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Wednesday
Sep122018

Money, money, money

Champagne corks will be popping in London and the North East.

In November last year I wrote:

For the best part of a decade [ASH] has received over £1.5 million of our hard-earned cash.

That may be small beer compared to ASH Scotland which has swallowed upwards of £800,000 a year from the taxpayer during the same period, but it's nevertheless a substantial part of ASH's annual income.

The money has been awarded by the Department of Health with the express purpose of supporting the tobacco control plans of successive governments ...

What may concern ASH is the fact that grants are now subject to a bidding process. This means that ASH could (and hopefully will) face competition for future DH grants.

See ‘Please, minister, we want some more’.

The following day I wrote:

The irony of course is that any grant ASH receives from the DH will come with a clear stipulation that it cannot be used to lobby government.

Lobbying, however, is what ASH is particularly good at – hence this sudden burst of activity. So here's another question:

What part of ASH's funding is currently being used to lobby government to grant the group funds to support the government's tobacco control plan?

Tricky, isn't it? Perhaps it would be best to exclude ASH from the process entirely so there is no confusion.

Either way, may I suggest that public health minister Steve Brine changes his Twitter banner as a matter of urgency?

It currently features the CEO of a certain anti-smoking lobby group that is seeking a grant from the Department of Health in what should be an impartial bidding process.

That process should not only be fair, it should be seen to be fair and impartial. Just a thought.

See ‘It’s all about the money’

To be honest, I don’t think anyone seriously thought ASH wouldn’t get the nod and, lo and behold, that’s exactly what has happened.

In answer to a written question by Philip Hollobone MP (‘To ask the Secretary of State for Health and Social Care, what progress his Department has made in tendering for the grant scheme relating to external stakeholder support for the tobacco control plan’), public health minister Steve Brine has replied:

The grant scheme to secure additional support to assist in the delivery of commitments made in the tobacco control plan was advertised in May and June 2018. Ten eligible organisations applied for this funding.

The Department reviewed these applications as per Cabinet Office guidelines in July and finalised this in August. Action on Smoking and Health (ASH) in a partnership application with FRESH North East scored the highest. All applicants have been informed of the results and paperwork is currently being finalised in order to award the grant to ASH and FRESH North East.

Note that it took a written question by a member of parliament to get this information out of the DH. Shouldn’t there have been a formal statement?

Apart from that, the most notable thing about Brine’s reply is not the fact that ASH won the bidding process (that was widely anticipated) but that it was a joint application with Fresh North East.

For years regional quit smoking groups have been under threat as councils have wised up to the fact that they can make long overdue savings by cutting budgets in this overcrowded area.

Smokefree South West and Tobacco Free Futures (formerly Smokefree North West) both succumbed to an outbreak of common sense among local councillors, but Fresh North East - run by Deborah Arnott’s mini me, Ailsa Rutter - kept going (supported, it must be said, by a hilariously compliant local media).

The award of £500,000 over five years will therefore come as a welcome boost for Fresh North East and ASH.

What’s laughable though is the fact that the Department of Health has taken so long to reach a decision everyone knew they would come to in the first place.

The only outstanding issues are:

One, who were the other nine bidders? (I think we should be told.)

Two, for the sake of transparency (a difficult concept for governments to grasp), the DH must publish the reasons it awarded the grant to ASH and our friends in the north ahead of those rival claims.

Watch this space.

Tuesday
Sep112018

Zero sum game

Gotta love Philip Morris.

Hardly a week goes by without some new announcement or initiative designed to bolster the idea that smoking is about to be consigned to history.

Today the company that wants to stop selling cigarettes in England by 2030 - the year Public Health England also hopes England will be ‘smoke free’ with fewer than five per cent of the population smoking - has released research that claims that one city, Bristol, could have ZERO smokers in just six years.

It’s nonsense, of course.

Nevertheless, according to the Daily Mail:

The research is based on a current smoking rate of 11.14 per cent of people in Bristol. The number of smokers in Bristol fell by 9.95 percentage points between 2011 and 2017, so the figure is based on current trends continuing.

Assuming that current trends will continue is hugely problematic, of course, and probably unrealistic.

After all, while there was a significant fall in smoking rates between 2012 and 2016 it just happened to coincide with a sharp increase in the number of smokers switching to e-cigarettes.

But that seems to have stalled with the number of people who vape falling from a peak of 2.9m to 2.8m (according to the latest figures).

