Guest post by Jocelyn Davies AM Plaid Cymru

 

Jocelyn Davies AM

Jocelyn Davies AM

I believe that the Welsh Labour Government’s plan to make using an e-cigarette in an enclosed public space illegal is wholly wrong.

The e-cigarette ban will mean that vaping is treated exactly like smoking tobacco under the law. The Government risk stigmatising a new product that is helping many people reduce the amount they smoke and even give up altogether.

I have to declare a personal interest in this issue: I vape myself. I had previously been using lozenges to help me stop smoking, and had been for a long time. It was worry about the effect they were having on my teeth that prompted me to look into alternatives.

A huge amount of the growth in popularity of e-cigarettes has been fuelled by word-of-mouth. I was attending a conference and noticed two women sitting on the next sofa in the hotel lobby vaping. We fell into conversation about it and it was on their recommendation that I then went into an e-cigarette shop to get advice from them. If the Public Health (Wales) Bill passes in its current form, I would not have been able to talk to those women and the e-cigarette shop would not have been allowed to demonstrate their products to customers like me to show us how they work. I may never have discovered that e-cigarettes are, for me, a device that is incredibly successful in helping me continue not to smoke in the long-term.

If you’re a smoker, one advantage of a cigarette is that it’s a highly reliable way to deliver the nicotine fix you need. As long as you have a lighter, you can be pretty sure that your cigarette won’t fail. If you plan to use an e-cig to help you give up, you need reassurance that the device is similarly reliable and unless you’ve had a conversation and a demonstration of how they work, you’re unlikely to have faith in their reliability. Making e-cigarettes less visible and more difficult to get hold of will not promote public health. Far from the Government’s concerns that e-cigarettes normalise smoking, in my experience, seeing people vaping normalises the use of an effective tool to help you give up.

I admit that e-cigarettes are so new that little is known yet about the long-term impact they may have on health. I think it is important to remain sceptical about manufacturers’ claims that you can put a numerical value on exactly how much better for your health they are than smoking. We just don’t know yet. But Government policy should be based on evidence and so far there is no evidence to suggest that e-cigarettes are anything like as dangerous as smoking and plenty of evidence to show that they help people quit.

Of course, there are many places where you might want to restrict e-cigarette use. They are not appropriate everywhere. Some restaurants already stop their customers vaping inside and they should be free to do so. But to treat e-cigarettes exactly like tobacco, to make it an illegal offence to vape in a public place, is an entirely wrong-headed policy and totally out of line with people’s lived experiences. It shows a complete lack of understanding of the psychology of addiction and smoking. On this issue, the Health Minister is completely out of touch.

The ban on e-cig use is not something that should be snuck into a Bill on an unrelated topic, this is something that should stand alone. If Welsh Labour are committed to banning e-cigarettes, then they should put it in their manifesto and wait until after the election when they have a mandate from the electorate to act.

Finally, and this is a pretty radical question to ask, I wonder why we tolerate tobacco use at all anymore? We know how damaging tobacco is for public health, why not ban smoking altogether? We could encourage everyone to move to e-cigarettes instead. The Health Minister seems to be using e-cigs as his own tobacco substitute, banning them rather than banning cigarettes as perhaps he’d really like to.

The Welsh Labour Government’s knee-jerk reaction to a new technology that is helping many more people give up smoking is an unpopular mistake. I will be pressing the Health Minister to reconsider.

 

Note from the Editor:

A few people were concerned about Jocelyn’s comment re banning smoking. To clarify,, Jocelyn is not advocating a tobacco ban, she is merely speculating about the health minister’s reasons for a vape ban, and is making the point that vaping seems to his substitute for tobacco.

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

Why we feel we are left with no option but to place our contentions in front of the judiciary.

Guest post from Fraser Cropper, CEO of Totally Wicked.

Judiciary

 

Totally Wicked, as some readers may be aware, has filed a challenge against the Tobacco Products Directive (TPD), and I want to take this opportunity on the Save e cigs blog to explain a little more about what we have done and why we feel we are left with no option but to place our contentions in front of the judiciary.

Firstly we haven’t taken the decision to challenge the TPD lightly, and we would not have undertaken this if we didn’t believe that a) we are doing the right thing, and b) that we have what we believe to be a solid case.

