The Tobacco Control Mindset

Many working in tobacco control see nicotine use as the new battlefront, we look at what experts are saying about the approach that would deny e-cigarettes to smokers. The evidence is clear: vaping is at least 95% safer than smoking according to Public Health England, and switching from cigarettes to e-cigs is fully supported by the NHS, Cancer Research UK and anti-tobacco group ASH.

One sentence sums up the current state of play in the world of vaping and tobacco harm reduction and it’s delivered by researchers at the London School of Hygiene and Tropical Medicine(¹): “Electronic nicotine delivery systems [ENDS] are a controversial new technology which has provoked strongly polarized responses within the field of tobacco control.”

The quest to balance encouraging smokers to switch away from tobacco is tempered by fears of teen uptake and compounded by those who have an ideological drive to prevent all nicotine use.

“In England,” researchers write, “policymakers have embraced the potential for ENDS to reduce tobacco-related harm by encouraging smokers to use ENDS to quit smoking or as a long-term substitute for cigarettes. They have accordingly regulated ENDS in ways that facilitate smokers’ access.”

This isn’t the case around the world where our positive approach hasn’t been adopted. For example, Australia, by most measures a comparable country to the UK, have imposed a de-facto ban on vaping products that contain nicotine – in turn producing a blossoming black market(²) in ‘illegal’ imported products and criminalising people who are just seeking to reduce their harm exposure. Cigarettes remain freely available.

The academic paper grants a lot of coverage to staunch anti-vaping activists Martin McKee, Simon Capewell and John Ashton, most likely because the authors work alongside McKee.

They influence tobacco controllers, “‘insanely’ turning their big guns on harm-reducing nicotine-related products instead of allowing market forces to edge out far more dangerous combustible tobacco products renown”, according to renown expert Clive Bates(³).

“It was blown up into a worldwide problem for e-cigarettes and affected risk perception which affected behaviour, slowing the rate at which they were eating into the cigarette market and stopping people from switching products.”

Viscount Ridley has frequently written on the topic of disruptive technologies and saw the potential for electronic cigarettes very early on. He summed up the approach of those like McKee, Chapman, and Ashton when he writes(⁴): “Suppose that millions of Britons were driving a dangerous type of car that was killing 80,000 people a year. Suppose somebody invented a new car that was much, much safer, significantly cheaper, and emitted far fewer fumes while performing just as well. Would you a) ban the new car, or b) encourage people to buy it? Not that difficult a question, surely. Yet the reaction of many public health professionals and politicians has been to choose a) in an exactly analogous situation relating to nicotine. Why? Because they would rather you did not drive at all.

“In the end, what I suspect people object to about vaping is the pleasure it gives. What if somebody made nicotine addiction really safe, they worry, so there was no longer any reason to argue against it, eh? What then? A puritan, it was once said, is a person who lives in terror that somebody somewhere might be enjoying themselves.”

 

References:

1. A first pass, using pre-history and contemporary history, at understanding why Australia and England have such different policies towards electronic nicotine delivery systems, 1970s-c. 2018 – https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.15391
2. Illegal e-cigarettes seized in crackdown – https://www.health.nsw.gov.au/news/Pages/20210218_01.aspx
3. Tobacco harm reduction product controls ‘insane’ – https://www.medicalbrief.co.za/archives/tobacco-harm-reduction-product-controls-insane-global-expert/
4. The war on vaping and the irresistible urge to ban – https://capx.co/the-war-on-vaping-and-the-irresistible-urge-to-ban/