Gerry has agreed to stay on as trustee and we are all looking forward to taking NNA to the next level.
Snus ban challenge hearing at the European Court of Justice 25 January Gerry and others went to the ECJ in Luxembourg for the snus ban challenge hearing. The Advocate General will give his opinion on 18 April and the final decision will be announced some time after that. You can read more about the hearing in our blog post here. A very exciting recent development is the #EUforSnus movement, please join the EUforsnus Facebook group and follow @EUforSnus on Twitter if you can. What we heard at the ECJ demonstrated that we vapers and we snus users share a lot of common ground - and that we will be so much more powerful if we join together to assert our right as adults to choose reduced risk nicotine products. You can find our snus campaign pages here.
Glasgow School of Vape 4 GSO4 was on 28th January and went incredibly well, thanks to NNA trustee Andy Morrison and Associates Eddie Black and Vic Mullin. The auction raised over £500 for NNA, a big thank you to everyone who contributed.
Meeting you We are really pleased to have been invited back to Vape Jam and Vaper Expo this year, so please do come and find us. We are grateful to the organisers of the events for making us so welcome and giving us the opportunity to be there and to meet up with our Supporters. We hope to see you there.
Only 1% of young Norwegian women now smoke - down from 30% in 2001
Only 3% of young Norwegian men now smoke - down from 29% in 2001
Other Scandinavian countries are also stopping smoking - Sweden’s average rate now 5%
Both Norway and Sweden have widespread use of the smoking substitute snus
Government figures show that smoking has almost disappeared among young Norwegian women. In 2001 the smoking rate among females aged 16 to 24 was 30%. By 2017 that had collapsed to just 1%. By contrast the smoking rate for young women in the UK is 16%. Over the same period smoking among young Norwegian men has fallen from 29% to 3%. (See attachments posted below.)
The collapse in smoking in Norway does not appear to be the result of vaping as nicotine containing e-cigarettes are only now being legalised. However there has been a sharp increase in the use of the oral tobacco product snus. During 2008-14 its use among young women grew from 5% to 14%. In neighbouring Sweden, where snus is also legal, 20% of the whole population use it and the adult smoking rate has fallen to 5%.
Last month the European Court of Justice held a hearing on whether the ban on snus in the rest of the EU should be lifted. The legal action is supported by the consumer charity the New Nicotine Alliance.
Its trustee Professor Gerry Stimson said: “Any reasonable person looking at the spectacular graph for smoking among young Norwegians will be struck by how the fall accelerated after snus became available in 2002. This is no fluke. The end of smoking is in sight in Norway and Sweden as people choose far safer snus instead. So reasonable people will ask why the UK government decided to urge the European Court of Justice to maintain the snus ban in the rest of the EU.”
His comments were echoed by the smoking substitutes expert Dr Konstantinos Farsalinos: "There is absolutely no doubt that access to snus in Sweden and Norway has played a crucial role in the rapid reduction of their smoking rates.”
Many international bodies - including the World Health Organisation - view snus as being far safer than smoking (see sources below).
We have reached a new stage in our challenge to the ban on snus.
The background: The sale of snus is banned throughout the EU, except for in Sweden. Swedish Match, the leading snus manufacturer, initiated a challenge against the ban. On 26 January 2017 the High Court in London ruled that the challenge should be heard at the European Court of Justice and that NNA could join the challenge as intervenor. On 25 January 2018 the case was heard at the European Court of Justice in Luxembourg.
NNA was represented in court by Paul Diamond, QC. Also present on behalf of NNA were Professor Gerry Stimson, expert witnesses Karl Lund and Lars Ramström, Atakan Befrits - the Chair of NNA Sweden and member of INNCO secretariat, Bengt Wiberg and Uwe Hille from the snus community, and Jessica Harding, NNA administrator. Professor Martin Jarvis was also there, as expert witness for Swedish Match.
Seven judges faced the courtroom from a distant row at the front, including the Judge-Rapporteur and the Advocate General. The court was reasonably crowded but far as we could tell the only consumers in the court were those in our party. We’d attracted some unwanted attention from the chief security guard when we were trying to film outside the court (“No Facebook! No Twitter!”), so he followed us into the hearing to keep his beady eye on us.