Our legal challenge is essentially questioning why the TPD mandates that e- cigarette laws should be stricter than tobacco laws. Article 20, the article that relates specifically to electronic cigarettes, to our mind represents a disproportionate impediment to the free movement of goods and the free provision of services. It places electronic cigarettes at an unjustified competitive disadvantage to tobacco products; it fails to comply with the general EU principle of equality, and breaches the fundamental rights of electronic cigarette manufacturers.

Therefore as a company are asking that the EU courts consider the TPD and pass its objective judgement on the regulatory framework that the TPD has delivered.

Article 20 will place unnecessary burdens on the industry, while at the same time completely ignoring the core needs of the user, those of diversity of product range, varying nicotine strengths and a vibrant community to encourage and support. All of these will be removed by the TPD.

We want all consumers to have enough information to make a judged decision and make sure that quality is of a standard that is acceptable. We want regulation that protects customers from ingredients and product deficiencies that could cause them harm, and this can easily be achieved through regulation that is proportionate, that gives the sector the justifiable opportunity it needs to have to give people a realistic option other than conventional cigarettes.

There is enough compelling evidence and research that proves e cigarettes are hundreds of time safer than conventional cigarettes, so our basic premise is this:why should our product be placed under greater regulatory constraint than a product that has killed many hundreds of thousands of people, and continues to do so? Where is the regulation that reflects the value these products are bringing? 2.5. million users in the UK have independently chosen to use e cigs, but nowhere in the TPD is the transformational potential recognised and engaged constructively.

It is a fallacy to suggest there is no ability for the government to affect the necessary controls, because there absolutely is enough control within the consumer regulations to suitably regulate electronic cigarettes, however the government have not chosen to utilise them. There are problems; there are imports that are not acceptable, yet the current regulatory environment could do away with them, if there was a will. Instead the TPD instructs disproportionate regulation that will significantly adversely affect a creative and paradigm changing nascent industry that deserves to be supported.

We want to grow as a business, we are an ethical company, we employ over 150 people directly and many hundreds more through our reselling base, but we have an illegitimate threat hanging over us. We are in the process of opening a new fluid production facility here in the UK that will provide jobs, and produce e liquid of the highest quality and standards, yet we have no idea how the TPD will impact this.

We are optimistic about the hearing in the Administrative courts on the 6th October, we expect to be heard in the CJEU next year, and we very much hope that the outcome will be a Tobacco Products Directive that reflects the reality of e cigarettes, the value they are providing, has them in a context that reflects the users needs and ultimately lets us get on with running our business – one of selling excellent quality products that have transformed many thousands of users’ lives.

 

 

 

 

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!

 

 

Letter to The Scotsman Newspaper

The Scotsman

 

Dear Sir,

I am writing in response to your recent article, ‘Call for ban on e-cigarettes in public places’ As a campaign that has the interests of e-cigarette users at heart, we are concerned that your journalist reproduced the comments of the British Medical Association (BMA) Scotland and Public Health Minister Michael Matheson MSP, without subjecting them to any scrutiny, if she had, she would have found them wanting.

In the article BMA Scotland made a number of statements that we unchallenged:

  • Increasing numbers of children use e-cigarettes,
  • E-cigarettes are a gateway to smoking tobacco cigarettes, and
  • E-cigarettes help normalise smoking.

Where to begin?

Research, including a recent survey commissioned by Action on Smoking and Health (ASH)[1], has shown time and time again that e-cigarettes are not attractive to young people, and are therefore not used as a gateway to smoking tobacco cigarettes.  Although awareness of e-cigarettes was widespread amongst young people aged 11 to 18, the ASH survey found no evidence that young people either used or perceived e-cigarettes as being a gateway to smoking.

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, especially the young, as they have no interest in the product.

Researchers from the ACS[2] looked specifically into the enticement of flavours.  They 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.”

Tobacco cigarettes are the gateway to tobacco smoking, not e-cigarettes.  Also, there is no evidence what so ever that e-cigarettes help ‘normalise smoking’.

The article goes on to report a motion being debated at the BMA Scotland conference welcoming moves by the MHRA to regulate e-cigarettes as a medicine.  Again, had your journalist carried out any independent research, she would have discovered that this is not actually what the MHRA intends to do.

On the 12th of June 2013 the MHRA stated that they wished to regulate ‘nicotine containing products’ (e-cigarettes) in line with the proposed EU Tobacco Products Directive (TPD), which at that time supported the medicinal regulation of all e-cigarettes.

