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A further shift will unlock greater potential

On Tuesday during questions to the Under-Secretary of State for Health in Westminster, Nicola Blackwood replied to a query from Conservative MP Adam Afriyie about the use of e-cigarettes and, specifically, the negative outcomes that will undoubtedly arise from implementation of the EU TPD.

The Government are very clear that vaping is significantly less harmful than continuing to smoke. Under the current regulatory regime, huge numbers of smokers are successfully using these innovative products as an effective quitting tool. We have already committed to reviewing the TPD and we will fully explore the opportunities that Brexit may provide, but until exit negotiations are concluded we remain a full member of the EU.

We note and very much welcome Ms Blackwood confirming that there will be a review of the terms of the TPD. They were hastily-drafted and implemented largely from a position of ignorance by MEPs and their advisers in 2014, and we still maintain that many of the requirements are not only unnecessary but also harmful.

In the intervening period since the TPD was formulated there has been a shift in perception – backed by a solid evidence base - of the benefits of vaping and tobacco harm reduction in general, so it is of great interest that a government minister is considering the TPD’s efficacy and legitimacy in a post-Brexit United Kingdom.

However, there is another small but significant shift in policy required if the full public health potential of tobacco harm reduction methods is to be realised, and it is only the UK government which can affect the change required to facilitate this.

It is still officially the government position that e-cigarettes, particularly, should only be used as a smoking cessation aid and not as a recreational product. Indeed, the Department of Health’s representative in the House of Lords, Lord Prior of Brampton, responded on Tuesday to his shadow Lord Hunt of Kings Heath’s support of e-cigarettes by saying that “better than vaping is not to vape or smoke cigarettes or anything else at all”. This is to fundamentally misunderstand the positive public health role that harm reduction can play.

Lord Hunt – on the other hand – understands the debate very well in his position as President of the Royal Society of Public Health, one of many UK health organisations to enthusiastically embrace vaping. The Royal College of Physicians has argued that e-cigarettes should be “promoted as widely as possible”, while the government’s pre-eminent public health advisers Public Health England recognise the advantages of vaping and have consulted with consumer groups such as the NNA on the matter. Guidance from the National Centre for Smoking Cessation and Training has also rightly warned against being alarmed about recreational vaping, stating that “we are not a ‘stop nicotine service’ and if we think getting people off their e-cigarette is a good use of our time, we are ignoring a far more important opportunity to help people quit and to stay off cigarettes.”.

With all this wise counsel from respected advisers moving in the same direction of travel, it is arguably time for the government to revisit and re-consider its stubborn policy towards recreational use of nicotine.

As the NNA has consistently advocated, a vast number of people derive great pleasure from nicotine just as millions enjoy coffee containing caffeine – both judged to be on the same toxicity level by experts – yet we do not hear of government campaigns to wean the public, or even MPs themselves, off coffee. Smokers are not ill and do not require a medical intervention; in fact, for many the very idea is anathema and would deter them from switching to a less harmful alternative.

The huge and swift success of vaping in the UK has occurred not because it is viewed exclusively as a smoking cessation device – quite the opposite – instead the success is attributable to vaping being an enjoyable, healthier pastime free from the pressure of real or imagined state coercion. If full nicotine cessation then ensues then so be it, however that should not be the sole consideration.

Nicola Blackwood and Lord Prior have been presented with a largely cost-neutral free market solution to their goal of reducing smoker prevalence, they should seize it by embracing recreational vaping, like many of their most respected public health advisers have. In doing so, and eschewing the siren voices of those who value moral judgements over concrete health benefits by calling for regulations, restrictions and bans, they can unlock the full advantageous potential of e-cigarettes and tobacco harm reduction.



The report from the US Surgeon General on e-cigarette use among youth and young adults is just one more example (as if any more were needed) of the lengths to which the prohibitionist faction of tobacco control will go in order to promote its evidence-free ideological agenda.

The report cherry picks 'scientific' claims of risk to young people, mainly from studies or analysis which have long since been debunked by experts in the field, and almost completely ignores the large body of science which details the benefits of e-cigarettes to smokers of all ages as either a cessation or harm reduction strategy. The fact that smoking prevalence among young people has declined dramatically concurrent with increased availability of e-cigarettes also seems to have escaped the Surgeon General's attention completely.

This report and the policy recommendations contained within leave us in no doubt that regulators in the US care nothing for the lives of current smokers, or of those who will take up the habit in the future. It compounds the misperception that vaping is as dangerous as smoking and it will serve as protection for the incumbent nicotine delivery method, tobacco cigarettes. Well done America.

