Time to discuss the ‘gateway effect’… the idea that e-cigarettes or snus (a form of low risk smokeless tobacco) might be a cause of children taking up high risk cigarette smoking that would not otherwise happen. There’s virtually nothing in this theory – it is largely a campaigning tactic. But you hear much less about the genuine beneficial gateway effects thatlead kids away from smoking. As my friend David Sweanor puts it:
“beware the unintended consequences of our fear of unintended consequences” >> read the full post
A public health academic is forceful and direct with the misguided opponents and over-zealous regulators of e-cigarettes. He describes the presentation of World Health Organisation’s Roberto Bertollini to a European Parliament workshop as ‘appalling’. This is a measured, compassionate, but quietly angry and exasperated interview by one of Europe’s leading experts on e-cigarettes, Professor Jean-François Etter. >> read the full post
MEPs on the European Parliament’s ENVI committee are about to consider 1,360 amendment proposals to the revision of the Tobacco Products Directive. I’ve written to them with suggestions on what to do and what not to do to get the best deal for consumers and public health.
Graphic with thanks to the team at Vapour Trails TV
Updated: 29 May.
It has to be asked… Is Linda McAvan MEP, European Parliament rapporteur for the Tobacco Products Directive, in an unholy alliance with the tobacco industry? Judging by amendment 1250, she might as well be.
Key votes in July and September – everything still to play for.
We’re getting closer to serious position-taking and the first decisions in the European Parliament. So here is a post with my suggestions for amendments to the directive and some information for anyone interested in following what is going on in the process.
The most important thing is the ‘harm reduction’ agenda – finding ways to decouple taking the not-very-harmful drug nicotine from the very harmful way of taking it by smoking cigarettes – mainly through low-risk alternatives nicotine products such as smokeless tobacco or e-cigarettes. >> read the full post
When the UK Medicines Regulator (MHRA) consulted in 2010 on whether e-cigarettes should be regulated as medicines, it gave three options: I summarise the first two and quote the third: Option 1. Regulate as medicines and withdraw unlicensed products in 21 days Option 2. Regulate as medicines and withdraw unlicensed products in a year (June 2011) Option 3. “Do nothing and allow these unregulated products containing nicotine that have not been assessed for safety, quality and efficacy to remain on the market.” [emphasis mine]
See what they did there…? It’s either medicines regulation or ‘unregulated’. We call this framing bias – and they were rightly criticised for it. But the idea persists that e-cigs are unregulated, and it is the reason why some people think they should be regulated as medicines. In reality, there is very little in the European Union that is ‘unregulated’. Most products fall under general consumer protection legislation. Here is a selection of the key EU directives and regulations that already apply (or could be applied) to e-cigarettes and other non-medicinal nicotine containing products: >> read the full post
Warning: nicotine may induce authoritarian urges, warped judgements and loss of purpose
Smokeless tobacco products, e-cigarettes and novel nicotine products have astonishing potential to reduce the expected one billion premature deaths from tobacco in the 21st Century. Yet some health organisations are spreading misinformation, stoking up unwarranted fears and pretending there is much more risk and uncertainty than there really is. So to provide some balance here is a collection of on-the-record quotes from researchers, experts and others who have grasped the important and disruptive significance of these developments. Enjoy! >> read the full post
Dave Dorn of VapourTrails TV - an e-cigarette user and enthusiast – explains e-cigs and goes through some commonly held misconceptions. >> read the full post
Christian Engström, the Swedish Pirate Party MEP, makes the case for unbanning snus to the European Parliament’s Internal Market and Consumer Protection Committee (IMCO) – also here on his blog. He is a shadow rapporteur to that committee, and they will provide an opinion to the Parliament on the European Commission’s proposal for the revised Tobacco Products Directive. >> read the full post
Completely counter-productive assessment of the value of e-cigarettes
Oh dear … Israel planning to ban e-cigarettes. I’ve responded to the consultation as below. You’ll need Google translate (the screen shot above is generated by Google) and I ended up sending my response to the site administrator as it was rejected by the web form on the site. Here’s my response. If you know Israeli vapers, please pass this on and extend my offer of solidarity. >> read the full post
It was painful to go through the European Commission’s attempt to justify the continuing ban on ‘snus’ (or ‘oral tobacco’ as it is known in Brussels). It’s hard to imagine a worse case of evidence being massaged into supporting a pre-determined policy conclusion – the conclusion is that beloved of bureaucrats everywhere: we were right all along! But they are not right and they never were.
Letter to The Times, 14 March 2013 on how misguided excessive regulation threatens one of the most promising technologies for public health – the e-cigarette. >> read the full post
Q. What do e-cigarettes and garlic capsules have in common?
A. Neither are medicines
Would it actually be legal to classify e-cigarettes as medicines? A landmark legal case involving the classification of garlic capsules suggests the European Court of Justice would not accept this definition. Other recent legal cases in member states support that interpretation. Let’s look at whether e-cigarettes really are medicines… >> read the full post
A response to the UK Balance of Competences Review…
Should the EU impose a blanket ban on oral tobacco (other than in Sweden, which is allowed an exception)? Why not allow each member state to decide? If a member state wants to take a robust evidence-based approach to tobacco harm eduction by allowing low risk alternatives to cigarettes, why should other member states prevent it?
Sweden is a stunning outlier in European Union smoking rates – and the benefits are lower death rates from tobacco-related disease – now and locked in to the future
On Monday 25th February 2013, the European Parliament committee that is scrutinising the proposed EU Tobacco Products Directive holds a public hearing, and take evidence from invited witnesses. The committee is the Environment, Public Health and Food Safety Committee (known as ENVI). This post provides links to the hearing details and my tobacco harm reduction briefing sent to all ENVI committee members in advance of the hearing. The committee needs to take the harm reduction agenda seriously – if they get it wrong, they will harm health and protect the cigarette industry.
