While the World Cup is currently taking place, the Scottish Government has marked the feast of sport taking place in Russia by scoring something of an own goal.
This week saw the publication of the Scottish tobacco control plan (TCP) led by Minister for Public Health and Sport, Aileen Campbell and – while there are many friendly references to e-cigarettes contained within it – it is somewhat schizophrenic when it comes to its approach to harm reduction overall.
NHS Health Scotland, which is referenced throughout the government’s plan, has come a long way with its position on e-cigarettes, from a deep mistrust and recommendations of vaping bans in all areas in 2014, to its current welcoming – if over-cautious – stance on the products.
The TCP document recognised that many smokers are now using e-cigarettes to cut down their combustible tobacco use or to quit entirely and boasts that stop smoking services are e-cigarette friendly. It even pledges “to develop guidance for health professionals and other relevant service providers so that they can offer basic advice on e-cigarette use as part of their support for smokers who choose to make quit attempts using e-cigarettes”.
This is all to be welcomed even though we feel that health professionals are not the best source of guidance on vaping products and that consumers should be consulted far more than we currently are. We have found that some stop smoking services are either unwilling or unable to support smokers who express an interest in e-cigarettes other than to nudge them down the path of licensed pharmaceutical products. For whatever reason, if the Scottish government truly wishes to reach a smoke-free future, they should be utilising the skills and knowledge of vaping consumers instead of placing faith in organisations who have scant understanding of the products.
We also welcome moves to allow use of e-cigarettes in prisons and mental health settings. It is a no-brainer when there is no valid reason to ban use of vapour products which carry no health risk to others. Indeed, they should be seen as a positive benefit in potential tinder box institutions where a large majority smoke but are being told they will not be permitted to do so in the future. We understand a need for strict control on devices that can be sold in such a febrile environment, but it is sensible for the Scottish government to recognise that the benefits of allowing vaping can more than compensate for the potential risks.
However, these mildly promising changes are undermined by a prevailing caution towards e-cigarettes which borders on paranoia. Nothing illustrates this more than the TCP’s stated intention to “consult on the detail of restricting domestic advertising and promotion of e-cigarettes in law”. Currently, e-cigarette manufacturers can advertise their products domestically where the same is not permitted for combustible products. This is a powerful incentive for smokers to switch to safer alternatives which the Scottish government, inexplicably, seems to want to eradicate.
We are concerned that the NNA has worked hard with NHS Greater Glasgow and Clyde (NHSGGC) over the years in overturning vaping bans in hospital grounds. It would be helpful if this were to be extended to all Scottish hospitals following the lead that NHSGGC were brave enough to make having listened to the evidence.
However, the Scottish TCP seems to want to make a debate of something which should be a given. The plan pledges to “work with health boards and integration boards to try to reach a consensus on whether vaping should or should not be allowed on hospital grounds through a consistent, national approach”. There should be no debate about this. If the Scottish government is serious about reducing smoking, a clear incentive should be evident, so the only acceptable policy is for health boards to emphasise the difference between vaping and smoking by allowing e-cigarette use wherever possible.
We are also disturbed that the Scottish Government implies changes in regulation towards non-nicotine e-liquids and other harm reduction products such as heated tobacco which, although research is still ongoing, were described as carrying a fraction of the risk of smoking by the FSA’s Committee on Toxicity in December.
This all appears linked to the suspicion that NHS Health Scotland has about recreational use of nicotine as expressed in their latest literature where they state that “e-cigarettes are useful for public health and health service purposes only as a potential route towards stopping smoking”. This is an idealistic view since the market for nicotine – as opposed to smoking – will never just vanish, so a more enlightened tone would be far more beneficial to the public’s health in Scotland.
The TCP places great emphasis on e-cigarettes being a health product rather than a consumer product which smokers can enjoy over and above combustible tobacco. The government’s report details the massive organic rise in e-cigarette use – which is simply because people enjoy using them – but then speaks of an aspiration to see the development of a medically-licensed vaping product. This entirely misunderstands the subject matter.
Smokers are not ill, they do not require a medicine. The entire reason for the success of e-cigarettes is because they are pleasurable. That is what is driving the huge boon to public health in Scotland as well as the UK in general. Scottish authorities can never begin to comprehend e-cigarette use if it refuses to understand it is because they are not medical products. The reason that Scottish stop smoking services are e-cigarette friendly now is not because of the success of tobacco control policies, but because they have had to react to where consumers were going without their government’s help. Rather than try to stop that, we should be heartily encouraging it. Less caution; more enthusiasm.
