My recent speech in the House of Lords on the dangers of too
much regulatory precaution over electronic cigarettes has sparked a
huge amount of interest among “vapers”. I am reprinting the speech
here as a blog:
I congratulate my noble friend Lord Astor, on securing this
debate. It is an issue of much greater importance than the sparse
attendance might imply and one that is growing in importance. I
have no interest to declare in electronic cigarettes: I dislike
smoking and have never done it. I have only once tried a puff on an
e-cigarette, which did nothing for me. I am interested in this
issue as a counterproductive application of the precautionary
principle. I should say that I am indebted to Ian Gregory of
Centaurus Communications for some of the facts and figures that I
will cite shortly.
There are, at the moment, about 1 million people in this country
using electronic cigarettes, and there has been an eightfold
increase in the past year in the number of people using them to try
to quit smoking. Already, 15% of ex-smokers have tried them, and
they have overtaken nicotine patches and other approaches to
become the top method of quitting in a very short time. The
majority of those who use electronic cigarettes to try to quit
smoking say that they are successful.
Here we have a technology that is clearly saving lives on a huge
scale. If only 10% of the 1 million users in the country are
successful in quitting, that would save £7 billion, according to
the Department of Health figures given in answer to my Written
Question last month, which suggest that the health benefits of each
attempt to quit are £74,000. In that Answer, Minister said
that,
“a policy of licensing e-cigarettes would have to create very
few additional successful quit attempts for the benefits to justify
its costs”.—[Official Report, 18/11/13;
col.WA172.]
But who thinks that licensing will create extra quit attempts?
By adding to the cost of e-cigarettes, by reducing advertising and
by unglamorising them, it is far more likely that licensing will
create fewer quit attempts. Will the Minister therefore confirm
that, by the same token, a policy of licensing e-cigarettes would
have to reduce quit attempts by a very small number for that policy
to be a mistake?
Nicotine patches are also used to reduce smoking and they have
been medicinally regulated, but there has been extraordinarily
little innovation in them and low take-up over the years. Does the
Minister agree with the report by Professor Peter Hajek in
the Lancet earlier this year, which said that the
30-year failure of nicotine patches demonstrated how the expense
and delays caused by medicinal regulation can stifle innovation?
Does my noble friend also agree with analysts from Wells Fargo who
this month said that if e-cigarette innovation is stifled,
“this could dramatically slow down conversion from combustible
cigarettes”?
We should try a thought experiment. Let us divide the country in
two. In one half—let us call it east Germany for the sake of
argument—we regulate e-cigarettes as medicines, ban their use in
public places, restrict advertising, ban the sale of refillable
versions, and ban the sale of e-cigarettes stronger than 20
milligrams per millilitre. In the other half, which we will call
west Germany, we leave them as consumer products, properly
regulated as such, allow them to be advertised as glamorous, allow
them on trains and in pubs, allow the sale of refills, allow the
sale of flavoured ones, and allow stronger products. In which of
these two parts of the country would smoking fall fastest? It is
blindingly obvious that the east would see higher prices—and prices
are a serious deterrent to attempts to quit smoking because many of
the people who smoke are poorer than the average. We would see less
product innovation, slower growth of e-cigarette use and more
people going back to real cigarettes because of their inability to
get hold of the type, flavour and strength that they wanted.
Therefore, more people would quit smoking in the western half of
the country.
What are the drawbacks of such a policy? There is a risk of harm
from electronic cigarettes, as we have heard. How big is that risk?
The Minister confirmed to me in a Written Answer earlier this year
that the best evidence suggests that they are 1,000 times less
dangerous than cigarettes. The MHRA impact assessment says
that the decision on whether to regulate e-cigarettes should be
based on the harm that they do. Yet that very impact statement says
that,
“any risk is likely to be very small”,
that there is,
“an absence of empirical evidence”
and “no direct clinical evidence”, that “the picture is
unclear”, and—my favourite quote—states:
“Unfortunately, we have no evidence”,
of harm.
There is said to be a risk of children taking up e-cigarettes
and then turning to real cigarettes. Just think about that for a
second. For every child who goes from cigarettes to electronic
cigarettes, there would there have to be 1,000 going the other way,
from e-cigarettes to cigarettes, for this to do any net harm. The
evidence suggests, as my noble friend Lord Borwick has said, that
the gateway is the other way. Some 20% of 15 year-olds smoke, and
evidence from ASH and a study in Oklahoma suggests strongly that
when young people use electronic cigarettes they do so to quit,
just like adults do.
If we are to take a precautionary approach to the risks of
nicotine, will the Minister consider regulating aubergines as
medicines? They also contain nicotine. If you eat 10 grams of
aubergine, which you easily could with a plateful of moussaka, you
will absorb the same amount of nicotine as if you shared a room
with a cigarette smoker for three hours. It is not an insignificant
quantity. That is data from the New England Journal of
Medicine in 1993. If we are worried about unknown and small
risks, can the Minister explain to me why, as Professor Hajek, put
it, more dangerous chemicals, such as bleach, rely on packaging and
common sense rather than on medicinal licensing?