For more detailed analysis of the report please read
Clive Bates post here: Bad science, poor insights and likely to do harm - rapid reaction to the Surgeon General's terrible e-cigarette report

Expert responses here: http://www.sciencemediacentre.org/expert-reaction-to-us-surgeon-generals-report-on-e-cigarettes-and-young-people/

 

Yesterday I spoke at the first meeting of the All Party Parliamentary Group on E-Cigarettes that has been held since trade body UKVIA took over the secretariat. The meeting was in two parts, the first part being an overview of the public health challenges and the second being "industry views" - I found myself rather incongruously in the second part.

Professor Kevin Fenton led off the first part by detailing the work undertaken to date by Public Health England in this area and outlining the challenges we still face. These included public perception of relative risk and the appalling manner in which the media approaches the subject. Professor Peter Hajek then explained the role that researchers have played in this, and detailed some of the methods employed in order to portray what are often trivial or irrelevant risks as important indicators of harm. After a brief foray into the role of UKVIA and how their involvement with the APPG may relate to article 5.3 of the FCTC, George Butterworth then described Cancer Research UK's involvement in research, and in particular their role in analysing and, if appropriate, debunking poor, or poorly reported studies.

After a couple of questions the second part began with Charlie Hamshaw Thomas (UKVIA and Nicopure) praising the UK stance on tobacco harm reduction and also how far industry had come in delivering new and ever better products. Ian Green (IBVTA) then spoke about the challenges which 'Italian style' enforcement would pose to an industry which had spent considerable sums on compliance. A representative from Trading Standards in the audience was asked how they intend to approach the issue, and he replied by saying that their response would be proportionate given the other issues which they are expected to deal with, and would likely be complaint-led in practice.

My turn came to offer the consumer view and I presented the challenges which consumers face under the new regulations and also due to the very poor public perception of vaping. Points raised included nicotine concentration limits, advertising restrictions, usage bans, and the activities of prohibitionist groups such as the BMA and the WHO.

Finally, Andrew Allison of The Freedom Association was invited to speak briefly about the report they compiled which revealed the atrocious state of local authority vaping policies. Kevin Fenton responded by explaining that PHE are working with some authorities on changing this, and will continue to try to improve the situation.

I'm told that 9 parliamentarians attended the meeting, either in person or via their researchers. Some interesting and pertinent questions were asked although time was very limited as we only had an hour. Hopefully future meetings can focus in on the individual challenges identified so that they can be discussed in more detail.

Sarah Jakes

Board Member

NNA (UK)

Transparency was on the agenda at COP7, apparently there were concerns after COP6, but (almost) unbelievably, what they achieved was to make it less transparent than ever before.

Prior to COP7 I asked the UK department of health what the problem was with allowing the media and the public, including the tobacco companies, to observe (not participate) and report on the negotiations that go on there. The answer was that the tobacco companies would target and intimidate those delegations with whom they disagree, and go on to interfere in tobacco control policy in those countries. The public and media had to be similarly excluded because the tobacco companies would infiltrate them, or go disguised as them. Paranoid stuff.

I don't think it's a secret that the tobacco industry had numerous representatives in Delhi, as did other independent interested parties such as Asian vaper groups, and even experts on tobacco harm reduction who were there to try to correct the appalling claims made in the WHO report on e-cigarettes. On the first day of COP all of these people were excluded, together with the scant media representation.

The result of this decision was that all independent reporting of the machinations of COP was blocked, but more importantly, so was scrutiny of the actions of the delegates involved. This gave them free rein to attempt to bring in draconian restrictions on harm reduced products with no fear of being challenged by anyone outside of the hallowed halls of WHO.

Well it would have, if it weren't for the numerous leaks that emanated from the process and filtered through to the excluded groups milling around outside.

FCTC is a treaty which the signatories agree to pass into national law. Those present at COP meetings are deciding law in 180 countries. They are deciding the fate of millions of people like me, who smoke or vape and they're doing it on our taxes. And yet the only route of communication we have with the process is via a confusing myriad of snippets occasionally leaked. The idea that the policy positions of the numerous party delegations should be kept secret for fear of intimidation is absurd and undemocratic. These are national government positions for heavens sake. As I write this I still don't know what the official decision on vaping actually is, although rumour has it that the UK position of blocking any new lunacy has prevailed. Who knows. The situation is beyond disgusting and cannot be allowed to carry on.

COP8 will be held in Geneva in 2018, which is a comparatively short journey for the millions of vapers in Europe. I hope to see a large number of them there. If they will not open the doors to us voluntarily we will just have to do whatever we can to force them. Bring it on.

 

Sarah Jakes

Along with Adjunct Professor of Law at the University of Ottawa, David Sweanor, NNA associate Clive Bates recently submitted a response to the New Zealand Ministry of Health review into legalising e-cigarettes.

