July 21st, 2017

Challenging the prohibitionists - submissions to Australian parliamentary inquiry into e-cigarettes

Since 2013, UK smoking prevalence fell at three times the rate of Australia despite Australia’s plain packs and sharp tax increases. Why might that be?

Really, it should be a no-brainer!  But here is an effort to encourage Australia’s legislators to look beyond the unaccountable clique that dominate Australia’s tobacco control field, and instead to look kindly on lifting the absurd Australian de facto prohibition of e-cigarettes and other low risk nicotine products.

Let’s boil it down to its essentials: supporters of e-cigarette prohibition somehow think it makes sense to deny at-risk citizens, smokers, access to much safer products that are alternatives to the market leader and to only allow the most dangerous products, namely “tobacco prepared and packed for smoking“, onto the consumer nicotine market. Well, I guess it would make sense if you were trying to protect the cigarette trade and harm as many smokers as possible. In my view, Australia’s policy has no basis in science, ethics or compassion. The approach bears the twin hallmarks of fanaticism and incompetence, and it needs to change.

So, here at some length is my submission to the Parliament of Australia, House Standing Committee on Health, Aged Care and Sport, Inquiry into The Use and Marketing of Electronic Cigarettes and Personal Vaporisers in Australia [link to inquiry]

Submission #271 by Clive Bates (PDF – 30 pages)

Executive summary (1 page) reproduced below…

Executive summary

  • I am pleased to provide this evidence to assist the Committee’s important work. This submission follows the format of the five questions set in the terms of reference for the inquiry.
  • E-cigarettes and personal vaporisers function as consumer products and alternatives to smoking. Their positive impact for public health arises from their attractiveness as alternatives to smoking. These products are not medicines and not poisons in the way they are used by consumers and medicines and poison regulation are inappropriate and ill-fitting regulatory frameworks.
  • The experience from the United Kingdom and United States has been highly positive. In both cases, smoking has fallen rapidly among both adults and youth as vaping has risen, consistent with vaping products being used to quit smoking and displace cigarettes in the marketplace.
  • Declines in smoking in the UK have proceeded at three times the rate of Australia since 2013, despite Australia’s punitive tobacco policy. The United Kingdom now has achieved parity in adult smoking prevalence with Australia on a like-for-like basis – the first time since records began.
  • E-cigarettes and personal vapourisers do not involve the combustion of tobacco leaf and inhalation of thousands of toxic products of combustion. They are, beyond any reasonable doubt, much less harmful than smoking. Though we cannot have decades of data, nor are we entirely ignorant. Based on what is known, a working estimate endorsed by UK experts is that e-cigarettes are at least 95% lower risk than smoking, and may be substantially lower than that.
  • There is no scientific, ethical or compassionate case for Australia’s de facto ban on e-cigarettes and personal vaporisers. The is no credible case to justify why Australians exposed to the health risks, stigma and punitive cost of smoking should be denied options widely available, welcomed by consumers and successful elsewhere. The burden of proof remains with the prohibitionists.
  • There are many regulatory options available, but the primary concern should be with the unintended consequences of overzealous regulation. This can have the effect of protecting the cigarette trade and sustaining smoking by degrading the appeal of the lower-risk alternative.
  • The proposal made to amend the Poison Schedule should have been accepted by the TGA – it makes no sense on to permit the most dangerous forms of nicotine (“tobacco prepared and packed for smoking”) and to impose a de facto ban all the lower-risk alternatives.
  • The best regulatory approach will be to provide a light-touch framework of standards and only deviate from a market-based approach where there is a clear consumer benefit. This will minimise the risk of unintended consequences. No additional tax on these products is justified.
  • The prohibition on other low-risk tobacco and nicotine products, for example smokeless tobacco and heated tobacco products, should also be lifted to widen the options for smokers to quit.

