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?

 

 

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E-cigarettes: Flavours

A major characteristic of the e-cigarette market is the availability of a large number of different flavoured e-liquids. This causes concern for some policy makers who worry that certain flavours may be specifically targeted at young people and that ultimately this could lead to young people taking up e-cigarettes and then going on to smoke actual cigarettes.

The good news is that there is no evidence to support these concerns.

Commenting on Action on Smoking and Health’s (ASH) 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.”[1] This same research showed 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 more 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.

We also know from recent research that flavours are not enticing children to use e-cigarettes either.

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[4] 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.

However for those adults 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.

“For many (a ban on flavourings) it would be disastrous – they’ve moved away from “ciggie” flavours onto any one of dozens, in some cases, or, in many cases, they switch flavours during the day to suit their moods. This, apparently, is to get away from their taste buds becoming used to one flavour, so that every change makes it a “fresh” experience and helps them avoid going back to fags. It’s not something that bothers me, particularly, but I do know that for a very large proportion of folks, it’s a vital part of the e-cig experience. Without it, going back to cigs isn’t too much of a stretch. Folks are worried about it. The thing about e-cigs is that they’re customisable in terms of flavour, nicotine strength, diluent (and therefore vapour density) and temperature – so anyone, given the chance, can sort out for themselves something that gives them a much more attractive experience in comparison with cigarettes, the consequences of which are pretty obvious, really.”

David Dorn, e-cigarette user and commentator

In research[5] 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.

Many politicians worry that certain flavours are created with children in mind, again this fear in unfounded. Research actually shows that adult vapers (18 – 65) prefer supposedly “juvenile” flavours[6].

 

 

Conclusion

Removing flavourings risks driving existing e-cigarette users back to tobacco cigarettes and limiting the positive discrimination between tobacco cigarettes and e-cigarettes, which is a significant factor in encouraging smokers to transfer their usage to less harmful e-cigarettes. Research produced by the Consumer Advocates for Smoke Free Alternatives Association[7] found that just under two thirds of e-cigarette users would return to smoking cigarettes if the electronic version was made harder to get or was altered in some way such as through the banning of flavours.

In the UK each year 114,000 people die from tobacco related illnesses according to figures produced by the NHS[8].

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[9].

 

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

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

[6] http://www.forbes.com/sites/jacobsullum/2014/07/17/survey-shows-adults-who-use-e-cigarettes-to-quit-smoking-prefer-allegedly-juvenile-flavors/

[7] http://casaa.org/uploads/8_Biggest_Electronic_Cigarette_Myths.pdf

[8] http://www.nhs.uk/chq/Pages/2344.aspx?CategoryID=53

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

Meetings with politicians 2 – There is gold in them there debating chambers.

Kirsty Williams

 

Today, on behalf of the Save E-cigs campaign, I was lucky enough to have a chat with one of the most vocal assembly members. If you didn’t know, Kirsty Williams AM, (Leader of the Welsh Lib Dems and Health Spokesperson) has been on the side of vapers ever since the proposals for banning vaping in “enclosed public spaces” came to light.

Rather than a meeting, this was more like a chat with a friend. I was the first appointment of the day and as Kirsty hadn’t had her coffee fix her assistant asked if she wanted a coffee and even asked if I wanted one. I gladly accepted tea to warm up my insides due the fridge-like temperatures outside. Once a bit of ice breaking chat was exchanged we got down to the nitty gritty of why I was there.

Instead of Kirsty asking the first question, I actually did. This was to find out her opinions on the Consultation Summary document 1 and it turns out that she hasn’t read it yet. This nicely led the discussion into full swing.

The main point of disappointment from my view point is that the Consultation “analysis” classified over half of the 412 responses as “not specified” due to them being a standard letter from Smokers Angel customers. This made me rather mad as each of these letters signed by individuals are still the opinion and should be counted. This came across in the answer figures from the questions, if these letters were considered as opposing the proposals; the change in weight of the answers would dramatically change. Kirsty completely agreed that this is a concern. It was like the opinion of voters just didn’t count and agreed that they were essentially ignored. She said that this will be brought up at the next possible moment.