As is customary, Clive and David’s work is exemplary and has been featured online at New Zealand news source Stuff in an article entitled “International anti-smoking campaigners' ten messages on e-cigarettes”. It is a concise guide to the many harm reduction benefits of e-cigarette use - and conversely the dangers of over-regulation - which we can highly recommend all interested parties read.

However, one of their observations is particularly well-drawn and will resonate with many vaping consumers. On the subject of bans on e-cigarette use, Clive and David had this to say:

"It is quite possible that banning vaping in public places or severely restricting it would have adverse effects on health."

Today the Chartered Institute of Environmental Health has called for a voluntary ban on smoking everywhere and anywhere that children play or learn. On the face of it that would seem like sensible advice - except it wouldn't be advice, it would be a command, albeit not one that is currently enforceable.

The Framework Convention on Tobacco Control is the World Health Organisation’s masterplan to eliminate tobacco use. Its main activity is the two-yearly Conference of Parties, and the next one – COP 7 – will be taking place in India this November. Preparation for the conference is now in full swing, and various documents have now been released. This includes the WHO’s latest report on vaping.

Yesterday, NNA trustee Lorien Jollye took part in a half day panel debate at the Royal Society of Medicine entitled “Regulation of Pleasure”.

It was an eclectic event which encompassed topics as diverse as illicit drug use and consumption of online pornography, and was attended by around 40 interested medical practitioners and students. Lorien’s contribution was to recount “My relationship with nicotine” and she received much interest from the attendees during the question and answer sessions.

Make no mistake about it, Action on Smoking and Health (ASH) are lobbying very hard to rally opposition against Lord Callanan's fatal motion, which, if it were passed, would kill the Statutory Instrument (SI) which transposes the TPD into UK law.

In the now (almost) immortal words of Professor Gerry Stimson, 'vapers and vape shops are the new front line in smoking cessation services'. Typically this is an informal process with vape shops doing their best to help their customers to understand the products and how to use them, and vapers talking to their smoking relatives, friends and colleagues about their transition from smoking to vaping. Any vaper will tell you that there is a lot of interest among smokers about the devices and techniques involved, but also simply in 'how you managed to do it' and 'what it was like'.

In his recent paper published in the journal 'Addiction' Robert West and colleagues tried to count the number of additional people who successfully quit smoking in 2014 and would not have done so if ecigs didn't exist.You can read the paper here. The conclusions drawn in this analysis have prompted a great deal of debate.

In a report covered by PGVG magazine it was revealed that in Belgium a drug administered to patients with pulmonary fibrosis in order to stabilise the condition will no longer be reimbursed* by INAMI (the Belgian statutory national medical insurance association) to those who have smoked in the last 6 months.

Vaping as a recreational alternative to smoking - an holistic approach to tobacco harm reduction and smoking cessation (and pleasure).

Steve Christie tells about his journey from smoking to vaping, why he fights and why all vapers should be concerned about tha TPD.

NNA calls for consumer input to MHRA on ecigs:

The UK Department of Health has today released its consultation on the implementation of the EU Tobacco Products Directive (TPD). The consultation is open to all, so please do respond - the consultation documents can be found here: https://www.gov.uk/government/consultations/draft-regulations-on-the-sale-and-manufacture-of-tobacco-products

Recently Dr Chris Russell, Senior Research Fellow for the Centre for Drug Misuse Research, requested assistance from vapers in completing a survey on perceptions and experiences of using electronic cigarettes. The survey produced a somewhat mixed response! Sarah Jakes spoke to Chris last week to learn more.

It's been a busy year for NNA already - in addition to finally receiving charitable status after a year of trying we have been quite literally all over the place trying to spread the message about tobacco harm reduction and in particular vaping as a harm reduction strategy. Here is a brief round up of the year so far, and what we have coming up:

Here at NNA we we are very lucky to have an incredible group of associates who never cease to amaze us with the things they do in their own spheres to reduce the harms of smoking. This week a major talking point both here and in social media were the guidelines brought out last year by the National Centre for Smoking Cessation and Training (NCSCT) and recently promoted, which in short, has recommended that smoking cessation services offer the following advice to people keen to try e-cigarettes, and also those who have tried other methods and failed: 

We asked Dave Dorn, NNA associate, VTTV team member and vaper extraordinaire to give his views on vaping and consumer advocacy. As always we were very far from disappointed!

Following NNA's response to their recent consultation on 'Electronic Cigarettes and Strengthening Tobacco Control in Scotland '  we were asked by the Scottish Government research group to provide more information on the issue of bans on use in enclosed public spaces.

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