Why PHE's pro-vaping crusade is the enemy of choice
Tuesday, February 6, 2018 at 8:55
Simon Clark

I've heard it all now.

According to the Telegraph (and most other national newspapers):

Hospitals have been told to start selling e-cigarettes and letting patients vape indoors - and even in bed - under controversial new health advice.

Public Health England (PHE) said every smoker struggling to quit, including pregnant women, should be encouraged to take up e-cigarettes.

Officials urged hospitals to replace smoking shelters with vaping lounges, and said patients should even be allowed to vape in their beds, if they had single rooms.

Let me be clear. I've no problem with vaping being allowed in hospitals or anywhere else (I welcome it), but does anyone else feel ever so slightly queasy witnessing this evangelical crusade by a body that, let us not forget, is well known for its high-handed interventions in people's lives, whether it be smoking, eating or drinking.

PHE also want e-cigarettes to be 'given out by GPs on prescription, to encourage wider takeup'. The idea that the taxpayer should pay for smokers to quit (or switch from one nicotine device to another) has always struck me as a pretty poor use of public money.

As Chris Snowdon wrote in 2015, 'If you can afford to smoke then you can afford to vape'.

But there's another issue here.

What we are seeing is a public body trying to take ownership of a product that, until now, has succeeded without government intervention.

This is PHE’s manifesto:

Smokers – anyone who has struggled to quit should try switching to an e-cigarette and get professional help. The greatest quit success is among those who combine using an e-cigarette with support from a local stop smoking service.

Local stop smoking services and healthcare professionals – should provide behavioural support to those smokers wanting to quit with the help of an e-cigarette. A new training course on e-cigarettes for healthcare professionals by the National Centre for Smoking Cessation and Training is now live.

MHRA – continue their work in regulating and licensing e-cigarette products and support manufacturers to expedite the licensing of e-cigarettes as medicinal quit aids. PHE believes there is compelling evidence that e-cigarettes be made available to NHS patients.

NHS Trusts – to become truly smokefree Trusts should ensure: e-cigarettes, alongside nicotine replacement therapies are available for sale in hospital shops; vaping policies support smokers to quit and stay smokefree; smoking shelters be removed; and frontline staff take every opportunity to encourage and support patients to quit.

The issue I have with this approach is that e-cigarettes will eventually be seen as little more than a smoking cessation aid alongside patches and gum.

Worse, PHE's pro-vaping crusade ignores one vital element – choice.

If you smoke and don't want to quit PHE wants to make your life even more uncomfortable by removing outdoor smoking shelters and banning smoking on all NHS sites.

Some people will no doubt applaud unconditionally PHE's support for e-cigarettes. Personally I think it comes at a price – and that price is tolerance and choice.

Anyway, here's Forest's response:

"We welcome PHE's support for e-cigarettes but further attempts to remove smoking shelters or ban smoking on NHS sites will be fiercely resisted.

"E-cigarettes are great for some smokers who want to quit but you can't force smokers to switch if they don't want to. The key issue is choice.

"Regardless of the health risks, many people smoke because they enjoy it. Give them the choice of vaping but denying smokers the comfort of a cigarette when they may be at their most vulnerable is inhumane.

"Vaping is a consumer driven success story. The problem with PHE's approach is that e-cigarettes could become just another smoking cessation aid alongside other nicotine replacement therapies.

"If that happens they will almost certainly lose their appeal to independent-minded smokers who don't want the state dictating their behaviour."

Btw, having been critical of Philip Morris in my previous post (PMI's 2030 vision), I was pleased to read comments by David O'Reilly, group scientific director at British American Tobacco, in yesterday's Daily Mail.

According to the Mail:

Plans to prescribe e-cigarettes on the NHS have collapsed following the abandonment of the only product licensed for medical use.

The eVoke device received approval two years ago amid hopes it could help thousands of smokers to quit.

But British American Tobacco, which holds the medical licence, says the product is unlikely to ‘see the light of day’ because of production difficulties.

In response O'Reilly said:

"We were never really interested in prescription products. At that time, the medicinal route was the only route to market, but smokers do not see themselves as patients.

"Now there are additional routes to market, and we are devoting significant time and resources to extending consumer choice and delivering ever better next-generation tobacco and nicotine products."

In my experience, having listened to him at several conferences, no-one is as committed to harm reduction as David O'Reilly (nor as enthusiastic about next generation products including e-cigarettes).

Note however the use of the phrase 'extending consumer choice', in sharp contrast to PMI's clear declaration of war on smoking.

I'm delighted too to read the unambiguous comment that "Smokers do not see themselves as patients" (or victims, come to that).

The contrast with tobacco control, including Public Health England, could not be clearer. As far as PHE is concerned smokers are patients and part of their treatment is to be offered e-cigarettes alongside other nicotine replacement therapies.

As for 'extending consumer choice', forget it. PHE wants to bludgeon smokers into submission, removing outdoor shelters and prohibiting smoking wherever they can.

In the meantime you may be allowed, at their discretion and under their rules, to vape indoors.

In those circumstances some smokers may indeed elect to switch but I imagine many more will feel resentful that tobacco control has, once again, dictated how you live your life.

According to reports, the number of people vaping in the UK has flatlined at just under three million. I'm not suggesting this is the only reason, but could the fact that e-cigarettes are increasingly being adopted as a tool of the tobacco control industry have something to do with that?

Article originally appeared on Simon Clark (http://taking-liberties.squarespace.com/).
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