Initial response from Save E-cigs to WHO proposals for the future regulation of e-cigarettes:

As a campaign we are particularly concerned about proposals to regulate e-cigarettes as both a tobacco product and a medicinal product, a ban on the use of flavourings in e-liquid, and a ban on the use of e-cigarettes indoors.

Quote for interested journalist:

“E-cigarettes are neither a medicinal nor a tobacco product, they are simply a viable alternative to conventional tobacco products that millions of current and former smokers globally rely upon to prevent them returning to smoking cigarettes. We are therefore very concerned that many of the WHO’s proposals, some of which go against independent and credible scientific research, will simply result in many existing vapers returning to smoking. This cannot be what the WHO wants. We urge the WHO to think again and to engage with vapers who after all are the ones most impacted by these proposals.”

 

Postponement of our event in the House of Commons,

Sadly our event event- E-cigarettes and Harm Reduction and Why Getting the Regulation Right is Vital, due to take place in the House of Commons at 14:00 on the 2nd of September, has been postponed to a later date.

We had put a huge amount of effort into this event and had secured, what we thought was, a good line-up of speakers.

We have not taken the decision lightly and are acutely aware of the inconvenience this may cause some people, however, it had always been our intention that this event would not be ‘just another e-cigarette event’, but instead one that genuinely moved the debate forward. For that we had hoped to have a significant number of politicians attending.

Due to global events and the possibility of major debates regarding said events taking place when parliament returns in September, it has just not been possible for many politicians to be able to commit to attending this event and therefore we took the decision to hold our event at a later date.

We will let you know when a new event is planned, but until that moment I would like to ask you all to put your efforts into supporting these very important petitions:

Welsh Petition to prevent the ban of vaping in public places (closing date 12/09/2014): https://www.assemblywales.org/epetition-list-of-signatories.htm?pet_id=1023

EFVI: http://www.efvi.eu where if we can get 1 million signatures across Europe, then the EU Parliament have to take another look at the Tobacco products Directive, which at the moment is set to radically alter the e cig landscape for the worse.

And finally, if you can – go along to the e cig summit – http://www.e-cigarette-summit.com or more importantly – GET YOUR MP to attend it – as we need to get the TPD changed, and for that to happen, we have to take action. We went last year, and it really was a very worthwhile event.

 

 

 

 

 

 

 

 

 

Cigalike vs. refillable e-cigarettes: Don’t stub out the cigalikes just yet….

Lynne Dawkins, Drugs & Addictive Behaviours Research Group, School of Psychology, University of East London

 

E-cigarettes are the subject of intense debate: some consider them one of the greatest public health breakthroughs of our time, with the potential to save millions of smoking-related deaths; others fear they could re-normalise smoking, undermining tobacco control efforts which have made smoking socially unacceptable.

E-cigarettes come in all sorts of shapes and sizes. Some, commonly referred to as first generation devices, resemble tobacco cigarettes (cigalikes) with an orange mouthpiece resembling a cigarette filter, a white battery and an LED which glows when the user inhales on the device. These devices comprise low-capacity disposable or re-chargeable batteries and combined cartridges and atomisers (cartomisers). Second generation devices resemble pens or gadgets and use larger batteries and fluid filled reservoirs (clearomisers or tanks), filled from bottles of e-liquid. Third generation devices bear little visual resemblance to cigarettes, use larger-capacity batteries, replacement heating coils and wicks for atomizers, and adjustable and programmable power delivery.

