March 4th, 2017

Challenging the proposed e-cigarette prohibition in Taiwan

Vaping in Taiwan – the approaching darkness of prohibition or a new dawn for rational policy-making?

The government of Taiwan has been consulting on amendment its Tobacco Hazards Prevention and Control Act. Article 14 of the amendment bill bans the manufacture, import, sale, and display of e-cigarettes (unless authorised as a pharmaceutical product).  See newspaper coverage.  The original Taiwan Chinese language bill is available online and a vendor has produced a summary in English.

See my full response here (PDF) and the summary below

Obviously, I strongly advise against this measure. E-cigarettes present an important strategy to reduce the harm caused by smoking and offer a way to achieve rapid reductions in smoking through market-based means. There is no evidence anywhere in the world that e-cigarettes add to harms associated with smoking.

The danger of a prohibition of e-cigarettes is that it will protect the cigarette trade from competition, increase smoking and harm health. This is exactly the opposite of what the Act and the government are trying to achieve. The summary page is below.  >> read the full post

February 27th, 2017

Are e-liquid flavours really 'hooking another generation of kids'?

Attraction to vaping? Or attraction from smoking? Or just a consumer preference?

Predictably, depressingly, the US anti-vaping lobby has mobilised against a new Cole-Bishop Bill, HR 1136 that would hold off near complete destruction of the industry by grossly disproportionate FDA deeming regulation and implement the first steps in a sensible reshaping of American tobacco policy. But look at the argument they used.

“By working on what purports to be a technical change, “ Myers said, “ it leaves on the market the candy and fruit-flavored e-cigarettes that are so popular among young people.”

“You can put any gloss on it you want, this is the tobacco industry’s effort to continue to market flavored tobacco products to hook another generation of kids.

You hear this narrative a lot: regulators protecting kids from industry predators bearing flavours as bait. But I just wonder whether the anti-vaping activists have paused to even think about flavours and teens at all. 

To evaluate the demand to regulate these flavours (by which they mean ban them) you first need a framework for thinking about the issue – and that is not simple and may yield surprises.

Here is how I would think about this… >> read the full post

February 16th, 2017

Hold the Mayo

Get a grip…

Once again the Mayo Clinic indulges in unethical and misleading risk communications in the form of a new article on e-cigarettes,  promoting fear and confusion and dissuading smokers from trying them.

Mayo clinic: Electronic cigarettes: Not a safe way to light up 

>> read the full post

February 16th, 2017

Australian medicines regulator intends to continue to protect the cigarette trade - we challenge its bizarre reasoning

Solid as a rock?  The TGA justification for banning e-liquids certainly isn’t

This post summarises and gives background to a new harsh-but-fair submission on nicotine classification in Australia – go straight to it > here

In Australia, nicotine is classed as a poison unless in a form exempted from the poison schedules.  There are two relevant exemptions: for veterinary or medical use (e.g. NRT) or when nicotine is in the form of:

…tobacco prepared and packed for smoking

This has the effect of making manufacture, import or sale of nicotine e-liquids illegal in most circumstances [see note]. It also bars smokeless tobacco, heated tobacco products, and other low-risk non-combustibles from the market of 2.8 million adult smokers (16 percent of the adult population), while bizarrely granting exclusive market access to cigarettes and other combustible products. So this is obviously insane, so there has been an attempt to change that. >> read the full post

February 3rd, 2017

Vaping and tobacco harm reduction in Ireland - consultation response in five quotes

Vaping in Ireland: already making a difference

On 5th January, Ireland’s Health Information and Quality Authority published a draft Health Technology Assessment on smoking cessation interventions with a press release. The assessment was positive about e-cigarettes.

Dr Máirín Ryan said: “This HTA found a high level of uncertainty surrounding both the clinical and cost-effectiveness of e-cigarettes. While the long-term effects of using e-cigarettes have not yet been established, data from Healthy Ireland reveals that 29% of smokers currently use e-cigarettes as an aid to quitting smoking. HIQA’s analysis shows that increased uptake of e-cigarettes as an aid to quitting would increase the number of people who successfully quit compared with the existing situation in Ireland and would be cost-effective, provided that the currently available evidence on their effectiveness is confirmed by further studies.”

In Ireland, that is very positive!

The report is out for public consultation until the 3rd February 2017.  The consultation page allows for a free-form response.  You can put in whatever information you think will assist the review team.   Here is my response, framed around five quotes from the Royal College of Physicians:

>> read the full post

January 31st, 2017

Reshaping American tobacco policy: eight proposals for the Trump administration

Many variations, all much safer than cigarettes – but what does FDA/CDC do about that?

Welcome to a new report written by me, Clive Bates, with David Sweanor of Ottawa University, and Eli Lehrer, President of the R Street Institute. The fully designed report is available at R Street with press notice.

