A reply from The Chief Medical Officer for Wales, Dr Ruth Hussey.

Dear Save E-cigs,

Thank you for your email regarding the recently published findings from
researchers at Cardiff University about e-cigarette use among children and
young people in Wales.

I am glad you found the research of use. It is important we increase our
understanding in this area and in doing so, work with our academic
colleagues, submitting the findings to scientific journals to ensure the
research is subject to scrutiny. I recognise that this and other studies
show regular e-cigarette use among young people is largely limited to
current and ex-smokers at present. These studies also show that regular use
of e-cigarettes, as currently defined, is limited to a small number of young
people.

As it will be some time before definitive evidence becomes available
regarding both the efficacy of e-cigarettes as an aid to smoking cessation
and their long-term health impacts, it is important that we continue to
monitor the evidence as it emerges. In the meantime, I believe that we
should be doing everything we can to prevent a new generation becoming
exposed to nicotine, which is an addictive substance and has been shown to
impact on brain development. Whilst I recognise that e-cigarettes, along
with nicotine replacement therapy, may be helpful to smokers in giving up
tobacco, I believe we should remain cautious in our approach to
e-cigarettes, particularly use among children and young people.

Dr Ruth Hussey OBE

E-cigs, journalists, newspapers and the truth?

On Thursday of last week The Daily Mirror newspaper, either on line or in print, carried three stories relating to e-cigarettes:

 

  1. E-cigs DON’T help smokers quit fags – in fact they make it harder to stop, written by Stephen Beech

 

  1. E-cigarette health warning: Flavoured nicotine liquid packed full of danger chemicals, researchers claim, written by Jasper Hamill

 

  1. Do e-cigarettes encourage smoking? School children more likely to try ‘vaping’ than tobacco, written by Mark Smith

 

And they have recently run the following front page:

 

Mirror

 

The first story highlighted above, written by Stephen Beech puts forward an argument that using e-cigarettes actually makes it harder for people to quit smoking. The overwhelming body of credible evidence makes it clear that this is not actually the case: E-cigarettes actually make it easier for people to quit smoking, by offering them a viable and less harmful alternative. There are 2.1 million vapers in the UK and 700,000 of them have completely stopped smoking as a direct result of vaping. 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.”[1] As e-cigarette use has risen smoking rates have fallen.

 

The second story highlighted above, written by Jasper Hamill states that flavoured nicotine is packed full of dangerous chemicals. This study is based on a tiny sample and crucially does not analyse the vapour that is actually breathed in by users. A number of leading toxicologists have already discounted its findings. The key conclusion in this study was for regulatory action to include requiring ingredient identification, limiting levels of some individual flavour chemicals, and limiting total levels of flavour chemicals. Many of these are things that responsible companies already do and the industry in the UK is working with the British Standards Institute on a recognised standard that will cover all of these issues.

 

The third story highlighted above, written by Mark Smith is very similar to the  papers front page story, namely that children are trying e-cigarettes. However, when you look behind the headline you see a very different situation. The key issue is not how many children are trying e-cigarettes, but how many children having tried them then go on to become regular vapers.

 

Recent research produced by ASH[2] demonstrated that children are not using e-cigarettes in significant numbers. The survey found that regular use of e-cigarettes amongst children and young people is rare and is confined almost entirely to those who currently or have previously smoked[3].

 

Research undertaken by Queen Mary University in London[4] 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. A recent study by John Moores University found that, ‘Overall seven out of eight young people had never accessed e-cigarettes’[5].

