In February, Dr Caroline Johnson MP introduced a ten minute rule bill proposal in the House of Commons to ban single use “disposable” vaping devices. It was passed without objection and will now have its second reading on 24 March.
Additionally, on 11 February, the Local Government Association proposed adding vaping products to the tobacco display ban and imposing plain packaging while Action on Smoking and Health (ASH) suggested a tax of £4 per disposable vape to make them more expensive than refillable devices in order to deter youth uptake.
We question whether there is a better way of dealing with the problems that single use devices pose, as some of the measures proposed will almost certainly be damaging to public health.
There is understandable concern about youth vaping, but it is important to remember that the latest ASH survey highlights that only 0.5% of 11 to 17 year olds who regularly vape were not former smokers. In an ideal world, those under 18 would neither vape nor smoke but we need to consider that some will go straight to vaping, bypassing smoking. Would we really prefer them to have a few months or years smoking before they switch to vaping? It also needs to be noted that smoking is concentrated more in groups who have mental health issues and use Child and Adolescent Mental Health Services (CAMHS), young people in Looked-After Children’s services, and those who have been caught up in the criminal justice system. Even young people who have had more stress than normal because of COVID, missing school, increased social isolation and now the cost-of-living crisis causing distress in their family, might be turning to vaping to manage their stress rather than doing something worse – self-harm, for example.
Figure 1: Children alcohol consumption based on number of household members who drink alcohol
To put it in perspective, 14% of children drink alcohol weekly, 9% of kids take drugs monthly and 2% of 11-15 year olds and 5% of 15 year olds were regular smokers, according to ASH in 2019. ASH also points to the fact that “most youth vaping is experimental and most young people who vape have already tried smoking, which is far more harmful.”
It is clear that single use vape devices are popular among young people. But it seems to have been forgotten that 25 years ago the same demographic would have been initiating their nicotine use from smoking instead of vaping. We are seeing a generational shift of nicotine use from burning tobacco to using a far safer delivery device and if, as they will, adolescents are to experiment with anything, is it not far better that it be vaping than combustible cigarettes?
When it comes to adult use, the more forward-looking stop smoking services regularly recommend smokers opt for a single use vape both as a cost-efficient entry-level product to help them quit, and for the purpose of trying out different flavours before opting for something more permanent. Banning the devices would close off this option for adult smokers seeking to quit. It would also affect older would-be quitters and those with disabilities, who say they find disposables easier to manage, without the added complication of filling a tank and changing coils.
Those who have already successfully quit using single use products would see their exit from smoking closed off and could relapse to combustible tobacco. Considering that smoking is predominantly prevalent amongst lower socio-economic groups, doubling the price of the products would have a similar effect; illicit tobacco would suddenly become attractive again from an economic point of view.
It is fanciful that removing single use vaping products from the market will naturally lead to adult users buying refillable alternatives instead. The reason so-called disposables are so popular is precisely the simplicity and lack of complication required to use them. Restrictions or an outright ban will result in many consumers giving up on vaping entirely and reverting to smoking. Considering the vast difference in risk between smoking and vaping, it would not take many to choose that path to result in a counterproductive result for public health.
The proposals should be weighed against the other policy options available which could alleviate some of the perceived problem and would be more amenable to helping people switch. For example, zero rating VAT on refillable devices but not on disposables could be a nudge to better choices of device. A deposit scheme for single use devices and educational materials would encourage users to return them to be suitably recycled. If the goal is to make disposables less affordable to adolescents, raising the arbitrary EU-imposed tank size in single use vapes from 2ml to 10ml would make them more expensive than refillables. This would mirror the ban on sales of ten packs of cigarettes which was supported by public health groups to set costs of smoking beyond the budget of minors.
We need to reflect on the damage that bans and restrictions can cause to public health and consider other avenues first. Nicotine has been enjoyed for thousands of years and this will continue no matter how much people want to stop others using it. The best we can do is to ensure that the public consume it in the least harmful ways.
The UK is quite rightly lauded for its world-leading policy of guiding smokers towards lower-risk nicotine alternatives such as e-cigarettes. The government-commissioned independent tobacco review last year, led by Javed Khan OBE, recommitted to this by recommending that government “embrace the promotion of vaping as an effective tool to help people to quit smoking tobacco” and identifying that “the alternative is far worse.”
We would urge policymakers to consider the damage that bans and restrictions on problematic products will have. It may make for a virtuous feeling for those who feel that “something must be done” about single use vapes, but that is not the same as doing the right thing for public health.
There have been reports this week that the new Secretary of State for Health, Thérèse Coffey, is delaying publication of the new tobacco control plan, along with rumours that the government is not minded to take forward recommendations contained in the summer’s independent tobacco review led by Dr Javed Khan.
In light of this, we have written to Ms Coffey today to re-emphasise our 20 recommendations for reducing smoking which rely on consumer choice, deregulation, competition and private sector innovation. We have also copied the letter to the Minister for Brexit Opportunities, Jacob Rees-Mogg, to highlight five quick wins which simply require scrapping of unnecessary and counterproductive EU regulations within the government’s Brexit Freedoms Bill proposals.
You can read the full letter here.
The organisation which replaced Public Health England, the Office of Health Improvement and Disparities (OHID), released its final Vaping in England review in the latest series last week and overall it is largely positive.
Stretching to a hefty 1,468 pages, this review is the most comprehensive yet and covers a wide range of evidence on the use of vaping products amongst adults and youth, as well as brief commentary on heated tobacco and nicotine pouches.
The review’s main finding, much reported in the media, is that using vaping products “poses only a small fraction of the risks of smoking” with OHID re-emphasising that it estimates that vaping to be “at least 95 percent less harmful” than combustible tobacco. This is important because those who are bitterly opposed to vaping continually attempt to discredit this statistic. OHID has doubled down on previous reviews by confirming that it is still “broadly accurate”.
The importance of flavours was also acknowledged, with there being “evidence to suggest that non-tobacco flavours, particularly sweet flavours, may play a positive role in helping people switch from smoking to vaping.”
Among other observations, OHID also found that vaping is more common among disadvantaged adult groups in society which corresponds with smoking prevalence in those areas, strongly suggesting that vaping is a direct substitute for smoking, as we have consistently argued.
Although emphasising that vaping is not risk-free, OHID reported that evidence is showing there to be significantly lower relative exposure from vaping compared to smoking in biomarkers for cancer, heart and lung disease. As a result, the review advises that people who smoke should be encouraged to switch completely to vaping as a way to stop smoking. To do so, it calls for there to be accurate information about the “magnitude” of relative risk between vaping compared to smoking. This, it claimed, could help to address much of the misperception about vaping which is prevalent in society.
