Let’s start with the good news….

Another response to Welsh Health Minister Mark Drakeford and his lack of evidence.

Let’s start with the good news. There are at least 100,000 vapers in Wales, which has mainly grown over the last 2 years. A vaper is simply someone who uses an e-cigarette. These people are now smoking fewer or no cigarettes. With 5,000 people dying every year in Wales from smoking related illnesses according to the Welsh NHS, this should be a cause for celebration not concern.

Recently published figures from the Welsh Health Survey has shown a fall of 2% in the proportion of people who smoke. Given that the Welsh population currently sits at around 3.5 million, 2% of that number works out at approximately 70,000. Given that there are 100,000 vapers in Wales, could not a large proportion of that smoking reduction be attributed to the rise of e-cigarette use ?

Now onto the bad news: the Welsh Government’s proposal to ban the use of e-cigarettes in enclosed public spaces, substantially enclosed public places, and places of work.

Health Minister Mr Drakeford, whilst recognising the benefits of e-cigarettes stated in his recent article that he has a number of concerns regarding their use in public. These concerns include e-cigarettes undermining the current smoking ban, contributing to a renormalisation of smoking, being a gateway product, and being targeted at children.

These concerns would be perfectly valid if they had any foundation or evidence base, but they do not. In fact the available evidence points to the contrary.

The Chartered Institute of Environmental Health stated that there is a 99.7 per cent compliance rate with the smoking ban[1], and there is no evidence to support the idea that the use of e-cigarettes in public is undermining this. Yes, some companies have introduced a vaping ban, but we are seeing a growing number of such companies reversing these bans. Recently, Cambridgeshire Police, following a review of “health fears”, decided to allow their officers to vape at work[2].

Leading Pubco Enterprise Inns have recently reversed their ban on e-cigarettes in their licensed premises. In a further move, Enterprise Inns has signed a new supply deal for its tenants to stock and sell Nicolites e-cigarettes which will form part of their open welcome to the vaping community.

There is no evidence that e-cigarette use in public leads to a renormalisation of smoking either. Professor Robert West, Professor of Health Psychology and Director of Tobacco Studies at University College London’s Department of Epidemiology and Public Health, following his latest research concluded:“Despite claims that electronic cigarettes risk re-normalising smoking, we found no evidence to support this.”[3]

When it comes to concerns about e-cigarettes being a gateway product and their use amongst children, of course experts need to monitor this, but all the evidence to date shows that we have nothing to worry about.

To justify his concerns, Mr Drakeford cited a study produced by John Moores University, yet this study actually concludes that ‘Overall seven out of eight young people had never accessed e-cigarettes’. Recent research produced by ASH also shows that e-cigarettes are not a gateway to smoking[4]. Furthermore, the survey found that regular use of e-cigarettes amongst children is rare and confined almost entirely to those who are currently or have previously smoked[5]. Research undertaken by Queen Mary University[6] 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. Thankfully the Welsh Government has introduced a ban on the sale of e-cigarettes to under 18s, a move that we fully support!

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 (Researcher, Onassis Cardiac Surgery Centre, Greece, University Hospital Gathuisberg, Belgium) and Professor Riccardo Polosa (Director of the Institute for Internal Medicine and Clinical Immunology of the University of Catania, Italy) concluded that the ‘effects of e-cigarette use on by-standers are minimal compared with conventional cigarettes.’[7]

In his article, Mr Drakeford stated that this proposal was rather minor and that it would have no impact on the e-cigarette industry or vapers. However, in Spain where a ban on the use of e-cigarettes in public places has been introduced, 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[8]. People that had made the switch to e-cigarettes are unfortunately now smoking again.

If the Welsh Government succeeds in banning e-cigarettes in public places, they will be forcing vapers to vape alongside smokers and exposing them to the dangers of second-hand smoke. We are in contact with vapers on a daily basis and many have said such a ban would simply force them back to smoking. Is this really what the Welsh Government wants?

A recent open letter to the World Health Organisation was signed by no less than 53 of the leading scientists in nicotine and public health policy. The open letter appealed directly the WHO to adopt a positive, proportionate and rational approach to products that provide very low-risk alternatives to smoking – products such as e-cigarettes. It called upon the WHO to recognise that this approach, tobacco harm reduction, as an important part of the solution offering great promise for public health, and not part of the problem.

In a recent BBC[9] poll 62 per cent of the public said e-cigarettes should not be banned in public and Professor John Briton 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.”[10]

The rise of e-cigarette sales is directly contributing to a decline in cigarettes sales. In the words of Professor Robert West: “What is the problem that requires further regulation?”[11] What public health gain does the Welsh Government hope to achieve with this proposal?

With a ban on the advertising of e-cigarettes soon to be introduced, following the passing of the Tobacco Products Directive, where are smokers to find out about e-cigarettes, particularly if they are banned in public? Smokers need to see people using e-cigarettes in public, they need to be able to go up and speak to e-cigarette users so that they can find out further information and then hopefully make the switch to a safer alternative.

In its approach 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 than good.

 

 

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

[2] http://www.cambridge-news.co.uk/Cambridge/Police-in-Cambridgeshire-can-smoke-e-cigarettes-after-health-review-but-they-are-banned-on-our-trains-20130821131920.htm

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

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

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

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

[7] 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

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

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

[10] The Independent Newspaper, 29 March 2013

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

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4 thoughts on “Let’s start with the good news….

  1. The only people who are re-normalising the use of cigarettes are big tobacco, hence the reason for having “cigalikes”, everyone with what looks like a cigarette or is an actual cigarette between their fingers does their advertising for them – they then hit their target market of 11-15 year olds to compensate for the other customers they used to have who are either too ill to smoke or have died because of smoking. I want all e-cigarettes to look like eGo’s, Vision Spinners, KangerTech, Innokin, Smok and the like – and as far removed from the imitation cigarette. Ask yourself why big tobacco is buying all the huge vaping companies around the globe, so they can monopolise again and reign supreme – they cannot be the POISON AND THE MEDICINE TOO!!

  2. Linda. I fully agree with your post but would add a word of caution. It is a bigger jump for smokers to go straight to an ego style than to a cigalike and for the full health benefit to be realised as many smokers as possible need to be encouraged to switch. May be ban cigalikes in public places? I would love to see NO cigalikes as it would be a big kick in the whatsit for the tobacco and pharma companies. Just thinking out loud.

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