As NNA lead in Scotland, I will be writing to Aileen Campbell to express our concerns on this TCP, as it is hopelessly confused. We will also be responding as an organisation to any consultations which arise and will be objecting strongly to any further restrictions on products which have driven an unprecedented decline in smoking prevalence not just in Scotland, but the UK and also most of the western world.
It is well past time that this antiquated and blinkered view of harm reduction was altered so that the reasons for success of risk reduced products were recognised and – instead of booting the harm reduction ball into the back of our own net – we began passing it up the other end of the pitch instead.
I’d like to start with a little anecdote of something that I came across a few months ago. I got an Uber - it was fairly late at night and I’d been out with a friend.
We’d been drinking and vaping. He said “Oh, I’ve been vaping too, I’ve got an e-cigarette” I said “Oh, that’s interesting, what have you got, let’s see it?”. He said “Oh no, I don’t bring it out with me, I don’t bring it to work.” I said “Whyever not?”. He said “Well, Transport for London have banned vaping in private hire vehicles so I can’t use it and it’s too much of a temptation.” And I said “So, what do you do, when you go on a shift?”. And he said “Well, I always buy a packet of cigarettes before I start work”.
Now, If you don’t understand why he would do that then you maybe don’t understand how e-cigarettes work, and sadly, if you don’t understand how e-cigarettes work there’s a possibility you could work in tobacco control. Because a lot of these policies come about because of misinformation that has been spread mostly by tobacco control organisations. The Uber driver’s just fallen foul of a policy of misinformation where Transport for London have obviously picked up on all these stories you hear and imposed a ban. And the fact that it’s in his private property as well just makes it even worse.
Here are some recent examples of this misinformation: This is just in the last week or so because these are regular events, and the public will be reading these sort of things. In a BBC article, last week I think it was - it was a positive article but they quoted the World Health Organisation with a few desperate excuses as to why e-cigs are bad - and one of them was: “the users replacing the liquid in refillable e-cigarettes might spill the product on their skin, possibly leading to nicotine poisoning”. I was tempted to demonstrate - just get a 10 ml bottle and smear it all over my arm - to prove why this is a bit alarmist but I didn’t bring enough!
The European Respiratory Journal recently described vaping as “a one way bridge to smoking”. So, you’ve got vaping going up, smoking plummeting, but apparently this is happening the other way round. Two researchers from a well respected university stated categorically “we don’t know yet if vaping is safer than smoking”. A US researcher from San Francisco, that some people might have heard of, said that smoking triples the chance of a heart attack but using e-cigs as well increases it five fold! I mean, what sort of information does this send out to people about what e-cigarettes are all about and what vaping’s all about?
There are some public health people who are responsible, some have been here [in Warsaw] and they say positive things, but they are just being drowned out by what seems to be a coordinated effort of misinformation, quack science, doubt merchanting, diversion, all of these things. Consumers need to have meaningful and consistent advice if they are going to make their free choices. And public health at the moment simply isn’t offering that. Instead they are mimicking the tobacco industry that they’ve always said we shouldn’t talk to, because we shouldn’t trust them! So, if we’re not meant to supposed to trust tobacco companies back then, because they were handing out misinformation, why should we be trusting tobacco control?
When we are alarmed at imaginary dangers how can anyone trust those sort of people? I just think the public, and specifically consumers, should be better served by public health and tobacco control because at the moment they just can’t be trusted.
The fifth Global Forum on Nicotine (GFN) has just taken place in Warsaw, Poland, and again the NNA featured prominently, as we highlighted in our May newsletter.
The plenary address given by NNA's Sarah Jakes, has already been published here and there will be further articles soon expanding on our contributions to the event.
Aside from this, there were many other positive reflections to take from the conference but also – as is always the case with this subject matter – other issues which need to be addressed.
This year’s event saw over 500 delegates attend, a new record, and this despite the European Network for Smoking and Tobacco Prevention’s Conference taking place at the same time in Madrid, resulting in the absence of many in public health who had attended in previous years. This is not to say that public health was not represented, they were, but they were presented with a conference which was one of the most optimistic yet and would have left with a healthy view of tobacco harm reduction.
