Clive Bates: the liberal argument for electronic cigarettes
Saturday, April 20, 2013 at 12:22 Ten days ago Clive Bates, former director of ASH, posted a comment on this blog.
It was on a thread dated February 17 so it's unlikely you will have seen it.
The post was entitled Wanted: a consumer champion for e-cigarettes who is not anti-smoking. In it I wrote:
As a champion of consumer choice Forest is happy to support and defend the use of e-cigarettes (and other smokeless tobacco products).
My concern is that, media wise, a vacuum is developing that may be filled by e-cigarette spokesmen who are profoundly anti-smoking and no more tolerant of tobacco than ASH or the BMA.
That is why I view with caution the plaudits that have been showered on Clive Bates, the former director of ASH who has been remarkably vocal on the subject of e-cigarettes.
Not just a voice either. Putting words into action, Bates wrote to the Press Complaints Commission complaining about a laughable report headlined E-cigarette ‘can cause more harm than smoking’, experts say. (Significantly the article is no longer available online.)
I commend him for that but don't be fooled. Most public health campaigners who advocate the use of e-cigarettes regard them as a medicinal alternative to cigarettes and they will continue to bully and belittle smokers until they give up.
In response Clive has written:
Simon, you can accuse me of many things (and have) but you can't argue that I think of e-cigs as medicines. See my briefing: Are e-cigarettes medicines?.
And said the following in a letter to a government planning to ban them:
The ethics of a ban. There is a liberal argument that goes like this: if people want to sell them, people want to buy them, they are much less risky than cigarettes and they comply with norms of consumer protection – like being acceptably safe, working as intended (ie not faulty), and as-described – then what is the ethical basis for a ban on e-cigarettes?
Nicotine is a widely-used legal recreational drug that in itself is almost harmless, so why obstruct a much less dangerous way to take it with huge regulatory burdens that do not apply to cigarettes? When the state denies a smoker a product that could save their life, the state becomes complicit in the mortal consequences that follow from that decision.
There are no precedents in other areas of consumer protection or health policy and no ethical basis for banning a much safer alternative to the dominant high-risk tobacco-based nicotine products.
Thanks, that's pretty clear.
As an aside, I would add that I have always had a soft spot for Clive, even when he was director of ASH.
By all accounts some of his predecessors were humourless zealots driven by an ideological hatred of Big Tobacco and anyone who dared to challenge the new anti-smoking orthodoxy.
Many of today's tobacco control campaigners are cut from the same cloth. Sometimes their prohibitionist zeal is combined with an ego the size of an elephant and the result is a Doctor Who style monster with no redeeming features.
Clive was never like that. Unlike many people in public health he's had a varied career outside that cosseted industry. He's not obsessed to the point of lunacy by smoking or anything else.
Most important, he has a sense of humour.
Back in the day Forest produced a quarterly magazine called Free Choice. I introduced a tongue-in-cheek feature called 'What's My Vice?' and invited Clive to contribute.
To my surprise he accepted the challenge although his choice – Belgian beer – seemed a bit tame.
Today, after numerous trips to Brussels (with the occasional detour to Bruges and Antwerp), I understand the attraction and the potentially addictive nature of the product!
If I can find a copy of the article I'll publish it here.
Cheers!
Reader Comments (8)
...The ongoing debate over e-cigs...tobacco product, consumer product or medicinal product.
Tellingly, on the 7th March 2013, the Estonian State Agency of Medicines, tried to classify e-cigarettes as medicines. In response, the Tartu Administrative Court said...
The respondent [...] has not explained why the electronic cigarette is to be classified as a medicinal product, while the normal cigarettes which also contain nicotine and its consumption goal is the same, have never been defined as medicine products. It is not clear why the pharmacological effects of the manufactured liquid nicotine on the body are different from the effect of the nicotine in a normal cigarette or whether any pharmacological effect manifests itself in a normal cigarette. In the contested decisions, there is no answer to the claim raised by the complainant that there is no science based evidence and examples of why particularly E-Lites products or their properties negatively affect public health and influence human physiology more than do conventional cigarettes.
[...]
