WHO on e-cigarettes – protecting cigarette sales and causing more disease and death

Original image removed at the request of WHO Legal Counsel

Following publication of WHO’s paper on e-cigs for the FCTC COP-6 meeting in Moscow the statement below went out to media from Professor Gerry Stimson. I agree with all of it, but think he is far too polite.  My initial reaction was as below (Update 15 Sept 2014: a more complete analysis is now available):  Continue reading “WHO on e-cigarettes – protecting cigarette sales and causing more disease and death”

Briefing: the case for e-cigarettes

Shorter briefingIn response to my longer briefing, sometimes people say: well could you please state the case more concisely?  So here is a shorter briefing, starting with a one paragraph summary…

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Briefing on e-cigarettes for policy makers

Longer briefing
I am occasionally asked for a briefing on e-cigarettes and related policy issues – so here’s one I produced recently, that I hope some readers of this blog might find useful – for example in talking to Directors of Public Health, NHS officials etc. This is the longer one… I also did a shorter one with more recommendations.
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Some hard messages for the tobacco control establishment – Peter Hajek

Brilliant!! No doubt in my mind – the best speech of the Global Forum on Nicotine conference by far. Professor Peter Hajek uses the conference keynote, the Michael Russell oration, to explain through the work of Michael Russell (1932-2009) and his protégés the case for tobacco harm reduction. He then tears into the zombie arguments (18′ 48 sec), ideology (22′ 38sec) and motivations (23′ 18sec) of the ‘tobacco control’ activists who oppose e-cigarettes, often for moral reasons (24’00 on), drawing the brutal conclusion that for them “evidence is just a tool to gain converts”. I really liked the lines about all the concerns of the tobacco control establishment do not matter unless they increase cigarette sales (27′ 14 sec). As he puts it: “Are you saying that if you allow e-cigarettes on the market it will somehow increase smoking?” – that’s the question that matters.  Mike Russell was a very smart guy with real rigour and edge, matched by a compassion for people and the risks they faced: he would have been very proud of Peter Hajek’s tribute.

Turning the tables on public health – let’s talk about the risks *they* create

I’m here to tell you what to do, not to take responsibility for it

I’ve had enough of the one-sided conversation about the risks associated with e-cigarettes… poisons, gateways, renormalisation, fires, explosions, MRSA, pneumonia, dual use, undermining tobacco control, nitrosamines, anti-freeze, particulates, heavy metals, dead dog, dead cat…. blah blah blah.

ENOUGH! The public health establishment is conspicuously failing to recognise the risks associated with its preferred policy responses to e-cigarettes: with not having e-cigarettes, with banning snus, with prohibiting vaping in public places, with confusing people about risks, with controlling everything.  They carry on as if these risks are zero or somehow not their responsibility – but they are all plausible and all end in more smoking and more cigarette sales. We need to press them much more assertively on the risks they create and the harms their ideas may do:

  • “do you accept these risks are plausible and can you see how and why they might arise?”
  • “what evidence do you have regarding these risks?”
  • “what make you so confident your policy ideas will not cause more harm than good?”
  • “at what level of risk would you stop advocating these policies, or at least call for more evidence?”

For almost every policy idea there is for regulating harm reduction, there is a realistic risk that it will make things worse for health. And for almost every theoretical risks from vaping, there is a more plausible theoretical benefit. Let’s consider the following:
Continue reading “Turning the tables on public health – let’s talk about the risks *they* create”

Letter to WHO on low risk alternatives to smoking: a reader’s guide

Gent smoking
If only I was reading this in 2014….

A very positive development today, which I am pleased to say I had a hand in organising. 53 specialists in nicotine science and public health policy have written to Dr Margaret Chan, Director General of the WHO about tobacco harm reduction. The letter appeals for WHO to adopt a positive, proportionate and rational approach to products that provide very low-risk alternatives to smoking. In short, it calls on WHO to recognise this approach, tobacco harm reduction, is an important part of the solution offering great promise for public health, and not part of the problem.

I thought it would be good to have commentary on the text of the letter: so here is my ‘reader’s guide’.  The letter  text is picked out as quotes in boxes with a commentary beneath each section.  Note: the commentary and interpretation are mine, and only the text is endorsed by the signatoriesContinue reading “Letter to WHO on low risk alternatives to smoking: a reader’s guide”

53 public health specialists write to WHO about alternatives to smoking – here’s the letter

Here below is the text of the letter sent to WHO this week, and full list of signatories (as a PDF here).  Now published on the next page – a reader’s guide to this letter.

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Public Health England goes positive on e-cigarettes

Cover page - click to access report
Sensible, balanced, reasoned

This is rather good. Public Health England commissioned a background paper on e-cigarettes from Professor John Britton and Dr Ilze Bogdanovica of Nottingham University and UK Centre for Tobacco and Alcohol Studies.  It is a relief to read good, evidence-based, optimistic reasoning from top figures in public health, and to have this commissioned by England’s main government public health agency. I’m sure there are things that I might have said differently in the report, but I can’t disagree at all with the positivity and vision of the summary and conclusions.  Continue reading “Public Health England goes positive on e-cigarettes”

People using e-cigarettes to quit smoking 60 percent more likely to succeed than those using NRT sold over the counter

AddictionThe survey of e-cigarette use published today is great news for those of us who long suspected that e-cigarettes are effective in helping people stop smoking.  So now we have a population study (i.e. a survey of real users’ experience, not a trial) that shows very positive results for e-cigarettes, but also showing NRT users have no better success rates than those quitting cold turkey, at least without behavioural support.  This is part of a pattern of positive results from UK survey data… Continue reading “People using e-cigarettes to quit smoking 60 percent more likely to succeed than those using NRT sold over the counter”

Regulation of e-cigarettes – general ideas

Warning symbols
Be careful out there…

I’m chairing a panel on “Vapor Industry Standards” at the SFATA spring conference today, and thought it was a good day to publish some general thoughts on regulation. This is part one of two…  I always learn a lot at gatherings like this, so I will publish more specific thoughts on nicotine regulation after the conference once I have stolen digested all the good ideas and insights. I hope this prompts discussion and is a useful step on the road to the must-attend Global Forum on Nicotine in Poland at the end of June, where further discussion will follow.  Continue reading “Regulation of e-cigarettes – general ideas”