Global participation appeared to be noticeably expanded this year which bodes well for the future. Contributions from - and presence of - public health experts, scientists, industry and consumers were evident from a wider range of territories and continents than before. The posters on display were the most extensive yet, taking up two long walls and then some.
Tobacco harm reduction, it seems, is becoming a hot global topic.
In the centre of it is the UK, which was widely praised by those in attendance for the enlightened attitude it affords vaping, in particular. Many attendees spoke of how the success on these shores had inspired others to pursue the same policies in their own jurisdictions. We at the NNA are proud to have been involved in advising our government and NGOs on harm reduction since 2014 and we are thrilled to see that our optimism is beginning to be shared by others throughout the world.
We understand that presentations are already available at the GFN website here and that video of the sessions will be uploaded shortly. We would have no hesitation in recommending you take time to view some of them if you were unable to attend yourself, they are sure to be a hearty resource.
In particular, we welcomed David Sweanor of Canada calling for more data on the seismic successes enjoyed by countries such as Iceland, Japan, France, Norway, South Korea and the UK so that the size and potential of disruption can be better understood. It was also good to hear more about the panoply of products available; which populations might benefit from them; and how there could be a better understanding of the industry, consumers and their interaction with public health goals.
It was also good to hear Martin Jarvis talk of the vital importance of harm reduction as identified by Michael Russell 40 years ago, and how Russell’s legacy should be celebrated as a breakthrough in understanding of the role of safer nicotine. Rather than condemnation of safer alternatives and personal attacks on those like the NNA who promote them, a better public health approach for all would be dialogue and an adherence to evidence.
The polar opposite approaches to the subject were no more acutely illustrated than by Dr Konstantinos Farsalinos, who had hot-footed from the Madrid event to report to GFN what he had heard in Spain from tobacco control. He spoke of how they view reduced risk as a danger and a threat, with delegates there making apocalyptic predictions which conflict wildly from reality. He suggested that delegates should not be in Warsaw, but instead in Madrid trying to rectify misperceptions.
The NNA and other advocates would like nothing more, but often when we try the doors shut, and ranks are closed. It should not be for consumers to beg for an audience with ivory tower public health, it should be up to public health to engage with consumers since we are the people who will thrive or suffer under their edicts.
We would suggest, instead, that next year those in tobacco control who were in Madrid bite the bullet, swallow their pride and prejudice, and come to Warsaw to see the enthusiasm and drive behind the tobacco harm reduction movement. Reducing harm from tobacco requires compromise and co-operation from all sides, not trenchant obstinance and blind adherence to coercive policies which have only offered chequered success.
The NNA will be present and correct at the next GFN and we can only hope that more from public health around the world will join us for meaningful discussion, rather than the unhelpful dismissal of consumers as a voice which has sadly plagued the debate amongst some.
Sarah Jakes spoke at the opening plenary at the GFN earlier today. Here is the text for Sarah's presentation, "Rethinking why people like nicotine":
In his talk there, Joe mentioned the scream test. I have a test of my own, I call it the ‘glaze test’.
It’s not always easy, especially when talking to a large group of people, to tell whether they’re really with me.
They tell me they’re passionate about helping people stop smoking and I don’t doubt them. They say they support e-cigarettes and I don’t doubt that either, but do they really understand?
So my test is to throw in a slide about Pleasure. Normally it will include a photo of Vapefest – happy people at an open air festival, celebrating nothing more than the one thing they have in common – their love of vaping.
I tell them about the colourful tents, the thousands of different devices and liquids for sale, the camping, the barbecues, the music and the friends who wait all year for this event just to see each other in person.
And as I look around the room I often see amusement or surprise. The fact that thousands of people come together to celebrate vaping is a revelation.
But in others I see eyes glazing over. It’s as if they’re saying ‘look, I’ve reluctantly come to the conclusion that vaping might be helpful, but enjoyable? Gimme a break’.
Often people are so fixated on the concept that smokers are nothing more than the pitiful victims of an evil industry, that they cannot process the idea that people can enjoy the use of nicotine.
I’ve lost count of the times that I’m told (by people who don’t use nicotine) that the only thing I enjoy is the relief from cravings. Well no, actually I enjoy the taste of my mango cloud, the feeling of the vapour as I inhale it and the sight of it as I exhale.
I value the friends I’ve made through vaping, and the knowledge that we’re a part of something important. Oh and the mild effect of nicotine of course.