 

E-cigarette use (commonly referred to as ‘vaping’) resembles the act of smoking : the user holds the device and draws on it like a cigarette; the vapour produced is drawn into the lungs and exhaled like smoke; and tobacco (or menthol) flavouring mimics the taste of inhaled tobacco smoke. Moreover, first generation cigalikes look exactly like cigarettes and are often contained in boxes resembling cigarette packets. Although regular e-cigarette users (‘vapers’) tend to use second and third generation devices which deviate from a cigarette-like appearance (Dawkins et al., 2013), most e-cigarettes found in retail outlets across the UK and US (and therefore most likely to be encountered by smokers) are first generation cigalikes. This has led to a growing concern among public health officials that e-cigarette use may re-normalise smoking, especially if they look like cigarettes and their use is misperceived as smoking. Given the gradual cultural shift over the last 50 years which has transformed tobacco smoking from a ubiquitous socially acceptable behaviour into a distasteful or repugnant habit, fears abound that e-cigarettes may allow re-entry of tobacco smoking into public view.

So, just how important is cigarette-like appearance for a smoker transitioning to e-cigarette use?  Or, is visual appearance irrelevant as long as there is effective nicotine delivery? If first generation cigalikes are indeed less effective than their refillable, newer generation counterparts and few smokers opt for them when presented with a refillable alternative, there would be little reason to encourage their promotion.   Drawing on data from the combustible literature, although nicotine is clearly a critical component of tobacco smoking, increasing evidence points to the role of non-nicotine, sensorimotor factors – the look and feel of the cigarette. For example, smokers prefer smoking to other forms of nicotine administration (e.g. patch, gum, nasal spray) and report enjoying the hand-mouth activity, taste, smell and sensation of smoke in the respiratory tract (Parrott & Craig, 1995). Smokers have also been shown to prefer smoking a cigarette containing no nicotine (denicotinised) over receiving nicotine intraveneously (Rose et al., 2010) and denicotinised smoking can also reduce nicotine withdrawal symptoms and smoking urges (Barrett, 2010; Perkins et al., 2010).

 

In order to explore preferences for cigalikes versus later generation refillable devices, we asked 100 smokers who had little or no experience of e-cigarettes to choose between a first generation cigalike and a second generation eGo when both devices were placed in front of them. 50% chose the cigalike device and stated that they did so because it resembled a cigarette. Clearly, cigarette-like appearance is important for many smokers who are thinking about using an e-cigarette. But is cigarette-like appearance important when the e-cigarette is actually used?   To address this question, we randomly assigned 63 abstinent smokers to one of two conditions: a first generation cigalike with a white battery and orange filter (white; cigarette similar condition) or a first generation cigalike with a red battery and orange filter (red; cigarette dissimilar condition). The flavour (tobacco) and nicotine content (18mg/ml) were the same in both conditions. Participants rated their urge to smoke and nicotine related withdrawal symptoms before, and 10 minutes after, using the e-cigarette.   The reduction in urge to smoke and withdrawal symptoms was significantly greater for those in the white (cigarette-similar) condition compared with the red condition, especially for those who had not used an e-cigarette before (Dawkins et al., under review).   We concluded that visual similarity to a cigarette is important for smokers who are new to e-cigarette use, at least after short term use in the lab. This could be an expectancy effect or a secondary reinforcing effect whereby cues (e.g. the visual appearance of the cigarette), by virtue of their continued association with nicotine delivery, become moderately pleasant in their own right, capable of alleviating some of the discomfort associated with not smoking.

Nevertheless, regular vapers tend to move away from cigalikes to second or third generation refillable devices (McQueen, Tower & Sumner, 2011) and there is some evidence that these may be more effective for quitting (Farsalinos et al., 2013), perhaps due to more efficient nicotine delivery (Farsalinos et al., 2014). We therefore explored whether a second generation eGo device was better than a disposable cigalike for reducing urge to smoke and nicotine withdrawal symptoms in 100 abstinent smokers who used the e-cigarette for 10 minutes. There was a significant reduction in craving and withdrawal symptoms in both groups. In other words, the disposable cigalike was as good as the second generation device, and both groups reported receiving a ‘hit’ from the e-cigarette. There were some differences though – those in the second generation condition rated the e-cigarette as more satisfying and were more likely to use it in a quit attempt (Dawkins et al., under review). Although there are hundreds of cigalike products available and these findings cannot be generalised to all first generation devices, they do demonstrate that cigalikes at least have the potential to be as effective as refillable devices for short term alleviation of tobacco craving and withdrawal symptoms. Perhaps as smokers transition from smoking to vaping however, cigarette-like appearance becomes less important alongside an identity shift away from a ‘smoker’.

