Saturday
Jul292017

Nicotine wars

Yesterday's announcement by the US Food and Drug Administration that it aims to lower nicotine levels in combustible cigarettes took many people by surprise, myself included.

I got the news from a friend in Dublin who was watching Bloomberg News. Thirty minutes later the story began to trickle in from other sources.

As it happens it was a big story in the States but there has been relatively little coverage over here. (Reports in the UK have focussed mostly on the "plummeting" fall in the price of tobacco shares, although that had rallied a bit by the close of play.)

The lack of interest was due partly to the time difference - the FDA announcement broke late afternoon in the UK - but the significance of the story may have been lost on Britain's news editors.

The first thing to note is that the announcement marks a major shift in US policy.

In particular, and more significant perhaps than the headline grabbing nicotine story, the FDA also declared that it would delay implementation of deeming regulations on e-cigarettes by four years.

If I understand it correctly, products that may have been taken off the market in 2018 now have a stay of execution. Likewise smaller e-cigarette companies that may have struggled to bring new products to market because of the proposed regulations, and the red tape involved, can breathe a little easier.

Vaping advocates are overjoyed, naturally, but I would issue a word of caution. I've long argued that the public health endgame is not a world that is smoke free but one that is nicotine free as well, and far from challenging that view the FDA announcement would appear to confirm it.

By announcing that it aims to reduce nicotine in cigarettes to "non-addictive" levels, the FDA has effectively declared war on the drug (if it hadn't before).

The justification is of course that while nicotine itself may be relatively harmless it hooks people to a product that is potentially bad for them.

Nevertheless the underlying message - the one that will be picked up by the media and the general public - is that nicotine itself is the enemy.

Furthermore, and despite the apparently favourable outcome for vapers, the FDA announcement is probably no more than a stay of execution.

Like it or not the long-term aim of the FDA, the World Health Organisation and every other public health body is to eradicate any form of nicotine addiction.

To achieve that goal the first stage is to lower the nicotine levels in all products that contain the drug.

It's a process that has already started. The EU's Tobacco Products Directive includes strict regulations on the nicotine strength of e-liquids and there's only one direction that's going to go.

The good news for confirmed smokers is that combustible cigarettes, in one form or another, are going to be around for a long time to come.

Unlike the manufacture of petrol or diesel cars, for example, prohibition is not an option because the authorities know full well what would happen.

Criminal gangs - bootleggers - would step in to meet demand and the government would lose control of the market and the huge amounts of revenue cigarettes generate.

As for lower nicotine cigarettes, I would fight attempts to make them compulsory for the same reason I would oppose excessive restrictions on the strength of alcohol in wine or beer or restrictions on the strength of caffeine in coffee.

The issue, as I keep saying, is one of choice. Offer consumers a range of products, including lower nicotine and nicotine-free cigarettes (and e-cigarettes), and let the market decide.

Driven by health considerations I suspect many consumers will opt, ultimately, for lower strength nicotine but that's speculation on my part.

What I do know, based on research, is that nicotine is not the only reason people smoke, hence Forest's response to yesterday's announcement:

"The FDA assumes wrongly that people only smoke for the nicotine. There are numerous reasons people start smoking or continue to smoke and nicotine is only one of them.

"If smoking was just about the nicotine hit the overwhelming majority of smokers would have switched to safer alternatives such as electronic cigarettes.

"What many people like most about smoking is the ritual and the taste and smell of tobacco. Lowering nicotine levels won't change that."

We also pointed out that according to a survey of over 600 "confirmed smokers" by the Centre for Substance Use Research in Glasgow nearly all respondents (95%) gave pleasure as their primary reason for smoking:

Well over half (62%) liked the physical effect of nicotine, 55% liked the way smoking provided “time for oneself”, 52% liked the taste or smell of tobacco, and 49% liked the ritual involved in smoking.

Although a majority (56%) felt that they were addicted to smoking, many described the habit as a personal choice rather than behaviour determined by their dependence on nicotine.

See Forest's response to FDA announcement on lowering nicotine levels in combustible cigarettes.

Last night I also posted this on the Friends of Forest Facebook page:

"Question to smokers: would a reduction in nicotine levels encourage you to quit?"

Of those who commented not one said they would stop smoking.