Additionally, OHID found that 98.3% of young people who had never smoked were also not currently vaping, and that fruit and menthol flavours are the most popular amongst adults, making up nearly 60% of the total. It also reconfirmed that vaping products remained the most common method used to quit smoking.
We were pleased to see that OHID recognised the potential of higher nicotine strengths, reporting that “higher nicotine concentrations might increase the … appeal of vaping”, and that “this could help someone completely substitute tobacco cigarettes for vaping products”. The NNA has consistently called for the nicotine limit imposed on the UK by the EU’s Tobacco Products Directive should be revisited; this observation by OHID tends to add weight to our proposal.
OHID also commented on the World Health Organisation’s approach to harm reduction, listing a host of dangerous and damaging proposals in recent WHO reports such as bans on flavours and advertising, high taxation, and treating vaping and smoking the same. Specifically, it highlighted the WHO’s repeated call for a ban on devices which allow users to control device features and liquid ingredients, commonly called open systems. The review commented that this “would seriously restrict what vaping products are currently being used by adults in England” and implied it could protect cigarette sales.
The UK is a shining example of how freeing up the potential of safer nicotine alternatives to smoking can deliver incredible results. In light of the conclusions in this part of OHID’s review, the UK government should double down on this success by sending a strong delegation to meetings such as the WHO’s COP10 next year in Panama to show that we are proud of our success and that the WHO should follow our lead.
Lastly, the OHID review called for more research in a number of different areas, including into how vapers vape, both nicotine and non-nicotine products, and regular monitoring of the use of flavours to track use over time. It also recommended further independent studies on heated tobacco to be commissioned on smoking prevalence and cessation, and also proposed implementing proportionate regulation of nicotine pouches in the Tobacco and Related Products Regulations as we have called for previously.
The NNA welcomes this report, noting that it is largely positive about vaping and confirms that the UK’s recognition of tobacco harm reduction has been a big success in that respect. We would like to see further roll out of policies which embrace this principle, which we have detailed in correspondence prior to the Independent Tobacco Review earlier this year (see our 20 recommendations here). The OHID review has comprehensively highlighted the potential benefits of reduced risk products with its support for vaping, but other options such as nicotine pouches, heated tobacco and snus could also be useful alternatives for people who are looking to reduce their use of combustible tobacco.
The latest annual report by Action on Smoking and Health (ASH) on “Use of e-cigarettes (vapes) among adults in Great Britain” has just been released and concludes that there are now around 4.3 million vapers in England, Scotland and Wales, a significant increase from 3.6 million in 2021.
The report follows a survey of over 13,000 people conducted by polling company, YouGov, earlier this year and contains detailed analysis of current trends in vaping in the country. It also finds that of those who say they vape, 2.4 million are now former smokers having quit smoking entirely.
These are welcome figures and reinforce our belief that tobacco harm reduction can deliver favourable results if governments allow it to do so as, to its credit, the UK government has done by leading the world in its endorsement of vaping.
The data also offer some telling signs of how damaging media misinformation has been in recent years and how future tobacco policy could be tweaked to achieve even better results.
There are still 28% of smokers who have never tried an e-cigarette. The reasons given point towards their being scared away from vaping by negative coverage they have seen and read in the media. For example, 21% of smokers said that they were afraid of replacing one addiction for another, and 23% said they are concerned that vaping is not safe enough or that they did not know enough about the products. What’s more, 36% of smokers who have not tried a vape believe that vaping is equally or more harmful than smoking, and a further 26% simply don’t know.
It is clear from this that there is still the need for the public to be much better educated about vaping products, specifically, and on the concept of harm reduction in general. The fact that only 14% of smokers correctly believe that vaping is “a lot less harmful” than combustible tobacco use can only deter hundreds of thousands from trying vaping and therefore means a large cohort of the population is needlessly smoking when they could be getting nicotine in a far safer form.
Encouragingly, the data confirm points that the NNA and other consumer groups have been making since the early days of vaping. Namely, that vaping products are a direct substitute for smoking, which some vaping opponents still try to deny, with ASH finding that people who vape everyday smoke on average less than those who smoke non-daily. The report also confirms the importance of flavours, which the NNA and other consumer groups have always highlighted, but which opponents claim are only designed to attract children. The ASH report found that the most popular flavours were fruit flavours, favoured by 41%, followed by menthol by 19%. Only 16% of all adult vapers use a tobacco flavour.
Significantly, the data tend to align with the NNA view that there is still room for reform of vaping and nicotine policy in the UK. 47% of smokers have tried a vaping product but no longer use one, suggesting that, for many, e-cigarettes are not working for them. 23% of these said vaping was not similar enough to smoking and 17% said it did not help with their cravings. The NNA has consistently called for the nicotine limit of 20mg/ml to be increased in order for vaping to be a more attractive alternative for smokers, something that can be done now that the UK has left the EU. A higher limit could be useful in attracting smokers for whom the current limit is not working.
Additionally, the data suggest that vaping may not be the best alternative for many smokers. The NNA believes all lower risk nicotine products have their place as a smoking substitute and that they should be well promoted and made widely available. However, there is still reticence to promote other reduced risk products like heated tobacco, snus and nicotine pouches to smokers in the UK.
The ASH report did not ask about heated tobacco this year but in 2021, only a paltry 14% of smokers were aware that heated tobacco existed. Likewise, although ASH report that 44% of the public are aware of nicotine pouches, only 3.9% have ever tried one. Snus is banned here due to the UK adhering to the Tobacco Products Directive, but the ban can be lifted post-Brexit. Sweden boasts by far the lowest smoking rate in Europe and Norway is seeing its first ever smokefree generation due to snus use, with a survey earlier this year finding only 1% of 16-24 year old Norwegians smoked. It makes no sense to prohibit an alternative which could be the product which helps many smokers quit.
Lastly, many media articles have predictably attempted to create a scare story around ASH’s survey by highlighting a rise in vaping by never smokers. Considering that smoking rates in Great Britain are still declining, this is a non-story. We contend that what we are seeing is a change in the way people initiate use of nicotine, which will always be enjoyed by a proportion of the population as has been commonplace for thousands of years. 25 years ago, the overwhelming majority of nicotine use was with combustible tobacco, but we now have a generational shift where young adults are choosing far safer products instead of smoking.
In ASH’s report, they declare that a “vaping revolution” has taken place over the past decade. We agree, and the latest statistics bear that out. It is important that we learn from the survey results and ensure that better information is provided for smokers, that journalists and irresponsible academics are persuaded to stop peddling harmful misinformation, and that we refine public health policy to fully realise the potential that lower risk non-combustible nicotine products can provide.
You can read the full ASH report here.
Action on Smoking and Health (ASH) has this week released a briefing for local authorities on youth vaping. This is a timely document which follows a steady stream of alarmist media headlines on the subject in recent weeks. ASH’s briefing, also endorsed by several other public health organisations, offers an objective look at current regulation and the latest evidence on youth vaping data from the most up-to-date surveys.