Also, if the option of e-cigarettes combined with the smoking ban, display ban, plain packaging and punitive taxation haven’t persuaded almost one in six adults to quit, it’s hard to see that figure dropping below five or even ten per cent any time soon.

Indeed, according to the same research, at current rates the country as a whole won’t kick the habit until 2050.

Anyway, I look forward to hearing what Peter Nixon, MD of Philip Morris UK, has to say at the Global Tobacco and Nicotine Forum that begins in London tonight and continues on Wednesday and Thursday.

He’s one of the keynote speakers and I hope he will repeat his company’s commitment to stop selling cigarettes in the UK within 12 years.

The announcement attracted a lot of headlines but, as someone pointed out to me the other day, it’s hardly very brave to announce that your company intends to stop selling cigarettes in a country in which your market share is a fraction of your competitors who have far more to lose.

A declaration that PMI would like to stop selling cigarettes within twelve years in regions where they are market leaders for combustible tobacco would be far more impressive but I doubt if that will happen.

Meanwhile I will continue my search for someone who uses iQOS, the heat-not-burn device that Philip Morris wants smokers to use instead of combustible cigarettes.

As readers know, based on consumer feedback I’m favourably impressed with iQOS. However, it’s almost impossible to find anyone who uses it in the UK. Believe me, I’ve tried.

A few weeks ago I even contacted PM to ask if they could suggest one or two people in the Westminster village who use the product and they couldn’t come up with a single name!

(I’m aware, btw, that Mark Littlewood, director-general of the IEA, is an occasional user of iQOS, but he’s unavailable for the event we’ll be announcing shortly).

Frankly, this doesn’t bode well if Philip Morris wants every smoker in England to quit or switch to iQOS within the next 12 years.

If ‘current trends’ continue they may have to revise that target.

Monday
Sep102018

Points of view

God played a little joke on me last night.

I was at Magdalene College, Cambridge (above), to speak at a dinner ahead of the Global Tobacco and Nicotine Forum that takes place in London this week.

Following drinks outside, we were ushered in to the old candlelit hall (no gas, no electricity), first built in the early 16th century. And there, sitting directly opposite me, was a senior research analyst from the Foundation for a Smoke-Free World.

What are the chances?

I discovered she has a background in human rights and is also interested in gender issues. If I understood her correctly, smoking is a gender issue because, worldwide, the majority of smokers are men and by smoking they are imposing their habit (or worse) on the women around them.

Anyway, I had an enjoyable discussion with her and a chap who works for Juul Labs, and following my after dinner 'speech' – which emphasised the need to respect those who choose to smoke – things got even livelier with several other guests pitching in.

Summing up, our host Elise Rasmussen made the point that the pre-conference field trip tends to lend itself to more robust discussion because people are more relaxed and tend to open up more.

Sadly, such contrasting views are unlikely to feature on any of the panels at this week's conference which is dominated by those who want to see smoking eradicated from the planet. That's a pity because I think it would liven up some of the sessions.

We are however promised a MAJOR ANNOUNCEMENT.

Watch this space.

Sunday
Sep092018

Dinner date

I’m giving an after dinner speech at Magdalene College, Cambridge, this evening.

Among other things I'll be talking about Forest and the work we do supporting smokers.

The event, which starts with drinks on an outside terrace, is part of the field trip that precedes the Global Tobacco and Nicotine Forum (GTNF) that takes place in London this week.

The first GTNF (or Global Tobacco Network Forum as it was then called) was held in Rio de Janeiro in 2008. I missed it due to a misunderstanding (the invitation sounded too good to be true!) but I’ve attended every GTNF since - in Bangalore (2010), Antwerp (2012), Cape Town (2013), West Virginia (2014), Bologna (2015), Brussels (2016) and New York (2017).

I’d be hard pressed to choose my favourite because they were all memorable for different reasons, good and bad.

But if I was to judge it purely on our hotel, the memorable reception we received when we arrived at 6.00am following a nine-hour flight, and the fact that it was my first and only visit to India, Bangalore is the one that really sticks in my mind.

Cape Town would be up there too, although it didn't make quite the same impression. Nevertheless it’s somewhere I’d like to re-visit because even though I stayed on for a couple of days I saw very little of the actual city.

That’s the problem with conferences. During the event you rarely see much beyond the hotel grounds, even though you might be driven 20 or 30 miles to some ‘special’ location for a drinks reception or gala dinner.