Physical cravings are not the only thing that lead people back to smoking. Much more powerful for many people is the feeling of missing something, even decades after stopping smoking.
To understand this better, I’d like to read you something written by Liz Hilton. Liz is in her 70s, smoked for 50 years and has been a vaper for 7.
She started a YouTube channel called ‘vaping for the over 60’s’ and through her channel and blogs has helped many hundreds of smokers switch to vaping.
In her latest video, which she also says is her last, she describes her relationship with smoking and this is what she says:
“Smoking is deeply rooted in my psyche. And I believe it is rooted that way for many people. Smoking is a comfort for me. A way to fill a hole. A pleasurable activity, meaningful.
It is the marker of peak experiences, deep lows, celebrations, triumphs, a friend that accompanies me through my life. My best friend. How thoughtless it is for someone to tell me I must simply ‘quit’.”
I expect by now, that some of your eyes are glazing over. Some are probably making a mental note to ask whether I would agree that this friendship is an abusive relationship. In many ways I do agree.
But just as we would hope that anyone in an abusive relationship can find a new and better friend, so too can smokers.
Smoking is a personal journey which most smokers consider to be no one else’s business. Quitting smoking is also a part of that journey and can be a deeply personal act. It is unfortunate then, that at this crucial point, everyone seems to want to butt in and take over.
No doubt, some people who want to stop smoking appreciate help from a health practitioner. But for many others the medicalisation of cessation is in itself a barrier.
Asking for help, or being told you must seek it can be seen as a weakness, and addiction as a personal or moral failure. It doesn’t have to be that way.
Nicotine itself is a mild stimulant and also relaxant. Nicotine withdrawal is unpleasant, slightly uncomfortable, but not painful or sickness inducing. It is everything around smoking that is so captivating.
So when you offer me a patch you are offering a solution to what for me is the easy part. I’m expected to go cold turkey on the rest.
I choose not to.
My own relationship with smoking was similar to Liz’s, though maybe less intense. My relationship with vaping is somewhat different. If smoking is James Dean, vaping’s more like the Fonz: more fun and pretty harmless. Probably not quite as cool though.
What we’re seeing now is a revolution. People can take control of their own smoking without feeling ashamed, replace it with something equally pleasurable but less risky and be satisfied in the knowledge that they did it for themselves.
It’s empowering and it works.
So why does pleasure seem to be such an issue? I’ve seen many suggested explanations, all may play a role, some more than others.
There are fears that it might attract non nicotine consumers into regular use. We’d be burying our heads in the sand if we denied this could happen. It is almost inevitable.
But so far at least, the numbers are tiny and the minimal risk of harm is dwarfed by benefits gained by the people attracted to switch from smoking. Somehow that side of the equation often seems to be forgotten.
There are fears that vaping could be the ‘training wheels’ for future smoking. The mechanism for this isn’t clear. Nicotine isn’t like some other drugs, where users become habituated and seek ever larger doses. It baffles me what the attraction of smoking would be for anyone who wouldn’t have been attracted to it anyway.
For me, the most likely explanation is that pleasure plus minimal risk of harm equals zero incentive to stop.
Public Health England’s message is that it is better not to smoke or vape, but if that’s not an option – vape. I would argue that for me, the benefits of vaping outweigh the risks and so that statement isn’t true -and I think PHE understand that.
They may not endorse it, but they get it.
For others long term nicotine use in any form is a problem. If it’s not a problem for me I don’t see why it should be for them.
As Joe said earlier, Mike Russell’s words were prophetic. He understood that there was a potential for new nicotine products to become a long term replacement for smoking tobacco, and that for that to happen they must be, in his words, “as palatable and acceptable as possible”. Another word for that is ‘pleasant’.
Mike said that 27 years ago and yet vapers still today find themselves faced with moralistic opposition to their ongoing use of a mildly addictive, approximately harmless and ultimately enjoyable product.
A product which for many if not most has improved their health and extended their lives.
No doubt snus users will tell you the same story, and the heat not burn fans still have it to come.
At the beginning of May, the World Health Organisation issued a draft report on its approach to non-communicable diseases (NCDs), meaning illness arising out of making unhealthy choices rather than the traditional understanding of disease.
The report recognised the “lack of progress” towards tackling NCDs, spoke of fears that the WHO’s targets might not be met in this area, and invited responses to a consultation on the matter. The NNA submitted a response which addressed concerns raised by the WHO in their preamble.
