A tale of two conferences

As I wrote on Wednesday, repeating what I have said several times before, public health campaigners are very clearly trying to control the debate on e-cigarettes.

By issuing 'guidelines' about vaping in the workplace the aim of Public Health England is not merely to 'encourage' more smokers to quit but to control where and how often adults can vape as if it's part of a smoking cessation programme.

Advocating rooms where people can vape, plus extra vaping breaks, may seem liberal in relation to other tobacco control policies but it still seems a bit controlling to me.

If I remember there were similar 'guidelines' about smoking at work until, one day, legislation was passed that imposed strict regulations on employers with threats of fines and other penalties if anyone contravened the law.

Vaping rooms, like smoking rooms, are designed to divide and conquer. I'm reluctant to use the word but in its more general meaning it's really a form of apartheid (ie segregation on grounds other than race).

It's also a subtle form of denormalisation. Want to vape? There's a designated room for that.

Another way public health is trying to exert control is by organising or dominating all those "summits" and seminars on the subject.

Take the E-Cigarette Summit, now in its third year. I went to the first one, in 2014, but chose not to attend last year's event.

There were several reasons (see Why I'm not attending today's E-Cigarette Summit) but the main one was the appearance of so many familiar faces from tobacco control, many of whom had spoken at the inaugural event the previous year.

In alphabetical order they included:

Prof David Abrams, John Hopkins Bloomberg School of Public Health
Deborah Arnott, Action on Smoking and Health (ASH)
Prof Linda Bauld, University of Stirling, UK Centre for Tobacco and Alcohol Studies (UKTAS) and Cancer Research UK
Clive Bates, former Director, ASH
Prof John Britton, UK Centre for Tobacco and Alcohol Studies
Shirley Cramer, Royal Society for Public Health
Andrea Crossfield, Tobacco Free Futures
Martin Dockrell, Tobacco Control Lead, Public Health England
Dr Konstantinos Farsalinos, Onassis Cardiac Surgery Centre, Greece
Prof Peter Hajek, Queen Mary University, London
Beryl Keeley, Medicines and Healthcare Regulatory Authority (MHRA)
Jim McManus, Director of Public Health, Hertfordshire County Council
Prof Ann McNeill, UK Centre for Tobacco and Alcohol Studies
Prof Ricardo Polosa, Institute for Internal Medicine, University of Catania
Louise Ross, Leicestershire Partnership NHS
Prof Robert West, Director of Tobacco Studies, Cancer Research

To that list the organisers belatedly added a handful of actual vapers but only those who could be relied upon to not rock the boat or ruffle a few public health feathers.

Tobacco control only wants to hear from vapers who have quit or are trying to quit smoking. Dual users? Not so much. Smokers who don't want to quit? No chance.

The tobacco industry – or anyone with links to Big Tobacco – were noticeable by their absence on the list of speakers and panellists despite the fact that the companies clearly have a huge role to play in the development of e-cigarettes and other harm reduction products.

Anyway, confirmed speakers for the E-Cigarette Summit 2016 currently include:

Prof David Abrams, John Hopkins Bloomberg School of Public Health
Deborah Arnott, Action on Smoking and Health (ASH)
Beryl Keeley, Medicines and Healthcare Regulatory Authority (MHRA)
Prof Linda Bauld, University of Stirling and UKCTAS*Martin Dockrell,* Public Health England
Dr Konstantinos Farsalinos, Onassis Cardiac Surgery Centre, Greece
Prof Peter Hajek, Queen Mary University, London
Jim McManus, Director of Public Health, Hertfordshire County Council
Prof Ann McNeill, Professor of Tobacco Addiction (UKCTAS)
Ram Moorthy, British Medical Association
Robert Morrison, Committee of Advertising Practice (CAP)
Prof Marcus Munafo, UK Centre for Tobacco and Alcohol Studies
Prof Ricardo Polosa, Institute for Internal Medicine, University of Catania
Louise Ross, Stop Smoking Services, Leicestershire NHS Trust
Prof David Spiegelhalter, Winton Professor of The Public Understanding of Risk, Cambridge University
Prof Robert West, Director of Tobacco Studies, Cancer Research

If that list seems familiar it's because it is. (Those who spoke at the 2015 event are highlighted in bold.)

Note that both sets of speakers include Deborah Arnott, CEO of ASH. That's right, the same Deborah Arnott whose alleged complaint about "unpleasant and distracting" vapour led the organisers of the Global Forum on Nicotine to ban any vaping in plenary and parallel sessions.

In other words, same old, same old – and still no sign of any speakers from the tobacco industry.

But it doesn't have to be like that. For example I was asked recently to speak at something called the Next Generation Nicotine Delivery conference in London.

According to the invitation it "brings together KOLs (key opinion leaders) in the alternative nicotine delivery and tobacco industries, alongside regulators and advocates".

It was suggested I might moderate or take part in a session entitled 'Gaining valuable insight into consumer needs and consumption of alternative nicotine delivery in different markets/regions'.

I didn't want to moderate so I replied as follows:

I would be happy to be on the panel, if you want a slightly alternative viewpoint. (I don't think I would be suitable to chair or moderate the session.)

