Today the Royal Society of Public Health is pitching its ‘undercover investigation’ into vape shops selling stuff to adults who don’t smoke. Naturally, the primary purpose of this exercise has little to do with public health but is a publicity stunt for an ailing organisation in a declining field that offers ever less to the public or to health.
Here’s the release: Undercover investigation finds 9 in 10 vape shops prepared to sell to non-smokers – and some predictable media have duly obliged the RSPH’s lust for publicity with the uncritical reporting we have come to expect in this field.
I have written to this Royal Society of Public Health explaining why I am “dismayed and disappointed” by such a cheap stunt. Here’s the letter:
Shirley Cramer CBE,
Royal Society of Public Health
John Snow House
59 Mansell Street
London E1 8AN
7 April 2017
Dear Dr. Cramer
I write to express dismay and disappointment at your ill-founded criticism of vaping retailers with an ‘undercover investigation’ (press release Undercover investigation finds 9 in 10 vape shops prepared to sell to non-smokers 7 April). It is a bizarre and contrived study raising a false alarm about a non-problem. RSPH have made much of the idea that vape shops do not check if their customers are non-smokers. But it is not surprising that they do not make these checks for several reasons. These reasons are missing context in the press release you have sent out to national media. Let me try to provide that context here.
1. Over 97% of vapers are smokers or ex-smokers
Use of e-cigarettes by never-smoker adults is very low indeed. According to the Office for National Statistics, 97.4% of current vapers are either current or former smokers (see Table 2b in E-cigarette Use in Britain, 7 March 2017). That means you are raising a concern to national media level about 2.6% of the vaping public, or 0.12% of the adult population. Yet all this tiny minority is doing is something much safer than smoking and for which no material risk has so far been identified – see the Royal College of Physicians report, Nicotine without smoke: tobacco harm reduction if you are still uncertain about this.
2. Many of the rest may be former smokers or potential smokers
Of the remaining 2.6% that self describe as never-smokers but current vapers, the reasons given for vaping suggest that many either have been smokers or that they are potential smokers. Table 3b in E-cigarette Use in Britain gives the main reason why people vape by smoking status. These are the findings – and please remember that these are percentages of percentages – shares of the 2.6% who say they are never-smoking vapers. Some of these reasons suggest prior smoking or possible intention to smoke, with vaping as an alternative.
Main reason given by ‘never-smokers’ for vaping Perception that they are less harmful than cigarettes 38.8% Can be used indoors 0.0% Cheaper than tobacco products 12.1% Novelty 6.2% Aid to stop smoking 27.4% Range of different flavours available 0.0% Other reasons 15.8%
So even this tiny minority maybe be benefitting from vaping as an alternative to smoking.
3. Use by never-smokers should be expected and can be beneficial
It is important to understand that there will be increasing first-use of vaping by people who have never smoked, and that this is a good thing. This is good because it means people who would otherwise have become smokers use vaping instead and may never initiate smoking. For those who do take a serious interest in public health, the experience of Sweden is important. Swedes increasingly make first use of snus, and many will never smoke. A recent paper on the Swedish experience is instructive:
Those who began daily tobacco use using snus were much less likely to subsequently take up smoking than those who had not, both among males (17.6% vs. 45.9%), and females (8.2% vs. 40.2%). […]. Indeed, those who were primary snus users were also more likely to have quit altogether than those who only ever smoked. Snus was also reported as the most common smoking cessation aid among men and yielded higher success rates than nicotine replacement therapy and other alternatives.
Ramström L, Borland R, Wikmans T. Patterns of Smoking and Snus Use in Sweden: Implications for Public Health. Int J Environ Res Public Health. Multidisciplinary Digital Publishing Institute (MDPI); 2016 Nov 9;13(11). [link]
The authors go on to conclude:
As conclusions, snus has both contributed to decreasing initiation of smoking and, when used subsequent to smoking, appears to facilitate smoking cessation. All these effects suggest that the availability and use of snus has been a major factor behind Sweden’s record-low prevalence of smoking and the lowest level of tobacco-related mortality among men in Europe.
How can you be sure that efforts to deny adult non-smokers access to vaping would not be a cause of harm? I am guessing you cannot and that RSPH’s position is not thought-out or evidence-based.
4. Were these shops bound by the code you are criticising them for breaking?
It is disappointing that RSPH chose to go straight to the media and sidestep publication in a journal or, apparently, any quality control whatsoever. At the heart of this made-for-media story is the idea that these shops were violating the Code of Conduct of the Independent British Vape Trade Association. The IBVTA is not a regulator, its code is not mandatory and it does not apply to non-members. Can you explain how, or indeed if, the RSPH established whether the 100 vaping shops visited were actually bound by this code? As far as I am aware, the IBVTA consists mainly of larger companies and many who sell through the internet. It is quite possible that many shops are not members. It is also possible that they either do not think this is an issue (see above), do not agree with the IBVTA, do not want to ask their customers intrusive and distracting questions, or simply think that adults should make these decisions for themselves.
5. This is a matter of adult choice and you should not be wasting resources on it
Finally, we have come to expect that public health organisations will rarely reflect with any insight on the appropriate limits of public health interventions or the role adult autonomy or personal volition. This is a matter of adult choice involving a low-risk activity that is an alternative to a high-risk activity. Is RSPH about to start intervening on every minor risk-taking activity?
So, have you considered that this is simply none of your business? Perhaps you should stop wasting time and money on stunts that have the aim or effect of demonising much safer alternatives to smoking, harming decent businesses doing a good job, misleading the media and diverting attention from much more pressing problems.
For the Royal Society of Public Health, this has not been its finest hour.
- Statement on vape shops and non-smokers – New Nicotine Alliance
- Real implications of the RSPH sting – Carl V Phillips, Anti-THR lies (good on the ethics of this sort of investigation).
- Today’s lesson in who not to trust – Dick Puddlecote
- Much ado about nothing – Facts do matter
- Vapers in Power responds to the RSPH – Vapers in Power
- Should e-cigarettes be sold to non-smokers? – Freedom to Vape
- Mountains out of molehills: UK tells vape stores not to sell to non-smokers – Vapes news