“There are many proven interventions for the prevention and management of NCDs. However, for many reasons, implementation of these has been slow and progress disappointing."
“Thus, we have sought to imagine different ways of doing things and to formulate recommendations that are not overly technical but policy-friendly.”
Article 1(d) of the WHO’s Framework Convention on Tobacco Control specifically mentions“a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products” as part of its remit. With this in mind, and with the WHO seeking “different ways of doing things”, the NNA – a registered UK charity – submitted a response to the consultation which you can read here.
Quoting the Royal College of Physicians, Public Health England, the European Commission and even the World Health Organisation itself, we set out the case for a more robust role for reduced risk products within global tobacco control legislative policies.
We believe our submission was a useful contribution to the debate and drew on proven successes in various jurisdictions to promote precisely the imaginative solutions that the WHO’s report implied it was seeking.
However, to our surprise, when the WHO published the responses it had received, ours was included in a section entitled “feedback received from entities with which WHO does not engage”, insinuating that we work for tobacco companies and likening us to the arms industry! From this we can only assume that the WHO is refusing to read our suggestions or, at least, plans to ignore them entirely.
We wrote to the WHO on 22nd May to complain about our inclusion in that section on their page and to request an explanation but have yet to receive a reply. The New Nicotine Alliance does not accept funding from the tobacco industry, nor do we work to further the interests of the tobacco industry and our website clearly states that “NNA welcomes donations from individuals and organisations to support our campaigning work. We are however unable to accept such donations from manufacturers and distributors of nicotine products.”.
The NNA is a registered charitable organisation in the UK and we are therefore required to publish our annual accounts on the Charity Commission website. The WHO can clearly see our funding and should note that we are a group of mostly consumer volunteers working unpaid to raise awareness of tobacco harm reduction strategies from which many of us have benefitted ourselves.
Indeed, the WHO has often spoken about the need to engage with consumers like us. In its Jakarta Declaration, it spoke of how “participation is essential to sustain efforts. People have to be at the centre of health promotion action and decision-making processes for them to be effective”, so the fact that it now chooses to eradicate consumers from its decision-making is disappointing to say the least.
It is shameful that the WHO has decided to ignore the voice of consumers such as we are, and we will be raising this matter with the public health community in the UK and with legislators who are responsible for approving funding to the WHO. We feel that this is a gross abuse of authority on the part of the WHO and that they should swiftly reconsider.
Our submission is relevant to the subject matter, addresses the areas of concern raised by the WHO and adheres to the criteria that the FCTC declares in its articles of association. There is no valid reason why it should not be considered alongside those submitted by other NGOs and interested stakeholders.
To do otherwise betrays the lofty goals of the WHO and strongly suggests that there is an ideological agenda at play. We believe that this area of policy is far too important to be hijacked by such petty politics, and that smokers should be afforded a plethora of less harmful products should they choose to quit or reduce their consumption of lit tobacco. Accordingly, we are sorely disappointed that an organisation such as the WHO seeks to frustrate those choices for reasons that they will not disclose.
The public for whom the WHO claims to wish to assist deserve better than closed minds on the subject of tobacco harm reduction. The WHO should be looking to expand an embrace of its own article, 1(d) of the Framework Convention on Tobacco Control, and the strategies for health promotion outlined in its own Ottawa Charter, rather than distancing itself from these commitments.
Changing Those UK Pub Vape Bans One Bar At A Time Through “Considerate Vaping”
An extract from an article by Neil H, posted on the ecigclick website HERE
The advocacy groups can’t do it all on their own – sure they have access to the politicians and some of those ‘jobsworths’ imposing the silly vape bans up and down the country – but we as vapers are the grass roots – the ones who can change reluctant landlords minds.
And to prove I’m not just talking the talk…I’m actually walking the walk…
Over the last few weeks I’ve been talking all things vape to landlords – managers and bar staff in a few of the pubs in my hometown of Leamington Spa and with I might add some success.
Obviously larger chains such as Wetherspoon can’t lift vape bans at local level – that’s down to the management team – however as vapers we are like it or not – not only pseudo advocates but the ones that can get those bans lifted by setting the right example.
You’ll see what I mean by that in a wee while.
OK let’s just show you what the New Nicotine Alliance campaign of Considerate Vaping Welcome actually means in the real world and how sensible conversations on vaping can and do change pub landlord’s minds.