Anyway, based on what I remember, I’d mark my experiences as follows:

Bangalore 9/10
New York 8/10
Cape Town 8/10
West Virginia 7/10
Bologna 6/10
Antwerp 5/10
Brussels 5/10

Inevitably perhaps the conferences that were easiest to get to were the least memorable, which is why I'm struggling to get excited about this week’s event in London (11-14 September).

In fact, until very recently - based on the programme and the list of speakers - I was in two minds whether to go at all.

But more about that next week.

In the meantime here are some posts from previous GNTF conferences:

Welcome to Bangalore
Postcard from India - parts 1, 2 and 3
GTNF 2012 – the highs and lows
Out of South Africa
Greetings from the Greenbrier
Pork chop at a bar mitzvah – reflections on GTNF 2015
Mandela, moon landings and JFK GTNF 2017

Sunday
Sep092018

More thoughts on smoking and the nanny state

Further to my previous post, here are more of my comments from last week’s interview on BBC Radio Guernsey.

On smoking in the open air

There is no research that says that smoking in the open-air poses any risk to any non-smoker. You would have to be in very close proximity to a smoker and be a very serious asthmatic for that to have any effect whatsoever and asthma is rather an interesting one because over the last 30, 40 years, while smoking rates have more than halved, cases of asthma have actually tripled. So clearly there is something else going on there, but in terms of cancer there is not a shred of evidence that exposure to somebody smoking outdoors is going to have any impact on you whatsoever. I don’t want to go over old arguments but even passive smoking indoors, there's been a lot of research over many many years, and even there the evidence of long-term harm is pretty insubstantial.

I do accept that smoking indoors can be unpleasant for a lot of people and I totally accept that smoking should be restricted in indoor public places. I would still argue very strongly that there should be indoor public smoking rooms in pubs. You were speaking to Peter Lee [a Guernsey publican]. I remember seeing Peter many years ago and I don't see there is any reason why we shouldn't have smoking rooms indoors. And of course this is one of the problems. Because smoking is now banned everywhere indoors it has forced people go outside and so you get people complaining [about] people hanging around outside pubs and clubs or somebody who wants to smoke outside the airport or outside the harbour and it does seem rather petty to ban smoking in designated smoking areas outside the harbour or even outside the airport.

We know that flying for example can be quite stressful for a lot of people. I have only been to Guernsey airport once. Obviously it is quite a small airport so you are probably not there for hours on end [like] you might be at larger airports like Heathrow and so on, but to say you can't smoke even in a designated smoking area takes the whole war on tobacco too far. It's nothing to do with public health because if you smoke it’s a private health matter. It’s not a public health matter if you're smoking outdoors and I just think that politicians and anti-smoking campaigners need to get a grip. There are far more important things in life than banning people from smoking in the open-air.

On the nanny state

I am reluctant to use that term these days because it’s been overused. I personally would use the term bully state because I think we've gone beyond nannyism. Nannyism is quite benign. It's trying to help people make the right choices but the point is, in recent years, particularly with tobacco and smoking, we have had the bully state because it is no longer [about] nudging people to change their habits, it’s about forcing them to quit smoking and I think often that's quite counterproductive because I think a lot of people don't like being told how to behave and what you're seeing increasingly now is some smokers reaching for their fags in defiance because we are now down to, if you like, the core smokers which is about 15 to 16 per cent of the population, and I think it’s going to be very difficult - without bringing in very authoritarian practices - to actually push the smoking rates down into single figures because there are, as I said before, a considerable number of people who smoke because they enjoy it. They may admit that they're addicted to it [but] we've done research which shows that, of what we call confirmed smokers, over half will say, yes, I'm addicted to smoking but I don't care because the pleasure outweighs the thought that they are addicted, and I say we have to respect people who choose to consume a legal product. If you want to go down the line of banning the product, like alcohol in United States, well that’s a different matter, but as I say that won't work. You will simply drive it underground and people will continue to smoke.

On smoking on hospital grounds

I understand that hospitals don't want to be seen to encourage it, but the reality is that people get comfort from smoking and if you are in hospital, particularly if you are elderly, you have gone in to hospital for a completely non-smoking related reason, you might be having a hip replacement, for example, you might be in hospital for six, seven, eight weeks. If you're told you can't go out and have a smoke then I think that’s actually quite cruel. We've seen situations where hospitals ban smoking on hospital grounds and elderly people, people who might be attached to a drip, [are] wheeled off site perhaps a quarter of a mile away where they sit or stand on a busy main road with all these diesel buses and cars going past them. This is inhumane. So while I understand why hospitals don't want to be seen to encourage smoking I think it’s a question again of being pragmatic and actually, you know, showing a bit of humanity to people who are in a stressful situation.