We then went through more of the e-cig related consultation questions discussing Mark Drakeford’s flawed evidence. At this point her PA, said that they looked at some papers used by the vaping communities “favourite” scientist Mr Glantz. I then used the “kwik fit fitter” analogy or similar to describe most vapers opinion and they both laughed.

The conversation moved on about “gateway effects” to which the latest Office of National Statistics data2 on it came to the fore. Kirsty was not surprised with the data at all which is very positive for us. The ONS data will be used against Mark Drakeford.

Further conversation about “normalising smoking” was had and I offered information from presentations given at the E-cig Summit 2014 but without verbal context the slides were just slides. I then said that any useful presentation videos will be sent to her and she welcomed it.
More “evidence” in favour of the proposals was brought up by me including the private companies’ policies to ban the use of e-cigs. Kirsty thought it was rubbish. “When I am in a Wetherspoons I am subject to their own rules but it doesn’t mean they can tell me how to live my life. They can’t tell me what I can and can’t do” or words to that effect. This nicely led on to Mark Drakeford so-called “authoritative voice” the WHO. I went on to describe how the FCTC COP6 blocked out any media etc. but then related it to Deborah Arnott’s presentation at the summit which I will also send her just because it will confirm why vapers aren’t too keen on the WHO.

Finally, I directed the conversation towards how policy should be made which completely echoed Ian Gray and Hazel Cheeseman who did a presentation on policy making for work places at the E-cig Summit 2014. Kirsty and I agreed that this is how it should be done rather than national legislation. Again the videos of the presentation will be sent to Kirsty.

Lastly she asked what she and the Welsh Lib Dems could do for me and the Save E-cigs campaign. This next bit is the gold I mention in the title. As I knew she was on the Health & Social Care Committee, I asked if there was a way to have a face to face meeting with all the members which includes Kirsty, Darren Millar AM (Welsh Cons, who supports us), Elin Jones AM (Plaid Cymru, who Rob Heyes spoke with earlier this month) amongst others. She informed me that the HSC Committee will have their own consultation on the White Paper Bill. She then said that myself and my colleagues in the Save E-cigs campaign will be allowed to submit written and oral evidence to the Committee. There may even be the opportunity for the Committee to hear from independent experts as well. This is brilliant!

Finally, she insisted that we met with all AMs as we cannot assume that there is 100% agreement within each of the parties. This is why Save E-cigs and vapers like me are doing these meetings. Vapers across Wales can help us by meeting with their local AMs. By convincing AMs in face to face meetings we can build a majority in the Assembly to defeat these proposals. Come on vapers of Wales, do your bit!

1] http://wales.gov.uk/docs/phhs/consultation/140402consultationen.pdf 

2] http://www.bbc.com/news/health-30192181

Dear Mr Speaker,

Mr Speaker,

 

Dear Mr Speaker,

Save E-cigs is a campaign representing the interests of e-cigarette users (vapers), their friends, and their families, a growing number of whom work within Westminster.

We are writing in regard to recent advice you have received in relation to banning the use of e-cigarettes within the House of Commons.

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 the only possible justification for including e-cigarettes within this ban must also be to protect the health of non-vapers. Is passive vaping dangerous? No. 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.”   A review of the available literature conducted last year by researchers at the Drexel University School of Public Health in Philadelphia concluded that “exposures of bystanders pose no apparent concern.” Finally the US Food and Drug Administration conclude that all other substances measured for e-cigarettes were far below allowable levels for human inhalation. They state that levels are so low that it is more hazardous to an individual’s health to breathe the air in any major metropolitan city during rush hour. Importantly, the Chartered Institute of Environmental Health have stated that there is a 99.7 per cent compliance rate with the smoking ban[1], and they have found no evidence to support the idea that the use of e-cigarettes in public is undermining this.