Over regulating the alternatives is a form of protection for the most harmful and dominant form of nicotine delivery – cigarettes
E-cigarettes represent an amazing market-based, user-driven public health insurgency. From nowhere to €500m in Europe, the market is growing rapidly and already almost equals the market for NRT, according to the European Commission’s consultants (see chart and Matrix report p21). Without anyone in the professional public health field doing anything and without spending any public money, smokers have been quitting, switching and cutting down using e-cigarettes. Enter the regulators… >> read the full post
The European Commission has published a draft directive on tobacco products. Unfortunately it bans and obstructs much lower-risk alternative to cigarettes, such as smokeless tobacco and e-cigarettes, so its effect would to protect cigarettes and harm health. However, it is not too late to do something about it. >> read the full post
On 30 November, the draft EU Tobacco Products Directive was circulated for inter-service consultation (ie. sent round all other Directorates General in the European Commission). Its contents are not yet public, but it is widely thought to maintain the ban on snus and to impose strict restrictions or even bans on reduced risk non-combustible tobacco products, e-cigarettes and novel electronic nicotine devices. I cannot sufficiently stress how wrong and harmful that would be, given the role these products play as alternatives to smoking. I remain ever hopeful that good science, ethics and law (and common sense) will eventually prevail. To that end, I have written to the new Commissioner, Dr Tonio Borg, to suggest he makes five changes to the Commission’s approach. Here’s the letter: >> read the full post
I am writing as you gather in Seoul with colleagues from around the world from 12-17 November 2012 for the fifth Conference of the Parties of the FCTC. Your work is vitally important in the global struggle against cancer, cardiovascular disease and respiratory illness, and I wish you well with your negotiations and deliberations this week. However, I would like to ask you to consider two important and difficult but related issues: >> read the full post
I gave an interview recently about nicotine and tobacco harm reduction – you can read it here. But it’s nothing like as good as Gerry Stimson, one the of the greats of public health, explaining it here on YouTube. It is a great blend of genuine concern for health, scientific insight and respect for individual choices all embedded in real world understanding of behaviour. He calmly explains how smokeless tobacco or e-cigarettes work as low risk alternatives to smoking cigarettes and why this is a crucial public health strategy.
Campaigning by so-called health groups to ban much less hazardous alternatives to smoking is dangerous, unethical, lazy with facts and utterly without regard for the people they are supposedly trying to help – see my detailed post Death by regulation. But they go to a whole new level of awfulness – evil maybe – when it is done with deliberate deception and falsification. When that happens, it becomes something much darker – in fact as bad, and as deadly, as the worst excesses of tobacco industry PR. And that is what happened – they used Tipp-ex to erase inconvenient truths in a report intended to inform science based policy on alternatives to smoking. >> read the full post
Is it right to ban certain types of smokeless tobacco from sale in the European Union? The short and unequivocal answer is ’no’.
But surely banning any type of tobacco can only reduce the size of the overall tobacco market and therefore be good for health? No, not at all, it just isn’t that simple…
This post gives my personal take on this important public health issue.
The reason for allowing it on the market is that smokeless tobacco is an effective substitute for smoking, but far less hazardous to health than cigarettes. The chart to the left puts it quite well. It models the effect on life expectancy of switching from smoking to a type of smokeless tobacco (‘snus’ or Swedish oral snuff) at a given age. These are dramatic findings. Given the addictiveness of nicotine and how difficult some smokers find quitting even if they really want to, banning this option amounts to death by regulation. What has gone wrong? >> read the full post
I’ve moved to the Sudan… and I’m sitting under a fan in Khartoum writing this… I’ve now been here a couple of weeks and am no longer totally lost. I’ve a new job as the UN Environment Programme (UNEP) Representative for Sudan. We hail from UNEP’s Post-Conflict and Disaster Management Branch, which addresses the links between environment (or more specifically, ‘natural resources’) and conflict.
The Sudan programme has had a fantastic start through a two-year project to create a Post-Conflict Environmental Assessment for Sudan, which was published this year and is one of the best surveys of the challenges of a developing country environment you will find anywhere – a tribute to the energy and drive of Andrew Morton, who led the effort. The assessment develops some 85 recommendations, and our job here is to make as much of that happen as we can. >> read the full post
I don’t want to do a full scale critique of biofuels – not least because that would be to enter an already crowded field [see Biofuelwatch and Global Subsidies Initiative, for example]. But it’s worth looking at how narrowly-focussed, bottom-up policy-making now means we have somehow put the most financial support into the worst ideas… >> read the full post
On 30 November, the draft EU Tobacco Products Directive was circulated for inter-service consultation (ie. sent round all other Directorates General in the European Commission). Its contents are not yet public, but it is widely thought to maintain the ban on snus and to impose strict restrictions or even bans on reduced risk non-combustible tobacco products, e-cigarettes and novel electronic nicotine devices. I cannot sufficiently stress how wrong and harmful that would be, given the role these products play as alternatives to smoking. I remain ever hopeful that good science, ethics and law (and common sense) will eventually prevail. To that end, I have written to the new Commissioner, Dr Tonio Borg, to suggest he makes five changes to the Commission’s approach. Here’s the letter: 
Campaigning by so-called health groups to ban much less hazardous alternatives to smoking is dangerous, unethical, lazy with facts and utterly without regard for the people they are supposedly trying to help – see my detailed post 