If the effects produced by E-Lites cigarettes are unique to medicinal products only, then the question arises as to why the normal cigarettes do not have the same effect unique to a medicinal product. In this case, the desired nicotine is received from an e-cigarette instead of a tobacco cigarette; nicotine addiction is satisfied, not cured.
[...]
Nicotine is received from an e-cigarette instead of a tobacco cigarette. Also, people who have given up smoking tobacco cigarettes in favor of e-cigarettes for health reasons do not use nicotine as a medicinal product, but as a drug which is less detrimental to the health instead of a more hazardous cigarette.
Interpretation. The court does not find that the mere fact of a physiological effect is sufficient to regard something as a medicine. Throughout the judgement, the court compares e-cigarettes with cigarettes, not NRT or other pharmacological treatments for nicotine withdrawal.
Exuding commonsense.
The overwhelming commonsense by the Tartu Administrative Court is a shining beacon for any anti-tobacco/e-cig zealot to fear. This is the kind of decision that would be all too common place if court action were undertaken in many instances where claims have been made in the absence of some reasonable level of scientific scrutiny with regard to the smoking ban wherever it may be imposed.
There is no way around this kind of precision thinking when applied to what amounts to – in almost every case put forward by the antis – generalisations and prejudice.
In this instance the Estonian State Agency of Medicines has been put nicely back in its box. Naturally they would like to have e-cigs classified as medicines, giving overall control and massive profits to the pharmaceutical industry which would impose a strangle hold that would keep out tobacco companies, whilst at the same time with government backing, having done nothing whatsoever to earn those profits.
This judgement insures against that – creating an iron-clad precedent since Estonia is an EU member state and has been since 2004.
A cracking find Dave – one most certainly for the toolbox. A pdf would be nice.
Well done.
As someone who has corresponded with Clive I am in no doubt he is sincere. I have no objections to e-cigs as long as they are not used as a tool of coercion and certainly the choice to use tobacco should definitely remain.
However I think Clive has taken a risk. He no longer works in tobacco control and does this I guess for free. Clive I would guess has also burnt his bridges with tobacco control and Big Pharma must be apoplectic that e-cigs will be probably eclipse NRT. So what he has done is not without risk.
I hope the freedom to choose either method of nicotine delivery remains available.
What a nice way to communicate. Simple, clear, and to the point without the normal fodder and banter that is usually found with the Tobacco Control wackos, hypocrits and zealots. (yes, I have called them these names to their faces).I know, not very Christian of me. but just saying. I too, found Clive to have a sense of humor. I think you'll going to hear alot more from the usual suspects who no longer are on the payroll of Anti-tobacco establishment. They are jumping ship at an extrordinary pace..........hmmmm
You're welcome Dennis...
TARTU ADMINISTRATIVE COURT
Tartu Courthouse
COURT JUDGMENT
IN THE NAME OF THE REPUBLIC OF ESTONIA
http://www.ecita.org.uk/kohtuotsus_e-sigaretid_zandera%20vs%20ravimiamet_ha-3-12-2345_07032013_en-us.pdf
Much obliged Dave
I do not know whether this makes sense or not - I can only ask.
According to the PDF, a company called Zandera Ltd took issue with the 'medicine authorities' of Estonia about a decision by these authorities to class ecigs as 'medicines'. The matter went to court because the 'authorities' went ahead with the classification.
What interests me in this matter is that, in 2005, in the Scottish Supreme Court, an attempt by Tobacco Control to 'prove on the balance of probabilities' that smoking causes lung cancer failed totally. The Judge, Lord Nimmo Smith, found that Tobacco Control had not only failed to prove their claims, but had not even tried to prove their claims.
In 2006, the Health Bill which introduced the smoking ban was brought before Parliament.
I wonder if it ought not to have been at that point that the evidence regarding smoking harm (especially to bar staff) ought to have been contested.
The point that I am making is that there is not much point in contesting the decisions of Parliament after they have been made. The foundations of the decisions need to be contested before Parliament decides.
Over here in America, there is constant debate and awaiting pending classification and regulation. I work in the electronic cigarette industry and feel there needs to be limits to minor accessibility and proper health research completed. Public consumption should always serve the "greater good" but private use should be up to ownership.