The NNA spoke directly to MPs in the Palace of Westminster on Wednesday, an important day for vaping consumers.
At the UKVIA Forum last month, NNA Trustees Sarah Jakes and Gerry Stimson featured on a panel chaired by Norman Lamb, Chair of the governmental Science and Technology Committee which is currently taking evidence on the use of e-cigarettes in the UK. An IBVTA member asked a question to the panel as to why the Committee had not taken evidence from consumers and the independent vaping industry. Sarah and Gerry both commented that this was, indeed, an opportunity missed, and Norman Lamb agreed to think on it. Less than 24 hours later invites were issued to NNA, IBVTA and UKVIA to come to parliament on May 9th to give evidence.
It was because of this that Sarah travelled to Westminster yesterday afternoon to speak directly to the seven cross-party MPs comprising the committee on the day, along with Fraser Cropper of the IBVTA and John Dunne of the UKVIA. The MPs raised questions concerning short fills, pointless TPD regulations, potential excise duties, advertising, e-cigarettes by prescription and vaping bans, to which Sarah expressed the NNA’s positions.
It was a very useful exercise and we were grateful to be able to bring the issues vapers face throughout the UK to the heart of Westminster and present them personally to elected officials. However, Sarah’s opening remarks emphasised that many of those problems are caused by failings in government policy in the past.
After highlighting misjudged parliamentary reactions to tobacco harm reduction – specifically towards snus in the 1980s and 1990s at domestic and EU level and by ministers who were not even aware that e-cigarettes were included in the TPD more recently – Sarah urged the more enlightened politicians of today to show further commitment to encouraging the use of safer nicotine products for those who choose to quit smoking.
With Brexit on the horizon, the NNA feels now is a perfect opportunity to show further leadership, not complacency, towards harm reduction. The government’s Tobacco Control Plan seeks to build on evidence from Public Health England as to the benefit to public health of risk-reduced alternatives and broaden the Royal College of Physicians’ call for vaping to be promoted widely. What better way could there be than to celebrate shackles being lifted once Britain leaves the EU by also unburdening an e-cigarette market bogged down by petty and pointless regulations on tank sizes, nicotine strengths and e-liquid bottle volumes?
We believe that members of the Science and Technology Committee are receptive to our ideas, but the wider Westminster legislative community needs to be convinced too. Yesterday was constructive in putting some forthright opinions across and we maintain that when it comes to repealing unhelpful regulations from Brussels as Brexit unravels, the counterproductive terms of the TPD towards vaping should be discarded and would be a simple, uncomplicated way of ‘taking back control’.
This is your organisation speaking directly to MPs to help influence government policy and we fully intend to continue doing so. You can watch the hour-long committee hearing here, we think you will enjoy it. And if you do, please remember we are volunteers working on a shoestring budget, so if you like what you see, share widely and consider donating – details here - to help us carry on doing what we do.
On Tuesday evening, the New Statesman hosted a panel-based event in a lecture hall adjacent to Parliament Square entitled “When might England become Smokefree?”. The subject matter was a report from Frontier Economics which calculated when the UK would achieve the government’s stated ‘smoke-free’ target of 5% smoking prevalence or less, under various scenarios.
The central thrust of this research - using trusted statistical data from the NHS and the Office for National Statistics as its base – is that if the recent dramatic downward trend in smoking prevalence seen in England since 2012 can be maintained, the 5% threshold could be reached up to 11 years earlier than if government were only to primarily focus on traditional tools like tax rises and increased regulations (see graphic). 2012, of course, is when widescale use of e-cigarettes began to take hold and the number of smokers in England and the UK markedly tumbled after a few years of modest decline.
The report was prepared for Philip Morris International, which was prominently declared, and it is always wise to be wary of future forecasting based on current trends as the Frontier report does. Notwithstanding this, it is still a useful exercise in the art of the possible and prompted an interesting evening of debate Along with Dr Roger Henderson, columnist for the Sunday Times and Spectator, and Mark Littlewood, Director General of the Institute of Economic Affairs, Sarah Jakes, chair of NNA, was represented on the panel, which followed a short presentation of the report by Nick Fitzpatrick of Frontier Economics.
