O&A

Welcome, this is my 2020 Q & A on nicotine science and policy.

It mostly focuses on nicotine vaping as an alternative to smoking, but most of the argument also applies to heated tobacco products, modern smokeless tobacco and new oral nicotine products.  It consists of about 60 questions and builds on a brief Q & A that I submitted to a consultation, a critique of an absurd anti-vaping Q & A by the WHO and my critique of numerous false and misleading claims made by Professor Stanton Glantz.

Please propose new questions and new themes, or suggest better answers or additional recommendations for further reading in the comment section. Help make this better!

Further reading

Frequently Asked Questions

1. Strategy – what is the purpose of tobacco and nicotine policy?

  1. What are the goals of tobacco and nicotine policy?
  2. What is ‘tobacco harm reduction’?
  3. What products are involved?
  4. Shouldn’t we aim for a nicotine-free society?
  5. What is the ‘endgame’ for tobacco?

2. Safety and relative risk – what are the risks?

  1. Are e-cigarettes less harmful than cigarettes?
  2. Do the recent US cases of severe lung injury prove that e-cigarettes are very harmful?
  3. What about long term effects – shouldn’t we take a precautionary approach?
  4. It took decades for the harmful effects of smoking to emerge, won’t it be the same with vaping?
  5. How much less harmful are e-cigarettes than cigarettes?
  6. Is it fair to say e-cigarettes are likely to be at least 95% lower risk than smoking?
  7. Do people understand the risks of vaping?
  8. Isn’t this just the ‘light cigarette’ tobacco industry scam all over again?
  9. What does the novel coronavirus pandemic mean for smoking and vaping (updated 27 June 2020)

3. Quitting smoking – do vaping products displace smoking?

  1. Do e-cigarettes help people quit smoking?
  2. Isn’t most vaping ‘dual-use’ of e-cigs and cigarettes?
  3. What is the difference between NRTs, smoking cessation pharmaceuticals and vape products?
  4. Should the healthcare system cover e-cigarettes as smoking cessation aids?
  5. What about people who are disadvantaged and cannot afford to vape? Should they get support?
  6. Should the healthcare system help vapers to go nicotine-free and quit vaping?

4. Youth – how should we address the uptake of adult products by young people

  1. Why do e-cigarettes appeal to adolescents?
  2. Is there a ‘youth vaping epidemic’ in the United States?
  3. Is vaping a gateway to smoking?
  4. Should flavours be banned to stop youth vaping?
  5. Should e-cigarette sales be restricted to people aged 18 and over?
  6. Does nicotine damage the developing adolescent brain?
  7. What can be done to protect young people?

5. Regulation – how should governments handle reduced risk products?

  1. Should e-cigarettes be banned?
  2. Should e-cigarettes be regulated like cigarettes?
  3. Should e-cigarettes be regulated as smoking cessation medicines with pharmaceutical regulation?
  4. What is the right approach to regulating e-cigarettes?
  5. What are the potential unintended consequences of vaping regulation?
  6. Should different categories of vapour products like THC or nicotine salts be regulated in different ways?
  7. Should regulators impose limits on the strength of nicotine in e-liquids?
  8. Why does Juul use a high strength nicotine liquid in the US?
  9. Should there be a special tax on e-cigarettes?
  10. Does tobacco harm reduction undermine tobacco control?

6. Vaping in public places – should it be permitted and who should decide?

  1. Do e-cigarette vapours pose the same risks to bystanders as second-hand smoke from cigarettes?
  2. Should vaping be banned by law in public places and workplaces?

7. Marketing – what marketing freedoms or constraints are appropriate?

  1. Are vaping products aggressively marketed to teens?
  2. Should advertising for reduced-risk products be banned?
  3. How to maximise the benefit to smokers and would-be smokers, while minimising recruitment of non-users?

8. Retailing – who should sell and under what conditions?

  1. Where should e-cigarettes and other reduced-risk products be sold and not sold?
  2. Should e-cigarettes be available only through pharmacies or on prescription or over-the-counter everywhere?
  3. Should vaping products be available on-line?

9. Tobacco industry – pariahs, predators or player?

  1. Are e-cigarettes a tobacco industry ploy to keep people smoking?
  2. Should tobacco control authorities collaborate with tobacco-related industries in pursuit of public health objectives?
  3. If tobacco companies want to reduce the harm caused by cigarettes, why don’t they just stop selling cigarettes?
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