A crafty move by Mark Drakeford?

A lot has changed in the months since the Welsh Lib Dems started our fight against Labour’s illiberal vaping ban. Nine months, some rather tense Committee sessions, a hilariously embarrasing Government survey, plenty of emails to AMs and over 3,500 petition signatures later, we’ve succeeded in forcing Labour’s hand and watering down their original proposals.

 

Instead of a blanket ban in all enclosed public spaces in Wales, Mark Drakeford now only plans to ban vaping in a specific list of places. It seems that this list won’t form part of the legislation itself, however; it will instead be set out in regulations that will be passed separately to the Bill.

 

This is a crafty move on his part for two reasons. Firstly, it makes whatever list he comes up with much easier to change in the future. What may now include schools, public transport and establishments that serve food could be expanded much more widely with a lot less fuss than changing the law.

 

But secondly, and perhaps more crucially, this makes the entire Bill much easier to pass. Drakeford has said he needs to “work with others” to pass the Bill – those “others” I suspect are some Plaid Cymru AMs, who have been putting forward proposals very similar to what Labour now suggest.

 

The “others” certainly aren’t Welsh Liberal Democrats – we’ve been clear from the start in our opposition to these proposals. From a purely ideological perspective, as a liberal I’m uncomfortable with the idea of government banning something without clear evidence of the harm it could cause to others. But from looking at the evidence alone, it’s clear to me that the proposed vaping ban won’t just fail to improve public health – it could even lead to harm by preventing people from making the switch that many have made from tobacco cigarettes to the less harmful e-cigs.

 

It’s true that Welsh Liberal Democrats certainly couldn’t stomach any Bill that contained a vaping ban like the one we have in front of us. But the task of voting against this Bill is made a lot easier by the fact that, aside from some small changes to regulations around tattoos and piercings, this so-called “Public Health Bill” doesn’t actually achieve anything.

 

With so many public health issues facing our nation at the moment – obesity, cancer, heart disease to name but a few – is this Bill really the best that Labour can come up with? As it stands, the Bill does very little to solve any of these great public health challenges – and in the case of cancer, could even worsen the situation because of this vaping ban.

 

But we must not give up hope – there is still time to stop this ban in its tracks, but we all need to redouble our efforts in this fight. That’s why, as I write, we’re preparing campaign packs to send to vaping shops across Wales so they can do their bit in collecting petition signatures. If you haven’t yet added your name, you can do so by clicking here.

 

With your help, some determination and a bit of luck, I hope I’ll be writing on this blog in two months’ time in a Wales free of a vaping ban!

 

Kirsty Williams AM

Leader of the Welsh Liberal Democrats

 

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

Blink and you’ll miss it…the Totally Wicked court hearing

Guest post by Sarah Jakes.

So, after my earlier blog about the TW challenge to article 20 of the TPD, I decided to go to the hearing. The case was heard in the Administrative Court in the Royal Courts of Justice in London which is a fabulous building to visit, even if you don’t have an interest in a particular case.

Arriving early, and certain in the knowledge that this place was not going to be vape friendly, I mooched in the gothic portico entrance for a while, vaping and generally watching out for a face I recognised. I was soon joined in there by Jeremy Mean (Dept of Health) plus entourage, who gave me a ‘I vaguely recognise you but can’t think who you are’ kind of look before wandering off. I was on the panel at the APPG meeting in June, at which Jeremy also spoke.

Once through security, and having negotiated the labyrinth of stone corridors and spiral staircases to court 18 (the building is a bit like Hogwarts) I found the TW and DoH teams waiting to go in. Just before 10.30 we all took our seats, the lawyers to the front and the public (which included Jeremy and co) to the back. And so the hearing started. To say it was brief would be an understatement. It had actually been listed for two hours I believe, but this is how it went. Please note that judges and lawyers don’t actually speak like this, this is just my translation:

TW brief: We’d like you to let us go to court in Europe to ask whether article 20 is legally valid because we don’t think it is for several reasons.

Judge: Ok, you can go.

TW brief: I’ve got lots of other waffle prepared if you’d like to argue about it some more, but it sounds as if you’d rather not?

Judge: No thanks.

There followed some more brief discussion about how best to ensure that emerging evidence could be included in the case, and how to get the European Court of Justice to hear the case quickly, but by 10.34 the hearing was over. Even the TW team seemed surprised at how easily it had gone their way.

As a result of this decision by the court Totally Wicked can now take their battle to Europe, where they will ask the European court to decide whether or not article 20 is invalid for one or more of the following reasons:

It places restrictions on e-cigarette manufacturers and vendors which are disproportionate to the legitimate aims of the TPD, and there is no public health justification for doing so.

It imposes a higher regulatory burden on e-cigarettes than tobacco cigarettes, which are competing products, despite the fact that e-cigarettes are the vastly safer product and so there is no public health justification for doing so (I’m starting to see a common theme emerging here!)

