Ever since vapers in the UK began experimenting with this new technology over 10 years ago, we have been constantly surprised at how e-cigarettes have been attacked by the established public health profession. Why, when so many had found a way of quitting smoking as the government had been urging us to, were we being persecuted again?
Back in 2010, the MHRA – under the stewardship of Jeremy Mean - did its level best to have all devices banned within 21 days. It was only an extraordinary campaign by vapers, who submitted responses to the consultation in droves, which staved off the threat. The actions of these vapers prevented a ban which would have prevented the dramatic declines in smoking prevalence we see today.
In 2012, it was the EU which attempted to destroy vaping by originally proposing – with the backing of the UK government and UK health groups – to enforce a maximum 4mg/ml nicotine limit on e-liquid and full medicalisation of e-cigs, which would have created a dangerous black market in both equipment and liquid supplies. The EU had to back down in the face of thousands of angry letters written by vapers to their MEPs. If those proposals had been successful the decline in the number of smokers in the UK would not look like it does today as the market innovation in safer products would have been strangled and products would not have been as accessible to smokers.
It was vaping consumers lobbying their elected representatives – both here and in the rest of Europe – who contributed to making MEPs think again. Whilst the TPD is not perfect, and does need reviewing, it is far better than what could have been.
Painfully slowly, an establishment which only knew one way of tackling smoking, by abstinence only – the ‘quit or die’ method – began to realise that there were benefits in harm reduction.
Many organisations who were in full support of draconian EU rules on vaping six years ago are now supporters of tobacco harm reduction, often recanting on their previously strongly-held opinions on the dangers of e-cigarettes. This has often been as a result of dialogue between key people in these organisations and vapers. Many of them, as a result, are also now smeared in the same way as we consumers often are, as “shills” or “astroturf” - by the dwindling number of blind reactionaries.
The Behavioural Science (or Nudge) Unit, Public Health England and the Royal College of Physicians led the way with an appreciation of harm reduction as a policy, and slowly but surely other health groups followed. There is now – apart from a few scattered stubborn outliers – almost a consensus amongst public health opinion-formers that vaping is a valid route out of smoking, for those seeking a route.
The MHRA now regulate vaping products and have been largely sympathetic to the needs of consumers and vape businesses. Their previous heavy-handed approach has made way for an understanding that vaping has benefits that should not be eradicated by harsh regulation.
There was always one vital piece missing, but today’s report by the Science and Technology Committee, chaired by parliamentary grandee Sir Norman Lamb, an ex health minister, could be the catalyst for a step change in the UK establishment’s approach to e-cigarettes and other safer nicotine products.
The NNA represented vaping consumers – and arguably smokers who may wish to switch to safer products in the future – in giving evidence to this committee, and we fully welcome the report’s main recommendations as detailed in its press release:
• The Government, the MHRA (Medicines and Healthcare products Regulatory Agency) and the e-cigarette industry should review how approval systems for stop smoking therapies could be streamlined should e-cigarette manufacturers put forward a product for medical licensing.
• There should be a wider debate on how e-cigarettes are to be dealt with in our public places, to help arrive at a solution which at least starts from the evidence rather than misconceptions about their health impacts.
• The Government should continue to annually review the evidence on the health effects of e-cigarettes and extend that review to heat-not-burn products. Further it should support a long-term research programme overseen by Public Health England and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment with an online hub making evidence available to the public and health professionals.
• The limit on the strength of refills should be reviewed as heavy smokers may be put off persisting with them—and the restriction on tank size does not appear to be founded on scientific evidence and should therefore urgently be reviewed.
• The prohibition on making claims for the relative health benefits of stopping smoking and using e-cigarettes instead has prevented manufacturers informing smokers of the potential benefits and should be reviewed to identify scope for change post-Brexit.
• There should be a shift to a more risk-proportionate regulatory environment; where regulations, advertising rules and tax duties reflect the evidence of the relative harms of the various e-cigarettes, heat-not-burn and tobacco products available.
• NHS England should set a policy of mental health facilities allowing e-cigarette use by patients unless trusts can demonstrate evidence-based reasons for not doing so.
• The Government should review the evidence supporting the current ban on snus as part of a wider move towards a more risk aware regulatory framework for tobacco and nicotine products.
This is a significant document. The Science and Technology Committee carries a lot of weight and its membership is drawn from every political stripe in parliament.
Previously, there has been a slow drift towards an appreciation of tobacco harm reduction but only from advisory bodies like PHE and ASH. These bodies could issue guidance, but that guidance could be ignored by national and local institutions - and businesses were largely unaware of it. Today’s report is a government committee recommending a root and branch review of not only how vaping should be treated by facilities directly controlled from Westminster, but also how government should influence private companies and other non-governmental organisations to rethink their policies towards safer nicotine products.
Did vaping consumers also have a hand in bringing us to the point where such unequivocal support for harm reduction is being recommended by a governmental committee? Yes, we did. Quite apart from the NNA’s contribution to this report, we are 3 million strong now, and amongst our number there are vaping MPs, not to mention other parliamentarians who have seen first-hand from family, friends and constituents how switching to safer products can transform lives. Vaping is part of everyday life now and today’s committee report recognises that establishment policies have not kept up with that, so there is need for a change.
As our press release concerning today’s report states, the UK is a world leader in recognising the benefits of harm reduction, but we can do better. We fully welcome the Science and Technology Committee’s recommendations and would urge the government to implement an all-encompassing policy on encouraging safer nicotine use, a policy based solidly on evidence, not ideology and ignorance.
The full Science and Technology report is here
Our press release is here
NNA Chair Sarah Jakes’ oral evidence to the committee is here
NNA written evidence to the committee is here