 

What the paper’s article failed to mention was how many young people tried e-cigarettes and then went on to use them on a regular basis. There is a huge difference between trying something once and using something on a regular basis. We know from figures produced by ASH that very few young people are using e-cigarettes on a regular basis and of those that do they are confined almost entirely to those who have currently or previously smoked.[6] This is also exactly what the Cardiff University study showed. As Cancer Research UK have said, “Regular e-cigarette use is low among teens.”[7]

 

It is interesting how the paper chose to report this Cardiff University study because others papers took a different approach and arguably reported the study far more accurately.[8]

 

As a campaign representing the interests of vapers, their friends, and their families we are deeply concerned by these headlines. Not because we blindly support e-cigarettes, but because many of these headlines bear no resemblance to the articles that appear under them, more fundamentally, many of these headlines blow out of all proportion the research that the article is based on and often given undue prominence to second rate science that fails to stand up to even the most basic of expert scrutiny. One of the world’s leading experts on e-cigarettes, Dr Konstantinos Farsalinos writes regularly about this warped science narrative[9].

 

These headlines and others like them are now resulting in a decline in vaping as the graph below demonstrates. The latest figures produced by the authoritative Smoking in England survey[10] show that e-cigarette use in England fell in 2014 from 22 to 18.6 per cent, the lowest level since the second quarter of 2013.

stats

 

Professor Robert West, said that “misleading” and “sensationalist” reports were putting smokers off switching to e-cigarettes[11]

We know from research undertaken by Dr Konstantinos Farsalinos[12] that smokers’ perceptions of risk are very far from accurately aligned with reality. This affects their smoking/vaping behaviour. In Spain a sustained period of similar misreporting of e-cigarette safety stories resulted in a 70 per cent fall in the number of vapers. These people did not just quit vaping, they went back to smoking. As Dr Konstantinos Farsalinos makes clear, it is relatively easy for a vaper to go back to being a smoker!

 

We know based on figures produced by ASH[13] that 99.9 per cent of vapers are former or existing smokers. The latest statistical bulletin from the Office for National Statistics on Adult Smoking Habits in Great Britain, 2013[14] shows that only 0.14 per cent of non-smokers use e-cigarettes.

 

When it comes to the safety of e-cigarettes it is how safe they are compared to tobacco cigarettes. We know that there is never a situation where it is better to smoke than it is to vape. All the credible evidence shows that e-cigarettes are significantly less harmful than tobacco cigarettes. Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London states that electronic cigarettes are five per cent of the risk of tobacco cigarettes, in other words at least 20 times safer than tobacco cigarettes[15]. As Professor John Britton from the Royal College of Physicians has 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.”[16]

 

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. It is therefore vital that media coverage of e-cigarettes is accurate and balanced.

 

 

[1] 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

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

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

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

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

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

[7] http://www.cancerresearchuk.org/about-us/cancer-news/news-report/2015-04-16-regular-e-cigarette-use-low-among-teens-analysis-suggests

[8] http://www.dailymail.co.uk/health/article-3040282/Many-teenagers-try-e-cigarettes-regular-users-study-finds.html

[9] http://www.ecigarette-research.com/web/index.php

[10] http://www.smokinginengland.info/latest-statistics/

[11] The Financial Times, 03 February 2015

[12] http://www.ecigarette-research.com/research/index.php/component/k2/item/85-the-importance-of-proper-information-risk-perception-about-e-cigarettes-is-the-strongest-predictor-of-dual-use&Itemid=213

[13] http://ecigarettereviewed.com/ash-uk-survey-adds-further-evidence-that-e-cigs-dont-appeal-to-non-smokers

[14] http://www.ons.gov.uk/ons/rel/ghs/opinions-and-lifestyle-survey/adult-smoking-habits-in-great-britain–2013/stb-opn-smoking-2013.html

[15] Professor Peter Hajek speaking at the E-cigarette Summit, The Royal Society, London on the 13th of November 2014.

[16] The Independent, 29 March 2013

Open Letter to Chief Medical Officer, Wales.

Dr Ruth Hussey

 

Dear Dr Hussey,

We are writing to you in your capacity as the Chief Medical Officer for Wales about a Welsh Government funded study from Cardiff University looking at e-cigarette use amongst young people and your comments following its publication.

The Cardiff University study shows that six per cent of children aged 10 – 11 have tried an e-cigarette, so we also know that 94 per cent have not, which is good. Sadly you chose to focus on the six per cent figure rather than the 94 per cent figure.