Most importantly, it debunks some of the many myths seen recently in the media which have been negatively skewing the public’s view of vaping products and how they can continue to contribute positively to public health. The UK is a global leader in recognising the benefits of reduced risk products such as e-cigarettes to help smokers to quit, and we are pleased that ASH has reacted to recent negativity in the news with a calm and balanced set of evidence-based guidelines for local authorities to follow.
In particular, ASH’s briefing stresses the key point that “media reports that youth vaping risks becoming a potential ‘public health catastrophe’ leading to a ‘generation hooked on nicotine’ are not substantiated by the evidence.”
Regarding myths carried in the media, ASH is forthright with unequivocal corrective statements, including (emphases by ASH):
Disposable vapes DO NOT contain as much or more nicotine as a packet of 20 cigarettes. Comparing like with like, a UK standard 2 ml disposable vape contains 40 mg of nicotine, an average pack of 20 cigarettes contains 250 mg of nicotine which is more than six times as much.
There is NOT strong evidence that vaping is a gateway into smoking.
Most young people who try vaping DO NOT get addicted to nicotine. Those who vape are much less likely to be dependent than those who smoke.
E-cigarettes have been on the market in the UK for 15 years and have been the most popular quitting aid since 2013. During that time vaping has NOT BEEN associated with widespread health problems in the UK.
An outbreak of serious respiratory disease (known as ‘EVALI’) in the US in 2019 WAS NOT caused by vaping nicotine, but by vaping cannabis with vitamin E acetate added to it.
ASH also highlight how anti-vaping propaganda distorts truth in the minds of the public, contrasting the clear messaging being provided in New Zealand with the damaging approach being taken in the US which “led one group of young people to conclude that they would rather be seen smoking than vaping after viewing the campaign.”
Although it is sad that irresponsible media articles should make this exercise in truth-telling necessary, we wholeheartedly welcome ASH’s intervention and hope that local authorities and other organisations take note of the information.
In many other countries, the moral panic over youth vaping has derailed sensible policies towards reduced risk nicotine products to such an extent that the benefits smokers can derive from switching are lessened or eradicated entirely due to restrictions and prohibition.
It is good to see public health organisations in the UK reacting with common sense and reason in setting the record straight, to back up a world-leading UK regulatory recognition of vaping as a valuable means of helping smokers to quit or significantly reduce their harm from combustible tobacco use.
This latest briefing by ASH acts as a helpful resource for rebutting much of the misinformation and inaccurate rhetoric surrounding youth vaping in the UK. You can read the full briefing paper here.
In May, the EU Commission launched a call for evidence to assess its legislative framework for tobacco control. This was part of the process to evaluate if current tobacco control legislation has fulfilled its goals towards the proposed EU Beating Cancer Plan goal of achieving a tobacco free generation by 2040.
The NNA urged supporters to respond to the consultation in our web article here. We are more than pleased to report that many of you did just that and that the consultation received a record number of responses, according to EU Political Report this week.
The Commission’s “Call for Evidence” on the legislative framework for tobacco control received an unprecedented level of feedback, with consumers of alternatives to tobacco products – vaping, heated tobacco and oral nicotine pouches – making their voices heard in huge numbers.
More than 24,000 EU citizens responded to the call, launched by the Commission as part of its ongoing evaluation of what future EU tobacco laws will look like through revision of the Tobacco Products Directive.
The massive interest in the issue may surprise some and may put the European Commission on the back foot as has been seen by some as having previously failed to support ‘tobacco harm reduction’.
90% of responses were from EU citizens and an “overwhelming majority” supported tobacco harm reduction. This should be a wake-up call for the EU Commission which is ideologically opposed to reduced risk products in any form – and, as a result, cherry picks biased evidence to support its pre-conceived stance - despite their proven success in reducing smoking rates across the continent.
It is testament to the power of the consumer voice that such a response is considered “problematic” for the EU Commission. It shows that our voices count, and that we should continue to put pressure on authorities to recognise the potential of harm reduction and regulate safer nicotine products accordingly.
A 12-week consultation process will follow so consumers will need to be ready to make our voices heard once again to oppose unnecessary and counterproductive over-regulation of vaping products, heated tobacco and nicotine pouches, and to call for sensible regulation of snus instead of the counterproductive EU-wide ban which currently exists. When that consultation process begins, we will be sure to inform and guide consumers as best we can.
In the meantime, 20th July is the closing date for the EU’s call for evidence on extending smoke-free environments to outdoor spaces such as hospitality and widening their scope to include vaping products and heated tobacco, so do consider responding to that today. You can read our guide on how to do so here.
At the end of June, the EU Commission launched a call for evidence on a proposal to extend a 2009 recommendation on smoke-free environments to include vaping products and heated tobacco. The purpose is to encourage all EU member states to implement bans on vaping and heated tobacco use in a variety of public places.
Additionally, a supporting document describes the current recommendation as covering “indoor and enclosed spaces” and that policies for “outdoor spaces, such as schools, playgrounds and outdoor eating establishments” are not included in the scope of the EU recommendation, but rather decided on a case-by-case basis by national or local governments.
The Commission intends to change the recommendation to “explicitly include certain outdoor and quasi-outdoor spaces in the definition of smoke-free environments” and to widen the scope to include not just combustible tobacco, but also far less harmful vaping and heated tobacco use.
There is, of course, no credible evidence that use of these products is harmful to bystanders in either indoor or outdoor public places, but the EU is pointing to highly criticised and flawed reports by the WHO and the SCHEER Committee as its justification.
The NNA has submitted a response to this misguided proposal which you can read below, but it is open to individuals too, so we would encourage all to respond. UK consumers may feel that this does not concern us now that we have left the EU but an order of this kind across the EU will be influential globally and could have an impact here too.
We hope many of you will take the opportunity to have your say before the closing date of 20 July by accessing the call for evidence here where you can download a PDF file detailing the Commission’s plans. Here is how to respond.
Quitters are increasingly turning away from less effective traditional Nicotine Replacement Therapy (NRT) smoking cessation methods, though a continued decline in the smoking rate highlights the success of vaping for cigarette smoking cessation.
According to the latest Public Health England (PHE) data, the number of smokers setting a quit date using traditional NRTs through the NHS Stop Smoking Services hit a record low of 3.5% in 19/20, down from 7.3% in 13/14. That’s a 52% drop in six years. The figures show that just 1.8% of smokers using the service successfully quit after four weeks in 2019/20. This represents a 51% decrease from 13/14.
Despite this, the percentage of people in England smoking has continued to fall, and currently sits at an all-time low of 13.9%. The new data highlights the ever increasing role of vaping as a smoking cessation tool, with people increasingly taking smoking cessation into their own hands.