Reshaping American Tobacco Policy

Eight federal strategies to fight smoking and ignite a public health revolution

[PDF – 23 pages]

The report is an unforgiving and but fair critique of the United States’ federal approach to tobacco policy, which we think is an unmitigated regulatory disaster.  Whatever the stated intent, the effect is to protect the cigarette trade from competition, damage pro-health American businesses, mislead and harm consumers and add unnecessarily to healthcare costs.  Federal agencies are preoccupied with negligible or imaginary risks at the expense of great opportunities to address the health risks to America’s 38 million smokers. Around nine million vapers are already taking action to protect their health, the federal bureaucracy is set to block their efforts.

So far smart, self-interested consumers, innovative producers and disruptive technologies have interacted in a lightly regulated free market to begin to tackle the huge burden of disease arising from smoking. That is about to change: the dominant reaction of the federal government is to choke these highly positive developments with huge regulatory burdens, opaque authorization procedures, impossible evidential tests and misinformation about risks.

American federal tobacco policy couldn’t be much worse, but it could be a lot better. The fundamental change required is to embrace and maximise the huge opportunity of vapor and other low-risk nicotine products, while keeping a sense of proportion about minor risks.

The eight proposals to reshape policy are listed below. The report provides a context, summarises the proposals and provides two pages on each. >> read the full post

December 8th, 2016

Bad science, poor insights and likely to do harm - rapid reaction to the Surgeon General's terrible e-cigarette report

Warning: The Surgeon General has crossed the boundary between science and propaganda

The Surgeon General’s report on e-cigarettes is out. E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. It is truly terrible – a heady mix of emotive propaganda and a completely warped and one-sided account of the science built on a lack of insight into youth behaviors and no knowledge of the tobacco and nicotine market or its consumers.

Previous posts: see Five questions for the Surgeon General about e-cigarette science and The critic’s guide to bad vaping science (both 7 Dec 2016)

I’ve extracted the overall conclusions and main chapter conclusions from the report and provided a rapid reaction to each of these.

>> read the full post

December 7th, 2016

Five questions to put to the US Surgeon General on e-cigarette science

sg-smoking-thumbs-down

Will he get the thumbs up for his e-cigarette report?

Update 8 December – my reaction: Bad science, poor insights and likely to do harm – rapid reaction to the Surgeon General’s terrible e-cigarette report (these questions remain unanswered).

On 8 December 2016 the U.S. Surgeon General will release a new report on e-cigarettes.  I don’t yet know what’s in it, but these are the five questions I would like to see honestly and candidly addressed (with supplementaries and some supporting data)

  1. How much has vaping played a role in the recent accelerated decline in U.S. adult smoking and how beneficial for health will this be?
  2. How much of the decline in youth smoking is attributable to vaping and how beneficial for health will this be?
  3. Compared to smoking cigarettes, how harmful are e-cigarettes?
  4. If nicotine is harmful to the developing brain, where are the smokers with brain damage?
  5. On what basis is it possible to claim any material risk to bystanders for second-hand vapor exposure?

This is part two of a twin posting. Part 1. is The critic’s guide to bad vaping science – this is the informed critic’s plain language guide to questioning the science of sensationalist and alarmist e-cigarette studies.  >> read the full post

December 7th, 2016

The critic's guide to bad vaping science

bad-science

“Full of sound and fury but signifying nothing” – Shakespeare

This is part one of a twin post. Part 2 is Five questions to put to the US Surgeon General on e-cigarette science (next posting).

To respond to the forthcoming publication of a new US Surgeon General publication on e-cigarettes, I have have expedited my long-planned guide to bad science in the field of e-cigarettes and vaping in the hope that commentators, opinion formers and members of the public will give this review proper critical scrutiny.

So here it is: Version 1.0 of a critic’s guide to bad e-cigarette and and vaping science. This is the informed critic’s plain language guide to questioning the science of sensationalist and alarmist e-cigarette studies.

Here it is: The critic’s guide to bad vaping science (PDF – 15 pages)

This is the table of contents, which I hope is in itself a handy guide to interrogating bad science.  >> read the full post

December 6th, 2016

Bad science, accountability and courage - speech by AG Tom Miller

Iowa Attorney General Tom Miller

Tom Miller: “public policy through facts and science rather than ideology”

On 17 November 2016, the Iowa Attorney General, Tom Miller, gave a speech at the E-cigarette Summit 2016 (with biography) on e-cigarettes examining the claims of anti-vaping activists, and their scientific, ethical and legal basis. The full text of the speech is here: America Needs England (PDF). I reported an earlier speech here.

The speech should be widely read, especially in the United States. To facilitate an informed reading, I have reproduced the speech here, with some thematic subheadings, source links and illustrations [these are my additions].

>> read the full post