Each party had fifteen minutes to give their oral observations, where they could respond to the Written Observations which had been submitted previously by the other parties. The Counsels acting for Swedish Match were up first, followed by Paul Diamond for NNA, then the Counsels for the UK Government, the Government of Norway, the European Parliament, the European Council and the European Commission.
What follows are some brief notes on some of what was said:
Swedish Match argued that snus has a lower health risk than the other products covered by the directive (TPD), that snus has a positive effect on public health (“the Swedish experience”), that the FCTC covers all tobacco products so all should be regulated, that there is no product that is completely safe for everyone in all circumstances, that the EU legislator had failed to do a proper assessment and failed to analyse the evidence correctly, that the ban was discriminatory, irrational and disproportionate.
NNA’s Paul Diamond was up next. The court heard that NNA was there to represent the people who hadn’t been asked - the smokers - and to assert the right to be able to choose a safer alternative. Paul argued that the ban is disproportionate, that it infringes on the right to health of citizens, and that it is contrary to the harm reduction purpose of the WHO Framework Convention on Tobacco Control. He told the court that snus protects people from smoking, that it is not new and the effects have been well researched. He welcomed seeing that the government of Norway was represented in court, and asked whether Norway’s recently reported drop in smoking rates and rise in snus use could have been possible were Norway an EU state. He concluded that the court bore a heavy responsibility as thousands of lives would be affected.
Counsel for the UK Government The UK argued in favour of upholding the ban. This was baffling - and very disappointing - as the recent tobacco control plan states that “the government will continue to embrace developments that have the potential to reduce the harm caused by tobacco use” and the UK government policy with regards to electronic cigarettes is (relative to other countries) extremely progressive and liberal. The UK observations here focused on proportionality. We heard that snus is highly addictive, that it has harmful effects, that it may be a gateway to tobacco use, that the scientific evidence is disputed so falls within the “margin of discretion” allowed to the legislators. Lifting the ban would allow an addictive product onto the market and would prevent the legislator from protecting public health. The UK counsel argued that we should take note of the “evidence-based FCTC” and “the law must prevent the initiation of a tobacco product by young people”. Also, that commercial interests cannot override public health risks of a product that might be harmful to the young, and the protection of human health has priority over economic interests.
Counsel for the Norwegian government Norway also defended the ban. We heard that Norway’s goal is for a tobacco free society, so the rapid increase in the use of snus in Norway is of serious concern to the Norwegian government, its use by young people in particular, and that the government views it as “an epidemic”. In a relatively emotive presentation the lawyer asserted that “there is no doubt” that snus is highly addictive, harmful and may cause cancer. Their view is that oral tobacco can be an entry point to addiction. The Norwegian success in reducing smoking prevalence is, the counsel said, due to anti-tobacco measures rather than to snus. He asserted that NNA couldn’t show a direct causal link between the use of snus and the decline in smoking. Also, that there is an ethical concern about harm reduction theory – is it fair to use young people as an experiment in order to protect others against a more harmful product?
Counsel for the European Parliament We heard that: The impact assessment on the EU was that “snus is a toxic and addictive product” and that the 2004 case (the last time the ban was challenged) is still relevant. A high level of protection of human health is required, and the FCTC requires the EU to prevent the initiation of, and to decrease the consumption of, tobacco products. Credit for reducing the risk of smoking in Sweden is due not to snus but to tobacco control and healthy living. Snus complicates attempts to quit and promotes dual use. The present case we were told relies on studies by a single scientist whose conclusions do not reflect the view of the scientific community and as expressed in SCENHIR and IARC. “Lifting the ban would have irreversible effects”. Less restrictive measures would not provide a high level of health protection. “The proven harmfulness of tobacco consumption” means that it is in the discretionary power of the legislator to ban and it is not manifestly inappropriate.
Counsel for the European Council Counsel argued that the ban is perfectly appropriate and proportionate. The ban provides protection of the population from snus, which is addictive and toxic, increases risk of cardiovascular death and is a risk for the foetus. The negative health effects justify the ban. This was the scientific evidence at the time of the legislation.