Some companies have introduced vaping bans, but we are seeing a growing number of such companies reversing these bans as new evidence emerges as to the benefits of e-cigarettes. 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.

The charity ASH and the Chartered Institute of Environmental Health are currently working together to help organisations in the public sector develop vaping friendly policies. This may be something you would like to consider.

Perversely, if vaping were to be banned within Westminster, then it is likely there would be an increase in smoking rates. 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[3]. People that had made the switch to e-cigarettes are unfortunately now smoking again. Smoking rates also increased in New York by a staggering 2.1 per cent following the introduction of a ban on the use of e-cigarettes in public.[4] A ban on the use of e-cigarettes in Westminster would force vaping MPs, Peers, staff, and visitors to vape alongside smokers, thus exposing them to temptation and the dangers of second-hand smoke.

We know from the latest statistics produced by the Office for National Statistics that e-cigarettes are used almost exclusively by current and former smokers. We know that e-cigarette used in public does not renormalise smoking[5]. We know that e-cigarettes are not a gateway into smoking[6]. We know that e-cigarette use in public does not lead to children using e-cigarettes[7].

There is never a situation where it is better to smoke than to vape. E-cigarettes are after all at least 95 times safer than tobacco cigarettes according to the latest research produced by Professor Peter Hajek, director of the Tobacco Dependence Research Unit at Barts and The London School of Medicine and Dentistry, Queen Mary, University of London. 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.”[8] What possible health benefit do the House of Commons’ authorities hope to achieve with this ban?

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.

Finally, if this ban were to be introduced what would happen to e-cigarettes that have a medicinal license? Recently the Medicines and Healthcare products Regulatory Agency granted a medicines license to the Voke e-cigarette manufactured by Nicoventures[9]. It is highly likely that other e-cigarettes will receive such licenses going forward. These e-cigarettes look no different to those sold as consumer products. Would MPs, Peers, staff, and visitors be banned from using what would in effect be their medicine? If not how would you expect the House of Commons authorities to distinguish between a medicinal e-cigarette and a consumer one?

We urge you to think very carefully about this issue before taking a decision. If you require further information we would be happy to meet with you. If you would rather take independent expert advice then please do consult some of the experts cited in this letter.

We very much hope that you will continue to support your colleagues who have done the right thing by switching from smoking to vaping. Banning e-cigarettes within the House of Commons will not help them, it will only make their lives harder and may force some of them back to smoking.

 

Yours sincerely,

Save e-cigs

 

 

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

[4] http://www.churnmag.com/news/smoking-rates-increase-new-york-e-cigs-banned/

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

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

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

[8] The Independent Newspaper, 29 March 2013

[9] http://www.pharmaceutical-journal.com/news-and-analysis/news/big-tobaccos-nicotine-inhaler-approved-by-uk-regulator/20066466.article

 

 

 

 

 

 

 

 

 

 

 

 

 

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

[4] http://www.churnmag.com/news/smoking-rates-increase-new-york-e-cigs-banned/

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

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

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

[8] The Independent Newspaper, 29 March 2013

[9] http://www.pharmaceutical-journal.com/news-and-analysis/news/big-tobaccos-nicotine-inhaler-approved-by-uk-regulator/20066466.article

And you thought job interviews were tough! Meetings with politicians by Rhydian Mann.

Interview

On Weds 22nd Oct I met Antoinette Sandbach for the Save e-cigs campaign. Antoinette  is a Welsh Conservative Assembly Member representing North Wales . She has a rather positive voting history if applied to vaping and she comes across as being on our side, and  she mentioned that she has always voted against any regulation proposals.

Normally I am rather prepared for discussions with people regarding e-cigs, but this time dealing with a politician was a completely new and somewhat daunting event to prepare for, especially around my normal day job.

So what did I have to contend with?

