American writer and tobacco risk reduction expert Carl Phillips posted an interesting thread on Twitter at the weekend.
It concluded with him urging advocates of the right to vape to join what he called the ‘larger fight’ to erode ‘the credibility of the myth-creating [tobacco control] machine’.
But more on that later.
I have long argued that vaping advocates are making a mistake if they focus almost exclusively on health in support of e-cigarettes.
The significantly reduced risk provided by e-cigarettes is a powerful argument in their favour, but the problem, as I have said before, is that it only takes one major health scare - genuine or otherwise - to have politicians and public health officials demanding immediate action to curtail their use.
The US vape scare is a classic example. It doesn’t matter how unjust (or plain wrong) the case is against legal vaping products, those opposed to any form of recreational nicotine have been able to create a general sense of panic around e-cigarettes.
And not just in America. India recently announced a ban on the manufacture, sale and distribution of e-cigarettes.
In Ireland, as I mentioned on Saturday, a former minister of health has called for a ban on flavoured e-cigarettes, the president of the University of Limerick has urged the government to ban vaping across all Irish educational institutions, and a leading heart consultant has called for a complete ban on vaping, saying, “It’s more dangerous than smoking and booze combined.”
Even closer to home, it’s been reported that ‘The Scottish Government could introduce a ban on advertising for e-cigarettes and vaping products. First Minister Nicola Sturgeon said a consultation on the move would take place in the “coming months”.’
This is happening despite the fact that there is no evidence of harm caused by vaping regulated e-cigarettes or liquids. Consider the reaction therefore if genuine evidence were to emerge. Imagine, for example, that a study into long-term use of e-cigarettes concluded that there is a risk from vaping even regulated products.
Meanwhile, in the absence of evidence, the safety of e-cigarettes is likely to be left in a permanent state of limbo because how do you prove that something isn’t harmful, long-term, when it still a relatively new product? “More research is needed,” researchers will say (with no hint of self-interest), leaving the issue tantalisingly open to debate.
Even if studies find no significant risk, I guarantee there will be plenty of studies whose results are nevertheless spun to suggest a threat far beyond the actual risk.
That’s what happened with passive smoking, if you remember. The overwhelming majority of studies found no significant risk to non-smokers yet even a tiny relative risk - far below the threshold at which something might be considered a serious risk - was used to justify bans on smoking in public places.
Even when the largest study of its kind found no significant risk from secondhand smoke on spouses of smokers in the home, the tobacco control industry refused to accept it. Why does anyone think public health - or indeed the media - will act differently on vaping?
UK vapers are probably a bit complacent because, for now at least, they have Public Health England, Action on Smoking and Health and other tobacco control bodies advocating the use of e-cigarettes in preference to smoking.
But how long will that last? Let’s be clear. The only reason PHE, ASH et al ‘support’ e-cigarettes is because they have identified vaping as a weapon in the war on smoking. To date, not one tobacco control group or public health body has endorsed e-cigarettes as a recreational product. For them, it’s a smoking cessation tool, nothing more, nothing less.
None of these bodies support long-term recreational vaping yet vaping advocacy groups cite them as if they are friends and allies. If and when the number of vapers exceeds the number of smokers in the UK, I suspect PHE, ASH and even the government will adopt a very different attitude to e-cigarettes.
The problem is, if advocates of vaping put all their eggs in the health basket, where do they go if it is one day found that e-cigarettes are NOT the panacea for smokers that current evidence suggests them to be. If and when that happens there has to be another reason to defend their use, and that is why I continue to bang the drum for choice.
My point is that, whatever the health risks, adults must be allowed to smoke, vape or consume other nicotine products like heated tobacco and snus without excessive regulation. Educate, inform and update consumers about the risks, but ultimately the choice must be theirs.
That argument should be consistent across all nicotine and tobacco products. Unfortunately, by playing the ‘health’ card to the max, vaping advocates are boxing themselves into a corner because if, one day, ‘evidence’ emerges that e-cigarettes are not as safe as advocates currently say there are, there will be no room for manoeuvre. The entire basis on which e-cigarettes have been sold to regulators will be undermined overnight.
In the meantime, as Carl Phillips has pointed out, even if you accept the PHE estimate that vaping is 95 per less harmful than smoking (Carl believes the true figure is nearer 100 per cent), that is still a substantial risk, in numerical terms, if you believe everything the likes of PHE and ASH say about the dangers of smoking.
