December 4th, 2014

A blunt challenge to some common arguments against e-cigarettes

johnbritton

“Live with it”

Professor John Britton is in the top tier of public health professionals in the UK.  He is Professor of Epidemiology at the University of Nottingham, Director of the UK Centre of Tobacco Control Studies and Chair of the Royal College of Physicians Tobacco Advisory Group.  He has been one of the most important influences on the generally positive approach the UK takes to tobacco harm reduction over at least the last 15 years.  A selection of relevant work he has led includes: RCP(2000), RCP(2007), RCP(2008)PHE(2014) and Thorax(2103).  And he still runs a respiratory clinic and see people who are ill.  So it is always interesting to hear what he has to say and how he chooses to say it.  Directly and bluntly, as it turns out…

Here are two slides from a presentation he gave at the UK Society for Behavioural Medicine Conference on 3rd December 2014. He picks out common arguments in the left column and addresses them pragmatically in the right column. This is what real public health looks like in my view.

JB1

JB2

 

I hope the bullshitters, fear-mongers and ideologues are paying attention.  I’m not going to further dissect or discuss this.  But you can… in the comments.

Note: SSS = Stop Smoking Services provided by the National Health Service.

15 comments to A blunt challenge to some common arguments against e-cigarettes

  • Adam Williams

    Sorry Dodderer,but on this one, I have to disagree with you (Unusually)in some of the best films I can remember, the heroes have come over from the dark side and won the day.
    (Not very scientific I know but makes the point)

  • Roger Hall

    I welcome Prof Britton being on our side. It may well be that his previous opinions were based on the hope that Pharma were going to provide the THR solution, but the realisation that Pharma actually aren’t interested in eliminating the profitable golden egg that is tobacco smoking has made him radically re-think. So now faced with an alternative of allowing Big T to control ecigs and their potential future success with prohibitive and unnecessary regulatory solutions that hand the market over to them or fight for less regulatory interference he’s placing faith in the free market solution, which incidentally has already proven itself with in excess of 700,000 full time UK quitters. Perhaps he’s been enlightened?

  • Very simply put – I’d much rather have a john batting for us than against us. And it seems he is.

  • Dragonmum

    As I recall, this whole e-cig thing has been the huge challenge of not just raising awareness of the enormous potential that these have for revolutionising the pleasurable habit of smoking (by providing an alternative) but we also needed to win the hearts and minds of those in a position to judge that potential on a risk/harm basis. If I am interpreting Prof Britton’s charts correctly then it would appear that he has joined the ranks of the enlightened. As long as “Dark Marketing” isn’t any firm not clasped in the greedy grasp of Pharma or BAT, and Monitor and Regulate doesn’t mean “Close down the SMEs so there’s no choice”?? The accessibility of
    e-cigs has been key to their success and if this is tampered with then vapers will return to smoking or operate outside the law. Of that there is no doubt.

  • Louise Ross

    Prof Britton consistently champions ecigs and harm reduction (snus too) and most importantly is listened to by policy-makers.

    • Irish Lass

      Well said Clive and Louise!

      Not sure why so many on here are carping at someone in the public health domain who is supportive of e-cigarettes. Whatever his position may have been earlier, we need more people like Prof Britton, i.e. more supporters who actually have a chance of being listened to by the law-makers!

  • Mark Davis

    Ban lifeboats
    They stop people from swimming/using approved armbands
    In one test in 2007 one lifeboat was found to have a leaky hull

  • Mark Magenis

    I don’t think it’s wise to wish to punish the converts, when there are still so many on the dark side.
    Those with poor positions need an olive branch to help them jump the cravass.

    • john

      YES!
      A famous strategist one said: ‘there is a point in any war where you shift your aim from killing the enemy, to capturing territory’ – i.e encouraging your enemy to surrender , treating prisoners civilly.

  • Dodderer

    From memory,the RCP paper in 2007 highlighted the ineffectiveness of NRT,called for new (medicinal) nicotine products and recommended a nicotine regulatory authority.The new authority was impractical and limiting products to medicines was narrow-minded.

    At the time of the MHRA consultation,again we got the brave,new progressive rhetoric – now light-touch medicinal regulation.Of course,there was no practical assessment as to whether MHRA could/would comply.He obviously never thought to talk to them.

    Wind on to summer 2013 when there was a threat of a two-tier TPD – medicines or light-touch tobacco product.He joined ASH to lobby MEPs for the medicinal route – no doubt ‘toned’ down in line with the MHRA’s ‘right-touch’ proposal earlier that year.Effectively,dropping the Phase 3 trials and reducing the per product regulatory cost from £7m to £3.5m.Obviously,a great solution!

    Remember the paper he wrote for PHE – at the end calling for ecig companies to do their own research rather than use TC ‘scarce’ research funds.He also notably said that ecigs could reduce smoking by half – 5m smokers.What more promising areas of research does he think justifies the funding?

    Sorry, Clive,but we’re in this predicament because of fools like him.

    • Clive Bates

      I see it rather differently – he has pursued the harm reduction agenda with the right motivations and good insights from the start. They thought in 2007 that the products would come from pharma industry and geared up with a regulatory approach fit for that. It takes quite a lot to switch ‘paradigm’ but judging by presentations given earlier this year he sees snus as the better analogy and proof of concept. So I would rather welcome his support, his pragmatism and his ability to inspire others than find fault with the route he took to get there.

      • Dodderer

        I think the problem is that he’s one of the architects of Tobacco Control’s Grand Plan.THR is a contentious issue in this Plan – the latest compromise being PH45 i.e. long-term nicotine use but only if medicinally approved.

        His nod to reality was his call for light-touch medicinal regulation-without any attempt to assess its likelihood.Had the EU parliament not provided a dual route,one wonders what his position would now be.

        The $64k question is:What impact will the proposed regulation have on future consumption and prevalence?I guarantee that he hasn’t got a clue.

  • Rob McCarroll

    What is one to do? The evidence; for those who really want to learn about ecigs, is out there. Not the fear mongering, sky is falling BS spewed out by “professors” or “anti-vaping” groups but real hard facts. Problem is most people are either too lazy or not interested enough to give a crap.

    Anyone can spin things to fit their adgenda. But before I go off on a rant here’s some tips: 1. Watch some of available videos; pros and cons, on ecigs. 2. Stop relating smoking with vaping. Two totally different means of injesting nicotine. One “burns” leaves; and whatever else is put in with them (4000+chemicals are emitted from cig smoke-70 cancer causing) other is a heating process that turns ejuice: mixture of 4 item; Propylene Glycol used in inhalers and hospitals, Vegetable Glycerne found in food products and skin softner, flavourings suprisingly the most harmful of the four but found on top cupcakes and nicotine which is about as harmful/addictive as caffeine. 3. Think “does this really change my life in any way, shape or form. 4. Remember being a teen and how it really didn’t matter what you were told kids experiment. 5. This is supposed to be a free country.

    Don’t take my word for anything but don’t take the anti vape zealots words either. Use common sense and decide for yourselves.

    Thank you;

    R. McCarroll

  • Mark Magenis

    This parrot I purchased not half an hour ago,
    Oh yes sir the American Glantz, lovely plumage, what’s wrong with it?
    I’ll tell you what’s wrong with it, it’s dead……..

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