To rely on the “so called Swedish experience” is, we were told, inaccurate because of the flaws in the data. The applicants, Counsel said, argue that there is a causal link between snus and the reduction in smoking, but this has not been proven. In Sweden women smoke as little as men yet do not use snus to the same extent. Parental leave is encouraged in Sweden and the decrease may be due to the high levels of parental leave taken by men who are less likely to smoke when looking after children. Evidence from the US, not presented by the applicants, shows that snus undermines attempts to quit smoking. The applicants have failed to demonstrate that the use of snus would reduce smoking in the European Union. Snus is less dangerous than smoking (as the NNA has shown), but Counsel argued that there is a need to weigh the potential benefits against the risks – in particular the risk of non-smoking young people taking up snus “cheered on by Swedish Match”. The original products were attractive to young people. No authorities (including WHO) argue for a lift in the ban. The Swedish government’s aim is to reduce the use of all tobacco products and the evidence does not support the lifting of the ban. “If we are going to win the fight against the tobacco epidemic we have to take action where we can”; “Snus was legitimately banned in the past”; “A guiding principle of the FCTC is of a fundamental conflict between the tobacco industry and public health”.
A lifting of the ban on snus would have far reaching and unforeseeable consequences therefore the Council requests that the court rejects the application.
Counsel for the Commission Counsel asserted that the case in 2004 remains applicable and that there has been no fundamental change in the legal and regulatory framework or the science. Snus is a “harmful and addictive product”. “It has been argued that it is less harmful and less addictive” [than smoking] but relativizing harm is a distraction to direct attention away from the harms of snus. The claim that snus is harmful has already been established and is manifest from studies included in the EU impact assessment.
The written observation (submitted to the court) from Finland is that snus is highly addictive and a reversal of the policy would send a negative signal. The FCTC requirements indicate the need to uphold the ban. The objective is to reduce all forms of tobacco consumption.
Snus is addictive therefore the ban is the most effective measure.
There is a market potential for snus. The product has been marketed to young people in the past. It is a particular problem because snus can be used surreptitiously eg by children at school and it may be a gateway to smoking. The Commission data leads to the conclusion regarding the Swedish experience that there is a lack of causal link between snus and the decline in smoking.
It is acknowledged that NNA may wish to help existing smokers to give up, but, Counsel argued, legislators need to regulate for the population as a whole. Wide discretion is allowed [by legislators], hence the ban is not manifestly inappropriate.
Judges’ questions This was followed by (largely inaudible) questions from the judges. One judge noted that there was a big discrepancy in the conclusions in the evidence offered by the institutions and the expert witnesses, and asked the Commission: “Should the Court conclude that you blend together evidence to find a solution more appropriate policy wise that accords with your view?" Another judge asked whether it might be politically difficult to lift the ban, and asked whether that had coloured the judgement of the institutions with regards to the scientific evidence. One judge questioned whether the institutions were supporting the ban because snus is harmful and addictive or because of a wish to ban nicotine. A judge proposed that snus could be sold in pharmacies only.
Five-minute replies Each party then had five minutes to reply. NNA’s barrister stated that the NNA represents the real party here, i.e smokers and consumers, that the policy advocated here today had been to “quit or die”, that snus will save lives and that smokers are sensible and will take a safer choice if offered. He stated too that ‘dignity’ permeates the Charter of Fundamental Rights and accused those defending the ban of arrogance. He thanked the court for listening to NNA.
Other summary points were:
Swedish Match again asserting the need to look at all the evidence, stating that there is no evidence that snus poses a greater risk to foetuses and citing the Intoxicants in Norway 2016 report, which found that the increase in snus use amongst Norwegian youth had plateaued.
The Commission asserting that one of the problems is that people can use snus anywhere, and some people even snus while sleeping.
The Council stating that if the ban was lifted they would pursue another type of restriction.
Parliament “we are here especially to protect young people” and concern about tobacco company use of attractive packaging.
The hearing ended by lunchtime. We went to get lunch in the ECJ canteen and then did some filming in the rain - under the bike shelter and away from the security guards.
Next steps The Advocate General will give his opinion on 12 April 2018, after which the Court will come to a decision.
Overall it was very disappointing to witness the UK and Norway, as well as the three EU institutions, defending the ban and relying on arguments debunked long ago to do so. However, it was a relief to hear some of the judges questioning the defendants’ motives and addressing the discrepancies in evidence, and we are cautiously optimistic for a positive result.
Another plus is that this process has demonstrated that there’s a huge amount of common ground between us vapers and snus users: common themes in the arguments used against our choices are that only state sponsored tobacco control will do (quit or die and do it our way), concerns about children (unsupported by evidence), gateway concerns (unsupported by evidence) and current smokers being viewed as collateral damage in the pursuit for a tobacco free world.