Sarah expanded on the NNA’s position on alternative products and how they can be beneficial to smokers switching by pointing out that no two smokers are the same. This is a crucial aspect of the debate that legislators and public health advocates always under-estimate. Just because smokers have previously bought into a tobacco market which has been almost totally free of innovation for many decades, it does not mean that safer alternatives will be taken up in great numbers if they are restricted to homogenous products which cannot satisfy a wide range in tastes and nicotine usage patterns.
It is apt that a company called Frontier presented the research for Tuesday’s event, because the use of nicotine in England and elsewhere is indeed at a new frontier between smoking and safer substitutes.
A cigarette is just a cigarette; but a reduced risk product can be a low wattage e-cigarette, a high wattage mod, a heated tobacco device, smokeless such as snus, as well as a plethora of other products such as dissolvables, patches, gum and other innovations which have yet to come to market. Each will play a part in achieving the government’s 5% smoke-free target if just one vital fact can be properly understood. The fact is that nicotine use is never going away.
The government’s tobacco control plan appears to recognise this and its aspiration to “maximise the availability of safer alternatives to smoking” is laudable. However, its insistence on continuing to resist the legalisation of snus in the EU suggests that the government’s words speak louder than its actions.
Repeatedly referring to high levels of smokers who claim they wish to quit - without recognising that it is a preference for many only if it can be done without hardship – merely leads to further ineffective and expensive policies of coercion which have been largely rejected by millions of smokers. Human nature dictates that punishing smokers away from smoking will be far less successful than offering them something more pleasurable to move towards.
The tobacco control plan claims to wish to see more uptake of safer nicotine alternatives, and this is to be welcomed. However, if the government truly wants to see a smoke-free England sooner rather than later, it will happen when smoking tobacco becomes an inferior choice than safer nicotine devices for smokers themselves.
The best way for government to achieve this would then be to remove pointless restrictions and bans on reduced risk products, encourage innovation and stop stigmatising people who choose to continue using nicotine. Embrace the fact that recreational nicotine use is here to stay, and that much-vaunted 5% target will become increasingly more in focus and therefore far easier to hit.
European Court official says ban on smoking substitute snus can be upheld
ECJ’s advocate general says the European Parliament has the right to ban snus
Snus is behind massive falls in smoking in Sweden and Norway
Many professional footballers also use it
The European Union’s ban on the smoking substitute snus can be upheld according to the European Court of Justice's advocate general. In his preliminary opinion, ahead of the court's decision this summer, Henrik Saugmandsgaard said that while the evidence for the ban was not clear cut, the European Parliament had the right to impose the ban in 1992. He said that he did not find that the ban was “manifestly inappropriate”. (The opinion was released this morning.)
Reacting to the news the New Nicotine Alliance charity which is an intervening party in the case said that it was a bitter disappointment for EU smokers who could benefit from using snus to give up smoking. However it was pleased that the opinion recognised that there was a substantive case for snus.
“Widespread snus use has been behind the extraordinary collapse in smoking in Sweden where only 5% now smoke. In Norway the effect has been even more dramatic with only 1% of young women now smoking - down from 30% in just 16 years. And that is in a country where selling nicotine e-cigarettes has been illegal,” said NNA trustee, Professor Gerry Stimson.
“Smoking is evaporating where snus is widely used and yet the court now seems set to ignore the overwhelming interests of EU citizens,” said Professor Stimson.
“The European Union still has a big smoking problem with the latest EU figures actually showing smoking going up in France and Italy. The Scandinavian success with snus makes it imperative that this is tried out in the rest of the EU. Banning snus has been a crime against public health,” said Sarah Jakes who chairs the NNA.
There is a considerable underground market in snus across the EU with recent media coverage indicating significant use of it among professional footballers.
Snus is little known in the UK because it is banned but in Norway it has been the key to reducing smoking among young women from 30% to just 1% in the last 16 years. In Sweden smoking has collapsed to 5% among adults, due to widespread snus use.
The key question is whether it carries lower health risks than smoking.
In answering that today’s Sun described snus is a "poison in the mouth" and "unequivocally a bad thing” with a campaigner quoted as saying "whether you jump from the tenth storey of a building or the 20th, the effect is the same” as smoking.
Yet according to the world’s most respected public health bodies and scientists that is completely wrong. Action on Smoking and Health says it is 100 times less harmful than smoking. The WHO says it is “considerably less hazardous” and the EU says the lower risks are “undeniable.” A report in the Lancet last year found no evidence of harm caused by decades of widespread snus use “for any health outcome.”
