PHE freedom of choice

BBC: Smoking v vaping: Watch lab test results


At the turn of the new year, Public Health England took the opportunity of a lack of political news to launch a short film showing the difference between what is inhaled from a cigarette and from an e-cigarette. It was featured prominently by the BBC, which reproduced the film with subtitles on December 28th, and also gained much national media coverage elsewhere.

As the film mentions, nearly 50 percent of smokers still believe that vaping is as bad, or worse, than smoking. This is a misperception that the NNA would like to see change and so we are pleased that such an important message has received so much publicity. There have, however, been some doubts expressed about the method used by PHE here, which we feel are misapplied.

It is true to say that the film is intended to shock by illustrating the difference between what comes out of a cigarette with what is emitted from an e-cigarette. Lurid headlines from irresponsible media outlets who promote irrational fear about vaping are having a real-world effect of scaring smokers away from alternatives and, consequentially, corrupting free choice. They need to be countered robustly. If a consumer is denied true facts about a product, they are not able to make an educated decision.

Nothing in the film is inaccurate, it has long been known that the dangerous component of lit tobacco is not nicotine, it is the tar. It is the principle that underpins the acceptance of NRT which has not yet been similarly accepted for new safer nicotine delivery systems like e-cigarettes. All PHE has done is present this information in a simple, visible and straightforward way.

It is also important to note that there is nothing coercive about this film. It does not order smokers to quit, it merely presents information in a stark and accessible way in order that smokers might see that their misperceptions about e-cigarettes have come from dubious sources.

The film also only seeks to guide viewers, not to direct them. It is correct that the lung is a marvel of evolution and can filter out much of the tar that is sent its way, but PHE has left the smoker to make the decision as to whether to take that risk or not.

Many smokers will watch the film and dismiss it; they will have made their own risk assessment and decided that their love of smoking is worth continuing with, and we would support that decision. Others who have thought of quitting will have tried e-cigarettes and not been able to get on with them so other options may be available to them, again something that the NNA supports. However, there is a large body of the smoking public who would like to choose to stop smoking with e-cigarettes – and could well be successful - but will have been put off by dishonest scaremongering. It is this demographic that the PHE film seeks to speak to. Like any marketing or advertising, it will only find a receptive audience in those who were already contemplating the idea.

The NNA exists to promote wide availability of alternative products, rather than coercion. We believe – many of us through personal experience - that forcing smokers to quit with a stick is nowhere near as effective as tempting them with a carrot. Harm reduction is grounded in such a philosophy. Availability of accurate information goes hand in hand with availability of the products; it is no use having a wide range of devices on the market if smokers have been conned into avoiding them.

It has long been frustrating for both the public and industry that the truth has not been told about the reduced risk of vaping products in relation to combustible tobacco, and the NNA has often called for this confusion to be addressed. Just like the ASA are doing with the recent decision to allow health claims for e-cigarettes, PHE has tackled the confusion head-on with their film and the more smokers who see it, the more who might be better informed to make a free choice to choose an alternative. To not show the film, or to not produce it, would take away that choice from many thousands of smokers who are dishonestly told that there is little difference between the two options.