We are delighted that the court hearing has led to new advocacy activity for snus, including #EUforSnus@euforsnus on Twitter, and the EUforsnus Facebook group. Please join and follow #EUforSnus: it is essential for us snus users and vapers to make our voices heard and the consumer voice will be much more potent if we join together to assert our right as adults to choose safer products.
Our snus pages are here, please see Snus facts for accurate information on snus.
Video of Gerry Stimson speaking with Bengt Wiberg after the hearing. "We need more carrots and fewer sticks".
Uwe Hille introducing snus to the tobacco display in the ECJ shop
Gerry Stimson outside the ECJ.
Gerry Stimson, Paul Diamond and Jessica Harding in the ECJ canteen after the hearing
NNA media release, sent out on Friday 26 January 2018
European Court of Justice holds hearing on ban on snus
EU institutions argued collapse in smoking in Sweden due to “healthy living” not snus
UK government said ban was “protecting public health”
Scientists say “absolutely no doubt” that snus is a key factor in fall in smoking
The EU institutions have urged the European Court of Justice to uphold the ban on the smoking substitute snus which was imposed in 1992. They were opposing an action brought by the manufacturer Swedish Match at a hearing on 25 January 2018.
The oral tobacco product is used daily by 20% of people in Sweden which was exempted from the ban when it joined the EU in 1995. Smoking in Sweden has fallen from being more than 50% in the 1960s to just 5%. This is by far the lowest level in the EU where the average for daily smoking is 24%.
Outside the EU snus is also popular in Norway which announced this month that smoking has halved in the last ten years to 11%. It has been overtaken by snus use which is now at 12%.
Counsel for the European Parliament told the court that these dramatic falls had nothing to do with snus. It was instead the result of “healthy living.” Meanwhile the European Council argued that “high levels of parental leave for men” in Sweden were reducing smoking as it meant men could not smoke as they were with their children.
The UK and Norwegian governments argued that the ban should continue with counsel for the UK saying it was “protecting public health.”
The legal action is supported by the consumer charity the New Nicotine Alliance. Speaking after the hearing its chairman Professor Gerry Stimson said: “snus has been the gateway out of smoking for both Sweden and Norway which has led to vastly better health outcomes. It is disappointing that while the UK government has shifted from opposing e-cigarettes to being an enthusiastic supporter, it has still not changed its mind on the EU snus ban which it was pivotal in instigating.”
His comments were echoed by the smoking substitutes expert Dr Konstantinos Farsalinos: "There is absolutely no doubt that access to snus in Sweden and Norway has played a crucial role in the rapid reduction of their smoking rates.”
An academic study in 2017 showed that up to 355,000 deaths could have been avoided in just one year if Sweden’s rates of smoking and snus use had been replicated in the rest of Europe.
4. World Health Organisation: snus is “considerably less hazardous” than smoking. EU Commission: the health advantages over smoking are “undeniable". US Food and Drug Administration: authorised snus after exhaustive testing
5. Two academic studies have shown that if snus were available in the rest of Europe it could save between 200,000 and 355,000 lives - every year. (Brad Rodu, 2004, Snus Commission Report, 2017) - see table on page 19 of the Snus Commission Report for annual mortality gap in your country.
On Thursday 25 January the European Court of Justice will be hearing evidence on the EU prohibition on snus which is very popular in Sweden.(1) It has driven the astonishing reduction in the country’s smoking rate from 50% to just 5%. By contrast the EU average is 24%.(2)
In Norway official figures published on 18 January showed that snus has helped to halve its smoking rate to 11% in just ten years. For the first time snus use has overtaken smoking with 12% of the population using it in 2017 compared with 10% the previous year. (3)
The EU banned snus in 1992 - Sweden was exempted when it joined in 1995. Since then health experts have increasingly opposed the ban. Along with the collapse of smoking in Sweden they have seen substantial evidence showing that snus is far safer than smoking.(4) The experts argue that snus is responsible for the sharp divergence in tobacco mortality rates between Sweden and the rest of Europe.(5)
One of them is Professor Gerry Stimson who chairs the consumer group the New Nicotine Alliance which is intervening in the ECJ action.
“I am thrilled that influential figures like Stephen Fry are challenging this absurd ban on the world’s most successful smoking substitute. Snus has been the way out of smoking for vast numbers of people and it should be available to British smokers too,” said Professor Stimson.