The number of ex-smokers who now vape has risen from 11.7% to 12.3%.
The PHE data comes as a new study warns quitting smokers of the potential for relapsing this Christmas — alcohol is the third-most common factor in cigarette cravings, according to the Quitting Smoking for Mental Health Study conducted by the UK's largest online vaping retailer, Vape Club. 25% of ex-smokers state cravings are at their strongest when drinking alcohol.
Ex-smokers highlight the greatest causes of cravings
Alcohol follows mental health pressures as the leading triggers for cravings. Cited by 40.8% of study respondents, stress is the strongest driver of temptation, followed by anxiety (28.9%). Such issues have been acutely felt during the pandemic, with mental health charity Mind finding that 60% of adults suffered more mental health problems during lockdowns. See the full study here.
Other significant factors include socialising with active smokers, which affects 19% of ex-smokers, and depression, which tempts 17% of respondents to light up.
From your experience, when do you most get cigarette cravings? (Select up to three)
When drinking alcohol – out with friends/family
While out with active smokers
I do not get cigarette cravings
When drinking alcohol – at home
When suffering workplace burnout
When experiencing an episode of poor mental health
Dan Marchant, founding UKVIA member and director at Vape Club, says:
“With the New Year coming we’d expect to see plenty of new years resolutions to finally quit smoking for good. The figures show us that if people are intending to quit, they will be turning to newer forms of alternative nicotine delivery and smoking cessation methods"
“Of course, Christmas is always a difficult time to do it: for numerous reasons. There’s lots of socialising and drinking at this time of year, which naturally leads to smoking for some people. Others might find it a stressful time, when families can easily get caught up in little arguments. The other thing is that many people will see Christmas as their last hurrah before quitting in the New Year. So if people are aiming to quit right now, they should bear in mind that it’ll take lots of willpower.
"Studies have shown that vaping is far more effective than old fashioned NRT’s at enabling smokers to quit. And with the recent news from the NHS that they hope to soon be prescribing vaping products to people looking to ditch the habit, we hope that many more smokers will benefit from the incredible harm reduction potential of vaping, and leave cigarettes behind."
Dr Zirva Khan, a GP in North Staffordshire’s Loomer Road Surgery, says:
“Unfortunately because of the pandemic, many healthy lifestyle changes people had started to make including smoking cessation, abruptly came to a halt. Education needs to be holistic, and not just focussed on the health benefits, but social and financial advantages too. Another big issue to tackle is that smoking cessation services need to be accessible. Services have become centralised and there is no incentive for people, employers or organisations to tackle smoking cessation. Smoking cessation services ideally should also be trained to signpost people who access them to other relevant services to tackle the underlying reason of why they are smoking. For some it is indeed a choice, for many others it’s their escape from their difficulties”.
-Article Provided by Distinctly PR
A number of newspapers have reported on Friday’s announcement by the Secretary of State for Health, Sajid Javid, that medicinal licensing of e-cigarettes may be more of a possibility after guidance was changed by the Medicines and Healthcare products Regulatory Agency (MHRA). The story appeared on the front page of no fewer than four national dailies.
While this is a ground-breaking policy proposal, and rightly described as world-leading by Mr Javid, there is much more to it than the media headlines suggest. Social media has been abuzz with a diverse range of opinions on what this entails so here is an explainer.
Firstly, this is not a change in current policy, nor is it an instant guarantee that doctors will begin to prescribe vaping products. Instead, it is billed as a streamlining of the process by which the MHRA would accept a vaping product to be licensed for medicinal purposes. You can read the new guidelines on the MHRA site here.
It is important to note here that if you smoke and want to stop, there is no need to wait for a vape on prescription, not least because the Under-Secretary of State estimated in parliament yesterday that the process from application to approval would take 18 to 24 months. Go into your local vape shop now and ask for help to choose a product that’s right for you. They’ll be happy to help
There have been regular calls in recent years by public health bodies for the MHRA to make it easier for manufacturers to register a product for this purpose. Regulations are incredibly strict which has severely deterred companies from pursuing this route. The only products gaining approval up to now were those submitted by a tobacco company which never made it to market, presumably to test the system. The new guidance seeks to address this by lowering those barriers.
There is some uncertainty if this will be the outcome as the MHRA has placed a number of conditions on measuring nicotine delivery which are unrealistic, but presumably those matters will be ironed out at some point, or the proposal will fail at the first hurdle.
Consumers will rightly be concerned as to how this will play out. Considering the long-term stated ambition of some public health groups to see e-cigarettes medicinally regulated, there will understandably be a level of suspicion at this new development. Consumers who fought the EU Tobacco Products Directive nearly a decade ago will remember that medical licensing was the primary aim for many health groups in this and other member states and resisting it was a focus for early adopters of reduced risk products in the UK who subsequently set up the NNA to speak for the rights of consumers here.
The issue of value for money must also be addressed. The National Institute for Health and Care Excellence (NICE) assesses whether the taxpayer is best served by interventions supplied by prescription on the NHS, and it is not yet known what their view may be on this announcement.
There is then the selling of the idea to GPs and health practitioners who may be resistant. This is no easy task considering a survey commissioned by Cancer Research UK two years ago revealed significant reluctance to endorse vaping due to perceived doubt about long-term effects.
Consumers, in general, would agree that a prescribed product will most likely be bland and uninspiring due to precautionary barriers imposed by authorities; that smokers are quite able to cover the cost of a starter kit considering the high price of cigarettes (a reaction widely held on social media); and that smokers do not consider themselves ill so why the need for a medicine?
On the other hand, for many less well-off smokers – of which there are many due to prevalence being overwhelmingly amongst lower socioeconomic groups – the risk of spending even the modest outlay for a starter kit will prove prohibitive if they are unsure if it will work for them. While the NNA has written regularly of the need to abandon the upper nicotine limit of 20mg/ml for e-liquid now we have left the EU, there has not been any movement by government so far to change that and we know that heavier smokers require the higher kick than 20mg can provide. Medical licensing may afford an option for strengths higher than those available as consumer products.
It could also provide assurance to sceptical GPs and other medical staff that vaping is nothing to be afraid of for smokers looking to quit. This is important as where doctors lead on health issues, history tells us that the public tends to follow.
As consumers, we should be very wary of this proposal being employed by public health organisations to insist that it is the only way of bringing vape products to market. Vaping products and accessories should continue to be sold as consumer products under a twin-track approach, as recommended by PHE since 2014. It is also important that the sale of other safer nicotine options such as nicotine pouches and heated tobacco are not restricted or encumbered by the new policy.
And snus, as we have consistently advocated, should be legalised at the first opportunity to correct the indefensible mistake made by the UK and the EU to ban its sale in the 1980s and 1990s.
