April 7th, 2017

In cheap publicity stunt Royal Society of Public Health sounds a fake alarm about a non-problem

Life-saving retail outlet serving adults – no need for ‘public health’ to be involved (note: photo not UK)

Today the Royal Society of Public Health is pitching its ‘undercover investigation’ into vape shops selling stuff to adults who don’t smoke. Naturally, the primary purpose of this exercise has little to do with public health but is a publicity stunt for an ailing organisation in a declining field that offers ever less to the public or to health.

Here’s the release: Undercover investigation finds 9 in 10 vape shops prepared to sell to non-smokers – and some predictable media have duly obliged the RSPH’s lust for publicity with the uncritical reporting we have come to expect in this field.

I have written to this Royal Society of Public Health explaining why I am “dismayed and disappointed” by such a cheap stunt. Here’s the letter:

Shirley Cramer CBE,
Chief Executive
Royal Society of Public Health
John Snow House
59 Mansell Street
London E1 8AN

7 April 2017

Dear Dr. Cramer

I write to express dismay and disappointment at your ill-founded criticism of vaping retailers with an ‘undercover investigation’ (press release Undercover investigation finds 9 in 10 vape shops prepared to sell to non-smokers 7 April). It is a bizarre and contrived study raising a false alarm about a non-problem. RSPH have made much of the idea that vape shops do not check if their customers are non-smokers. But it is not surprising that they do not make these checks for several reasons.  These reasons are missing context in the press release you have sent out to national media. Let me try to provide that context here.

1. Over 97% of vapers are smokers or ex-smokers

Use of e-cigarettes by never-smoker adults is very low indeed. According to the Office for National Statistics, 97.4% of current vapers are either current or former smokers (see Table 2b in E-cigarette Use in Britain, 7 March 2017). That means you are raising a concern to national media level about 2.6% of the vaping public, or 0.12% of the adult population. Yet all this tiny minority is doing is something much safer than smoking and for which no material risk has so far been identified – see the Royal College of Physicians report, Nicotine without smoke: tobacco harm reduction if you are still uncertain about this.

2. Many of the rest may be former smokers or potential smokers

Of the remaining 2.6% that self describe as never-smokers but current vapers, the reasons given for vaping suggest that many either have been smokers or that they are potential smokers.  Table 3b in E-cigarette Use in Britain gives the main reason why people vape by smoking status. These are the findings – and please remember that these are percentages of percentages – shares of the 2.6% who say they are never-smoking vapers. Some of these reasons suggest prior smoking or possible intention to smoke, with vaping as an alternative.

Main reason given by ‘never-smokers’ for vaping
Perception that they are less harmful than cigarettes  38.8%
Can be used indoors   0.0%
Cheaper than tobacco products 12.1%
Novelty 6.2%
Aid to stop smoking 27.4%
Range of different flavours available  0.0%
 Other reasons  15.8%

So even this tiny minority maybe be benefitting from vaping as an alternative to smoking.

3. Use by never-smokers should be expected and can be beneficial

It is important to understand that there will be increasing first-use of vaping by people who have never smoked, and that this is a good thing.  This is good because it means people who would otherwise have become smokers use vaping instead and may never initiate smoking. For those who do take a serious interest in public health, the experience of Sweden is important. Swedes increasingly make first use of snus, and many will never smoke. A recent paper on the Swedish experience is instructive:

Those who began daily tobacco use using snus were much less likely to subsequently take up smoking than those who had not, both among males (17.6% vs. 45.9%), and females (8.2% vs. 40.2%). […]. Indeed, those who were primary snus users were also more likely to have quit altogether than those who only ever smoked. Snus was also reported as the most common smoking cessation aid among men and yielded higher success rates than nicotine replacement therapy and other alternatives.

Ramström L, Borland R, Wikmans T. Patterns of Smoking and Snus Use in Sweden: Implications for Public Health. Int J Environ Res Public Health. Multidisciplinary Digital Publishing Institute (MDPI); 2016 Nov 9;13(11). [link]

The authors go on to conclude:

As conclusions, snus has both contributed to decreasing initiation of smoking and, when used subsequent to smoking, appears to facilitate smoking cessation. All these effects suggest that the availability and use of snus has been a major factor behind Sweden’s record-low prevalence of smoking and the lowest level of tobacco-related mortality among men in Europe.

How can you be sure that efforts to deny adult non-smokers access to vaping would not be a cause of harm? I am guessing you cannot and that RSPH’s position is not thought-out or evidence-based.