Taken together, these findings suggest that first generation cigalike products may have their place among the plethora of e-cigarette devices, at least to draw smokers into initial e-cigarette use and away from smoking. Nevertheless, this needs to be balanced carefully against any disadvantage associated with a possible re-normalisation of smoking. Moreover, cigarette related visual cues, may even serve to maintain a tobacco smoking addiction if they remind the smoker of cigarettes, which may explain why second generation devices are preferred for stopping smoking. Nevertheless, until trials comparing cigalikes and refillables for quitting smoking are conducted, there is no compelling evidence as yet to stub out the cigalike.

 

References

Barrett SP. (2010). The effects of nicotine, denicotinized tobacco, and nicotine-containing tobacco on cigarette craving, withdrawal, and self-administration in male and female smokers. Behavioral Pharmacology, 21, 144-152.

Dawkins L, Kimber C, Puwanesarasa Y, Soar S. (under review). First versus Second Generation Electronic Cigarettes: Predictors of Choice and Effects on Urge to Smoke and Withdrawal Symptoms. Addiction.

Dawkins L, Munafò M, Christoforou, G, Olumegbon, N. (under review). The effects of e-cigarette visual appearance on urge to smoke and withdrawal symptoms in abstinent smokers. Nicotine and Tobacco Research.

Dawkins L, Turner J, Roberts A, Soar K. (2013). ‘Vaping’ profiles and preferences: An online survey of electronic cigarette users. Addiction 108, 1115-1125.

Farsalinos KE, Romagna G, Tsiapras D, Kyrzopoulos S, Voudris V. (2013). Evaluating nicotine levels selection and patterns of electronic cigarette use in a group of ‘vapers’ who had achieved complete substitution of smoking. Substance Abuse , 7, 139-146.

Farsalinos KE, Spyrou A, Tsimopoulou K, Stetopoulos C, Romagna G, Voudris V. (2014). Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices. Scientific Reports, 4, 4122.

McQueen A, Tower S, Sumner W. (2011). Interviews with ‘Vapers’: Implications for future research with electronic cigarettes. Nicotine and Tobacco Research, 13, 560-7.

Parrot AC, Craig D. (1995). Psychological functions served by nicotine chewing gum. Addictive Behaviors 20, 271-8.

Perkins KA, Karelitz JL, Conklin CA, Sayette MA, Giedgowd, GE. (2010). Acute negative affect relief from smoking depends on the affect situation and measure but not on nicotine. Biological Psychiatry, 67, 707-714.

Rose JE, Salley A, Behm FM, Bates JE, Westman EC. (2010). Reinforcing effects of nicotine and non-nicotine components of cigarette smoke. Psychopharmacology, 2010, 1-12.

 

 

 

 

 

 

 

 

Major event in the House of Commons…..

Houses of Parliament

 

On the 2nd of September Save E-cigs is organising a major event in the House of Commons hosted by Rt. Hon Jack Straw MP (Labour), Mark Pawsey MP (Conservative), and John Pugh MP (Liberal Democrat). The meeting will be held in the Attlee Suite from 14:00 – 16:00.

At present there is a significant debate taking place as to how exactly e-cigarettes should be regulated. The Tobacco Products Directive, which the UK Government will be transposing over the next two years, sets some guidelines, but does not dictate actual regulation in many areas. Should they be included in the smoking ban as the Welsh Government has proposed? Should they be regulated as a medicinal product, a tobacco product, or something else? Our event will look at all these issues in detail. Speaking at this event will be:

· Professor Gerry Stimson, London School of Hygiene and Tropical Medicine and the National Institute for Health and Clinical Excellence
· Clive Bates, Former Head of Action on Smoking and Health
· Louise Ross, Leicester Stop Smoking Services
· Professor Robert West, Professor of health psychology and director of tobacco studies at University College London’s department of epidemiology and public health
· Oliver Kershaw, Founder of the E-cigarette Forum
· Jill Rutter, Institute of Government

This meeting will not be just another event discussing e-cigarettes, it will genuinely move the debate forward; setting the scene, looking at what happens when policy makers get regulation wrong, and setting out how e-cigarettes could and should be regulated.

