Category: Public health

Independent review of tobacco policy in England misses the point

England aims to reduce smoking to less than 5% by 2030, but this will need mass switching to smoke-free products as a consumer alternative to smoking, and it must be achieved by consent rather than coercion

Meeting the 2030 smoke-free target (5%) requires an accelerated decline
[Source: ONS, Adult Smoking Habits in England]
Note: a linear trend continuing from 2010-2020 should not be assumed as a given or ‘business-as-usual’ in the absence of further measures

The government has established a ‘smoke-free’ goal to reach 5% adult smoking prevalence in England by 2030. This represents a significant acceleration in progress (see chart above with linear trends). As a prelude to announcing a plan to achieve the goal, Ministers appointed Javed Khan OBE to head an independent review of tobacco policy to make recommendations for measures to meet the target and contribute to reducing health inequalities.

Here is what Dr Khan has come up with:

These are recommendations to the government, not government policy. We have yet to see what the government will actually do and when it will get around to doing it.

In this blog, I set out an overview critique of the Khan programme and then look at each of the fifteen recommendations in more detail. Finally, a few words on what should be done.

Continue reading “Independent review of tobacco policy in England misses the point”

Fake news alert: WHO updates its post-truth fact sheet on e-cigarettes

The World Health Organisation continues to present misleading information about e-cigarettes that spreads doubt and confusion among the public, media and policymakers. This post reviews its latest Q & A and finds multiple errors of analysis, misleading statements, and obvious biases.

The World Health Organisation provides information on e-cigarettes that contains false and misleading statements while overstating risks and ignoring opportunities.

The World Health Organisation maintains a Q & A on e-cigarettes. It was updated on 25 May 2022.

This has been updated several times (see history below). In each of its incarnations, this web page has presented a profoundly misleading account of the risks and benefits of e-cigarettes. It ignores the fact that eight million people are dying annually from smoking (around the same order as COVID-19) and that hundreds of millions of smokers could benefit from switching to low-risk alternatives to smoking. The Q & A is primarily a vehicle for promoting prohibition and generating hostility to the pragmatic public health strategy of tobacco harm reduction. It is anti-scientific, its information is misleading, and its effect or purpose is to sow confusion and doubt rather than to candidly explain e-cigarettes.

I have set out the main sections of the latest Q & A below with a short general commentary on each section followed by the main claims in each section drawn out in block quotes followed by comments.

Continue reading “Fake news alert: WHO updates its post-truth fact sheet on e-cigarettes”

Will Brazil rethink its vaping prohibition?

“O Brasil vai repensar sua proibição de vaping?” Brazil is consulting on lifting its ban on vaping products. Will it recognise the perverse consequences of prohibition and shift to risk-proportionate regulation? We argue it should rethink its approach to nicotine.

Prohibition is about the worst regulatory response to safer alternatives to smoking

Brazil’s public health agency, ANVISA, has been consulting on whether the long-standing policy of prohibition of vaping products should be retained or lifted. The consultation questionnaire seeks comments on a technical document.

Shortcut to full response (PDF).

Here’s my take…

Continue reading “Will Brazil rethink its vaping prohibition?”

Health Canada heading in the wrong direction on tobacco and nicotine policy

Health Canada’s review of its tobacco and vaping legislation focuses only on reducing youth vaping. It shows no awareness of the links between smoking and vaping, between adults and adolescents, and the case for harm reduction at all ages

Health Canada’s tobacco policy continues to depart from a true public health mission

This blog takes a critical look at Canada’s ongoing review of its tobacco and vaping legislation. Health Canada produced a discussion document to inform the review, posed twenty-two questions and invited comments. Responses from me and David Sweanor are set out below.

Continue reading “Health Canada heading in the wrong direction on tobacco and nicotine policy”

Psychoactive Podcast: The E-cigarette revolution – vaping, nicotine and harm reduction

I had an excellent conversation with Ethan Nadelmann, the founder of the New York-based Drug Policy Alliance for his outstanding Psychoactive podcast series about all aspects of drugs and drugs policy, which I highly recommend.