The estimated figures vary, but ASH currently claims that 100,000 people die of smoking every year in the UK. Five per cent of 100k is 5,000.
Smoking was banned in public places in the UK on the grounds that 1,000 non-smokers were estimated to die every year from passive smoking. The figure mysteriously rose to 11,000 before MPs voted for the ban, but you get my point.
Given that cigarette vending machines were banned in the UK on a 2:1 majority after the presiding Appeal Court judge argued that if the legislation saved even one life it was worth it, the precautionary principle alone would support a ban on all sorts of products.
Bans on e-cigarettes, flavoured or otherwise, are an obvious case of the precautionary principle being taken too far. They also reflect a phenomenon that, paradoxically, affects e-cigarettes more than traditional cigarettes but, to the best of my knowledge, has not been commented upon - fear of the unknown.
When you smoke the overwhelming majority of people know the long-term risks. But is that true of vaping? Current evidence suggests the risks are very small. But e-cigarettes are still a very young product compared to traditional cigarettes so no-one can truthfully say they know for sure what the long-term effect might be.
Fear of the unknown is a powerful force and it may explain why some smokers prefer to stick with what they know, including the well-publicised health risks. The key argument therefore has to be choice. Consumers should be informed about the relative risks of using cigarettes, e-cigarettes, cigars, snus and other nicotine products - indeed, they have a right to that information - but their right to choose should also be sacrosanct.
In short, none of these products should be prohibited. Unfortunately we live in a world governed by politicians and public health campaigners who want to create a risk averse society that puts prohibition and the infantilisation of adults above pleasure and personal responsibility.
Anyway, as I said at the beginning, Carl Phillips posted a long thread on Twitter that is well worth reading. However, I can spare you the effort by reproducing his final comments:
Which brings us to the final and most important point here: if you are an advocate for the right to vape, please learn some history and join the larger struggle. Don't just fiddle at the surface.
Of course you are most focused on educating and fighting myths about vaping. But the larger fight is eroding the credibility of the myth-creating machine in general. So learn about and speak up about the myths about snus, environmental smoke, the effectiveness of tobacco control measures, that all smokers want to quit, etc.
And FFS, at least stop perpetuating tobacco control myths yourselves, or allowing other ostensible THR advocates to do so with impunity. The Tobacco Wars will [be] won or lost in toto. I trust it is finally clear that vapers are not going to be granted a deferment.
The message "yeah sure, most of what tobacco controllers say is true, but their stuff about vaping is wrong" is a sure loser. “Most of what tobacco controllers say is bullshit, including what they say about vaping" takes more effort, but it is what has a chance to succeed.
I agree with every word of this. Indeed, I’ve been banging a similar drum for some time. Unfortunately, I sense we are fighting a losing battle persuading vaping advocates to join what Carl rightly calls the ‘larger struggle’.
The problem is that many vaping advocates are tobacco control activists of long-standing and their goal is the eradication of smoking. Those who don’t share that aim (ex-smoking vapers mostly) nevertheless see an alliance or accommodation with tobacco control as the best way to secure vaping’s future.
Long-term they will be proved wrong (and Carl and I will be proved right!) but by then it will be too late. Tobacco control’s grip on all forms of nicotine consumption will be so strong it will be almost impossible to reverse.
Sadly, but perhaps understandably, hardly anyone is taking the long-term view. In the UK, many vapers and vaping advocates bask in the hilarious illusion that PHE and ASH are somehow the ‘good guys’. The reality, as I have noted before, is that the tobacco control industry in the UK now ‘owns’ vaping.
With the exception of the UK Vaping Industry Association (UKVIA), all the prominent ‘pro-vaping’ spokesmen are professional tobacco control campaigners. They include Martin Dockrell, head of tobacco control at PHE; Prof John Newton, director of health improvement at PHE; Deborah Arnott, CEO of ASH; and Prof Linda Bauld who has so many job titles I can hardly keep up.
To overcome this imbalance, more people from outside the tobacco control bubble need to step forward and join the ‘larger fight’.
This morning on Newstalk (Ireland’s largest independent radio station) Forest Ireland spokesman John Mallon went head-to-head with Senator James Reilly who has called for a ban on flavoured e-cigarettes in Ireland.
Contrast this with the fact that the leading ‘pro-vaping’ advocates in Ireland have so far shunned Forest because of our connection with Big Tobacco. Sooner or later they need to understand they won’t win the war on vaping by ignoring the bigger picture or the one ally that has spent decades fighting for consumer choice.