The Netherlands is proposing to ban e-cigarette flavours – what could possibly go wrong?
The government of the Netherlands, led by Paul Blokhuis, State Secretary for Health, Welfare and Sport, is in imminent danger of fooling itself into becoming an unwitting ally of the cigarette trade. By taking measures to make vaping less attractive (notably by proposing a ban on all non-tobacco flavours for e-cigarettes), it threatens to degrade the appeal of a low-risk rival to cigarettes, provide regulatory protection to the cigarette trade, prolong smoking, obstruct quitting, and add to the burden of disease and death. All this in the name of protecting youth, while managing to harm both adults and adolescents. Quite a feat for any politician.
The problem is hubris – believing that the world responds to regulation in the way the regulator thinks it should. Experience suggests foreseeable perverse consequences will be the result of the ill-conceived prohibitions of much safer alternatives to smoking, including flavoured e-cigarettes.
It really isn’t difficult to understand why and how this would happen – I can only assume the State Secretary received very poor advice, which would not be unusual in this field. Nevertheless, twenty-four international experts have set out the arguments and evidence in detail in a submission to the Dutch government, hoping to spare Mr Blokhuis later embarrassment and, even more importantly, to avoid yet more death and disease from smoking in the Netherlands. It should also be a wake-up call to like-minded politicians and naive policymakers in the United States, European Union, and the World Health Organisation who continue to fail to grasp the impact of low-risk products in the real world.
The case is set out in 30-page submission to a Dutch government consultation on the measure. The relevant documents are:
The preliminary scientific opinion is open for consultation responses until 26 October 2020. The consultation system is here: Public consultation on electronic cigarettes and looks designed to deter responses to the extent possible. ETHRA, European Tobacco Harm Reduction Advocates, provides guidance on responding here. However, that is not the only way to respond to it, though responding directly is important. Another way is to approach the people who are intended to make sense of and use the opinion – policymakers in EU member states and European Commission, politicians in the EU legislature, and stakeholders in the political policymaking process. This post is for them.
In this post, I discuss why the SCHEER preliminary opinion offers no useful analysis or relevant insights to policymakers. It is not that the committee has not reviewed a lot of literature: it has. It stems from a more fundamental problem: a failure to frame the scientific knowledge in a way that will assist policymakers in considering what, if anything, to do next. Though policymakers should be the primary audience, the report also provides little of value to other communities of interest – smokers, vapers, parents, public health or medical practitioners, or businesses.
I did a Twitter chat with the Campaign for Safer Alternatives on the typical objections raised to tobacco harm reduction. For those interested in the responses but who missed the live chat or got as confused as I did in trying to follow threaded answers, here is the chat as it unfolded over 15 questions with everything in the right order.
I’m visiting Australia next week and looking forward to some good discussions with people holding any and all points of view on vaping, nicotine and smoking. My aim is to share experience from the US and UK where we are seeing encouraging uptake of low-risk vaping alongside an unusually rapid decline in smoking. Historically, UK has always had substantially higher levels of smoking than Australia, but in 2016 that gap has finally closed. Both countries have comprehensive tobacco policies – albeit with some differences in the details and Australia generally the first to do new measures, like plain packaging. But there is one major difference. UK (and especially England) now encourages smokers to switch to low-risk alternatives like vaping, while Australia actively prevents it and actually criminalises people who try to protect their own health in this way.
Five talking points inspired by the Royal College of Physicians
On 17 November 2016, the Iowa Attorney General, Tom Miller, gave a speech at the E-cigarette Summit 2016 (with biography) on e-cigarettes examining the claims of anti-vaping activists, and their scientific, ethical and legal basis. The full text of the speech is here: America Needs England (PDF). I reported an earlier speech here.
The speech should be widely read, especially in the United States. To facilitate an informed reading, I have reproduced the speech here, with some thematic subheadings, source links and illustrations [these are my additions].
Regrettably, the influence of Professor Stanton Glantz of the University of California at San Fransisco is not confined to California or to the United States. Last month he made a visit to Europe – to Austria in fact. As good Europeans, we always take our American visitors seriously and listen to what they have to say. So I have done a review of the presentation he gave at the Austrian Acadamy of Sciences in Vienna.
Some quick notes on the NatCen report: Survey of Smoking, Drinking and Drug Use among Young People in England – see Summary and Full report PDF.
NatCen is contracted by the official statistician to conduct this survey, which provides data for 2014 for England on substance-using behaviours of 11-15-year-olds. It’s is possible that alarmist conclusions will be spun from a lazy reading of some findings on e-cigarette use. In fact, the survey provides a reassuring picture of young people’s smoking and vaping habits. Continue reading “Smoking and vaping among young people in England – reassuring new report”