In this episode, “The E-cigarette revolution”, we covered vaping, nicotine, harm reduction – science, policy, politics and controversy – with Ethan as host putting the challenging questions.   Listen via your usual podcast provider (search on Psychoactive)… or via these links.

Continue reading “Psychoactive Podcast: The E-cigarette revolution – vaping, nicotine and harm reduction”

The past is not the future – what lies ahead for tobacco and nicotine?

“Prediction is very difficult, especially about the future” – Niels Bohr, Physicist

Let’s have some debate on the future of tobacco, nicotine, tobacco control and the tobacco and vaping industry. Here are three provocative pieces to get things moving. Continue reading “The past is not the future – what lies ahead for tobacco and nicotine?”

International experts in tobacco policy say WHO is blocking innovation and wasting opportunities to save millions of lives

WHO NCD poster
WHO Tobacco Free Initiative and Framework Convention on Tobacco Control – you have one job!

As the World Health Organisation’s World No Tobacco Day takes aim at low-risk alternatives to smoking, several international experts have made critical comments in response. Continue reading “International experts in tobacco policy say WHO is blocking innovation and wasting opportunities to save millions of lives”

US vaping lung injury outbreak was a public health fiasco or worse – comment to FDA

Public health actors are now routinely more manipulative than Big Tobacco ever was

Update: I subsequently published a detailed rebuttal of the claim that nicotine vaping is implicated in these lung injuries: The outbreak of lung injuries often known as “EVALI” was nothing to do with nicotine vaping, Qeios, July 2021.

The Food and Drug Administration of the United States has requested information on “Vaping Products Associated With Lung Injuries” – see Regulation.gov and Docket FDA-2020-N-0597 to make a submission or read the views of others.

In my view, the sly attribution of this problem to e-cigarettes and nicotine e-liquids by activists, academics and supposed public health agencies has been as bad as the worst ‘merchants of doubt’ operations of Big Tobacco in the 1970s.  I have labelled it a mere “fiasco” only out of politeness because the word implies that only incompetence and negligence lay behind it.  But I think it was much more deliberate than that – and we know that because virtually nothing has been done to correct misperceptions that were created and spread across the US and worldwide from July to December 2019.

I don’t wish to indulge this propaganda operation by providing straight-up evidence to the FDA on this.  Pretty well everything that needs to be known is already known about the cause and consequences. What is missing is a truthful account of the response.  So instead, I would like to take the opportunity to speak truthfully and directly about what was done here. So here is my brief response to FDA’s call for information.

Continue reading “US vaping lung injury outbreak was a public health fiasco or worse – comment to FDA”

New nicotine science and policy Q & A published

I have just published a new question and answer (Q & A) resource on nicotine science and policy.  It is available as a page accessible from the top menu of this blog and also at this address: Nicotine science and policy Q & A.  I am hoping to keep it up to date… the questions as they stand at present are as below.  My answers are on the Q & A page above – please visit, leave comments, suggestions for other questions, better answers or further reading. Continue reading “New nicotine science and policy Q & A published”

A Surge Strategy for Smokefree New Zealand 2025

I have been pleased to collaborate with ASH (New Zealand) – Action for Smokefree 2025 – on a report on how vaping and other low-risk technologies could help get New Zealand back on track to meet its high profile target to have less than 5% smoking by 2025. The report is called: A Surge Strategy for Smokefree Aotearoa 2025.

…and these are all available here on the ASH Zealand web site.

Key features of wider interest include a focus on: (1) inequities (Māori smoking rates are over 30% and tax-driven policies add a further inequitable burden of harm to marginalised groups); (2) the concept of ‘risk-proportionate regulation’ as a framework to exploit the major opportunity while containing the relatively minor risks.

I include below the main report executive summary (more detailed than the two-page summary above): Continue reading “A Surge Strategy for Smokefree New Zealand 2025”