Ironically, the biggest losers following the FDA's announcement could be the pharmaceutical industry.

After all, the biggest threats to Big Pharma's smoking cessation market are e-cigarettes and heated tobacco.

Given time to develop and mature, the market for non-pharma harm reduction products is potentially huge, 36.5 million people in the USA alone.

Far from being a death knell for the tobacco industry, yesterday's announcement by the FDA gave the companies what they need - time.

As for consumers - smokers and vapers - the jury, I think, is out.

If a product is legal consumers have a right to be tolerated and their choices treated with respect.

Neither the FDA nor a myriad of other public health bodies seem willing to acknowledge a very simple fact.

Millions of people worldwide smoke and vape not because they are hopelessly addicted to nicotine but because they enjoy it.

The war on nicotine is a war on ordinary people, legitimate consumers of a legal drug.

Yes, there are different degrees of risk between combustible cigarettes, electronic cigarettes, heated tobacco and other nicotine products, but adults have a right to choose.

Educate and inform but discrimination and denormalisation must end. Freedom of choice, that's the battle ahead, for vapers as much as smokers.

Thursday
Jul272017

Quote of the week: "Let's have a coffee soon."

I hadn't intended to write about this but it made me laugh so I thought I'd share it with you.

Last week a group called the Corporate Europe Observatory (CEO) posted an article about the launch of "two curious new groups", Forest EU and the Consumer Choice Center.

The back-to-back appearance of campaigns with similar objectives (to promote freedom of choice and defend the interests of consumers) appears to have piqued the interest of a group whose declared purpose is "exposing the power of corporate lobbying in the EU".

'Transparency' is a key issue for CEO, as it is for Forest. The delicious irony is that while Forest EU could not be more open, the same does not appear to be true of CEO.

Margarida Silva, CEO's representative at our launch party on May 31, even chose to disguise her presence by omitting to say who she worked for when she registered. She also used her personal rather than her professional email address.

Forest events are of course open to everyone - we have nothing to hide - so even had we known who she worked for and the nature of her investigation she would still have been very welcome.

Contrast that with the Brussels-based Smokefree Partnership, a coalition of anti-smoking groups (including ASH) that has already barred Forest EU director Guillaume Perigois from attending two of its events.

Needless to say CEO has no interest in the rather more opaque world of tobacco control which says more about them than they could ever say about us.

Meanwhile, responding to an email from Silva that contained no fewer than six questions about Forest EU, our man Perigois not only gave detailed answers, he was also the perfect gentleman:

Thanks for your email. Hope you enjoyed our Forest EU launch event on May 31st – I remember our nice chat there.

Please come to our next event on July 11th. And let’s have a coffee soon, too.

I expect hell will freeze over before our adversaries make a similar offer to Forest.

In the meantime, instead of relying on the execrable Tobacco Tactics website as a source of information, the laughly self-important Corporate Europe Observatory would do better to investigate the influence of Big Pharma on tobacco control in Brussels and beyond.

Now that's a report I would read.

PS. When the CEO article appeared last week someone posted a link on Facebook with the comment, "It's not flattering."

Oh, I don't know. The time to worry is when opponents, the media and self-appointed vigilantes ignore you.

See also: The incognito transparency activist (Forest EU blog).

Monday
Jul242017

Taken for a park and ride

A week ago the Telegraph reported that NHS staff faced losing their homes after a court ordered them to pay thousands in parking fines racked up at a Cardiff hospital:

A judge has ruled that the employees, including nurses, doctors and admin staff, must pay the charges dating back to April 2016 after losing a legal fight with Indigo, the private operator that manages the car park at the University Hospital of Wales.

One nurse reportedly owes £150,000 after the court ruled that £128 must be paid for each unpaid ticket, plus £26,000 in court fees.

You need to read the full report to get both sides of the story because it's easy – but incorrect, I think – to cast Indigo as the baddies.

Nevertheless last week's report coincided with my own stand off with the company. It's insignificant by comparison but bear with me while I get it off my chest.

Back in May I had to go away on business for a few days so I left my car in the car park at my local train station.

The car park is managed by Indigo but parking tickets can be purchased at the station ticket office.

I asked for a ticket to cover the period I was going to be away – Monday May 8 to Thursday May 11 inclusive.