“There is compelling evidence that the EU ban has cost hundreds of thousands of lives,” said the Professor.
An academic study (6) in 2017 showed that the ban on snus has led to the premature deaths of up to 355,000 men a year in the EU.
1. 20% of people in Sweden are daily users of oral/chewed/nasal tobacco. See footnote on page 73 of EU Eurobarometer 2017
2. Daily smoking fell in Sweden from 8% to 5% over the last three years. The EU average fell from 25% to 24%. See page 27 of EU Eurobarometer 2017
5. Two academic studies have shown that if snus were available in the rest of Europe it could save between 200,000 and 355,000 lives - every year. (Brad Rodu, 2004, Snus Commission Report, 2017) - see table on page 19 of the Snus Commission Report for annual mortality gap in your country.
The case to overturn the ban on snus in the EU now reaches a new important milestone – a hearing at the European Court of Justice on 25th January (Case number = C-151/17).
Last year the ECJ asked all EU states and the EU Institutions to comment on the case. The court received five responses. On the 25th January our lawyer gets a brief opportunity to expand on our case before the court. Other parties also get this opportunity. And it IS brief – 15 minutes or so to put the main arguments.
But that’s not the end of the court process: after the hearing the Advocate General assigned to the case examines the arguments and evidence and comes up with a preliminary opinion for the court. The Court comes to a final decision sometime later this year.
The case was originally brought by Swedish Match. The New Nicotine Alliance asked to be joined to this case because it concerns the health of smokers in the European Union. It is not about markets and commerce, but about the right to be able to choose a safer alternative to smoking. For the NNA this case is about whether some 320,000 premature deaths from smoking can be saved in future years, as detailed by Dr Lars Ramström in his statement to the court.
The denial of access to lower risk snus leads to unnecessary deaths. The NNA believes that smokers have a right to safer nicotine products as alternatives to smoking and the right to make choices that help them avoid adverse health outcomes.
The core of the NNA’s case is that the ban on snus is both disproportionate and contrary to the right to health. There is no need for the ban, and the ban, if upheld, will continue to contribute to excess mortality from smoking in Europe.
This is the first time that a ‘right to health’ argument has been used to challenge a bad tobacco law: we argue that the Court needs to examine the compatibility of the Tobacco Products Directive with both the EU Charter of Fundamental Rights and the harm reduction obligation under the Framework Convention on Tobacco Control.
The test case scenario for the impact of snus on health is Sweden. The Swedish experience shows that snus is of little harm and, importantly, that using snus has led to the lowest death rates from tobacco related disease in Europe.
The EU tobacco legislation has perverse consequences when it comes to snus. It is based on a limited and flawed understanding of health protection. The perverse position that we find ourselves in is that in the EU smokers have a right to buy the most lethal form of tobacco – the cigarette. They do not, however, except in Sweden, have a right to buy snus.
There is thus a heavy responsibility for the court – to continue the ban and accept that thousands of EU citizens will come to an early death through smoking, or to allow smokers in the EU to freely choose to use a safer alternative to smoking.
Follow @NNAlliance on Twitter for updates
#LegaliseSnus (because) #SnusSavesLives
For more on snus and on NNA's involvement in the case see our snus campaign pages, HERE
image @ Cedric Puisney via flickr under Creative Commons Licence
As 2018 gets underway, Philip Morris International has reinforced its recent claims to be committed to a smokefree future by placing full page advertisements in three prominent and widely read UK newspapers, backed up by a website offering simple advice on alternatives for smokers. Grounded on the premise that the best thing a smoker can do is to stop smoking entirely, the company sets out some key goals which they would like to achieve to encourage those who can’t:
Offer to support Local Authority cessation services where smoking rates are highest
Seek government approval to insert, directly into its cigarette packs, information on quitting and on switching;
Expand the availability of new, alternative products in the UK.
As is to be expected, there is a certain amount of consternation from some in public health about this development from a tobacco company, but we believe that it is something that should be cautiously welcomed. As NNA trustee Sarah Jakes highlighted in her keynote speech at the e-cigarette summit in November, public health should consider what benefits harm reduction can have for smokers rather than who is providing it:
"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 overnight, and it won’t happen at all if you continually block them simply because of who they are."