On a political level, Mr Javid’s announcement and support for vaping is very good news. It re-emphasises that government and NHS support e-cigarettes as a harm reduction strategy. The message coming directly from the Secretary of State for Health is also a timely reminder that the UK delegation to the WHO FCTC’s Conference of the Parties (COP9) meeting in early November should resist any efforts by anti-vaping activists to impose binding bans or restrictions on vaping products. We trust they will take heed and do so.
While the media headlines were overly simplistic, this proposal is a positive one, albeit one which poses more questions than it provides answers. It is a development to be welcomed but progress towards it should be watched with care.
The NNA heartily welcomes the dramatic intervention of 100 specialists in nicotine science, policy and practice who have submitted a letter this week criticising the WHO for their objections to tobacco harm reduction.
They make a number of recommendations for the WHO which should be heeded. To ensure that tobacco harm reduction is adopted as a goal of the WHO worldwide rather than insisting on prohibition or stringent restrictions; to properly assess the potential of reduced risk products as a significant driver of smoking cessation where they are allowed to flourish; to recognise the damaging consequences of the WHO’s current prohibitionist approach towards harm reduction; to stop excluding valid stakeholders, including consumers, from debate on spurious grounds; to review the current precautionary approach and the unintended consequences it is creating; and to review the WHO’s current counterproductive approach to tobacco control.
In our view, this is well overdue and it is to the signatories’ credit that they are speaking up.
The WHO has been acting for far too long now as if reduced risk products have no effect on smoking prevalence when we know from data around the world that they are making a huge difference where traditional tobacco control methods of taxes, restrictions and bans have failed. The denial cannot continue if the WHO is to be seen as seriously invested in reducing the harms from combustible tobacco use.
It is telling that the expert signatories, drawn from every continent in which the WHO operates, have found the prohibitionist approach so exasperating that they have come together to make a stand.
The NNA was formed of consumers who have seen their lives dramatically improved due to reduced risk products but not only are we excluded from the debate but also actively pursued for having the temerity to diverge from the prevailing orthodoxy amongst global tobacco control that “quit or die” is the only option for smokers. We vehemently disagree with this, as we have always done, especially as the stunning results in countries which have allowed safer nicotine alternatives to compete with cigarettes prove that we are on the right side of history.
The voices in favour of harm reduction are growing, just as they did in the same debate about harm reduction towards drugs and HIV in previous decades. Relying on carefully selected research to justify policy that does not deliver results can only hold back real-life evidence of the efficacy of harm reduction for so long. Sooner or later, the WHO must face reality or face their own irrelevance in the modern world.
We are pleased to see many UK voices included in the 100 signatories. The UK is a global leader on tobacco harm reduction and the NNA hopes that not only does it stay that way, but that the government continues to put faith in reduced risk products as an example to the rest of the world on how to reduce the number of smokers, at little cost to the taxpayer but with maximum results.
This can be done by the UK standing up for our world-leading approach at the upcoming COP9 and ordering the formation of a Tobacco Harm Reduction Working Group to properly assess the science rather than present the shoddy evidence base that the WHO is currently providing, and which these 100 experts rightly object to.
The World Health Organisation (WHO) is a threat to vapers, not just in other parts of the world, but in the UK too. Consumers have a role to play in protecting reduced risk products that have benefitted us so much and could do for many more smokers in the future.
NNA is issuing a call to action for consumers to write to their MP, with these requests:
We have some wording suggestions when you write to your MP which you can read here.
To explain, here is a whistle stop guide to what the threats from the WHO are and why this is important.
There is a lot of consumer misunderstanding about the WHO and its upcoming ninth Conference of the Parties (COP9) meeting, which is understandable because it is opaque and restricted from the public despite relying on taxpayer funding (the UK is the biggest funder of the FCTC). The COP meetings are held every two years. The latest was scheduled for The Hague in 2020 but was postponed till this year due to COVID. It is now taking place virtually in November, with an abridged agenda and reduced working hours. This is dangerous as it makes it even more opaque.
The “Parties” in question are government signatories to the Framework Convention on Tobacco Control (FCTC), which is a legal treaty ratified by over 180 countries. Each of those countries – including the UK which is no longer represented at the meetings by the EU and free to speak for itself - sends a delegation to the COP to decide the future of global policy towards tobacco products, but also recently e-cigarettes and other reduced risk alternatives.
Decisions cannot be waved away by politicians
The COP Secretariat – which provides background and guidance documents to the government Parties - is extremely hostile to safer nicotine products. Despite harm reduction being one of the three pillars of policy strategies agreed when the FCTC was formed in 2003 and explicitly mentioned in the text of the treaty, it is conspicuously absent of late now that discussions on new and emerging products are on the table. The WHO and the FCTC have been recommending restrictive policy before exploring potential pros and cons of such an approach and ignore countries that have regulated safer nicotine products successfully, such as the UK which has achieved the lowest smoking prevalence ever.
As a legal treaty the FCTC’s contents are binding on governments to implement, however, further decisions made by the Parties at COP meetings can guide governments politically to take them into account when forming national policies. The COP does not make laws itself, but it strongly advises Parties to create policy based on the legally binding provisions of the treaty. Decisions at any COP meeting cannot just be waved away by politicians, they are highly influential – largely because to become a COP decision, governments must take part in the consensus decision. Any COP decision means that all governments participating have given consent to that decision.
Treating safer products the same as smoking
The materials being provided to the Parties for consideration at COP9 by the Bureau are absurd, consisting of cherry-picked research to demonise reduced risk products while completely dismissing any potential benefits of harm reduction. They seek nothing less than railroading parties into treating every alternative nicotine product the same as smoking. This includes bans on public use, restrictions on packaging, flavour bans, taxation the same as cigarettes and worse (which we shall come to). The WHO and the FCTC Secretariat are seeking to influence government delegations to take decisions in the absence of any other strong government direction – the UK should take that role together with other strong harm reduction countries.
The All-Party Parliamentary Group on Vaping held an inquiry into COP9 earlier this year and one of the prime recommendations in its March report was for the UK delegation to COP9 to “establish a Working Group to look at the science and evidence for new and emerging products”. Procedurally this requires the UK to put the proposal on the table and ask other government Parties to support it on the basis of the solid science on which the UK bases its decisions.
A ban on open systems and all products the same
This is incredibly important because if a more balanced assessment of evidence on vaping and other products is not presented to the parties, they will only have the WHO study group on tobacco product regulation report (TobReg) and the WHO Global Tobacco Epidemic Report 2021 to go on.
TobReg advocates for flavour bans as mentioned, but also a ban on open tank systems. It recommends that heated tobacco should not be classed as a reduced risk product so should be treated as smoking, while also claiming that switching to vaping is not smoking cessation. It does this by completely dismissing Cochrane evidence reviews - renowned as the highest standard for health research – which state that e-cigarettes work better than nicotine replacement therapy for smokers looking to quit.