There has been approximately an 8% reduction in the use of
tobacco in Europe in the past year. The tobacco companies are
worried. A big part of that reduction seems to be because of the
rapid take-up of electronic cigarettes. They are facing their Kodak
moment—the moment when their whole technology is replaced by a
rival technology that, in this case, is 1,000 times safer. Does my
noble friend think that there may be a connection between the rise
of electronic cigarettes, the rapid decline in tobacco sales and
the enthusiasm of tobacco companies for the medicinal regulation of
electronic cigarettes?
It is not just big tobacco; big pharma has shown significant
interest in the regulation of electronic cigarettes. That is not
surprising because they are, again, a rival to patch products and
other nicotine replacement therapies. Perhaps more surprising is
that much of the medical establishment is in favour of medicinal
regulation. I never thought I would live to see the BMA and the
tobacco industry on the same side of an argument. The BMA says that
electronic cigarettes cannot be considered a lower-risk option, but
this completely flies in the face of the evidence. As we have heard
already, electronic cigarettes are 1,000 times safer. The BMA says
that it is worried about passive vaping, the renormalising of
smoking and the use of electronic cigarettes as a gateway to
smoking. The excellent charity Sense About Science, to which I
am proud to be an adviser, has asked the BMA for evidence to
support those assertions. I must say that there is a strong
suspicion that the only reason the medical establishment wants to
see these things regulated as medicines is because it cannot bear
to see the commercial sector achieving more in a year in terms of
getting people off cigarettes than the public sector has achieved
in 10. Instead of talking about regulating this product, should we
not be talking about encouraging it, promoting it and letting
people vape indoors if they want to—in pubs, on trains and in
football grounds—specifically so that they are tempted to vape
instead of smoke? That would be of enormous benefit to them and to
the country as a whole.
I end by asking specifically in relation to the agreement that,
as we heard from my noble friend Lord Borwick, was agreed last
night, what its impact will be on what is happening, and in
particular on advertising. As I understand it, under the agreement
reached yesterday, it will be possible for the advertising of these
things to be banned as if they were cigarettes. What is the
justification for that, given the proportionality and the evidence
that they will actually save lives rather than harm them?
Here are some of the messages I have received since making the
speech:
I would like to show my sincere gratitude to you for the honest
facts on the debate in the House of Lords regarding e-cigarettes
… I was a 30+ a day cigarette smoker for nearly 50 years and have
not had a single one since I found the e-cig 11 months ago, my
health has vastly improved …. thank you!
I’ll lift my hat for your effort to explain, how vapers would
have been affected by eu regulations. Started to smoke at age
9, tried every thing to stop in the next 50 years (
nicorette-hypnosis akupunktur, you name it ) In juli i
bought my first e-cigarett, with 12mg/ml nicotine 🙂 for the
first time in 50 years I was not smoking but vaping, and are
now after 5 months down to 6mg nicotine.
Thank you for your support in our fight to give every smoker the
chance to move away from the lit tobacco that is killing them. I
hope you enjoyed being able to make all the statements from a
position of science and common sense, not fettered by the big
tobacco and pharma companies. I speak as an ex smoker who is
now a vaper with no attachment to the e cig business. Can I
leave you with one thought. I know, over Internet, thousands of
vapers and most of the long term ones reduce their nicotine. I have
reduced mine from 24mg to 6mg in nine months. What other form of
addiction has “users” REDUCING their substance of addiction.
Nicotine may not be “highly addictive” as commonly quoted.
From across the pond we are making your speech viral amongst the
fold of E-Cigarette users and yes you are right in every word.
I have quit smoking thanks to E-Cigarettes like so many
British and Europeans have. I am so proud of not smoking
anymore after 40 yrs. of smoking, and I am hoping that the TRUTH
that you spoke of will spread and grow eventually that it will out
way the greed from the opposition. Thank you from the bottom
of my heart for your bravery and brilliance.
I would like to thank you for your outstanding speech on
E-Cigarettes on 17 Dec 2013 (seen on CASAA link), I have to
applaud your sensible argument in support of E-Cigs based on
science and common sense. The rubbish that has been propagandized
by the anti-smoking, Big Tobacco companies and Big Pharma
groups has been obscene, especially when E-Cigs can save thousands
of lives. I smoked for 40 years and have now stopped for over 7
months by using an E-cig which I have lowered my nicotine levels
down to 9mg during this time. I know that thousands of people are
doing the same thing as I am.
And finally…!
I would just like to express my appreciation for the speech to
the Lords regarding Electronic Cigarettes. I was thinking I’d have
to vote UKIP next time.