The ticket office gave me two tickets, one for May 8 (half-day, £3.30), the other to cover a further three full days (£17.40).

I assumed the second ticket was for the period 9-11 May but the ticket office had made an error. Ticket number two began on May 8 and finished on May 10.

The two tickets therefore overlapped instead of covering the four consecutive days I had asked for.

I've been using that car park for almost 20 years and I've never had a problem before so it never crossed my mind to check.

Consequently when I returned on Thursday I found a penalty charge notice on my windscreen with a demand for £60 if paid within 14 days or more if I didn't.

So I appealed, explained what had happened, and sent photographs of my two tickets as evidence.

A month later I received an email from Indigo rejecting my appeal even though I had paid the full and correct fee for the time I was parked.

To add insult to injury the company's response to my appeal referred to my "motorcycle" and claimed I had parked within a "20-minute" bay. I don't have a motorcycle and my car was parked in a normal bay.

The email further informed me that "you have now reached the end of our internal appeals procedure" but added, "Should you remain dissatisfied with this decision, you may further your appeal to the Parking On Private Land Appeal service (POPLA)."

This I have done (albeit I may have missed the deadline by 48 hours) but I have no expectation of winning because no-one ever does, do they?

I know this is a trivial matter of no interest to anyone apart from me but what a shit world we live in where an honest mistake that has not hurt, inconvenienced or cost anyone anything (apart from the admin involved in rejecting my appeal) has led to a fine that is now in excess of £100 and could go higher if I choose to fight it further.

Grrr.

Wednesday
Jul192017

Media coverage of the Tobacco Control Plan announcement

Quick update on the media coverage of the Government's new Tobacco Control Plan.

Yesterday's announcement was reported widely online but coverage was substantially more muted in today's print editions.

Forest was quoted online by, among others, BBC News, The Times, Guardian, Daily Telegraph, Daily Mail, The Sun, Daily Mirror, Daily Star and City AM.

These reports were dominated, inevitably, by quotes from public health minister Steve Brine (more on him in a later post), ASH, Public Health England and the British Medical Association.

In general tobacco control welcomed the plan, with the proviso that to implement it there will have to be a substantial investment of public money.

The only critical voice was (of course) Forest. (Given the impact on individual liberty and the potential cost to the taxpayer of driving down smoking rates it's amazing how almost every liberal or free market pressure group goes missing at moments like this.)

The Forest soundbites most often quoted were:

"In the 21st century tobacco control policies should focus on harm reduction products, not prohibition and other restrictive practises."

"The most important stakeholder is the consumer, yet they are routinely ignored by Government. Ministers should stop lecturing smokers and engage with them."

"The Tobacco Control Plan should include a systematic review of the impact of measures such as the display ban and plain packaging. It's time too to question the use of public money to fund stop-smoking services and other anti-smoking campaigns."

You can read our full response here.

We didn't do any broadcast interviews yesterday. I did LBC and BBC Radio Oxford this morning but it's been pretty quiet on that front.

When I get a moment I might post something along the lines of, 'What does the Tobacco Control Plan mean for smokers and vapers?'

PS. Tomorrow I shall be on a local BBC radio station talking about vaping in the workplace. Stay tuned!

Tuesday
Jul182017

Government targets further reduction in smoking rates

The Government has published its new Tobacco Control Plan.

The plan, announced in a fairly low key manner this morning, is notable for its lack of detail.

No mention, for example, of a tobacco levy or retailer licensing or bans on smoking in outdoor areas or private vehicles sans children.

It does however set targets including a further reduction in smoking rates, from 15.5 per cent down to 12 per cent by 2022.

Targets make me nervous, hence our response:

Simon Clark, director of the smoker's group Forest, said:

"Setting targets encourages punitive measures. The best tobacco control plan puts education and choice ahead of prohibition and coercion."

Commenting on the commitment to extend smoking bans to all hospitals, mental health facilities and prisons, he added:

"In the 21st century tobacco control policies should focus on harm reduction products, not prohibition and other restrictive practises.

"Since the last Tobacco Control Plan was introduced in 2011 almost three million smokers have started vaping, with 1.5 million giving up smoking in favour of e-cigarettes.