After the introductions, I asked Antoinette what she wanted to know in order to judge her knowledge of ecigs rather than bursting into why are ecigs are amazing, healthier etc. Turns out she wanted a general background to start off with, however she also mentioned that ecigs are not medically tested. This is a situation I am always prepared for, I always carry with me a 1st gen ciggalike, a general gen 2 device and then there is my gen 3 device which I all placed on her desk. I gave a brief description of what each device was and the difference between them in terms of performance.

She then threw me off a bit by asking “what information is there to say that one is actually better than the other?” That’s something I will have to actually get into my head, however I told her that from personal experience I can say that gen 1 is not as good as the other generations. (Throw off semi averted).

Antoinette then expressed concerns about product safety which fell into 2 separate areas; e-liquid and hardware, especially batteries after recent stories in the media. She also felt that there was a lack of information regarding the actual amount of nicotine being inhaled by the users and a general lack of information about the products.

Let’s start with the batteries. Instead of unleashing the “people are stupid and use wrong chargers” approach, which could have been rather easy for me, I went on to state that all reputable vendors show exactly how to set up devices properly and how to charge them properly. I emphasised that reputable vendors give all necessary advice and kits include instructions.

Antoinette accepted this but still enquired that the products are unregulated. This is completely not true as us vapers know. For starters e-cigs have to meet 17 (forgive me if this incorrect) EU consumer products regulations including getting certification as electrical products which are the CE and RoHS markings on devices and batteries or their packaging. I went to say that ECITA are testing batteries to purposefully make them go beyond normal working parameters. So far the information from ECITA made available via their blog has shown that no batteries are able to “explode” on their own. So all these “explosions” are a result of user error.

Then onto e-liquid safety. Antoinette said that “there is no way of knowing how much nicotine a user inhales  compared to a pack of cigarettes, which has the nicotine content labelled”. This is an open door I didn’t exactly barge through at the time. I should have gone down the route of “actually tobacco pack labelling is wrong, cigarettes have up to 50mg or more according to Dr F” which my mind wanted me to say but I actually replied “tobacco smokers don’t know either, they don’t smoke an entire one in one breath” Maybe not the best I could have been. 

I then gave her a fully labelled bottle of e-liquid to have a look at. She seemed shocked by the safety phrases on the bottle. Especially “fatal if swallowed” and “fatal in contact with skin”. I then clarified that this label was from before the poison reclassification of e-liquid nicotine to the same level as washing up liquid. I then stated that the 10ml bottle had a concentration of 6mg/ml and has no more than 60mg in it and would cause nothing worse than vomiting if swallowed. She questioned “how would the nicotine concentration be true against the label?” or words similar.  My answer was testing, as reputable e liquid companies and  ECITA members get their liquids tested.

After much to-ing and fro-ing about quality, testing and even the TPD got thrown in to put some aspects of the conversation into some perspective, Antoinette dropped the question I half expected to get but always treat with some trepidation. That question being…

“Would you want to see regulation of electronic cigarettes?”

I gave my personal opinion and emphasised that it was. Of course I want regulation which can mean safer hardware and good quality e-liquids but not so much regulation that the market is crippled and user are not able to get products that satisfy them.

I was actually running out of steam, pardon the pun, with almost 30mins of discussion passed. Then mentioning the Welsh Government proposals brought out some rather good advice from Antoinette. She said that the best way to get the minds changing on the proposals is to get meetings with members of the health committee and get as many face to face meetings with constituency AMs as possible.

That is very good advice indeed from Antoinette. This is something that all Welsh vapers should do. If you are able, arrange a meeting with your local AM, the vaping community have a voice and it should be heard.

But what did I personally get out of this meeting?

1 – never go into a meeting politician with a pre-determined idea of what will be discussed.
2 – always have a good understanding of the science that we have on our side
3 – never be daunted, a politician is just a person and a consumer at the end of the day.
4 – don’t over complicate the topic, it can lead both of you into confusion.
5 – always hold back your first reaction to any questions.

 

Editors note : A big thanks to Rhydian for not only attending this meeting on behalf of Save e cigs, but for also writing this excellent post!

Good COP bad COP.

