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.

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With all due respect Mr Drakeford….

Dear Mr Drakeford,

We would like to thank you for taking the time to attend and listen to the debate on Welsh Government proposals for a ban on the use of e-cigarettes in enclosed public spaces, substantially enclosed public places, and places of work in Wales. In your response to the debate you raised a number of issues that cause us concern.

You stated e-cigarettes were renormalising smoking and undermining the ban on smoking in public places.

On both points you were unable to provide any evidence that e-cigarettes were either renormalising smoking or undermining the ban on smoking in public places. However, 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.”[1]

You stated e-cigarettes act as a gateway to smoking tobacco cigarettes and that this was a particular problem for children who are using e-cigarettes in growing numbers. You stated that many of these children were not currently or previous smokers of tobacco cigarettes and were attracted by flavoured e-liquid.

To justify this claim you cited a study produced by John Moores University entitled ‘Young People’s Perceptions and Experiences of Electronic Cigarettes’. You gave the impression that this report stated that as a direct result of targeted advertising by e-cigarette manufacturers, large numbers of children, who had not previously smoked tobacco cigarettes, were now using e-cigarettes and then going on to smoke tobacco cigarettes. What the report actually states is that ‘Overall seven out of eight young people had never accessed e-cigarettes’. The report goes on to say, ‘Despite widespread advertising of e-cigarette brands in print, visual and social media, the majority of participants reported that they had not seen any advertising for e-cigarettes and showed a lack of awareness of advertising and marketing strategies and approaches’.

What we do know from recent research produced by ASH is that e-cigarettes are not a gateway to smoking. Deborah Arnott, Chief Executive of ASH, said: “There is no evidence from our research that e-cigarettes are acting as a gateway into smoking.”[2] Furthermore, this same survey demonstrated that children are not using e-cigarettes. 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 by ASH[4] found that 96 per cent of 14 year olds had never used an e-cigarette, 90 per cent of 15 year olds had never used an e-cigarette, 90 per cent of 16 year olds had never used an e-cigarette, and 91 per cent of 17 year olds had never used an e-cigarette.

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.

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[6] 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.

Finally, there is no evidence to support your claim that e-cigarettes are used in significant numbers by people who have never smoked. 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.’[7] In fact, recent research showed that just 0.1 per cent of e-cigarette users had never smoked tobacco cigarettes previously[8].

You stated that nicotine is addictive and highly dangerous.

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.”[9]

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.”[10] The NHS has also concluded that e-cigarettes are 1,000 times safer than tobacco cigarettes[11]. You should also note that many vapers use an e-cigarette that does not contain any nicotine.

You stated e-cigarettes are no more effective than nicotine patches in helping people quit smoking.

Many vapers have tried numerous times to quit smoking using conventional nicotine replacement therapies, which have a 90 per cent failure rate, and have failed, however with e-cigarettes they have all cut down their smoking or stopped completely. Professor Robert West 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.”[12] E-cigarettes are however not some form of more effective nicotine replacement therapy, they are totally different and need to be regulated accordingly.

A key reason for calling for a ban on the use of e-cigarettes in public places would be if there was a problem with passive vaping. We note that you did not raise this issue in your response. Could this be because there is no evidence that passive vaping is a problem? In fact a major scientific study undertaken by Dr Konstantinos Farsalinos and Professor Riccardo Polosa concluded that the “effects of e-cigarette use on by standers are minimal compared with conventional cigarettes.”[13]

You also failed to raise the issue of what support your proposal has amongst the public at large. A recent poll by the BBC[14] 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.

On the specific case of banning the use of e-cigarettes in the work place, you may like to know that a number of pubs that had previously introduced a ban have now gone on to reverse the ban as new evidence has emerged. You may also be interested to know that Cambridgeshire Police, following a review of “health fears”, will allow their officers to vape at work[15]. We are confident that as the evidence continues to mount, a growing number of businesses and organisations will reverse their current bans. Far from leading on this issue, it would seem that this Welsh Government proposal would actually be a backwards step if it were implemented.

Smoking tobacco cigarettes kills over 5,000 people in Wales every year. We know that nicotine replacement therapies with their 90 per cent failure rate do not work. We also know that e-cigarettes are a safer alternative to tobacco cigarettes and that they enjoy widespread popularity amongst the public at large. You must see that it is clearly better for some to use an e-cigarette rather than a tobacco cigarette. As 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.”[16]

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?”[17] What public health gain does the Welsh Government hope to achieve by banning the use of e-cigarettes in public? You failed to answer this question in your response.

With a ban on the advertising and promotion 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 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 to a safer alternative.

Quitting smoking or cutting down on smoking is one of the most difficult things an individual can do. If the Welsh Government succeeded in having e-cigarettes banned in public places they will be forcing vapers to vape alongside smokers. We are in contact with vapers on a daily basis and many have said such a ban will simply force them back to smoking, is this really what you want? Surely you would rather people used e-cigarettes rather than tobacco cigarettes? Professor Antoine Flahault, Dean of EHESP School of Public Health (Ecole des Hautes Etudes en Santé Publique), concluded: “It is better to have an addiction to a behavior that is not harmful than to have an addiction to a behavior that kills you.”[18]

Yes e-cigarettes are relatively new, but new research, including long term studies, is being produced on a regular basis. Much of the recent research has rendered the arguments behind the Tobacco Products Directive redundant and out of date, and caused some policy makers to call for a rethink.