"E-cigarettes and other harm reduction products are a game-changer because they offer consumers a pleasurable yet safer alternative to smoking.

"If however adults choose to smoke that is their right and it must be respected. Denormalising or punishing smokers is unacceptable."

Calling on ministers to "stop lecturing" consumers, Clark said:

"The most important stakeholder is the consumer yet they are routinely ignored by government. Ministers should stop lecturing smokers and engage with them."

Calling for a "systematic review" of existing tobacco control policies, including the use of taxpayers' money to fund smoking cessation services, Clark said:

"The Tobacco Control Plan should include a systematic review of the impact of measures such as the display ban and plain packaging.

"It's time too to question the use of public money to fund stop smoking services and other anti-smoking campaigns.

"The government must also grasp the opportunity provided by Brexit to abandon some of the policies included in the EU's Tobacco Products Directive.

"Some measures, including restrictions on the sale and promotion of e-cigarettes, are not only an attack on consumer choice, they are undoubtedly counter-productive."

I'll link to the DH announcement when its online. I'll also post reaction from the likes of ASH and Cancer Research.

Update: Instead of a press release, here's the policy paper, Towards a smoke-free generation: tobacco control plan for England.

Update: Here is ASH's response – ASH Welcomes New Tobacco Control Plan for England: Funding needed for it to succeed.

A direct quote from Deborah Arnott read:

"ASH congratulates Steve Brine for showing his commitment to tobacco control by getting the new Plan published only weeks after taking over as Public Health Minister. The vision of a “smokefree generation” it sets out is a welcome step change in ambition from the last Tobacco Control Plan for England and should be achievable by 2030."

As you would expect there's also some special pleading for money:

"Funding must be found if the Government is to achieve its vision of a “smokefree generation”. The tobacco industry should be made to pay a through a licence fee on the ‘polluter pays’ principle. Tobacco manufacturers are some of the most profitable companies on earth they can easily afford the costs of radical action to drive down smoking rates."

As we all know the tobacco companies wouldn't pay, they would simply pass the cost of a levy (or 'licence fee') on to the consumer, many of whom are already impoverished by punitive taxation on tobacco.

Talk about regressive. And shameless.

Monday
Jul172017

Stubbed out: Scotland's answer to everything

Top story on BBC Scotland today?

The Scottish Prison Service (SPS) has said it intends to make Scotland's prisons smoke free by next year.

The date was announced at the launch of a major report into prison workers' exposure to second-hand smoke.

It showed high levels of second-hand smoke in parts of some prisons.

See Target date in 2018 for smoke-free Scottish prisons (BBC News)

There's a significant difference between "high levels of second-hand smoke" and illness and disease but that seems to have been overlooked.

Instead the mere presence of "second-hand smoke" is cited as enough to justify a comprehensive smoking ban, indoors and out.

Forest's response read:

"The risks of secondhand smoke have been greatly exaggerated. Allowing inmates to smoke in their cells poses no significant risk to prison officers.

"On the other hand, banning smoking in prisons risks inflaming a tense and sometimes violent environment.

"Tobacco is an important currency in prison. The removal of one of the few privileges inmates are allowed could also fuel the use of illicit substances."

In addition to BBC News we were quoted by the Daily Mail, Scotsman, Scottish Sun, Herald, Evening Times and iNews. Late afternoon I also did interviews for Reporting Scotland (BBC1) and Newsdrive (BBC Radio Scotland).

Needless to say we seemed to fighting a lone battle until I noticed this quote by Peter Dawson, director of the Prison Reform Trust, in the Evening Times:

"A sensible and considered approach to smoking in prisons would leave prisoners with a choice - at least to smoke outside."

He called for "proper support" while people give up, "not just smoking cessation aids, but increased vigilance for signs of distress that could easily turn into self harm or worse".

He added: "Prisons also need to ensure that tobacco does not become another illicit substance which is traded in prisons, leaving prisoners at increased risk of getting into debt and subject to violence and intimidation. The prison service will need the time and space to manage a difficult operational transition."

By coincidence the Daily Mail today reported that:

Prisoners have already started rioting ahead of a total smoking ban across many UK jails, it was revealed today.

Tobacco will gradually be outlawed in English jails from August 31 - but inmates have revealed that some started trouble as soon as the ban was announced.