We’ve even had examples where staff are being threatened with disciplinary action, (a) if they're caught smoking in their uniform even though they might be off the premises, or (b) if they had the temerity to help a patient who wants to smoke, if they have the temerity to help a patient off site so they can light up. Those people might have worked for the NHS for 20, 30 years looking after people, caring for people, and they have been threatened with disciplinary action and potentially the sack for doing that and I think that’s utterly outrageous.

On countries that are getting it right

I think Germany is quite a good example of a nation, possibly for historical reasons, that does not want to appear to be too oppressive in it's lifestyle regulations. In Germany of course they actually have smoking lounges in airports. They are well ventilated, they are not smoky because they've got the latest state of the art ventilation, and that seems to be a very good compromise. Also in Germany, not in every state but in some states, and in Berlin for example, you'll still find some bars where you're allowed to smoke and again that seems to me a reasonable compromise. We are not asking for people to be able to light up whenever or wherever they want. Those days are gone and we wouldn’t expect a return to that, but we don't see why you should not be allowed to have smoking rooms in bars if the owner decided that it was a good thing for his business. What you will actually find is that very few bars and restaurants would allow smoking but at least there will be some element of choice. At the moment I think Germany is quite a good example of a country that gets the balance right.

To read the full interview click here.

Saturday
Sep082018

Thoughts on smoking, vaping and middle-class snobbery

I was planning to publish the full transcript of my midweek interview on BBC Radio Guernsey.

Unusually however it was 24-minutes long and I don’t want to impose the whole thing on readers. Instead, here are some edited ‘highlights’:

On smoking being banned on government property

It would be excessive and also rather hypocritical because governments benefit massively from the taxation from tobacco. I mean the taxation that’s raised from tobacco far outweighs the cost of treating smoking related diseases for example. Now I understand the government, like hospitals, don't want to be seen to encourage people to smoke but I do think they have got to be a bit more pragmatic about this and stop treating smokers not just as second class citizens but really as third class citizens.

Tobacco is a perfectly legal product. It is not an illegal drug. People are allowed to buy it and as I say the state benefits massively in terms of finance. We've already got a ban on smoking in all enclosed public places and when that was brought in it was brought in, we were told, to protect the health of bar workers. There was no mention at the time that some years later the smoking ban was going to be extended to outdoor public places as well and if we talk about smoking outdoors there's absolutely no threat to the health of any non-smoker so there really is no justifiable reason to ban it, whether on government property or any other outdoor public place.

On tobacco being made illegal

I think there are two things here, one is pragmatic and one is to do with the pleasure of smoking. In purely pragmatic terms we know that prohibition doesn't work. We all know what happened in the United States in the Twenties and Thirties when they tried to ban alcohol. All that happens is you drive the product underground and the people who benefit financially are the criminal gangs, and exactly the same thing would happen with tobacco. You wouldn't stub it out. People would continue to smoke. I mean we see [what’s happening] where smoking is largely banned in prisons in England, for example, and what's happening is that prisoners are turning to illegal drugs such as spice, which I am told is cheaper than tobacco, [so] people will always get around prohibition and, quite often, you will move people on to products that are potentially even more dangerous, but what basically happens is that you lose control of the market. So you are never going to stub it out completely.

Also, there is a fundamental thing here which a lot of people think is almost taboo to talk about these days. Yes, there are people who wish to quit smoking, yes there are people who wish they had never started smoking, but there are still a considerable number of people who take great pleasure from smoking, they enjoy it. They know the health risks, they know that they are potentially putting their health at risk, particularly in the long term, but they get so much pleasure out of smoking that they are prepared to put that to one side and I think we have to respect people's choices and if people choose to smoke a legal product then I think they have every right to do that as long as they are considerate to those people around them, and I think you will find these days that smokers are increasingly considerate to people around them. They have to be because they know if they are not considerate to other people then we are going to get more and more people demanding a complete ban on smoking in public places.