It is vital that all those with an interest in e-cigarettes engage on this important topic. If you would like to attend this event please RSVP to campaign@saveecigs.com.

We have invited every MP to attend this event; however, to ensure that they attend it often helps if their constituents encourage them to attend. We would therefore be very grateful if you could please get in touch with your local MP and encourage them to attend this important event.

The Global Forum on Nicotine… was it worth it?

Global Forum on Nicotine

 

This was my first e cigarette ‘event’ so I had no pre-conceived ideas as to how it would go, who would be there and what the outcome would be. The line up looked interesting and the programme pretty compelling and I was delighted to be there.

It turned out to be two days packed to the rafters with talks and discussions, many conversations were held during the breaks, (where we had fabulous snacks and food, thank you Marriot Hotel) and much was learnt. There wasn’t an awful lot about nicotine if I am honest, but then this was always going to be about e cigarettes; where we are globally, and where we hope to go.

Deborah Arnott from ASH attended, she was on a fact-finding mission for the FCT. She gave a presentation at the end of the conference.  Sadly she still supports med regs, yet accepts the twin track approach agreed by the TPD, but then that presentation was made before she attended. I guess we can cling to a vain hope that she may still change her mind and have a road to Damascus conversion, and realise that e cigs should be pretty much left alone to innovate and get folks away from the dreaded weed.

All the eminent scientists were there, and it was lovely to finally meet them, see them in person and hear what they had to say without reading long and rather dull scientific papers. Prof Hajek is just lovely!

The well- know vapers were there in force, Dave Dorn, Lorien Jollye, Sarah Jakes, Dick Puddlecoat and more, with plenty of wine and beer flowing in the evenings amongst clouds of vapour. (Did anyone know that DD is a trained Opera singer?)

 

But what did Save e-cigs come away with from the Forum?

That Public Health can absolutely see the benefits of e cigs, but can they ethically allow the prescription of them on the NHS, if the Tobacco Industry makes them?

That Vapers, without a shadow of a doubt made the difference at the TPD. Rebecca Taylor MEP made this abundantly clear. Because of vapers getting involved and telling their story, MEPs had to respond. And somehow we need to keep this involvement up.

The reason why snus is still banned? They didn’t lobby, and they didn’t/don’t have the people power behind them. The travesty that is the snus ban was continually referred to, and it is incredulous that it is still banned. It makes absolutely no logical sense.

Working together. This was the common theme and common thread, and was heartening to hear. We all have to put egos’, differences etc. behind us. The TPD could have been better if we had been united. A divided house falls, and we need to ensure that that doesn’t happen again.

 

So what’s next for e cigs? In the words of the world famous fish Dory – we have to ‘just keep swimming’, there’s nothing else for it – keep writing, keep campaigning, and keep on keeping on!

Just keep swimming

Just keep swimming

There are moves afoot for there to be a Global Forum on Nicotine the same time, same venue next year. Let’s hope that the e cigarette industry and community will be able to come together again then, but this time with plenty of progress to report in the regulatory area. Good progress too, in our favour.

So was the GFN worth it? absolutely.

But one final note: Warsaw is lovely, very cheap, but quality cheap, full of culture and if you ever get the chance – go!

 

 

Our Letter to Kelly Evans, writer and marketer at Social Change UK.

Social Change UK

Social Change UK

 

Dear Ms Evans,

 

We are writing in response to your recent opinion piece published on the Social Change UK website.[1]

Save E-cigs is a campaign that represents vapers, their friends, and their families.