See Prisoners are RIOTING over a Government ban on smoking in jails being rolled out across the country (Daily Mail).

This follows a report in May that warned, A smoking ban in UK prisons could lead to months or even years of rioting (Metro).

For an insider view however I recommend this article by former inmate Alex Cavendish:

Prison smoking ban will worsen the crisis behind bars (Politics.co.uk).

Essential reading.

PS. Holyrood, 'Scotland's award-winning current affairs magazine', chose not to include a single comment by anyone opposed to the ban.

Fancy that!

Update: The Daily Record also has the story - Inmates furious as bosses reveal date for smoke-free Scots prisons.

Monday
Jul172017

Paul Bartlett's "caring obsession" with smoking

Some of you may recall Paul Bartlett.

Paul is the former councillor who in 2011 attempted to ban smoking in the centre of a small Buckinghamshire town called Sony Stratford.

A protest was organised and over 100 people took part. See Follow your head (and your heart) to Stony Stratford and The day the people spoke.

Rod Liddle interviewed Bartlett for the Sunday Times and their exchange included this little nugget:

Liddle: "Do you realise there's not a single person in Stony Stratford who's in favour of your plan? We've trawled the streets. We've walked up and down. We haven't found a single person who doesn't think that it's a fatuous idea.

Bartlett: "Well, that's not the feedback that I'm getting. Obviously there are people who are very passionate about it and want to continue contaminating the environment and killing themselves through cancer ...

Liddle: "That's none of your business, is it, whether they kill themselves, really?"

Bartlett: "It is because I'm a councillor and I care about my local people."

A few days later Bartlett's motions to ban smoking were rejected by his fellow councillors (see Stony Stratford - spread the word) and his "local people" later voted him off the council altogether.

Apart from a comment on Forest's old website in 2012 (Why is Forest supporting death and illness, asks Paul Bartlett) I'd heard no more of him until today when I found myself going head-to-head with him on BBC Three Counties radio.

The item was promoted by plans to introduce a voluntary ban on smoking in all Hertsmere Borough Council parks.

Bartlett is not involved in the initiative but he supports it, as you can imagine.

I took two things out of our discussion (which began politely enough!).

One, he admitted he had a "caring obsession" about smoking.

Two, he also stated, "I am not going to propose ever again what I proposed in Stony Stratford. I realised that was the wrong approach ..."

Unfortunately it takes just one person with an obsession to light a fire. Bartlett may not have succeeded in Stony Stratford but tobacco control campaigners have learned from it, hence the focus on play areas (not high streets) and, now, parks.

Click here to listen to the 23-minute discussion in full.

Finally, here's another exchange from the Rod Liddle interview in 2011:

Bartlett: "If you're walking in the street in Stony Stratford or anywhere else you have to walk through someone's smoke. You have to walk through their spit which they leave on the pavement through their cigarette butt, you need to get your clothes burnt and if you have a young child there's every chance that that child could get burnt and that's very, very important."

Liddle: "How many people in the last five years have been burnt in Stony Stratford as a consequence of walking past someone with a cigarette?"

Bartlett: "Well, I don't know the figure but I certainly know that ..."

Liddle: "None, probably, isn't it?"

Bartlett's obsession with people being burnt by cigarettes cropped up again this morning.

According to the former councillor people smoking in parks is putting not only kids at risk but also clothes and tables.

Part of me wishes there were more people like Paul Bartlett because his extreme reaction to smoking, his "caring obsession", is the antithesis of most people's attitude to smoking.

Unfortunately tobacco control is driven not by mavericks like Bartlett but by professional campaigners who have the same goal and the cynical, battle-hardened nous to achieve it.

Sunday
Jul162017

Heathen sent

"Hell comes in many forms," I wrote yesterday, "and playing cricket is one of them."

Dick Puddlecote, an avid cricket fan, was unimpressed. "Heathen!" he commented.

In fairness, I played for my school second XI but we were so bad (all out for 14 on one occasion) that it rather put me off. At least it guaranteed I got to bat, however low I was in the batting order.

As for fielding, even now I can recall the fear of standing on the boundary hoping the ball wouldn't be hit in my direction. The idea of having to catch something that was rock hard and arriving like a meteor from space was the stuff of nightmares. It still is.