“Smokers who are choosing alternatives to smoking need to hear real experts,not the nonsense on stilts served up by publicity hungry campaigners,” said Sarah Jakes, Chair of the New Nicotine Alliance, a charity which campaigns for better understanding of risk-reduced nicotine products.
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.
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.
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This policy is effective from 25th May 2018
Data protection is a high priority for the management of the New Nicotine Alliance UK. Use of the New Nicotine Alliance UK website is possible without the user needing to input any personal data; however, if a data subject wants to use certain services on our website, the processing of their personal data could become necessary. If the processing of personal data is necessary and there is no statutory basis for such processing, we generally obtain consent from the data subject.
The processing of personal data, such as the name, address, e-mail address, or telephone number of a data subject will always be in line with the General Data Protection Regulation (GDPR), and in accordance with the country-specific data protection regulations applicable to the New Nicotine Alliance UK. By means of this data protection declaration, we would like to inform the general public of the nature, scope, and purpose of the personal data we collect, use and process. Furthermore, data subjects are informed, by means of this data protection declaration, of the rights to which they are entitled.
As the controller, the New Nicotine Alliance UK has implemented numerous technical and organisational measures to ensure the most complete protection of personal data processed through this website. However, Internet-based data transmissions may in principle have security gaps, so absolute protection may not be guaranteed. For this reason, every data subject is free to transfer personal data to us via alternative means, e.g. by telephone.
1. Definitions The data protection declaration of the New Nicotine Alliance UK is based on the terms used by the European legislator for the adoption of the General Data Protection Regulation (GDPR). Our data protection declaration should be legible and understandable for everyone we engage with. To ensure this, we would like to first explain the terminology used. In this data protection declaration, we use, inter alia, the following terms: a) Personal data Personal data means any information relating to an identified or identifiable natural person (“data subject”). An identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person. b) Data subject Data subject is any identified or identifiable natural person, whose personal data is processed by the controller responsible for the processing. c) Processing Processing is any operation or set of operations which is performed on personal data or on sets of personal data, whether or not by automated means, such as collection, recording, organisation, structuring, storage, adaptation or alteration, retrieval, consultation, use, disclosure by transmission, dissemination or otherwise making available, alignment or combination, restriction, erasure or destruction. d) Restriction of processing Restriction of processing is the marking of stored personal data with the aim of limiting their processing in the future. e) Profiling Profiling means any form of automated processing of personal data consisting of the use of personal data to evaluate certain personal aspects relating to a natural person, in particular to analyse or predict aspects concerning that natural person's performance at work, economic situation, health, personal preferences, interests, reliability, behaviour, location or movements. f) Pseudonymisation Pseudonymisation is the processing of personal data in such a manner that the personal data can no longer be attributed to a specific data subject without the use of additional information, provided that such additional information is kept separately and is subject to technical and organisational measures to ensure that the personal data are not attributed to an identified or identifiable natural person. g) Controller or controller responsible for the processing Controller or controller responsible for the processing is the natural or legal person, public authority, agency or other body which, alone or jointly with others, determines the purposes and means of the processing of personal data; where the purposes and means of such processing are determined by Union or Member State law, the controller or the specific criteria for its nomination may be provided for by Union or Member State law. h) Processor Processor is a natural or legal person, public authority, agency or other body which processes personal data on behalf of the controller. i) Recipient Recipient is a natural or legal person, public authority, agency or another body, to which the personal data are disclosed, whether a third party or not. However, public authorities which may receive personal data in the framework of a particular inquiry in accordance with Union or Member State law shall not be regarded as recipients; the processing of those data by those public authorities shall be in compliance with the applicable data protection rules according to the purposes of the processing. j) Third party Third party is a natural or legal person, public authority, agency or body other than the data subject, controller, processor and persons who, under the direct authority of the controller or processor, are authorised to process personal data. k) Consent Consent of the data subject is any freely given, specific, informed and unambiguous indication of the data subject's wishes by which he or she, by a statement or by a clear affirmative action, signifies agreement to the processing of personal data relating to him or her. 2. Name and address of the controller Controller for the purposes of the General Data Protection Regulation (GDPR), other data protection laws applicable in Member states of the European Union and other provisions related to data protection is: New Nicotine Alliance UK 8 Northumberland Avenue WC2N 5BY London United Kingdom