4. Were these shops bound by the code you are criticising them for breaking?

It is disappointing that RSPH chose to go straight to the media and sidestep publication in a journal or, apparently, any quality control whatsoever. At the heart of this made-for-media story is the idea that these shops were violating the Code of Conduct of the Independent British Vape Trade Association.  The IBVTA is not a regulator, its code is not mandatory and it does not apply to non-members.  Can you explain how, or indeed if, the RSPH established whether the 100 vaping shops visited were actually bound by this code?   As far as I am aware, the IBVTA consists mainly of larger companies and many who sell through the internet. It is quite possible that many shops are not members.  It is also possible that they either do not think this is an issue (see above), do not agree with the IBVTA, do not want to ask their customers intrusive and distracting questions, or simply think that adults should make these decisions for themselves.

5. This is a matter of adult choice and you should not be wasting resources on it

Finally, we have come to expect that public health organisations will rarely reflect with any insight on the appropriate limits of public health interventions or the role adult autonomy or personal volition.  This is a matter of adult choice involving a low-risk activity that is an alternative to a high-risk activity.  Is RSPH about to start intervening on every minor risk-taking activity?

So, have you considered that this is simply none of your business? Perhaps you should stop wasting time and money on stunts that have the aim or effect of demonising much safer alternatives to smoking, harming decent businesses doing a good job, misleading the media and diverting attention from much more pressing problems.

For the Royal Society of Public Health, this has not been its finest hour.

Yours sincerely

Clive Bates
Counterfactual
L
ondon

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26 comments to In cheap publicity stunt Royal Society of Public Health sounds a fake alarm about a non-problem

  • […] Clive Bates: In cheap political stunt Royal Society for Public Health sounds a fake alarm about a non-problem (UK RSPH) https://www.clivebates.com/?p=4753 […]

  • […] followed up by writing to the Royal Society of Public Health, explaining why he is appalled by such a “cheap […]

  • […] Bates, is expressing outrage over the announcement, calling it nothing more than an anti-vaping “cheap publicity stunt” meant to incur wrath against the British vaping community by the general, non-smoking […]

  • […] In cheap publicity stunt Royal Society of Public Health sounds a fake alarm about a non-problem […]

  • ” Pruning of personnel and funding is of the utmost necessity.”

    :: Watching the sudden massive waving of hands in the air amidst shouts of “Me!”, “Hey, Me!”, “Yo, gimmee those gardening shears!”, “Outta my way! I was here first! Gimmee the big sharp ones!”, and “Can I have the model with the 100 horsepower motor and laser beam guidance system?” ::

    :>
    MJM

  • dodderer

    Taking the key points of the RSPH report together,it is very much prohibition+medicinal aid.
    I think it was Ms Cranmer who has previously said “we are supportive of ecigs…..for now”

    Calls to action:
    • E-cigarette retailers to adhere to a code of best practice
    • Business rates relief to be considered as a means to incentivise small retailers to no longer sell tobacco products
    • An end to tobacco advertising in trade publications
    • All local stop smoking services to become e-cigarette friendly
    • MHRA to encourage and support more e-cigarette manufacturers through the medicinal licensing process, so that suitable products can be prescribed on the NHS

  • Roberto Sussman

    E-cigs have been so much advertised and promoted as cigarette substitutes (or as public health would like it) as smoking cessation devices, that practically the totality of non-smokers feel no connection to them. This is persistently shown in all surveys.

    Some non-smoking friends and acquaintances who see me vaping feel curious about e-cigs. I always carry a plastic mouthpiece and I offer them to try vaping. I tell them to puff slowly and gently without inhaling the vapor. I have done this “experiment” about 10 times and in 8 out of 10 times the non-smokers found it pleasurable, 3 of them loved it. After all, and specially with mild fruity/sweet favors without (or with very low) nicotine the vapor is very gentle, and when not inhaled it does not produce a cough or an allergic reaction. A further bonus is that the vapor leaves no trace behind and no residual smell in the clothes and utensils.

    Given the fact that vaping is a very low risk activity that can be very pleasurable, and given the advancement of the technology to make it more pleasurable and appealing, it is not outlandish to consider a possible future scenario in which large numbers of non-smokers could become regular vapers, most likely vaping without (or with very low level) nicotine.

    This is possible scenario is probably an unbearable nightmare for the bulk of public health physicians and controllers, who are still wedded to the “abstinence only” regulatory goal they have pursued for decades. This crowd is willing to tolerate (at most) e-cigs as a cessation devise to be used temporarily until the desired abstinence occurs.