Submissions of note

Some great quotes in this twitter thread by The Vaper @vaper_the

See all submissions on Parliament of Australia inquiry web site

9 comments to Challenging the prohibitionists – submissions to Australian parliamentary inquiry into e-cigarettes

  • John R Walker

    I have ‘skimmed’ (most) of the submissions from individual MDs, scientists and Professors etc, as well as (most) of the submissions from the Australian ‘health establishment’.
    Its a fascinating example of ‘please consider the on the ground realities’ Vs Group think is only way to, think.

    The upper echelons of Australia’s medical and academic cultures are notorious for their markedly ‘bully-feudal’ cultures so I am not really surprised by the stark divide in the flavor of the submissions.

    God only knows what the parliamentary committee will make of it.

    • John R Walker

      BTW The parliamentary committee’s makeup looks fairly promising- the chair is a youngish ‘Liberal-Conservative’ and I’d guess it to also be fairly bipartisan.

  • Annette

    Thanks for your submission Clive, it was excellent. I sorta feel for the politicians in one way, it is going to be confusing for them. I hope they are courageous enough to ignore the submissions from the AMA etc and make a stand for the smokers and vapers of Australia. After all we are who they represent not medical associations.

  • Margaret Boyd

    Wow the submission from Stephen Woodward has been redacted in places but it is fabulous
    It is a must read
    He says quote

    “The Committee needs to be aware of the influence wielded by a very small group of determined Australian public health professionals on the issue of e-cigarettes.
    The views of this determined group are out-of-step with public health colleagues in Australia and elsewhere in the world. The divergence of opinion between so called “Australian tobacco experts”, and international tobacco experts has led to an extraordinarily aggressive, sometimes abusive level of dialogue and correspondence on issues around e-cigarettes. Examples of this can be provided on request. This abusive discourse indicates that the differences of opinion are related to matters other than the scientific evidence, which is usually discussed in more dispassionate terms.

    He says

    “c. The NH&MRC CEO Statement on e-cigarettes
    This statement as an objective analysis of the evidence about the health effects and possible harms of e-cigarettes is a pale shadow compared with international reports by similarly accredited health organisations. It begs the question how Australia’s NH&MRC can come up with conclusions that are completely opposite to the conclusions of similarly accredited international organisations on the issue of e-cigarettes.

    d. The Therapeutic Goods Administration(TGA)
    If e-cigarettes are defined as a therapeutic good, then the only companies that will be able to sell them in Australia are tobacco companies or big pharmaceutical companies, because they will be the only companies that will be able to afford the massive costs associated with getting therapeutic goods registered.
    It is disingenuous for the TGA to persist with its furphy about considering an application from e-cigarette manufacturers.

  • Adam Williams

    It would be interesting to how the Australian black market is doing, I very much doubt the graph takes that into consideration.

    • Clive Bates

      The data comes from surveys of households and asking people about their smoking habits, amongst other things. It doesn’t ask about how they source their products.

      Sources for the graph
      Office for National Statistics (UK). Smoking habits in the UK and its constituent countries, 2016. 15 June 2017 [link]

      Australian Institute of Health and Welfare, National Drug Strategy Household Survey, 2016. Datasets [link]

      • John R Walker

        Clive
        over the past few years seizures of illegal tobacco have been rapidly growing , from memory was something like a million $or more last year. Usual rule of thumb is that seizures of illicit drugs in general are around 10 to 20 percent of the total black-market for that drug.

        BTW The growing number of people who do not have a fixed landline phone number is creating a increasing problem for anyone trying to do national representative cross-sectional surveys , of just about anything.

        • Clive Bates

          The issue of response rate (are smokers overrepresented in the non-responders and how is that bias addressed?)and bias in reporting behaviours (do people deceive themselves about their smoking?) is more serious than the illicit trade point.

      • Andrew Thompson

        I became leery of answering questions after some online surveys not only asked the nature of the tobacco I smoked but also the source. I actually thought Australia’s smoking figures were largely based on the excise collected.

        A KPMG analysis of the ratio between plain packaged & cigarette packs still with branding, estimated that illicit tobacco took about 14% of the market. That was a few years ago before some eye watering tax excise increases. Of course, that analysis was rejected out of hand by Australian tobacco control because it was sponsored by a tobacco company.

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