In your piece you state that you are not against e-cigarettes, but this is not how your article comes across. In both tone and content it is hostile to e-cigarettes. More than that it is not a balanced article. You state at the beginning of your piece that ‘evidence is king’ yet you make a number of evidence free statements or deny, when it does not suit your line of attack, that evidence exists when it does.

In your piece you argue that there is not enough information available to disprove the argument that e-cigarettes are a gateway into smoking. There is actually a significant amount of very credible evidence that clearly demonstrates that virtually all e-cigarette users are either current or former smokers and that no evidence exists of e-cigarettes being a gateway product.

The latest research produced by Action of Smoking and Health (ASH) concluded that that just 0.1 per cent of e-cigarette users had never smoked tobacco cigarettes previously[2]. Commenting on ASH’s latest research, Deborah Arnott, Chief Executive of ASH, said: “There is no evidence from our research that e-cigarettes are acting as a gateway into smoking.”[3]In addition to this, the largest ever EU-wide study on this issue, carried about by the Harvard School of Public Health also concluded that there was no evidence that e-cigarettes were a gateway to smoking[4].

Looking specifically at children and the gateway effect, research undertaken by Queen Mary University in London[5] found that a child trying a tobacco cigarette for the first time is 50 per cent likely to become a regular smoker. The same research found no evidence that a child trying an e-cigarette for the first time goes on to become a regular vaper.

You suggest that e-cigarette use may actually encourage people to continue to smoke and may actually harm quit attempts. If ‘evidence is king’ where is your evidence?

Many vapers have tried numerous times to quit smoking using conventional nicotine replacement therapies, which have a 90 per cent failure rate, however with e-cigarettes they have all cut down their smoking or stopped completely. Professor Robert West, Professor of health psychology and director of tobacco studies at University College London’s department of epidemiology and public health said: “We found that those using the e-cigarette were about 60 per cent more likely still not to be smoking than those using the licensed product or nothing at all.”[6] E-cigarettes are however not some form of more effective nicotine replacement therapy, they are totally different and need to be regulated accordingly. Speaking in Parliament recently, Professor Robert West also made clear that in all his research he saw no evidence of dual use undermining quit attempts or prolonging smoking, if anything he saw evidence of a move amongst dual users to quit completely.[7] This was supported by the latest Smoking Toolkit Study, something you should be familiar with, which concludes, ‘evidence does not support the view that electronic cigarettes are undermining quitting or reduction in smoking prevalence.’

As the evidence shows, not only are e-cigarettes not a gateway to smoking, they do not re-normalise smoking either. Professor Robert West, following his latest research concluded:“Despite claims that electronic cigarettes risk re-normalising smoking, we found no evidence to support this.”[8]

When it comes to the advertising of e-cigarettes, you are concerned that some of these adverts make e-cigarettes look ‘desirable’; is that not a good thing? After all, e-cigarettes are recognised as being safer than tobacco cigarettes. Professor Peter Hajek of Queen Mary University London and the NHS have both made clear that e-cigarettes are “orders of magnitudes safer than tobacco cigarettes.”[9] The NHS made clear that they were 1,000 times safer[10]. Is it therefore not better for smokers to switch to e-cigarettes? Again the answer must clearly be yes. Professor John Briton from the Royal College of Physicians said: “If all the smokers in Britain stopped smoking cigarettes and started using e-cigarettes we would save five million deaths in people who are alive today. It’s a massive potential public health prize.”[11] Therefore, if these adverts are encouraging people to switch to a safer alternative then what is the problem?

Perhaps you are concerned about the impact of advertising on children? Well you need not worry. Research undertaken by John Moores University[12] concluded that, ‘Despite widespread advertising of e-cigarette brands in print, visual and social media, the majority of participants (children) reported that they had not seen any advertising for e-cigarettes and showed a lack of awareness of advertising and marketing strategies and approaches’.

Of course there must be regulation of advertising, which is why we welcomed the recent Committee of Advertising Practice consultation and look forward to reading their proposals. However, the issue of advertising will not be around for much longer as the revised Tobacco Products Directive bans the advertising of e-cigarettes from 2016.