Those six per cent of 10 – 11 year olds are reported as having tried an e-cigarette. This is important, because the key issue is not how many children are trying e-cigarettes, but how many children having tried them then go on to become regular vapers.

Recent research produced by ASH[1] demonstrated that children are not using e-cigarettes in significant numbers. The survey found that regular use of e-cigarettes amongst children and young people is rare and is confined almost entirely to those who currently or have previously smoked[2].

Research undertaken by Queen Mary University in London[3] 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. A recent study by John Moores University found that, ‘Overall seven out of eight young people had never accessed e-cigarettes’[4].

Cardiff University themselves came to the same conclusion, “E-cigarettes are popular with teens, including those who have never smoked, but few of those who try them become regular users, with most of those who do so also being smokers.”[5]

Cancer Research UK looked in detail at two major studies into e-cigarette use amongst young people in Wales, they concluded, “Looking specifically at two studies dedicated the use of e-cigarettes amongst young people in Wales only a minority of teenagers who try e-cigarettes go on to become regular users. And the majority of those who do use the devices regularly were already smokers.”[6]

You will also be aware that both the Welsh Government and the Department of Health in England have legislated to ban the sale of e-cigarettes to those under the age of 18. We have been calling for this for some time and welcomed the decision.

In conclusion, we are very aware of the Welsh Government’s proposals to ban vaping in enclosed public places throughout Wales. We note the fact that both you and the wider Welsh Government have tried to use this Cardiff University study as justification for a public vaping ban[7]. This study in no way provides any such justification.

In its approach to e-cigarettes in general the Welsh Government are going against the precautionary principle as it was originally intended, they are trying to mitigate for a risk that has yet to be proven and in doing so may do more harm to public health than good.

Like you we care about evidence. All our position papers are evidence based. All our conclusions are reached after a thorough examination of the evidence. We hope that you will consider the evidence put forward in this letter and that you will think again about e-cigarettes and in particular proposals for a ban on vaping in enclosed public places.

 

Save  e-cigs.

 

 

 

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

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

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

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

[5] http://www.cardiff.ac.uk/news/view/93573-e-cigarette-use-among-welsh-teenagers

[6] http://www.cancerresearchuk.org/about-us/cancer-news/news-report/2015-04-16-regular-e-cigarette-use-low-among-teens-analysis-suggests

[7] http://gov.wales/newsroom/healthandsocialcare/2015/e-cigarette/?lang=en

It’s really Ground Hog Day on National No Smoking Day.

Ground Hog Day

 
Last year on No Smoking Day, Save E-cigs decided to look at the official No Smoking Day website to see how much information they were providing regarding e-cigarettes. We were surprised, given the huge potential of e-cigarettes, that there was not one single mention of e-cigarettes on the website. We wrote at the time:

“Is it too much to hope that by National No Smoking Day next year, policy makers and public health campaigners will have realised the amazing potential of e-cigarettes? Is it too much to hope that these people will stop pretending e-cigarettes do not exist or that they are somehow “dangerous”? Is it too much to hope that these people will engage constructively with vapers and try and understand that for the vast majority of smokers NRT just does not work? Perhaps it is, but on this National No Smoking Day, this campaign’s message to policy makers and public health campaigners is this: This is a crucial moment, a narrow window of opportunity. If wisely regulated, e-cigarettes can make tobacco cigarettes obsolete. The stakes are high, and we need to play it right. Please, please, please do not blow it by focussing all your energies on concerns that have no foundation.”

So one year on and it is No Smoking Day again and a search of the official website reveals that yet again it fails to include a single mention of e-cigarettes.

So on a day dedicated to encouraging people to make an extra special effort to give up smoking, the official campaign website fails to mention the most effective method of helping people to quit smoking by enabling them to switch to a less harmful alternative.

Not only does the official website fail to mention e-cigarettes, but many of the individuals and organisations behind No Smoking Day have spent much of the last year doing their level best to undermine e-cigarettes and to discourage people from vaping. Why?