It distorts competition in the markets between the two products.

It imposes penalties for failing to comply with requirements which are almost impossible to achieve in the real world because of variations created by manner and requirements of use, and so without clear standards a manufacturer or supplier cannot be confident of compliance.

There is no need for Europe wide standardised regulation of e-cigarettes as consumer products.

It infringes on the rights of the e-cigarette industry to conduct their business and there is no public interest or public health justification for doing so.

So it’s next stop Luxembourg, probably in about a years time. Who knows how much more scientific evidence we may have accumulated to deal with those ‘public health justification’ arguments by then. A quick word of caution though, although the decision on Monday to refer TW’s challenge to the ECJ means that the national court believes it ‘has legs’, the battle on that front is far from won. We must all keep up the pressure on the WHO and national governments to ensure that sensible implementation is pursued regardless of the outcome of this case.

Dear Public Health England,

We are writing in regard to the well-publicised reports that Public Health England (PHE) is considering a ban on the use of e-cigarettes in public places.

We provide a united voice not just for e-cigarette users, but also their friends and families, the forgotten millions in this debate. We wish to see e-cigarettes robustly regulated as a consumer product and freely available to those who want to switch.

We note that yesterday ( 01 May 2014 ) PHE made a statement, via Twitter, that stated: “PHE has not called for a ban on e-cigarette use in public spaces”. However, we do not consider this a satisfactory response and nor do the many vapers we have been in contact with since this news story broke. Our campaign, and others, never stated that PHE “called” for a ban on the use of e-cigarettes in public places, we stated that PHE are “considering recommending” a ban on the use of e-cigarettes in public places. The leaked minutes[1] of the PHE meeting in February make clear that the recommendation of a ban is being considered, and to date, no one from PHE has denied that the recommendation of a ban is being considered.

The leaked minutes of PHE’s February meeting revealed that PHE is also considering a raft of other draconian and counter-productive recommendations. These include: restrictions on the promotion of e-cigarettes, regulation of packaging, a ban on the use of flavours, and the requirement for e-cigarettes to become a formal NRT product.

Such proposals, if implemented, can only lead to a negative public health outcome; let us explain why.

Are Tobacco cigarettes dangerous?

Yes. In the UK each year 114,000 people die from tobacco related illnesses according to figures produced by the NHS[2].

 

Are e-cigarettes safer than tobacco cigarettes?

Yes. 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.”[3]

 

Are licensed NRT products better than e-cigarettes?

No. The key health benefit of e-cigarettes is determined by how many smokers switch to them or use them as a staging post to quitting completely. It is therefore vital that e-cigarettes continue to be regulated as a consumer product. 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.”[4] E-cigarettes are however not some form of more effective nicotine replacement therapy, they are totally different and need to be regulated accordingly.

 

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

Yes. Professor John Briton 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.”[5]

 

Do e-cigarettes act as a gateway to smoking?

No. Commenting on ASH’s 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.”[6]

 

Are they used by children, who are particularly attracted by flavouring?

No. A recent survey commissioned by ASH has shown 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[7]. Research undertaken by Queen Mary University in London[8] 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[9] 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.

 

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.”[10]

 

Do e-cigarettes re-normalise smoking?

No. Professor Robert West said: “Despite claims that electronic cigarettes risk re-normalising smoking, we found no evidence to support this.”[11]

 

Are e-cigarettes popular with non-vapers?

Yes. A recent poll by the BBC[12] 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.

 

In conclusion, smoking tobacco cigarettes kills 114,000 people a year according to figures produced by the NHS. Conventional NRT products with their 90 per cent failure rate do not work. E-cigarettes are a safer alternative to tobacco cigarettes that are popular and work as an effective alternative to tobacco cigarettes. E-cigarettes do not re-normailse smoking. E-cigarettes do not act as a gateway to smoking. E-cigarettes are not attractive to children. Flavours in e-cigarettes do not make them more attractive to children or non-smokers. There is no problem with passive vaping. The rise is e-cigarette sales are directly contributing to a decline in tobacco cigarette sales. E-cigarettes enjoy wide support amongst the general public. In the words of Professor Robert West: “What is the problem that requires further regulation?”[13]

Perhaps you would be good enough to enlighten us!

 

Yours Sincerely,

Save e cigs.

 

[1] http://www.itv.com/news/update/2014-04-30/e-cigarette-ban-suggested-government-meeting/

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

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

[4] 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

[5] The Independent Newspaper, 29 March 2013

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

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

[10] 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

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

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

[13] Professor Robert West, Professor of health psychology and director of tobacco studies at University College London’s department of epidemiology and public health speaking at the E-cigarette Summit, The Royal Society, London on the 12th of November 2013.