In your piece you raise concerns about tobacco companies moving into this market. We are a vapers group and are not spokesmen for the industry; however, it strikes us as a good thing if tobacco companies are moving away from making and selling harmful tobacco products to making and selling e-cigarettes.

The key thrust of your piece is about e-cigarette usage amongst children. The latest research produced by ASH concluded that, ‘e-cigarettes are used by both smokers and ex-smokers, but there is little evidence of use by those who have never smoked or by children.’[13] ASH found that 98 per cent of 11 – 12 year olds had never tried an e-cigarette, the figure for 13 – 14 year olds was 96 per cent. The crucial thing is how many of these children, having tried an e-cigarette once go on to use them regularly. We know from figures produced by ASH that very few young people are using e-cigarettes on a regular basis.[14]

In your piece you made much of the issue of flavouring, implying that flavours are used to attract children. Evidence produced by a variety of organisations including ASH and the American Cancer Society (ACS) clearly shows that flavours do not entice non-smokers to use e-cigarettes either. Researchers from the ACS[15] found that flavours did not increase the attractiveness of e-cigarettes to teenagers. Rather, ‘Even after controlling for other statistically significant correlates, the odds of a smoker being willing to try an e-cigarette were 10 times those of a non-smoker.’

However for those adult smokers who have switched to e-cigarettes, flavours are important. Why?

The key health benefit of e-cigarettes is determined by how many smokers switch to them or use them as a staging post to quitting completely. This means that e-cigarettes have to be an attractive alternative to tobacco cigarettes for established smokers. Flavouring is an important part of this as the nicotine solutions have no flavour. Removing or banning flavourings would actually reduce the appeal of e-cigarettes to smokers.

In research[16] carried out by Dr Konstantinos Farsalinos and others, vapers stated that the availability of flavours was “very important” in their effort to reduce or quit smoking. This research also found that the majority of vapers would find e-cigarettes “less enjoyable” or “boring” if flavours were restricted, while 48.5 per cent of vapers stated that it would increase their cravings for tobacco cigarettes and 39.7 per cent of vapers said that without flavours it would have been less likely for them to reduce or quit smoking.

This major piece of research concluded:

 

  • That far from marketing flavours to attract children, flavours are marketed to ‘satisfy vapers’ demand’,
  • Flavours contribute to both perceived pleasure and the effort to reduce or quit smoking,
  • Restrictions on flavours could cause harm to current vapers, and
  • Current flavour variability must be maintained.

 

The proliferation of flavours reinforces that view that these are recreational consumer products, not smoking cessation aids, medicines or tobacco products.

We welcomed the decision by both the UK and Welsh governments to introduce bans on the sale of e-cigarettes to under 18s. As 99.9 per cent of e-cigarette users are current or former smokers, such a move was not just responsible, it was also common sense. It will now be up to the authorities to enforce this ban. As an aside, perhaps you could inform us as to which pizza takeaways in North Wales were selling e-cigarettes. A number of vapers took the time to call round such places and were unable to find a single one selling e-cigarettes.

In your piece you raise the issue of passive vaping and cite countries where public vaping bans have been introduced, including Wales where such a ban has been proposed.

The ban on smoking in enclosed public places was introduced to benefit the health of non-smokers whose health was put at risk as a result of being in close proximity to smokers. Therefore any proposal to include e-cigarettes within this ban must also be to protect the health of non-vapers.

Is passive vaping dangerous? A major scientific study undertaken by Dr Konstantinos Farsalinos and Professor Riccardo Polosaconcluded that the ‘effects of e-cigarette use on by-standers are minimal compared with conventional cigarettes.’[17]

One of the examples you cite, of a country that has introduced a public vaping ban, is Spain. Following the introduction of the ban in Spain there has been a 70 per cent fall in the number of vapers and a 60 per cent decrease in the number of vaping shops[18]. People that had made the switch to e-cigarettes are unfortunately now smoking again. Surely this is not something you would like to see repeated elsewhere?