TobReg also recommends that vaping should be regulated based on “nicotine flux” – their back-up plan if they don't get away with banning open systems. This involves removing any possibility of customisability so that all products will basically end up being the same, because in order to control flux, you would essentially have to put limits on everything!
And, most recently, there has been a proposal to redefine smoke as anything heated which “emits aerosols visible to the naked eye” for e-cigarettes to be classed as tobacco products and therefore be regulated, taxed, and banned the same in every respect.
Basically, denying the entire concept of harm reduction.
The COP Secretariat has produced an agenda for COP9 which was published in July and recommends discussions on reduced risk products be postponed until COP10 in 2023. This is a good thing because it means we have more time to ensure that Parties are being guided by better evidence rather than the wild and damaging recommendations emanating from TobReg and WHO. But this will not happen on its own.
Make your voice heard
As mentioned, the COP Secretariat doesn’t make decisions, the parties do. It only takes one country to demand that this all gets discussed at COP9 and it will be unless another Party objects, which is not a given. The UK delegation should ensure that these discussions do not take place this year, as recommended by the Bureau following consultation with the Parties.
The COP9 agenda also lists items that have so far been raised by Parties for discussion. There was no mention of the idea of forming a THR working group, as the APPG recommended in its COP9 Inquiry. In order to ensure a more sensible debate about safer nicotine products, please write to your MP and urge them to insist the UK delegation proposes the setting up of this group be added to the COP9 agenda for establishment at COP10.
We are not safe in the UK from harmful regulation towards vaping and other reduced risk nicotine products, it can spread across borders very quickly. We must not assume that the current UK political acceptance of vaping is fixed in stone and will never change. Things can move swiftly in the wrong direction in politics, especially if politicians feel they are an outlier to a global consensus.
It is also not just about protecting vapers in the UK. Britain has a moral obligation to stand up for its harm reduction policies that have been so successful at reducing smoking at home. We should be encouraging other nations to follow our lead. Rather than taxing, banning flavours or outright e-cigarette bans, the world should be following the British example, not trying to hinder it, in order to reduce smoking related deaths.
The most important people in this entire process – despite the great efforts to exclude us – are we, the public. We must make our voice heard. Please do write to your MP on the points above, now.
Last week saw the publication of an article at the American Journal of Public Health (AJPH) entitled Balancing Consideration of the Risks and Benefits of E-Cigarettes, written by no fewer than 15 past Presidents of the Society for Research on Nicotine and Tobacco (SRNT). SRNT is a globally respected organisation dedicated to evidence-based research on tobacco and nicotine use.
The lead author is Professor David Balfour from the UK, and Professor Robert West, Emeritus Professor at University College London is also a signatory, but their colleagues are based in the United States where debate over vaping has been fractious at best, and wildly inaccurate at worst.
We expect it is frustration which has prompted such prominent experts to produce a document which criticises the prevailing focus of debate amongst the public health community, and which makes the bold statement that “this article’s authors believe that vaping can benefit public health, given substantial evidence supporting the potential of vaping to reduce smoking’s toll.”.
This should not be controversial, but it speaks to the level of misinformation and ideology that has been at play that it should need to be said at all.
The article explains how the handwringing about youth use of e-cigarettes is harming public health by reducing options for adult smokers who would otherwise choose to quit with safer alternatives.
While accepting that youth vaping is a concern, the authors describe why this aspect has been overblown and how it is damaging to the public’s overall health in the long run. They also, quite rightly, emphasise the opportunities that are being lost while harm reduction deniers are allowed to run riot.
“While evidence suggests that vaping is currently increasing smoking cessation, the impact could be much larger if the public health community paid serious attention to vaping’s potential to help adult smokers, smokers received accurate information about the relative risks of vaping and smoking, and policies were designed with the potential effects on smokers in mind. That is not happening.”
In the UK we are blessed with an establishment understanding of how reduced risk nicotine alternatives can help those who choose to quit smoking. But there is a great deal of hysteria and ideological objection in the rest of the world which is unnecessary and contrary to the evidence which continues to mount up in favour of harm reduction as a successful policy option.
The AJPH article is backed up by an editorial from Martin Dockrell and John Newton of Public Health England which welcomes the report, stating that “These eminent authors conclude that the “singular focus of US policies on decreasing youth vaping” has been a distraction from the larger goal of tobacco control, namely reducing smoking and its harms”.
It is easy to forget that we consumer advocates in the UK are talking a different language to those in other countries who are embattled by an avalanche of misinformation, slurs, and ideological sophistry which seeks to dismiss legitimate advocacy for products that we know will work for many smokers.
Bans on use and supply, restrictions on where people can vape (or use snus or nicotine pouches), and even imprisonment for possession of vaping products are a reality for many consumers of reduced risk products in a lot of countries. The demonisation of people who have quit using safer alternatives is objectionable and wrong, but it happens anyway.
So, we welcome wholeheartedly this intervention by the 15 former Presidents of SRNT. Their credentials are beyond reproach and their message should be listened to.
We hope that this will lead to a greater global understanding of the benefits that e-cigarettes and other safer nicotine products can foster.
The UK has led the way in realising the benefits of allowing tobacco harm reduction to do its work. If the US were to join us in a special relationship agreeing the same principles, it would send a powerful message to the rest of the world to follow suit.
We hope that the AJPH article is well-received and that the ensuing debate can then become one of how we extend the benefits of reduced risk products worldwide, rather than how it is best to ignore and restrict their potential on spurious grounds.
In October 2020, the NNA wrote to the Parliamentary Under-Secretary of State for Prevention, Public Health and Primary Care at the Department of Health and Social Care – Jo Churchill – and the Director of the Number 10 Policy Unit – Munira Mirza – to suggest post-Brexit tobacco and nicotine policy reforms. Following up on that letter, we have now written again to provide a more comprehensive set of policy proposals for maximising the potential of safer nicotine products in order to match the government’s smoke-free 2030 and levelling up agendas.
We emphasise how traditional tobacco control approaches will not be enough to meet government targets and that these goals will only be achieved - both politically and as a public health measure - by embracing consent and consumer choice. Our document covers all aspects of strategy that would be required to maximise consumer switching, involving a fundamental change in approach towards the regulatory, fiscal and communications environment surrounding non-combustible nicotine products of all types.
You can read our October letter here, and our latest letter and full proposals below & HERE.
Yesterday, Public Health England (PHE) released its seventh independent report on vaping in England, carried out by researchers at King’s College London (KCL), and it brings some encouraging news but also scope for improvement.
In an article on the UK government’s website, PHE announced that not only is vaping now the most popular aid used by smokers trying to quit in England, it is also the most effective, with up to 74% quit success rates in 2019 and 2020. The article declares, boldly, that vaping is now “better than nicotine replacement therapy for stopping smoking”.