On vaping in public places

What people have to understand is that there are two different types of vaping. A lot of people can what they call ‘stealth vape’. You wouldn’t even be aware of it. You might be very close to them but you would have no idea because they are gently puffing away on a vape pen or something, but the pictures we see in the media tend to show people vaping these huge clouds of vapour. Now that is not the norm. Very few vapers do that and if they do that it in public places with a lot of people around them, frankly they are idiots and they are causing vaping to be banned in public places.

In pure health terms there is absolutely no reason to ban vaping in public places whatsoever. In fact if you're in the public health lobby or in government you would be absolutely mad to support a ban on vaping in public places because clearly at the moment vaping has been quite successful, it has been quite popular in the last few years. Smokers are switching to vaping. At the moment in the UK as a whole about there about three million vapers, about half of those are what we call dual users. So they are both vaping and smoking and but half have given up smoking completely.

The evidence at the moment suggests that vaping is massively less harmful, potentially less harmful, than smoking. So if you are in public health or government you really want to encourage people to switch from smoking to vaping. There’s absolutely no need, I mean it’s just ludicrous, to ban vaping in public places. If anything government should be encouraging smokers to switch and to vape instead.

On why a non-smoker defends smokers’ rights

I had the odd cigarette when I was 16 or 17 but I grew up in the Seventies when a lot of my friends smoked. I never took up smoking but I feel very strongly about this not just because I think smokers are under so much attack. I think it's quite wrong and unfair. I think it’s completely right that government educates people about the potential risks of smoking The government clearly has a role to play but when it comes to forcing, coercing people to give up through a whole raft of means, whether it's a comprehensive smoking ban, whether it’s punitive taxation, I think that's absolutely wrong.

I do think governments these days want to interfere in people's lives in a way that they wouldn’t have dreamt of doing 30 or 40 years ago and it's not just about smoking. It’s now alcohol, it’s now food and all the rest of it and in a civilised society we can't infantilise adults the way we are doing at the moment. People have to be allowed to make informed choices and if they choose to smoke that is a matter for them, it's not a matter for government.

On middle class snobbery towards smokers

There is a lot of snobbery, I have to say, around smoking. We get it all the time from cigar smokers. We defend people’s right to smoke cigars, smoke pipes, smoke cigarettes, we defend people’s right to vape, if that’s what they want to do. It all comes down to choice, but there is a huge amount of snobbery around smoking and you often find that cigars smokers will distance themselves from cigarette smokers and say, ‘Oh, we are a cut above them’, but I [also] think there is a lot of middle class snobbery here.

We know that, generally speaking, cigarette smokers tend to come from the C and D socio-economic categories. The majority of middle-class people have given up smoking and it tends to be people from perhaps poorer backgrounds who continue smoking. They are the majority of smokers these days. I think there is a huge amount of middle class snobbery that looks down their noses at people who smoke and I think it is quite outrageous actually.

For the full transcript, click here.

Incidentally, I’m glad to see that Chris Snowdon and I agree on middle-class snobbery. Here he is, speaking in Cambridge this afternoon:

Friday
Sep072018

PHE chief declares war on smokers

Further to yesterday’s post, The Sun has the story (above).

Nobody in England should be smoking within 12 years, a health chief has said.

The boss of Public Health England wants a “smoke-free society” by the year 2030.

Chief executive Duncan Selbie last night called for all smokers to be given help to quit.

He told the NHS England Expo in Manchester: “Smoking should no longer be seen as a lifestyle choice. It is an addiction that warrants medical treatment.

“Everyone who smokes must be offered the support they need to quit.”

The report includes a quote from me:

Simon Clark, of smokers’ lobby group Forest, said: “It’s laughable to think England will be smoke-free within 12 years.

“Some people will always want to smoke.

“It’s their choice and if you’re an adult you have every right to do so.

“Some smokers would like to quit but many smoke because they enjoy it and no amount of state-sponsored bullying will force them to stop.”

To read the full report click on the image above or click here.

Btw, we need to keep reminding people of the economic fallacy of Selbie's argument – that 'helping' smokers quit will 'free up almost £900 million a year, cash the NHS spends treating illnesses caused by tobacco'.

Where the hell does he think a sizeable chunk of smokers' hard-earned cash goes after the government gets its hands on all that tobacco duty (£10 billion plus VAT per year)?

It goes – ta da – to the NHS. What is the government/NHS going to do when that source of revenue dries up? They'll tax something else – e-cigarettes, certainly.

It would also help if the tobacco control lobby could be consistent in its relentless propaganda.