 Good cop Bad Cop

 

We’ve all seen the tweets from Drew Johnson from his time in Moscow when he was reporting on the Framework Convention of Tobacco Control (FCTC)– if you’ve not seen them, then follow him on twitter @Drews_Views.

Drew is a journalist and despite being frogmarched out of some FCTC meetings he managed to report what was going on – i.e. the removal of the press, the removal of the public and the holding down of dissenting delegates. He also told us about e cig discussions held behind closed doors – and we can all draw a parallel with the EU TPD there.

But what did COP6 do for vaping?

Did they head any of the warnings and letters that were sent?

Yes, yes they did.

They took note of all the ones that hate e-cigs.

We sent them a briefing – you can read it here:

Now, words have power – just say the word should, and then say the word love – and you will hopefully feel a difference in the way you feel and react. Should will probably make you tense a little, love will hopefully help you to relax. Words have a profound effect on how you feel and respond.

So, bearing this power in mind – why have the WHO FCTC coined the acronym ENDS when discussing electronic cigarettes. Are they subliminally telling us something?

But back to COP6 and was it a good COP or bad COP scenario?

Starting out with the good COP (to soften you up, make you relax a little – have a tea and some donuts…)

Did the WHO FCTC do anything good in relation to e cigs?

Well, they want to prevent e cigs ending up in young non-smokers hands – they don’t want a new generation of nicotine addicts.

They want to prevent unproven health claims for e cigarettes.

But that’s it – (remove said tea and donuts and let the heavy take over…)

Bad COP wants to ‘monitor’ e cigarettes, he wants to ban them, ban the advertising of them, and destroy the tobacco industry, (I’m paraphrasing here but you get the idea). He also wants make e cigs a tobacco product so the FCTC can destroy those too.

Now, there have been a great many articles written about the WHO’s FCTC COP6 meeting, and the usual phrases have been trotted out to defend these awful decisions –i.e., ‘they are protecting the children’, plus a nice new one – they are also protecting women and foetuses.

But what will the effects of these e cig policies be? Bearing in mind that signatories of the FCTC are obliged to implement them – and that includes good old Blighty.

The majority of the suggestions made are already in the TPD, so nothing too new – except the desire to ban e cigarettes if possible and to make them a tobacco product.

And these are bad things because they will warn people away from e cigarettes.

People do still give the WHO the credence it no longer deserves, they do listen to what comes out of the WHO media, and surprisingly, many see them as an authority on health.

I know, I know.

Essentially what the FCTC is doing though is telling people that switching to a product that is in the realms of 95% less harmful than tobacco is not the right thing to do – and they are doing it on the grounds of poor research and listening to people who just don’t like e cigs – its an ideology, much like communism or libertarianism.

It’s a belief.

But a belief that will harm people. People will carry on smoking instead of switching.

We at Save e-cigs think global health is far more important than implementing ideology, and it is a sad day for Public Health and the FCTC that they can come up with regulations like these.

Looks like Bad COP wins the day.

E-cigarettes: Briefing for policy makers ahead of the WHO FCTC (COP6)

Save e-cigs has sent this to every MP, MEP, every Member of  the Welsh, Scottish and Northern Ireland Assemblies and every Member of the House of Lords.

The sixth session of the Conference of the Parties to the World Health Organisation’s Framework Convention on Tobacco Control (COP6) is due to be held from the 13th to the 18th of October 2014 in Moscow.

The FCTC is an international treaty adopted by the WHO that entered into force in 2005 with the objective “to reduce the prevalence of tobacco use and exposure to tobacco smoke.”

The FCTC and its guidelines for implementation substantially influence how governments across the globe regulate tobacco. The COP is the governing body and decision-making organ of the WHO FCTC and meets every two years. All parties to the convention are invited to attend meetings of the COP to review and potentially recommend tobacco control policy measures across a broad range of areas, including e-cigarettes. The WHO report on e-cigarettes, published ahead of this conference made the following points in relation to e-cigarettes:

 

  • Recognition that there is a debate among scientific and public health experts around the world with respect to the role e-cigarettes play in reducing tobacco smoking.
  • Acknowledgement that it is likely that e-cigarettes offer a less harmful alternative to tobacco cigarettes.