As someone who doesn't smoke or vape I can't bring any direct personal experience to the session so I would have to talk in more general terms, from a Forest perspective.

Although we primarily represent adults who choose to smoke combustibles, an increasing number of our supporters also use e-cigarettes (for a variety of reasons). Common sense dictates that we embrace and endorse any harm reduction product but most of all we advocate choice, an issue that is sometimes lost in the current debate.

Consequently we are a little uncomfortable with the evangelical nature of many pro-vaping advocates who in their enthusiasm for e-cigarettes are blind to the fact that many smokers don't like or aren't attracted to e-cigarettes.

Likewise at the e-cigarette conferences I've attended there seems to be a general incomprehension that more smokers don't want to switch. This attitude was reflected only last week by Mark Pawsey MP, chairman of the All Party Parliamentary Group on E-Cigarettes, who said he found it "mind-boggingly incomprehensible" that, knowing the health risks, so many people continue to smoke combustibles.

As part of the session therefore I would like to address the reasons why so many smokers haven't switched to vaping, and why they shouldn't be forced to.

Also, most if not all of the vaping representatives at e-cigarette conferences tend to be ex-smoking vapers which makes them unrepresentative of many vapers, the majority of whom are (I believe) still dual users.

They are also unrepresentative in other ways – notably the type of products they use. We very much hope there is a niche for every product for which there is some consumer demand. Long-term however we believe that if the e-cigarette market is to grow substantially and attract more smokers to switch, the two essential factors will be cost and convenience.

Based on anecdotal evidence we also believe there are some aspects of the current pro-vaping advocacy that are actually driving some smokers away from e-cigarettes.

Overall I would be very positive about e-cigarettes and their role in harm reduction. At the same time however I'd like to raise issues involving current smokers (and potential vapers) that are often overlooked when pro-vaping advocates get together.

As a result of this I thought I might be quietly dropped from the programme. Not a bit of it. The conference organiser replied:

I believe having an alternative viewpoint will be valuable as we don’t want to regurgitate the same message and the audience would really benefit from hearing your experiences at Forest.

I believe your insights on smoker-centric approach with emphasis on understanding and educating the smoker, alongside not having a biased approach, will resonate well and will indeed support an engaging discussion.

How refreshing is that?

Interestingly my fellow panelists include a representative from a tobacco company and another from an "independent e-cigarette manufacturer".

Frankly the third Next Generation Nicotine Delivery conference, which describes itself as "an open, unbiased and interactive platform to discuss TPD implementation, alongside alternative nicotine delivery product innovation", sounds rather more open and interactive than its cousin, the public health dominated E-Cigarette Summit.

Sadly if you want to attend both conferences and compare notes there's one small problem – the dates overlap! Madness.

Comments

[Misty]

As I said in my comment on your previous post, Simon – more than meets the eye. Looks like you agree. And it looks as if Tobacco Control have finally made up their minds what to do about the “e-cigarette problem” which had clearly sent them into something of a flat spin, having appeared on the market and grown in popularity at a speed that they just hadn’t foreseen.

Having come dangerously close to splitting themselves in half on the issue – with some antis openly expressing that they hated e-cigarettes as much as they hated the real thing, and others cautiously positive about them as “smoking cessation devices” which should therefore be encouraged – it seems that they’ve finally come to the conclusion that, I suspect possibly for some of the reasons I mentioned in my last comment, they’ve come to the conclusion that even if they can’t agree amongst themselves about the good or badness of e-cigarettes, they can at least agree that they should unite to control them, and control the behaviour of vapers.

It’s just unfortunate that so many vapers can’t see this happening – in this instance right in front of their eyes. If I were a vaper, I’d be wondering where on earth on this list are the names of speakers from either (a) the many vapers’ forums/sites or (b) the e-cigarette manufacturers. I think their absence is telling. But I doubt that vapers will notice it. Until, of course, it’s too late, and the whole shebang is well under the thumb of Tobacco Control. I wonder when they’ll start referring to themselves as “Nicotine Control” instead of "Tobacco Control" to cover their newly-expanded role.

I just hope that the organisers of the New Generation conference can see what’s happened to the E-cig summit, and are committed to ensuring the same thing doesn’t happen to them, because you can bet your bottom dollar that if Tobacco Control get wind of another, similar event taking place, they’ll want in. On the other hand, maybe that’s precisely why the dates overlap. If so, then that’s a tiny stroke of genius - even Tobacco Control big cheeses can’t be in two places at once!

[Helen D]

Let's face it. The anti-tobacco industry did the same thing well before smoking bans and manufactured lies; they even laughed whilst they slaughtered tax-payers.

They killed off the safer cigarette long ago and would prefer smokers or vapers to not exist.

So sorry to admit that I"m still alive and kicking. According to the rhetoric, lies and propaganda, I should have been well dead.

Hey-ho. Quangos and politicians do lie. They love following lucre though.

[pat nurse]

Please also remember harm reduction is possible in many ways without quitting or taking up vaping. This is too often ignored. If I had time and a good WiFi signal from my camp site in Sardinia, I would give you many examples.