There is further soothing news on vaping amongst young people, with PHE stating that “around 4.8% of young people (aged 11 to 18 years) reported vaping at least once a month – the same as last year – and most of these were either current or former smokers”. In fact, in a survey by Action on Smoking and Health which was included in the review, it was found that “not a single [11-18 year old] never smoker reported vaping daily, and only 0.5% were previous users of e-cigarettes”.
Considering much of the rhetoric trumpeted by opponents of reduced risk products centres on fears around youth vaping - and while it is certainly right that we continue to remain vigilant in this regard - these data suggest the answer to those pleading that we should ‘think of the children’ should be “what children?”.
The New Nicotine Alliance very much welcomes this latest review, but along with the good news, it also reports on the damage that irresponsible anti-harm reductionists are causing. As Ann McNeil of KCL observes commenting on yesterday’s report, “What is concerning is that smokers, particularly those from disadvantaged groups, incorrectly and increasingly believe that vaping is as harmful as smoking. This is not true and means fewer smokers try vaping.”
This is a direct consequence of shameful scare stories promoted by those opposed to vaping - regardless of evidence – and is having a tangible negative effect on public health. The lack of willingness to debate by those ideologically opposed to vaping is also increasingly proving that they have no arguments left in the face of yet more clear evidence revealed by PHE yesterday. Our view is that they should embrace new innovative options like vaping and abandon their obstructionist stance before they sink further into the realms of conspiracy theorists.
In the UK we are fortunate that PHE and KCL examine the evidence without prejudice or hostility to harm reduction and it is why we are leading the world on enlightened policy in this area, but we can improve on that to further emphasise the benefits of our approach. For example, PHE draw attention to the disappointing fact that only 11% of stop smoking services supply vaping equipment, despite the superior success they can achieve. We sincerely hope that stop smoking services, healthcare professionals, health and wellbeing managers and policymakers read this report and take note.
The NNA also passionately believes that vaping is just a test case for the principle of tobacco harm reduction and that the UK government should seize the opportunity of Brexit to cast off over-precautionary restrictions on other alternative products such as snus, heated tobacco as well as vaping, along with welcoming the promise that modern products like nicotine pouches can offer. In October, we wrote to the Department of Health and Social Care with our post-Brexit recommendations on this subject which you can read here.
Even more importantly, those governments hostile to tobacco harm reduction, and the WHO, should read yesterday’s PHE review and ask themselves how much more quickly they could drive down smoking rates if they adopted the open-minded and evidence-based approach taken in England.
The UK has seen a remarkable shift in forms of nicotine use in the past decade, with consumers themselves choosing safer products over lit tobacco. As a result, smoking prevalence in the UK has declined at an unprecedented rate at little or no cost to the taxpayer. This PHE report suggests that this should not just continue, but that the scope could be expanded.
The government has pledged to “maximise the availability of safer alternatives to smoking” in its ongoing Tobacco Control Plan (to be updated in July). This evidence shows that harm reduction is beneficial to public health – as is accepted in many other areas of policy - and we should not be shy of doing more of it when it comes to reducing the harms from tobacco use too.
Please respond to the UK government’s open consultation for the review of the legislation which applies to vaping products. Brexit gives us an opportunity to diverge from the EU’s Tobacco Products Directive (TPD) and it is crucial that we consumers tell the government what changes we want. We have lived with the consequences of the TPD, no one knows better than us!
This is an easy and quick consultation to do, as there are only 6 questions which relate to safer nicotine products. The consultation ends on 19 March.
LINK TO THE CONSULTATION:
Tobacco and related products legislation introduced between 2015 to 2016: reviewing effectiveness
Here are the questions which relate to safer nicotine products:
Questions 6 to 9 relate to vaping:
Question 10 relates to heated tobacco products:
And, lastly, Question 13 gives an opportunity to raise issues not covered in the other questions (NNA will use this space to say that the sale of snus should be legalised in the UK):
On the consultation page the government says that “there is opportunity to consider, in the future, further regulatory changes that help people quit smoking and address the harms from tobacco.”. In NNA’s submission we will call for future legislation to distinguish between combustible and non combustible products - i.e between products which are very harmful (cigarettes) and those which are significantly less harmful (vaping products, snus, nicotine pouches, heated tobacco products). The experience of snus - a pasteurised oral tobacco product which is far less risky to health than smoking - shows us that the current distinction between tobacco and non tobacco products does not benefit health.
In September we wrote to the government to suggest post-Brexit tobacco and nicotine policy reforms. Our letter might be useful to read when considering points to include in your consultation response:
NNA writes to the UK government suggesting post-Brexit reforms
Please also look at this excellent guide from We Vape on how to respond to the consultation:
UK Government consultation on vaping & related tobacco products
Do take some time out of your day to respond to this - and please let us know how you get on.
On Tuesday 17th November we wrote to Cancer Research UK to express our disappointment that they were “excited” about a Bloomberg-funded report which was designed to paint the consumer voice as somehow part of a mythical tobacco industry plot. We asked for “comments clarifying the position taken by CRUK towards consumer engagement on this matter” but have received no acknowledgement or reply. Sadly, the tweet in question still remains, celebrating consumers being marginalised when - quite rightly - objecting to opaque policymaking.
We have also complained about the original article which prompted the ill-judged reaction from Cancer Research UK, by submitting a response to the publishing journal which you can read here.
Consumers are most affected by decisions made about products which many have found beneficial to their health, so should not be treated in such a casual and dismissive fashion. We hope that these organisations will embrace consumer engagement in the future, instead of attempting to demonise us for simply making our voices heard.
Yesterday, the NNA wrote to the Parliamentary Under-Secretary of State for Prevention, Public Health and Primary Care at the Department of Health and Social Care – Jo Churchill – and the Director of the Number 10 Policy Unit – Munira Mirza – to suggest post-Brexit tobacco and nicotine policy reforms.
On behalf of UK consumers of vaping and other low-risk nicotine products, we proposed steps towards creating a coherent risk-based framework for all safer nicotine products to promote a post-Brexit win for both public health and personal and economic wellbeing.
We emphasised how the proposals would meet government targets and add to the levelling up agenda, involve no additional public spending while also offering an opportunity to 'take back control’ from the mistakes of EU regulation in this policy area.
You can read our ten key proposals and the full submission below & HERE.
Please participate in this exciting new survey on nicotine use in Europe. This is no ordinary questionnaire, it has been designed by nicotine consumers, for nicotine consumers, and consumers have translated it into eleven languages.