Such bans are not supported by the public who are actually very supportive of e-cigarettes. A recent poll by the BBC[19] found that 75 per cent of the public would be happy if their friends or family switched from smoking tobacco cigarettes to using e-cigarettes, and 62 per cent of the public said that e-cigarettes should not be banned in public.

Finally, you raise the issue of regulation. E-cigarettes are currently regulated by at least 17 EU Directives and a number of other regulations at the Member State level.[20] The revised Tobacco Products Directive when it comes into force in 2016 will introduce further regulation and see e-cigarettes more strictly regulated than some tobacco products. You mentioned the specific example of the inclusion of health warnings. These warnings are not as you implied akin to those on tobacco products, they are simply to inform people of the addictive nature of nicotine.

Yes nicotine is addictive but that does not mean it is dangerous. Caffeine is addictive, is that dangerous? The nicotine contained in e-cigarettes is the same pharmaceutical grade nicotine used in NRT products (some of which are inhaled). As Professor Robert West said: “E-cigarettes are about as safe as you can get. We know about the health risks of nicotine. Nicotine is not what kills you when you smoke tobacco. E-cigarettes are probably about as safe as drinking coffee.”[21]

Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London, said: “E-cigarettes are orders of magnitudes safer than cigarettes because they do not release smoke which contains toxins which are responsible for heart disease, lung disease, and cancer.”[22] The NHS has also concluded that e-cigarettes are 1,000 times safer than tobacco cigarettes[23]. You should also note that many vapers use an e-cigarette that does not contain any nicotine.

In your approach you are going against the precautionary principle as it was originally intended, you are trying to mitigate for a risk that has yet to be proven and in doing so may do more harm than good. Given that 99.9 per cent of e-cigarette users are current or former smokers, and given that e-cigarettes are significantly safer than tobacco cigarettes, the only sensible thing to do is to encourage e-cigarette use up until the time (if such a time were ever to arise) when a direct negative risk between e-cigarettes and a vapers health can be proven beyond doubt. To do anything else would be to condemn millions of smokers in the UK to an even earlier death. Would you rather someone smoked or vaped?

All those with a genuine interest in public health need to stay focussed on the bigger picture – significantly reducing the number of people who die from tobacco related illnesses. Conventional nicotine replacement therapies are not tackling this in any significant number, but e-cigarettes could. Already 2.1 million smokers have switched to e-cigarettes. The rise of e-cigarette sales is directly contributing to a decline in tobacco cigarettes sales. In the words of Professor Robert West: “What is the problem that requires further regulation?”[24] This should be a cause for celebration, not concern.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[1] http://www.social-change.co.uk/news/post.php?s=2014-06-19-e-cigarettes-children-and-adults-who-like-gummy-bears-are-e-cigarettes-a-good-thing

[2] http://www.theguardian.com/society/2014/apr/28/e-cigarette-users-triple-ash-survey

[3] http://metro.co.uk/2014/04/27/e-cigs-cleared-of-being-route-into-smoking-4710734/

[4] http://tobaccocontrol.bmj.com/content/early/2014/04/30/tobaccocontrol-2013-051394.abstract?sid=e065daee-e796-4cd1-8bf5-30ae2696f39f

[5] Research undertaken by Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London

[6] Study carried out on 5,000 smokers, by Professor Robert West looking at the success rate of different methods to stop smoking: nicotine gum, nicotine patches, nothing, or e-cigarettes. Reported on BBC Breakfast 28 April 2014

[7] Meeting of the All-Party Groups on Smoking and Health, Pharmacy, and Heart Disease 10 June 2014

[8] http://metro.co.uk/2014/04/27/e-cigs-cleared-of-being-route-into-smoking-4710734/