However, on the 8th of October 2013 MEPs voted against the medicinal regulation of e-cigarettes, a move that was later supported by the Member States in Council.  Since then the MHRA is on record as stating that it no longer proposes to introduce the blanket medicinal regulation of e-cigarettes.  The TPD, passed in Strasbourg two weeks ago, proposes medicinal regulation only for those products which seek to make a medicinal claim or those products with a nicotine strength greater than 20 ml.

We welcome the aspect of the BMA Scotland’s motion that calls on the Scottish Government to ban the sale of e-cigarettes to under 18s, and have been calling on the Scottish Government to do this ourselves.  However, it is ludicrous to propose that e-cigarettes should be sold only alongside nicotine replacement therapies (NRT).  E-cigarettes are not some form of more effective NRT; they are a viable alternative to conventional tobacco cigarettes and should be on sale anywhere tobacco cigarettes are sold.

Finally, on the idea that e-cigarette use should be banned in public.  E-cigarettes are not just popular with those who use them; there is widespread support for them amongst the public at large.  A recent poll by the BBC[3] 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.

With a ban on the advertising and promotion of e-cigarettes soon to be introduced, following the passing of the TPD, where are smokers to find out about e-cigarettes, particularly if they are banned in public places?  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.

Of course there must be a consideration of those who do not use e-cigarettes, but who would be impacted by second-hand vaping.  However, highly credible research undertaken by Dr Konstantinos Farsalinos, M.D., Researcher, Onassis Cardiac Surgery Center, Athens Greece and Researcher, University Hospital Gathuisberg, Leuven, Belgium; and Professor Riccardo Polosa, Full Professor of Internal Medicine, University of Catania and Scientific advisor for LIAF – Italian League for Anti-Smoking, has proven that there is no problem with passive vaping[4].  The research concluded, “Based on the existing evidence from environmental exposure and chemical analyses of vapor, it is safe to conclude that the effects of EC use on bystanders are minimal compared with conventional cigarettes.”

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 1.3 million smokers have switched to e-cigarettes throughout the UK.

It is vitally important that all those reporting on or writing about e-cigarettes do so responsibly.  Irresponsible reporting has the potential to put smokers off making the switch to a safer alternative.  We are a campaign representing e-cigarette users; we have no interest in articles promoting e-cigarettes uncritically either.  All we are asking for is balanced and factual reporting.

Yours sincerely

 

Save E cigs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


[1] ASH surveyed 12,597 adults in 2010 – the questions focused on e-cigarette use and awareness in Great Britain. The preliminary survey was followed up by an additional study of adult smokers and non-smokers in February 2012 and more recently in 2013. ASH also surveyed children and young people aged 11 to 18 in March 2013.

[4] 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

 

Blanket e cig ban in Brighton Hospital grounds.

Professor John Britton 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.”

Yet Brighton and Sussex University Hospitals NHS Trust are to introduce a blanket ban on the use of e-cigarettes in its buildings and grounds.  This ban will involve the Royal Sussex County Hospital in Brighton, the Princess Royal Hospital in Haywards Heath, the Royal Alexandra Children’s Hospital and Sussex Eye Hospital in Brighton, and the Hurstwood Park Neurosciences Centre.

The NHS Trust has decided to ban e-cigarettes because they look too much like tobacco cigarettes and may “confuse” people.  Yes, a minority of e-cigarettes do look like tobacco cigarettes but, according to research produced by the University of East London[1] 72 per cent of e-cigarette users use products that are as about as far removed from looking like conventional tobacco cigarettes as possible.  There are literally thousands of products on the market at present, (about 5,000 in the UK alone)

This decision to ban is sadly typical of the thinking of so many people who appear hostile to e-cigarettes. They don’t know very much about them and show very little interest in finding out more.  They do not realise that, in terms of products, the e-cigarette world is a fast moving place with new and improved products being released on an almost daily basis.  It is sad therefore to see influential public bodies taking decisions like this based on out of date information and in some cases prejudice.

With a ban on the advertising and promotion of e-cigarettes soon to be introduced, following the passing of the TPD, where are smokers to find out about e-cigarettes, particularly if they are banned in public places?  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.

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 1.3 million smokers have switched to e-cigarettes[2].

A recent poll by the BBC[3] 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.