We know from official research that e-cigarettes are at least 60 per cent more effective than traditional NRT and smokers know this too. As a result NRT sales are falling, councils are spending less on smoking cessation services, but fundamentally smoking rates are at their lowest level in recorded history.

So the official No Smoking Day website and many of the organisations and individuals behind the day can continue to ignore reality, but what they should not do is go out of their way to spread unfounded fears about e-cigarettes and to agitate for regulations that bans vaping in public or prevents smokers receiving access to information about e-cigarettes.

If these people really want to help smokers quit then they should set aside their ideological prejudices and embrace those methods that provide the best chance of helping a smoker quit. You only have to look to Leicester to see what happens when a smoking cessation service embraces e-cigarettes.

Our sector needs tidying up; it does not need destroying

Fraser Cropper, CEO of Totally Wicked explains why TW is taking the EU to court.

Join us in saying NO

The electronic cigarette, personal vapouriser, call them what you will, is in my humble opinion a product group that has the potential to be a global catalyser of positive change that is deserving of Nobel appreciation.

However, we may never see its true potential due to the campaign of misinformation and craven capitulative regulation that is attempting to cripple the nascent begins of the vaping phenomenon. The Tobacco Products Directive (TPD), in its attempt to regulate these products under the auspice of existing tobacco product regulation, is one of the most ill-judged, morally questionable and divisive pieces of legislation that the EU has the arrogance to commit to law.

It is wrong on so many counts that one has to judge its framing on a level beyond sheer incompetence. It will have the potential to destroy what has been created in the past 6 years.

There is no reputable academic evidence that suggests these products are delivering a risk to health that requires such punitive regulation, nor evidence that the millions of users have been harmed by these products. Quite the contrary, all evidence, empirical and theoretical clearly concludes, that for smokers, the transfer to vaping products will transform their health outcome.

Here I risk the wrath of the Pharma clan ‘thought police’. That I, a mere ‘citizen’, never mind business leader, should have the temerity to associate the use of vaping products to the now irrefutable consequences of a self-determined improvement in ones probabilistic life outcome, is not mine to make. But, I will throw caution to the wind and state it nonetheless. However, I categorically do not represent a business that sells, markets or otherwise associates our products or customers to medicines or patients. Nor do I sell tobacco products.

Vaping products sit on neither of these ‘stools’. And I do not even mean with buttocks slightly askew on the seat, fundamentally not sat at all. (Forgive the poor metaphor).

I am very proud of the business that I have inherited the leadership of. I am proud of Totally Wicked, in large part because of what I believe our business stands for. Ignore the commercial considerations for a moment, as I have no intentions of marketing our business in this piece.

We are an independent business, owned by shareholders who share a simple common belief that our business will be a free spirit, answerable only to our customers. Our customers can buy their products from wherever they please, that they chose Totally Wicked makes our business responsible to them. I have promised that their patronage will never be assumed and taken for granted, specifically, they have invested in our business, it is a partnership, and I have a reciprocal responsibility to deliver my part of the partnership equation.

There is no more fundamental responsibility within this equation, than to ensure our customers can continue to find the products that they need and have the legitimate right to purchase and use. The TPD threatens this basic premise, and it does so from no moral or legal base. Every vaper should be eyes open to the agendas being played out in front of us. The young disaggregated industry base and atomized (no pun intended) user base and the resultant lack of collective power and influence is being exploited by the control driven bureaucrats and dizzy headed politicians; unwittingly (one hopes) to destroy this ‘vaping interloper’ that is threatening to destroy the previously unedifying tacit duopoly of the two big business incumbents that prey on the shackled 20% of smokers. So, (I know never start a sentence with ‘So’, but if politicians can start theirs with ‘Look’ than I can with ‘So’), if our business recognises this, and we are true to our word, we had no option other than to take the fight to the source of the TPD and demand that sense is brought to this matter with a court hearing in the European Courts of Justice.