[9]http://www.bbc.co.uk/news/health-27161965

[10] http://www.spectator.co.uk/features/9197731/vape-alarm/

[11] The Independent Newspaper, 29 March 2013

[12]John Moores University – ‘Young People’s Perceptions and Experiences of Electronic Cigarettes’

[13] http://ash.org.uk/files/documents/ASH_715.pdf

[14] http://www.ash.org.uk/files/documents/ASH_891.pdf

[15] http://www.jahonline.org/article/S1054-139X(12)00409-0/fulltext

[16] http://www.mdpi.com/1660-4601/10/12/7272

[17] Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review:

Konstantinos E. Farsalinos and Riccardo Polosa

published online 13 February 2014 Therapeutic Advances in Drug Safety

[18] http://www.thinkspain.com/news-spain/24345/e-cigarette-sales-in-spain-drop-by-70-per-cent

[19] http://www.bbc.co.uk/news/health-24909648

[20] http://www.clivebates.com/?p=1092

[21] The Guardian Newspaper, 05 June 2013

[22] http://www.bbc.co.uk/news/health-27161965

[23] http://www.spectator.co.uk/features/9197731/vape-alarm/

[24] Professor Robert West speaking at the E-cigarette Summit, The Royal Society, London on the 12th of November 2013.

The proposal to ban vaping in public in Wales. A comment by Darren Millar AM.

Darren Millar AM

Darren Millar AM

As smoking bans become more widespread around the world smokers are looking for alternatives that will allow them to continue to get their nicotine fix unabated and many have found a solution in electronic cigarettes.

Here in Wales, as is the case elsewhere in the UK, they are currently allowed just about anywhere in public – even where tobacco smoking is banned.

However, the Welsh Government’s public health white paper consultation, published last month, includes plans that would see Wales become the first part of the UK to ban the use of electronic cigarettes in enclosed public places.

Ministers say they are responding to concern that the devices normalise smoking and undermine the smoking ban.

Personally, I am unconvinced by the arguments for a public ban on e-cigarettes and I fear this would be a huge step backwards for quitters.

There is a clear danger that forcing someone who is using e-cigarettes to kick their habit to go outside into a smoker’s hut will put them in temptation’s way and harm their health due to second-hand smoke exposure.

We should be giving people a helping hand to quit – not yanking them backwards. Anything that stigmatises those working hard to improve their health should be very carefully examined.

Dr Pat Riordan, director of the Health and Healthcare Improvement Division, which runs Stop Smoking Wales, agrees. He has said “The last thing we want to do is alienate smokers who are using e-cigs in good faith as a part of their attempt to cut down or quit smoking.”

Public health guidance from the National Institute for Health and Care Excellence ‘Tobacco: harm-reduction approaches to smoking’ supports the use of licenced nicotine containing products to aid people in cutting down or quitting smoking.

And a recent BBC poll of nearly 1,000 people suggested most people supported the use of e-cigarettes in public places.

Professor John Britton, of the Royal College of Physicians has stated that if all the people in Britain who currently smoke traditional cigarettes switched to e-cigarettes, 5 million lives would be saved from smoking related deaths – a huge saving in not just unnecessary deaths but also many millions of pounds which would otherwise be spent on medical care and supporting a bereaved family.

Of course, quitting smoking would have the same effect, but it is clear that not every smoker could or would want to stop smoking.

A recent survey of more than 1,600 e-cigarette users found that 61% would return to tobacco if e-cigs were banned. With one person dying from smoking-related illness every 90 minutes in Wales and with smoking the biggest cause of avoidable ill health and early  death in the UK, surely it is better for people to be using e-cigarettes than the real thing.

E-cigarettes clearly work for 2.1million adults in the UK and the Welsh Government must bring forward the evidence behind their proposals to provide clarity on the justification for these proposals within the Public Health Bill.

People who choose to use e-cigarettes do so because they are trying to kick a very addictive and unhealthy habit. We should be supporting these people in their efforts as much as we can, not hindering them.

 

Please note Darren Millar wrote this piece in May of this year for his own blog, but has kindly allowed us to reproduce it here.