    However, the possible widespread usage of vaping beyond smokers or ex-smokers has very important consequences besides the disgust it may cause to ideologues. We could be talking of a potentially huge multi-billion market of vapers. I am certain that large cigarette corporations are aware of this potential market and would be eager to manufacture and sell e-cig and to invest in their technology, since after all it is a consumer product. The heat-not-burn technology is an attempt in this direction. Evidently, this would leave out the pharmaceutical industry (which cannot compete against a product that is not a medication).

    Perhaps the “cheap publicity stunt” by the Royal Society of Public Health should be understood in this context. Not so much as a sloppy dumb error, but as a first well planned attempt to defuse a potential development that would be seen as nightmarish by two types of crowds: publicly well funded public health bureaucrats who have preached abstinence for decades and their pharmaceutical allies and sponsors. Again, the issue is not health concerns for the actual and potential vapers, but protecting well paid bureaucratic jobs and vested pharma interests.

    • John Walker

      Roberto
      There are ‘dry ‘ States in India where if you want to get a drink , you have to officialy register as an ‘alcoholic ‘ and then go to a dispensary , I would not be at al surprised if a similar regulatory path for all tobacco use was at the back of the TC mind .

      • Roberto Sussman

        Jonh, yes, I agree, perhaps this “cheap publicity stunt” by the RSPH (and its unbelievably trashy and thuggish “investigation”) is the sort of “trial balloon” that precedes a sequence of policies aimed at a final goal: restricting the sale of vaping gear to “nicotine addicts” in some sort of official registry, just as in the dry states of India. Tobacco controllers know they cannot do this registry now because it would produce social outrage, so they follow the gradual “salami theory”. This is what they have always done. The difference is that vaping is now the target and the goal is to restrict it to be a smoking cessation medication for “nicotine addicts”.

        • John Walker

          Roberto
          Gut feeling is that ecigs and SNUS really bother TC for one particular reason: for a non smoker ,smokers are easy to detect even when they are not smoking, the smell clings, really is noticeable . In contrast ecig ( baring extreme cloud chasers) users are not nearly so easy to detect and single out for, special treatment.

          Afterall the ancient original opposition to smoking was all about the smell and the ash, not the health.

        • Roberto Sussman

          I agree, phobia to odor is an important cultural element that a lot of anti-smokers try to rationalize in scientific and medical terms. However, it lacks a scientific basis, as a lot of highly toxic substances are odorless (CO and nitrogen oxides) while a lot of smelly stinking substances may be irritant but harmless (assuming same dosage). I don’t think it is coincidental that anti-smoking feeling is particularly intense in social niches where strong odors are not socially acceptable, for example middle classes and academic circles in English speaking countries. I believe there are political initiatives to curtail strong perfumes, which may cause allergies to “sensitive” people, in San Francisco and in various Canadian cities (which coincidentally have imposed the most stringent smoking and vaping bans). I am convinced that a lot of this sensitivity is socially induced, which does not make it less real. However, it is unfair to demand that all of us must be hostage to it.

      • John R Walker

        Roberto
        While I agree totaly with what you are saying,
        my point was simply that smokers don’t need a ‘yellow star’ stuck on their foreheads to identify them to non-smokers as a group for special treatment.
        In marked contrast people who use smokeless products are (especially when not actually using the product) virtually indistinguishable for the rest of the crowd.

        Demonizing-persecuting any sub-group in society is much ‘easier’ if that sub-group can be painted as ‘other’.

  • John Walker

    There is also little evidence that points to ecigs being , for non smokers , particularly addictive .
    For example Michael Mosely for his TV show used a ecig for a month and at the end felt no ‘compulsion’ at all to keep on using them.

    They are talking about a tiny number of people who in all likelyhood have had a ‘out of curiosity ‘ try, or use their ecig only occasionally.
    Or as others have pointed out may simply be buying the ecig for their ‘husband’ etc.

  • Rob Spencer

    I remember the first time I ever went in a pub. I was 18 and the barman said ”have you ever drunk alcohol before lad?”, ”no” said I. ”Then get the hell out” he shouted…

  • Anonymous

    now why dont they go into ordinary shops that sell fags and see how many of them will sell to non smokers

  • michael d gross

    Amazing that PublicHealthEngland supports e-device use, yet the RSPH hasn’t seen the memo.

  • Lollylulubes

    People buying cigarettes don’t get grilled on whether they’re a smoker. One would assume that an adult, buying a legal product, is old enough to know what they’re doing and able to make their own decisions, without being treated like a child. For anyone with half a brain, it stands to reason that future potential smokers will be diverted to vaping instead, which will be a great result, particularly as nicotine isn’t addictive for never smokers. You’re right Clive, it’s absolutely none of RSPH’s business.