On the face of it, the new campaign from Philip Morris appears as if it has potential to deliver genuine benefits, and does indeed make it clear what alternatives are available and where to find them. This is the essence of harm reduction and dovetails with the aims of the government’s commitment to ‘nudge’ policies.
We understand that there is plenty of mistrust between public health and industry, but this should not blur the end goal of ensuring that smokers who wish to switch from lit tobacco are given ample opportunity to do so and made aware of all the options they have at their disposal to get there.
We hope that government will look kindly on the suggestion to provide information to smokers in their cigarette packs, it would speak directly to them just as health warnings used to when inserted in packs in the past. Support for Stop Smoking Services is also welcome as many smokers would benefit from the advice and support they can offer because e-cigarettes can be daunting for many.
The NNA fully supports efforts to raise awareness about nicotine alternatives – it is, after all, exactly what we are set up to do – but we also realise that campaigns like the one Philip Morris has embarked upon will be controversial. We hope, however, that potential benefits from this new campaign will not be strangled by in-fighting and dogma. There will be an intense amount of scrutiny from public health, and rightly so, but it should be exercised fairly and always with the welfare of smokers in mind.
However you helped us - by sharing our posts, by making a financial donation, by giving us your time, encouragement and feedback - your support has been crucial and none of this could have happened without you.
NNA’s year in review
2017 got off to a fantastic start when the High Court in London agreed that there is a case for legal review of the EU ban on snus and allowed NNA to join the action, as intervenor. The European Court of Justice will hear the case on 25th January 2018. The NNA legal case is the first time that a ‘right to health’ argument has been used to challenge a bad tobacco control law. We hope that this example might be a springboard for challenges in other countries.
When the snap general election was announced we wrote numerous emails to politicians to ask for tobacco harm reduction to be included in the party manifestos. We had some very encouraging responses and will be writing again.
Our campaign to oppose vaping bans, Challenging prohibition, launched in December and was mentioned in Matt Ridley’s article in the Times on 18 December (reposted on his blog, here). Vaping bans send out the wrong message and managers should give very careful consideration to their vaping policies. Read more on our campaign pages here and do get involved if you can.
We travelled, a lot. NNA had a stand at Vape Jam, Vaper Expo, the Vapefindr London Vape Show and the Telford Vape show. We really enjoyed meeting with so many interesting people and welcoming new supporters at the shows . NNA trustee David Dorn gave magnificent and rousing presentations at both Vape Jam and Vaper Expo:
We are very thankful to the Vape Jam and Vaper Expo organisers for their generous financial donations. Please do visit us at our stand in 2018, NNA’s presence at Vape Jam 4 and Vaper Expo is already confirmed. We are also delighted to be supporting Glasgow School of Vape 4 - join us there on 28th January, if you can.
NNA trustees were among those who gave presentations at both sets of the GFN Dialogues, held in the UK and in Ireland this year. You can watch some of the presentations on the Global Forum for Nicotine YouTube channel, here. Look out for further GFN dialogues in 2018; they are free to attend and well worth your time. NNA trustees and associates were also very involved with the Global Forum on Nicotine conference itself, which was held in Warsaw in June.
NNA Associate Terry Walker meets with Hon Lik at the GFN
Lorien Jollye spoke at the Nanny state index conference and Sarah Jakes gave presentations at the All Party Group on E-Cigarettes, the IBVTA conference and, very memorably, gave the keynote speech at the UK E-Cigarette Summit in November:
We were also kept busy with writing submissions to consultations, including the EU consultation on tax, the Inquiry into the Use of Electronic Cigarettes and Personal Vapourisers in Australia, the CAP/BCAP consultation on changes to the regulation of e-cigarettes advertising, the proposed online sales ban in Spain, the draft act amending the tobacco act in Estonia, the Northern Ireland Age of Sale consultation, the Mayor of London Health Inequalities consultation, NICE and the UK Parliament Science and Technology Committee Inquiry into e-cigarettes.
We worked with NCSCT on The SWITCH, a series of videos “inspired by people who have switched from smoking cigarettes to vaping”, you can see them on the NCSCT YouTube channel, here. NCSCT also kindly produced this video for NNA, of our Chair Gerry Stimson airing his sensible views on vaping:
The written word
We updated the NNA position statements, see here. We’ve added loads of posts to the NNA website over the past year too, so please have a browse. NNA trustee Paul Barnes has had several articles published in Vape Lyfe magazine and in November’s edition of Vapour Magazine, all well worth a read.