Sadly, far too many people who work in the public health arena and in our NHS seem more concerned with introducing counterproductive bans based on inaccurate information than they are about staying focussed on the bigger picture of seriously reducing the number of smoking related deaths.

 

 

 

 

 

Final vote on the TPD; what now for ecigs?

 

 

Guest Post from Rebecca Taylor MEP.

After several weeks of complicated discussions with colleagues, I was disappointed to hear yesterday that the Conference of Presidents (the leaders of the Parliament’s political groups) has not yet given the go-ahead to allow split or separate votes in next week’s final vote on the Tobacco Products Directive.

The current argument is about whether the split or separate votes should come before the single vote on the trilogue agreement or afterwards. If they come afterwards, they can only be voted in the unlikely event of the trilogue deal being rejected – so obviously they must come beforehand. I am of course working with colleagues to try to push for this. If there is the possibility to vote to remove certain parts of article 18 or reject the entire article, I will do that as will a number of ALDE colleagues.

So it is possible that on Wednesday MEPs may only have a single vote

(Yes/No/Abstain) on the entire TPD, with no opportunity to single out and remove specific parts of the text.

However, as I have already made clear numerous times, I will not vote against the Directive as a whole. Unlike some who have supported the case for sensible regulation of e-cigarettes, I also support the tobacco control measures in the directive (my voting record speaks for itself). I believe that tobacco control measures and e-cigarettes are two sides of the same coin; the tobacco control measures can discourage people from starting to smoke and sensible regulation of e-cigarettes can provide a way for smokers to quit their tobacco habit. I know that some e-cig users disagree with me about the tobacco control measures or consider them to be unimportant; there we can agree to disagree.

However, I believe that one of the key reasons that myself, Frédérique Ries and Chris Davies were able to get enough MEPs to vote in favour of the ALDE plenary amendment on e-cigarettes in the first place, is because none of us could be identified as MEPs who backed the tobacco industry line on the TPD.

This was against a backdrop of some opponents of e-cigarettes deliberately trying to blur smoking and vaping (and in fact some still are, which annoys me greatly).

So where does this leave e-cigarettes now?  Well, we must recognise that an awful lot of progress has been made compared to the initial Commission proposal, which would have seen across the board medicines regulation.

But the fact remains that there are parts of the agreed Article 18, which are far from satisfactory, and this is why the Liberal group negotiator

Frédérique Ries refused to sign up to the final deal. The problematic points include:

•   Continued option for Member States to regulate e-cigs as medicines “by function or presentation”

•    The arbitrary threshold of 20mg/ml of nicotine to be allowed in e-liquids;

•    The possibility for the European Commission to propose ban on a specific device in all Member States, if three or more countries remove it from their own markets.

This means that there is still work to do if the TPD is approved next week.

Implementation will be key and it is vital to ensure national governments take as flexible an approach to e-cigs as possible.

It is therefore necessary to keep up strong lobbying of national governments, so that ministers go for consumer product regulation of devices, which is set as a precedent by this Directive on a European level.

After reading clarifications of the technicalities involved in this

Directive provided by the Health Commissioner Tonio Borg (in response to questions from Chris Davies), I am optimistic that it would difficult for a

Member State to regulate a product under pharmaceutical rules, except where companies chose to opt for medicines regulation themselves. The wording of the article obliges governments to prove that an e-cig meets the definition of a medicinal product as set out in Directive 2001/83 EC – namely a substance must have properties for treating or preventing disease in human beings. Numerous courts across the EU have already rejected the application of this definition to e-cigs.

On the banning of devices across the EU, not only do three Member States have to prove that the devices have pose a ‘significant risk to human health’ (quite a high bar), but the Commission can only use this power through a procedure called ‘delegated acts’, which allows the Parliament to veto such a decision if enough MEPs disagree with it (and MEPs regularly reject delegated acts).

And finally, regarding the 20mg/ml threshold, this has been significantly raised from the original 4mg/ml suggested by the Commission, and the 2mg/ml put forward by national governments and, as we are told by a number of scientific experts that this will satisfy the majority of vapers, around 70% of whom use 20mg/ml or less. However, I accept that vapers who use a higher nicotine threshold may suffer unnecessarily because of this.

I understand and share consumers’ frustration and disappointment that the final text on e-cigarettes has enough caveats and loopholes to cause great concern. It is a massive improvement on the original proposal, but still not good enough.