Believe me or not, you will have to judge for yourself, but I will state the following knowing at least to myself the integrity behind the words. Our measure of success is to be allowed to operate within a sector that enables all ethical and professional vaping businesses, large and small, who are willing and able to comply with balanced and customer orientated responsibilities. This requires regulation that protects against the limited objective risk and suitably informs to enable considered choice, and allows trade that meets consumers’ needs.

Our sector needs tidying up; it does not need destroying.

I want Totally Wicked to be every day challenged by true competition that will test our ability to meet customers’ needs. I do not want to run a business that exploits regulation to the detriment of the consumer or legitimate smaller businesses. I have no issue with Tobacco companies selling electronic cigarettes, as long as they are not able to influence and constrain the sector to deliver a recovered monopoly. I back our business, that in a truly competitive environment, that, places customers first we can succeed and build a strong ethical and commercially viable business that can and will compete successfully with either the behemoth tobacco owned or small owner operated vaping stores or artisanal manufacturers.

I believe our case is a Vapers’ case not a simply a Totally Wicked case. Our success is everyone’s success, and I urge all those who care about our vaping future to get involved as necessary and specifically provide your name to the legal challenge site so you can be counted along with like-minded, concerned and threaten vapers.

 

You can sign up and support the legal challenge against the TPD here: http://article20legalchallenge.com/support-the-legal-challenge/

 

Politician and Quote of the week…

As supporters of vaping it can often feel like all in power are against us. However, those of us actively engaged in the policy debate surrounding e-cigarettes know that this is not always the case. There are a growing number of politicians who are willing to take a public stance based on an understanding of the facts. We have therefore decided to celebrate those politicians who are willing to stand up for vapers and vaping by launching a politician of the week.

The winner this week is Viscount Matt Ridley for organising the debate in the House of Lords this week.

Viscount Matt Ridley

 

And our quote of the week is:

 

Earl Cathcart (Con): My Lords, I started smoking before I was a teenager and in recent years smoked up to 50 cigarettes a day—not good for me. I started vaping in July and I have not had or wanted a puff of tobacco since. In spite of trying to give up on countless occasions, only these vaping e-cigarettes have actually helped me kick the habit. Surely that has to be a good thing. Should we not encourage it to help not just me, but the hundreds of thousands or millions of people who want to give up smoking?

 

 

Six months ago I had genuine concerns that we were going to throw the baby out with the bath water …

 

Guest Post by Mike MacKenzie, MSP.

Mike MacKenzie MSP

 

Six months ago I had genuine concerns that we were going to throw the baby out with the bath water as regards electronic cigarettes. An informal lobby was developing a head of steam urging us to do just that.

As a lifelong heavy smoker who has found redemption and a painless way to quit using e-cigarettes I had a personal axe to grind. I haven’t had a cigarette now for two and a half years but even so I still need the crutch of the electronic cigarettes. Intuitively I think I would find it relatively easy to give up electronic cigarettes but I am a great believer in picking the time to fight such battles. Fighting battles on too many fronts can mean you lose them all and I have a real fear that a ban on e-cigarettes would see me back smoking tobacco.

In any case as a lifelong keep fit enthusiast I am relatively in tune with my body and it is sending me signals that e-cigarettes are not nearly as harmful as tobacco was. I can measure my much better performance on the treadmill and the rowing machine, but my general energy levels are also higher as is my ability to remain alert and focussed for long periods. Medical evidence seems to support this view; that e-cigarettes are at worst benign and many health professionals argue strongly on their merits.

Of course regulation is required. We need to make sure that there is a consistently high standard and that no nasty products lurk needlessly within nicotine fluids. I believe we can do this effectively without denying smokers the opportunity to take the easy route offered to quit tobacco use.

I am reassured in this by talking to colleagues many of whom seem now to agree with me. Following the recent Scottish Government re-shuffle I am now a member of the Parliament’s Health and Sport Committee. You can be sure I will be taking full opportunity to make these arguments when the Committee undertakes it’s scrutiny of any forthcoming legislation.