The image above continued to be a common sight on our Twitter feeds, as NNA trustee Andy Morrison constantly travelled around Scotland, advocating for tobacco harm reduction. Andy and his team of experienced vapers worked mostly with Linda Bauld and her researchers on the Feasibility and acceptability of e-cigarettes as an aid to quitting smoking amongst lung cancer patients pilot study.
We were very sorry to see trustees Lorien Jollye, Heather Morgan,, Neil Robinson and Simon Thurlow go and wish them all the best in their future endeavours. We were delighted that new trustees Paul Barnes, David MacKintosh, Kevin Molloy, John Summers and Sairah Salim-Sartoni could join the Board and we are all looking forward to another dynamic year in 2018.
We were also very pleased to welcome Eddie Black,Kelvin Guy, Victor Mullin, Daniel Pidcock and Terry Walker as new Associates.
Unusually for a charity the bulk of the work is done by the trustees, assisted by just one part-time administrator. Your support is therefore crucial. NNA relies on donations from individuals and all money is used very wisely - our overheads are minimal. We are very grateful to everyone who has given so far and, as an organisation which is grounded in the principle of “nothing about us without us” we are also very proud to have earned your trust. Please visit our Donate page to see how you can help. NNA has also recently become a verified charity on Facebook so you can also now donate to us directly on there, or organise Facebook fundraisers on our behalf.
NNA is now an eBay charity so you can donate to us when you buy something or even donate the proceeds of an auction to us - as Torchy kindly did with these battery wraps
Our list of supporters is constantly growing - as it needs to. So, please encourage your friends and family to sign up. Rest assured that we don’t bombard our supporters with mailouts - even if we wanted to we simply don’t have the time.
Social media is essential for us to get the word out, please help by sharing our posts. Our Facebook page is here, so please like it and invite your friends to like it too. We are @NNAlliance on Twitter - our list of followers is growing steadily but we could always do with more. Please also consider subscribing to our YouTube channel,
So, a huge thank you from us to all of our supporters, we are looking forward to working with you to make 2018 an even better year.
On 25 January 2018 the European Court of Justice has the opportunity to end the EU ban on the world’s most successful smoking substitute.
In a hearing starting at 0930 the court will look at the legality of the EU prohibition on snus - an oral nicotine product which is very popular in Sweden (1). It has driven the astonishing reduction in the country’s smoking rate from 50% to just 5%. By contrast the EU average is 24% (2).
The EU banned snus in 1992 - Sweden was exempted when it joined in 1995. Since then health experts have increasingly opposed the ban. They have witnessed the collapse of smoking in Sweden along with substantial evidence showing that snus is far safer than smoking (3).. The experts argue that snus is responsible for the sharp divergence in tobacco mortality rates between Sweden and the rest of Europe (4).
One of them is Professor Gerry Stimson who chairs the consumer group the New Nicotine Alliance which is intervening in the ECJ action.
“Snus has been Sweden’s gateway out of smoking which has led to vastly better health outcomes. The European Court has the opportunity to open that gate to the rest of Europe,” said Professor Stimson.
“There is compelling evidence that the ban has cost hundreds of thousands of lives in the rest of Europe. The ECJ should respond with decisive action,” said the Professor.
Notes 1. 50% of people in Sweden have used oral/chewed/nasal tobacco. The EU average is 5%. See page 69 of EU Eurobarometer 2017
2. Daily smoking fell in Sweden from 8% to 5% over the last three years. The EU average fell from 25% to 24%. See page 27 of EU Eurobarometer 2017
3. World Health Organisation: snus is “considerably less hazardous” than smoking. EU Commission: the health advantages over smoking are “undeniable". US Food and Drug Administration: authorised snus after exhaustive testing 4. Two academic studies have shown that if snus were available in the rest of Europe it could save between 200,000 and 355,000 lives - every year. (Brad Rodu, 2004, Snus Commission Report, 2017) - see table on page 19 of the Snus Commission Report for annual mortality gap in your country. 5. The ECJ proceedings are case number C-151/17.
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).
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.
There are many ways to support us
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.
UK taxpayers: please consider filling out this short Gift Aid declaration when you donate. GiftAid increases your donation by 25%, at no extra cost to you.
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.
Please do support us financially, if you can. Small amounts can have a huge impact.
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.