We are asking for your help in making this the biggest survey of its kind. These are uncertain times for nicotine consumers in Europe. For EU countries, the TPD is currently being evaluated and the European Commission is looking at the possibility of including safer nicotine products in the tobacco excise directive. Here, in the UK, Brexit is giving us an opportunity to diverge from the TPD restrictions. How do you use nicotine products? How do the current regulations affect you? What changes would you like to see? This survey will be crucial, in the UK and the rest of Europe, for examining how consumers use nicotine products and what regulatory changes would benefit smokers who may wish to quit.
The survey has been organised by European Tobacco Harm Reduction Advocates (ETHRA), a consortium of tobacco harm reduction consumer groups. NNA has been very proud to partner with ETHRA since its inception, to add the UK consumer voice to that of 21 other European consumer groups.
Please take just 5 minutes to do the questionnaire yourself and then help us to get a ton of responses, by sharing it on social media.
Link to the survey:
Do please get in touch if you would like embedded links in order to put the survey on your website.
Back in October, the NNA issued a press release calling on policymakers to lift the counterproductive and unnecessary EU-wide ban on snus. This followed a decision by the FDA in the United States – based on a rigorous assessment of the available science - to categorise snus to be “appropriate for the protection of public health”.
At the time, our snus expert, Mark Oates said:
“It is inexplicable why the EU continues to perpetuate the ban on European smokers choosing to switch to snus, not only is the sale of snus permitted in the USA but they have now allowed one company to make the undisputed claim that “using snus instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis”, the difference in approach could not be more stark, and it is the EU which is being reckless with its public’s health, not America.”
With more and more consumers in the UK, Europe and globally opting for safer forms of nicotine use rather than combustible tobacco, awareness has grown about the existence and properties of snus. In countries where it is legally sold, substitution of smoking in favour of snus has often been remarkable, including Sweden which has an exemption to the EU snus ban and whose smoking rate is subsequently dramatically lower than all other EU member states.
However, the UK government and the EU have stubbornly refused to accept that harms from snus are negligible to non-existent, and that the continued prohibition merely denies smokers a far safer option, should they wish to quit but find it difficult by other means.
However, last week we saw positive signs in the UK with an answer to a parliamentary question on the subject from Jo Churchill, Parliamentary Under-Secretary of State for the Department of Health. Asked if the UK government will make an assessment of the effectiveness of the ban on snus products, she responded:
“The Government will consider in due course reviewing the position on snus, and whether the introduction of this product onto the UK market would promote a proportionate approach to managing risks, one which protects the young and non-smokers, whilst giving smokers access to products which may reduce harm.”
This contrasts with previous answers on the subject from the Department of Health - notably during Steve Brine’s tenure – which indicated that no research evidence was even being collated.
Whether it is a consequence of the UK leaving the EU or – hopefully – a realisation that the ban on snus is indefensible both scientifically and morally, this apparent new approach from the government is to be very much welcomed.
The UK has seen a remarkable shift in forms of nicotine use in the past decade, with consumers themselves choosing safer products over lit tobacco. As a result, smoking prevalence in the UK has declined at an unprecedented rate at little or no cost to the taxpayer. With new innovative options joining the market on a regular basis, this should surely continue.
The government has recognised this significant behavioural shift and, indeed, pledged to “maximise the availability of safer alternatives to smoking” in its ongoing Tobacco Control Plan. What better way could there be to honour that pledge than to legalise the sale of snus and finally consign to history a ban which was founded on ignorance and ideology, and is now a reactionary relic that has held back harm reduction progress for far too long.
Today saw the publication of a report by Public Health England entitled Vaping in England: 2020 evidence update summary, which you can read in full here.
It “updates on the prevalence of vaping among young people and adults and reviews literature on vaping among people with mental health conditions and pregnant women” in this country, and – crucially – draws on the latest evidence to deliver its view of how the UK government should proceed in this policy area moving forward.
It concludes that the UK’s current world-leading messaging on e-cigarettes remains valid, but it warns that misinformation is harming uptake of safer products amongst smokers and condemns the spread of doubt from outliers in the UK public health community who should behave better.
As the accompanying press release describes:
False fears preventing smokers from using e-cigarettes to quit
Current vaping use has remained stable in adults and young people since the last report. Of concern is the increasing number of smokers that now believe vaping is more harmful than smoking. This is out of line with expert reviews from the UK and US concluding that using regulated nicotine vaping products is far less harmful than smoking.
It goes on to feature quotes from PHE and others and suggests that some health activists and the media are responsible for deterring smokers from choosing to switch to products hugely safer for their wellbeing than lit tobacco. Deborah Arnott of ASH goes so far as to “urge smokers to have confidence in our regulatory system and not be put off by alarmist headlines about the risk of vaping which are not backed up by the evidence”.
Professor John Britton of UKCTAS is more robust still at the Science Media Centre, identifying “the urgent need for media campaigns to make sure that all smokers understand that switching to e-cigarettes is one of the most effective ways of quitting smoking and protecting their health.”
PHE also admirably represented consumers by pointing out the vital value of flavoured e-liquids. There has been a concerted effort to prohibit flavours worldwide, but PHE has shown it listens to those who use e-cigarettes by saying that "A ban on flavoured liquids could have adverse effects and unintended consequences for smokers using vaping products to quit". This is in stark contrast to organisations such as the WHO and EU which are stubbornly opposed to reduced risk products – and refuse any input from consumers whatsoever - so it is immensely valuable that PHE is setting out the UK’s stall prior to important meetings later in the year.
Consumers and other supporters of NNA will be well aware of the shameful actions of a diminishingly small number of anti-vaping activists in this country who seem hell-bent on wrecking potential for reduced risk products which could have so much positive impact, despite their proving to be the nation’s most popular and successful quit smoking aid. You will also have heard the increasingly desperate science-lite arguments before and read the irresponsible clickbait journalism that often just parrots scaremongery from fatally ideological – and often hopelessly conflicted – merchants of doubt. They are further out in the cold after today, and the widespread take-up of this report in the press should emphasise to them that their outlandish views are miles away from the established consensus.
So we welcome PHE’s report today as a timely reinforcement of the benefits of vaping to public health, plus an encouragement to the UK government to ignore siren voices and continue along the path laid out in the Tobacco Control Plan for England and the recommendations of the Science and Health Committee in August 2018.
A take-home conclusion of today’s publications is that over half of current smokers believe vaping is equally or more harmful than smoking. It is inconceivable that there should be such damaging information being spread when the potential for the world’s public from harm reduction could be revolutionary if only policymakers were exposed to evidence-led advice like PHE has provided, instead of baseless antiscientific heckling from shady vested interests on the sidelines.
If you are a vaper; a relative of a vaper; a smoker worried about making the switch; or a citizen of any country baffled by conflicting media stories, PHE and fellow weighty public health organisations in the UK did you a favour today on the subject of vaping, and did so on the UK government’s website.
Please share the wisdom widely.