    Public Health is getting out of control in many areas as they scrabble for ideas that will bring in more and more funding. Regarding vaping, I believe they’re terrified that all politicians will soon wake up and realise that it’s doing a great job of helping those who choose it over smoking, at no cost to the taxpayer. Maybe they could save the government £millions of taxpayers’ money by defunding the vast majority of anti-smoking groups, whose methods no longer work and some of which are actually very harmful. It’s down to constant misinformation from many such groups globally that vaping is under threat, with Big Tobacco, who they profess to hate, looking forward to being handed the vaping monopoly.

    • michael d gross

      Not sure what you mean in the comment…Nicotine is potentially addictive to anyone who is exposed to it. The real issue is the harm connected to the manner of ingesting it, as nicotine itself is benign.

    • Clive Bates

      I agree – this sort of opposition has two effects:

      1. It protects the cigarette trade from competition

      2. It shapes the vaping market (that’s left) to align precisely with the business model of tobacco companies.

      Ironically, I don’t even think the tobacco companies have to do anything – these people wake up every day with renewed fervour to assist the, but without actually realising that.

  • Mark Magenis

    So now I have to self declare as a problem drinker to get a pint?

  • Doug Neaves

    I have been vaping for a few years. I have never been to a vape shop, but a large amount of my vaping supplies has been purchased on my behalf by a never smoker.

    If challenged on her smoking status, I would like to think that she would have replied with “I am terribly sorry, I appear to be in the wrong shop”. Alas, I fear, the reply would probably have been a relatively obscure word, roughly translated as the entrance to the womb.

    As a result, the shop would have lost me as a customer, and the local fag shop, (English usage), would have regained me as a customer.

    A Right Royal Society of Public Health, is possibly a more appropriate naming convention.

    • Nate

      You’re not missing much, Doug. I’ve also been vaping a few years, and I find vape shops absolutely dreadful. Each one I’ve been in (admittedly only a few) I had to wade through a crowd of twenty-something kids who, it seems to me, ought to have something better to do than hang out at the vape shop filling the air with godawful fruity vapor clouds. Compared to the wondrously pleasant smells that greet a visitor to a tobacco shop, vape shops are always going to pale by comparison.

      I’m not exaggerating when I say that if I couldn’t order my vaping supplies online, I probably wouldn’t vape.

      • Lollylulubes

        I’ve only been to two vape shops … around a year ago; one of which was a brand new Totally Wicked franchise. Neither were particularly inspiring, neither carried the range I can get online and both of which I had to spend around an hour educating about the TPD, as they hadn’t even heard of it. These were very small shops though; I’m sure a larger shop in the city would be much more fun to explore.

      • Doug Neaves

        This is what makes the Right Royal Society of Public Health stance so insidious, Nate. I started vaping when I went blind, embarrassingly, I could not roll a cigarette properly. There was an increased fire risk, I was also dropping tobacco all over the place, so I thought vaping would be better.

        Problem number one, how do you access the products? My trade in my sighted life was using and supporting computers, (I call it a “Trade”, so a direct comparison with The Right Royal Society of Public Health, can be made. Their “Trade” does not appear to be health). The only way for me to access the information on computer was to use a text to voice program. Many weeks, months, years, of listening to the most unimaginable guff ever visited on the human race was interesting. Online ordering is “challenging”, blind bloke instructing a computer illiterate neighbour how to select and pay for items online. It was not fun, if I had a T-bird I would have torched it.

        The vape shop is an easier solution, neighbour goes shopping, pops into the vape shop with a list, phones for advice, comes back with the items. This is what neighbours do, you pick things up for your neighbours when you are shopping. Incidentally, the buy one get one free offers at supermarkets, you know the ones, you go to the shop see two for the price of one and give the other to a neighbour. They are now the work of the devil, apparently.

        Thankfully after a few operations I have now regained some sight, I still must use text to voice programs, but at least I can see all the ersatz tobacco control funding-hounds.

        The Right Royal Society of Public Health, with their latest thumbing their nose at their funders escapade, is a classic. A situation could have developed, whereby, a non-smoker neighbour writes a note to a vape shop, on behalf of a blind person, authorising the very same neighbour to purchase vaping supplies that are consumer products. Ideas that may appear perfectly rational, after quaffing a few jam-jars of decaffeinated Beaujolais, or whatever “the public funded rich” do to appear more working class, are seldom rational, unless viewed as “maintenance of funding stream”.

        If an “organization” touts for funding based on its stated desire to help smokers quit, then diverts funding to denigrate an alternative to smoking, there is an obvious problem within that “organization”. Pruning of personnel and funding is of the utmost necessity.

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