The only time I ever caught someone out was when I was standing at extra cover, the batsman mistimed his stroke and the ball lobbed gently towards me.

It took a while to reach me (I didn't even have to move) and during those precious seconds I did what I always did. I extended my arms, raised my hands to cover my face, and shut my eyes.

Surprisingly, rather than bouncing off my hands as it did normally, it stuck. Having caught the ball however I ended up flat on my back with my teammates wondering why I had made a meal of such a simple catch.

It didn't help that I went to school in St Andrews and most of the schools in Fife played cricket on the same fields that were used for rugby during the winter.

One outfield was so bumpy it was impossible to field the ball because it arrived like a Barnes Wallis bouncing bomb. There was no knowing how high (or low) it might deviate off the grass so the best you could do was put your body in the way and hope it didn't catch you in the mouth.

After a while, as both the bruises and the defeats accumulated, "taking one for the team" became less and less attractive.

I can't remember ever making double figures as a batsman so I reinvented myself as a bowler - a slow bowler, not a spin bowler.

Ironically the absence of any sort of threat (physical or mental) meant I picked up quite a few wickets because at that age most schoolboy batsmen haven't the sense to keep the ball down.

My bowling was easy to hit but it encouraged batsmen to take liberties (no pun intended) that led them to get out.

It was the fielding however that bored (or terrified) the hell out of me and encouraged me to quit.

As an adult I played one game for my village team. It wasn't a success and I retired thereafter to the other side of the boundary rope where there was a welcoming bar.

Watching cricket is a completely different matter but even there my interest waned eventually.

As a teenager in the early Seventies I'd watch Test cricket on television for hours. Randall and Boycott were my favourite players. They were complete opposites but I loved them both.

Nip out to make a cup of tea and Randall would most likely have got himself out (or taken a miraculous catch) while you were in the kitchen.

No chance of that happening with Boycott. He'd still be there, grinding out the runs.

I loved watching Boycott bat on TV because you could do other things at the same time, and I just wanted England to win. I didn't care how they won.

In the flesh however it was a different matter.

The first Test match I went to was England v. West Indies, Trent Bridge, 1977. Boycott was batting and for several hours nothing much happened apart from the regular loss of wickets at the other end.

Bear in mind too that in those days there were no replays on a big screen. If you weren't paying attention - because you'd been lulled to sleep or were reading your newspaper - all you saw was the batsman retreating to the main pavilion, dragging his bat behind him.

Anyway the tedium was only lifted when the West Indies - and Viv Richards in particular - came into bat.

Suddenly everyone sat up. We put our books and newspapers away and paid full attention. This was more like it. Richards could actually hit the ball!

The same was true of Ian Botham. In the era of Twenty20 it's hard to imagine the impact the likes of Richards and Botham had on cricket but they made batting gloriously entertaining.

To win Test matches you do of course need the likes of Boycott, Michael Atherton and Alastair Cook and that's why Test cricket remains the best and most cerebral form of cricket.

Twenty20 is the equivalent of going straight to dessert - no appetiser, no main course. It's a sugar rush that gets boring very quickly.

It's one of the reasons I've lost interest in cricket. That, and the fact that I am hopeless at the game and couldn't score more than a measly run for my local village team.

My son, in contrast, did show some promise as a cricketer and was selected to play for Huntingdonshire at several age levels.

Unfortunately that put me off cricket too because parental nerves got the better of me. I was rarely nervous watching him play football or rugby. Cricket was a different matter.

They say it's a team game but it's not really. It's mostly about the individual because as a cricketer you're judged on your stats - bowling, batting, fielding.

The worst moments were waiting for him to go into bat for his county, especially if he was on a poor run of form.

You could wait hours and it would feel like days. On one or two occasions I would leave the ground in the hope that it might bring him better luck (and I would be saved the agony of watching every ball).

I'd return a couple of hours later only to find he still hadn't been in to bat.

One summer he couldn't put a foot wrong and scored runs left, right and centre for his club and district.

I arrived late one afternoon when he was playing for his district side to be told by an admiring parent that he was three runs short of his maiden century.

Naturally he was out next ball.

Cricket? You can keep it.

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