In its approach the Welsh Government 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. As Professor Robert West said: “We have such a massive opportunity here. It would be a shame if we let it slip away by being overly cautious.” Professor Gerry Stimson, London School of Hygiene and Tropical Medicine and the National Institute for Health and Clinical Excellence, concluded: “It would be an appalling paradox if regulators, in the name of safety, ended up tipping the balance back in favour of cigarettes.”[19]

In your comments yesterday you were unable to provide one single piece of evidence for any public health gain arising from the Welsh Government’s proposals. We know from the evidence we have laid out in this letter, the experts we have consulted, and the vapers that we are in daily contact with, that should you succeed in implementing this ban that fewer people will make the switch from tobacco cigarettes to e-cigarettes. We therefore hope that following the consultation you will conclude that for the good of harm reduction there is no need to implement a ban on the use of e-cigarettes in enclosed public spaces, substantially enclosed public places, and places of work in Wales.

Yours sincerely

Save e cigs.

CC

All members of the Welsh Assembly

All Welsh members of the House of Commons

 

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

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

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

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

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

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

[9] The Guardian Newspaper, 05 June 2013

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

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

[12] 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

[13] 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

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

[15] 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

[16] The Independent Newspaper, 29 March 2013

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

[18] http://www.youtube.com/watch?v=wTHGsTPklY4&list=UUAy2QbmqgmTUJ–CoK5J3xA

[19] Open letter to ENVI Committee members form Professor Gerry Stimson 22 April 2013

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?

So today is National No Smoking Day – a day dedicated to encouraging people to make an extra special effort to give up smoking tobacco cigarettes, pipes, and cigars.

There are 10 million smokers in the UK[1] and each and every year, according to figures produced by the NHS, 114,000 people die from a tobacco related illness[2].  Policy makers and health campaigners need to focus on reducing this number.  Conventional nicotine replacement therapies (NRT), with their failure rate of over 90 per cent, are not tackling this number, but e-cigarettes could.  Already 1.3 million people in the UK have either quit or cut down the amount they smoke by switching to e-cigarettes[3].

E-cigarettes represent a market-based, user-driven public health insurgency.  No public money has been spent, yet smokers are switching, and cutting down through using e-cigarettes.  A staggering 40,625 smokers are switching to e-cigarettes every month in the UK alone[4].  This should be a cause for celebration, not concern.  E-cigarette sales now outstrip those of NRT products[5].

As 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.”[6]

Not our words, the words of Professor John Britton.  So e-cigarettes are pretty amazing.  It was therefore surprising to see that there is not one single mention of them on the official No Smoking Day website.  The website goes into great detail about Stop Smoking services run by the NHS and encourages the use of NRT products, but no mention of the one product that offers smokers a viable alternative to tobacco cigarettes, and an alternative that is several magnitudes safer.

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Professor Robert West, Professor of health psychology and director of tobacco studies, at University College London, said, “We have such a massive opportunity here.  It would be a shame to let it slip away by being overly cautious.  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.  All they contain is water vapour, nicotine, and propylene glycol (which is used to help vaporise the liquid nicotine).”[1]

Whilst recognising the benefits of e-cigarettes some policy makers and health campaigners still have a number of concerns about them.  Some believe that e-cigarettes could be a gateway to smoking tobacco cigarettes.  Others worry that the wide variety of flavours makes them attractive to younger people who have previously never smoked.

These concerns, however, have been proven time and time again to have no foundation.  Whilst these people focus all their efforts worrying about these mythical concerns and continue to promote services and products with a negligible success rate, they take their eye off the big picture – significantly reducing the number of people who smoke.

As Professor Gerry Stimson said, “We are only making small progress in further reducing the prevalence of cigarette smoking – encouraging current smokers to switch to e-cigarettes has the potential to speed up the process with consequent major public health gains.”[2]

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.

 

 

[1] The Guardian newspaper 05 June 2013

[2] Open letter to ENVI Committee members form Professor Gerry Stimson 22 April 2013

To the EU, don´t fix that which is not broken….

Over 7 million vapers live in the EU, that´s 7 million people no longer smoking as much tobacco as they did.

This is good thing.

Vaping is not a revolution, it´s an evolution and that means change.

Change in thought, change in process and change in paradigm.

Most humans’ don´t like change  – they resist it all they can – they get used to the status quo even though that status quo might not be comfortable, might be ineffective, or even harmful.

Vaping has upset the status quo.

Turning e-cigs into medicines returns the status quo, where tobacco rules and e cigs are as ineffective as NRT.

Can you image a world where millions of people smoke less?  If the EU leave e-cigs alone, allow them to be a force for change in the market place – that thought becomes a reality.

If the EU regulates e-cigarettes as a medicine, they will turn an evolutionary product into a broken one that no longer works. Your loved one will probably go back to smoking.

Please stop this – please sign our letter– share it anyway you know how – Facebook – Twitter – all your social media – let´s not allow the EU to fix something that isn´t broken and damage our loved ones health.

Non smokers  – vaping benefits you too – your friends and family that vape, that have switched from smoking are benefitting from not inhaling thousands of toxins, are not spending as much money, are not smelling, running off to smoke in the middle of meal – you get more of them, more of their time, more of their attention. Don´t let the EU take this away from them, and you.