For years we've been told the cost of treating 'smoking-related' illnesses on the NHS is £2.7 billion a year. (Before that it was £1.5 billion.)

According to Selbie the cost of treating 'illnesses caused by tobacco' (note the difference) is £900 million a year.

Either way these are just estimates and calculations – unlike the sums we know are raised by the Treasury through punitive taxation on tobacco.

Anyway, Selbie has made PHE's position clear. Smoking, he insists, is not a lifestyle choice. It's an addiction that requires medical treatment.

Vapers, take note. Eventually, at some point in the future, PHE will come for you too.

Update: Mail Online has the story too, with my quote – England should have NO smokers by 2030: Health chief calls for millions of smokers to quit within 12 years to save lives and cut NHS bills.

Thursday
Sep062018

Public Health England chief vows to get "ruthless" on smoking

What do Philip Morris and Public Health England have in common?

They're both targeting 2030 as the year England will be 'smoke free' (sic).

Their definition of 'smoke free' is a strange one because it actually corresponds to a smoking prevalence of five per cent.

As the IEA's Mark Littlewood said at an event hosted by Philip Morris earlier this year (and I paraphrase), no-one would say Britain is 'heroin free' yet the number of people who use that drug is far less than five per cent of the population.

Moreover, five per cent of an adult population of 40 million is two million, so PHE (and Philip Morris) intend to declare England 'smoke free' when there are still two million people smoking. Really?

Anyway, PHE's chief executive Duncan Selbie has once again been making noises.

According to one report published today, Selbie says the NHS long term plan, which is due to be published in November, must have a “really big” prevention ambition'.

The same report notes that:

In a statement released today, PHE said prioritising smoking cessation, cardiovascular disease and obesity in the long term plan will have a huge impact.

It said this could lead to reducing smoking prevalence to less than five per cent by 2030, and halving childhood obesity and the number of avoidable deaths from cardiovascular disease.

If you want to know what that means, Selbie has posted an article – 'Prevention and the NHS long term plan: 3 ways we can save more lives' – on PHE's Public Health Matters blog:

Smoking [he writes] remains England’s biggest killer and ends the life of 200 people every day. Our prevalence rates are at an all-time low at just under 15% but this belies huge variation, such as in affluent Epsom and Ewell, where rates are at 4.9%, but just 60 miles away on the south coast in Hastings the rate is more than five times greater at 25.7%. We also see big variation particularly in people in manual work and those who suffer with mental health problems. Our prisons are now largely smokefree but it can be harder to smoke outside a railway station or pub than it can outside a hospital, and this is not okay.

Smoking is the single biggest modifiable risk factor that impacts on infant mortality and morbidity, causing up to 2,200 premature births, 5,000 miscarriages & 300 perinatal deaths per year. Almost 11% of women in England are still recorded as smoking at the time of delivery, which translates into over 65,000 infants born to smoking mothers each year. We need to take action and support women to increase the number having a smoke free pregnancy, including implementing the actions set out in the Government Tobacco Control Plan in respect of pregnant women and of the Maternity Transformation Programme.

Our ambition to remove smoking from England will only be achieved by the concerted efforts of everyone, but it can be done, and the NHS could be a more powerful driving force by actively nudging patients and its own staff onto cessation programmes, treating smoking addiction as a medical condition and taking an absolutely zero tolerant approach to smoking on the NHS estate.

All of this and more will play out through the long term plan and this time we must be more literal about the priority that we are giving to prevention. We need less rhetoric and more action. We need to be ruthless in our priority setting and ruthless in our implementation.

Interestingly, and despite PHE's declared support for e-cigarettes as a smoking cessation tool, vaping doesn't get a single mention.

Selbie's contempt for smokers is all too obvious however.

Of course, if he achieves his ambition to make England 'smoke free' by 2030 (he won't), expect to see a new NHS plan featuring a "zero tolerant approach to vaping on the NHS estate" allied to the "need to be ruthless in our priority setting and ruthless in our implementation" of anti-vaping policies.

We probably won't have to wait that long because I predict that public health campaigners – even those that are currently advocating e-cigarettes as a smoking cessation tool – will turn on vaping the moment there are more vapers than smokers.

I'd bet my house on it, if my wife would let me. (She won't.)

Update: Here is Forest's response to PHE's statement:

Prioritising smoking cessation is an "attack on choice and personal responsibility"