 

The WHO report proposes the following regulatory options for e-cigarettes:

 

  • A ban on health claims unless substantiated by scientific evidence,
  • A ban on the use of e-cigarettes in public places,
  • A requirement for health warnings commensurate with proven risks,
  • A ban on the sale of e-cigarettes to under 18s,
  • A ban on the marketing and advertising of e-cigarettes,
  • A ban on the use of flavours, and
  • Requirements for product design and information requirements.

 

Given the primary objective of the FCTC, the question must be asked, do e-cigarettes lead to more or fewer people smoking?

Fewer. There are 2.1 million people in the UK who regularly use e-cigarettes. All of these people are now smoking significantly fewer or no tobacco cigarettes as a direct result.   At the same time the proportion of adult smokers in the UK has fallen to its lowest level since records began in the 1940s.[1]

Robert West, Professor of health psychology and director of tobacco studies at University College London made clear there is a direct link between the rise in the use of e-cigarettes and a decline in the number of smokers.[2]

Furthermore, as ASH have made clear, “The drop in smoking also shows that concerns that the use of e-cigarettes would lead to a renormalisation of tobacco use appear unfounded. The rapid increase in use of these products has coincided with a consistent steady decline in smoking.”[3]

Are e-cigarettes less harmful than tobacco cigarettes?

Yes and the WHO accept that they are. 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.”[4] The NHS made clear that they were 1,000 times safer[5].

Is it therefore better for smokers to switch to e-cigarettes?

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.”[6]

Will the proposed regulatory options set out by the WHO make it easier or more difficult for a smoker to switch to e-cigarettes?

The ban on flavours, the ban on advertising, and the ban on the use of e-cigarettes in public will make it more difficult for smokers to switch to e-cigarettes. These proposals when taken as a whole will result in a reduction in the range of products and those products that are available will be less appealing to smokers.

Banning flavours – In research[7] 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.

Banning public vaping – 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? No. 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.”[8]

Smoking rates also increased in New York by a staggering 2.1 per cent following the introduction of a ban on the use of e-cigarettes in public.[9] A ban on the use of e-cigarettes in public would also force vapers to vape alongside smokers thus exposing them to temptation, the dangers of second-hand smoke and cause many to go back to smoking.

With a ban on the advertising of e-cigarettes soon to be introduced, following the passing of the Tobacco Products Directive (TPD), 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 less harmful alternative.

In the words of Professor Robert West: “What is the problem that requires further regulation?”[10]

In the UK the debate surrounding e-cigarettes is highly active and following the introduction of the TPD, e-cigarettes will be subjected to a stricter regulatory regime than some tobacco products. Research into the effects of e-cigarettes is being carried out on a continual basis and the findings are reported openly.

Given the WHO’s recognition that e-cigarettes are an “evolving frontier”, it would be premature for FCTC to adopt any regulatory recommendations until all the scientific evidence has been fully interrogated. We therefore propose that sensible measures such as the ban on the sale of e-cigarettes to under 18s and the ban on e-cigarette companies making health claims without the necessary scientific facts to support them are supported as a matter of priority. The WHO should then resist recommending any further regulatory measures until a need can be proven.

Final question – e-cigarettes are a consumer product; they do not contain tobacco, so why are they even included within the scope of the FCTC?

[1] http://www.theguardian.com/society/2014/oct/07/smoking-falls-lowest-level-uk-recording-started-1940s

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

[3] http://www.theguardian.com/society/2014/oct/07/smoking-falls-lowest-level-uk-recording-started-1940s

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

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

[6] The Independent Newspaper, 29 March 2013

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

[8] 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

[9] http://www.churnmag.com/news/smoking-rates-increase-new-york-e-cigs-banned/

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