I have just returned to my home in Mexico City after a 12-day academic visit to Queen Mary College (University of London). Even in my locality thousands of miles away, and elsewhere globally, the positive effects of health policies in the UK endorsing e-cigarettes as a substitute for smoking are widely known.
However, I would like to share how I perceived the vaping experience in London, as a foreign visitor and strictly from a vaper’s perspective.
I found it very disappointing that even with vaping being embraced by health authorities, the story is completely different when it comes to perception in public and private social areas, especially indoors. I understand that clouds are inconvenient to many non-smokers, but I still felt that permission to vape (whenever granted) was a gracious concession rather than a recognition of the hard, scientific fact that harms from second hand vapor are close to nil.
I was told that too many folks still associate vaping with smoking. Disgust with clouds is an inconvenience, not a health threat. So, why are there not far more vaping lounges or areas in pubs and in airports, for example? Or policies that welcome considerate vaping? Would this not be more consistent with declared public health policies?
The possibility to eliminate stigma, to be able to socialise comfortably while vaping (rather than being forced outdoors) is essential if a public health policy which encourages harm reduction is to succeed. Telling a smoker “your health will improve, and you will likely live 10 more years” is an abstract proposition because harms from smoking usually take decades to materialise. Telling a smoker “you can vape in some comfortable indoor spaces because your vaping poses no risks to bystanders”, is a much better approach which could lead to many more smokers trying e-cigarettes and eventually switching as a result.
The promise to be able to consume nicotine through a new gratifying habit in comfortable indoor spaces, without the stigma and the social shame, is a concrete immediate bonus.
An important example: vaping is treated exactly as smoking in Heathrow airport. This is very disappointing, since Heathrow is not only the entrance/exit gate to the UK, but a connection hub to millions of travellers worldwide. The message this is sending is that the health authorities of the “most vaping friendly country” still consider that vaping poses the same risks to non-smoker bystanders as smoking.
While some pubs allow for vaping indoors, I was always reminded to vape discreetly or even secretly. No vaping sections or lounges. Again, permission as a gracious concession.
This is a key issue in Tobacco Harm Reduction because it allows for the necessary socialisation that can make vaping pleasant and attractive (for us vapers and for potential smokers that could try it or switch).
The harms from involuntary exposure to second-hand smoke by non-smokers have served as justification to restrict (through increasingly intrusive bans and social stigma) the social spaces where smokers can smoke. This is what Tobacco Control calls “denormalisation”.
We must not allow this type of social stigma to be applied to e-cigarettes and vaping. Banning e-cigarettes in all indoor spaces makes vaping much less attractive to potential smokers and sends the wrong signal – that vaping is as dangerous as smoking - to smokers and non-smokers alike.
Despite British public health policies endorsing vaping, I still found far too many vaping restrictions in London that cannot be justified on medical or scientific grounds. In practically all my acquaintances and interactions, I detected a very widespread and dismal ignorance and indifference about vaping. Most people I talked to still conceive vaping as “some form of smoking”. Or that yes, it may be “less harmful” but it is “still not OK”. Also, most people still believe that nicotine is carcinogenic.
I cannot claim that my experiences are a sociological study with scientific methodology. However, I do sense that PHE and British health authorities have not done enough to translate their policy statements into public perception. For THR to work they must overcome this deficiency.
While the public health authorities in the UK should be applauded for their relaxed acceptance of vaping overall, they should be doing far more to correct these poor perceptions by those who formulate policies on vaping in public spaces. If they do not, a momentous public health opportunity is being wasted and their stated policy aims will ultimately fail to reach full potential.
Dr Roberto Sussman
Senior Researcher in Physics, National University of Mexico (UNAM)
Please see the NNA’s resources towards challenging vaping restrictions in the UK here
No smoking sign at London City Airport