The commentary claims to show the “invalidity” of the statements made by Public Health England (PHE) and the Royal College of Physicians (RCP) regarding the relative risk of vaping and smoking – in short that vaping is likely to be at least 95% lower risk than smoking. As this is an important harm-reduction risk communication, it is worth asking: how valid is this critique?
I thought this might be a better critique than it actually is. But somewhat to my surprise, it is very poor indeed.
At best, the authors try to show the absolute risk of vaping is not zero and that some harm is plausible. In doing so, they are refuting a claim that neither PHE or RCP make and challenging an argument not used by anyone sensible in tobacco harm reduction. However, not a single word of their paper addresses the supposed foundation of their critique – that PHE/RCP are wrong and the risks of vaping are likely to exceed five per cent of those of smoking. As well as a number of baseless assertions that are not even relevant to the “at least 95 per cent lower” relative risk claim (gateway effects, smoking cessation efficacy and second-hand aerosol exposure), there is just nothing in the paper about the relativemagnitude of smoking and vaping risks. No analysis, no data, no evidence – nothing that discusses relative risk and why PHE/RCP are supposedly wrong. Niente. Nada. Rien. Nichts. Nothing.
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
Update 24 September: Cancer Research UK says its hasn’t “been prevented from doing anything by the ASA that we are aware of, so don’t know why this story appeared” and PHE ads were still running on TV last night. So please treat the posting below as an analysis of the legal situation.
The ASA said yesterday: “Our rules prohibits ads for unlicensed, nicotine-containing e-cigarettes, in line with European law which took effect in 2016. Ads for products and brands are prohibited and have not been seen or heard on TV or radio since last year.”
I have not seen the Cancer Research ads, but the TV advert from Public Health England (screen shot above) clearly mentions e-cigarettes so would be caught by the ASA’s reasoning.
The embrace of vaping and other low-risk alternatives to smoking runs through the text. This is probably the first significant government policy paper anywhere that recognises and pursues the opportunities of tobacco harm reduction, rather than defining these technologies as a threat to be suppressed. For that, the Department of Health and its allies deserve considerable credit. Continue reading “English tobacco control plan embraces tobacco harm reduction – world first”
It’s hard to keep up with the public health madness in Europe. Not content with creating the worst EU Directive ever made, laden with unintended consequences, many member states are now working hard on compounding their error by gold-plating the directive’s wholly unjustified costs, burdens and limitations on e-cigarettes and smokeless tobacco with additional measures that go beyond the minimum.
Professor Gerry Stimson and I have made a small effort of resistance – here are two submissions to the Austrian consultation on TPD implementation. Austria proposes to ban internet sales of e-cigarettes and to ban all forms of smokeless tobacco, not just snus. We have tried to place these in the wider context of harm reduction and unintended consequences of poor policy-making. Continue reading “TPD implementation – maximising harm by going beyond the minimum”