More evidence that UK health advocates have made it into a lab to test whether e-cigs will reduce -- or increase -- harm

Of all countries grappling with e-cigarettes, health advocates in the UK have been the most optimistic that they would actually reduce harm.  ASH UK has even said that it"does not consider it appropriate to include e-cigarettes under smokefree regulations," opening the door for normalization of e-cigarette use everywhere.

The hope is, as John Britton recently wrote, that smokers will switch the less dangerous e-cigarettes or use them to quit nicotine use altogether.  No one seems to be considering the possibility that the aggressiive marketing of e-cigarettes will increase youth initiation or deter quitting enough to offset any drop in individual harm from switching from conventional cigarettes to e-cigarettes.  (Dual users, who simultaneously use both products, are unlikely to see much, in any, health benefit because of the continued cigarette use, even if daily consumption drops.)

Last week the New York Times described how e-cigarettes are bringing back 1950s-style cigarette advertising in the US.  Now e-cigarettes are bringing back youth sports sponsorship in Wales, where an e-cigarette company is sponsoring a local football (soccer) club.

According to  the BBC story, public health advocates are expressing concern:

But BMA Cymru Wales, responding to the renaming of Merthyr's ground [the stadium], said the sale and use of E-cigarettes needed to be regulated urgently
"to ensure they are safe, quality assured and effective at helping smokers to cut down or quit".

"We need to restrict their marketing, sale and promotion so that it is only targeted at smokers as a way of cutting down and quitting and does not appeal to non-smokers, in particular children and young people," said senior public affairs officer John Jenkins.

Campaigner Elen de Lacy, chief executive of Action on Smoking and Health (ASH) in Wales, said they were also concerned about marketing to children.

"It is important that E-cigarettes are only promoted to adult smokers and we oppose the marketing of this product to young people through sponsorship of a family friendly stadium," she said.

The reality, however, that e-cigarette companies are out to make as much money as fast as they can, not comport with naive ideas about how the products will be marketed and used narrowly to help people quit smoking (whether they continue with e-cigarettes or not).  They are not interested in the kind of academic hair splitting that has dominated discussions of e-cigarettes among health authorities.

With the house well out of the barn, we should all watch what happens in the UK over the next couple years.

If the optimists turn out to be right, other countries can try and allow introduction of e-cigarettes.  If, on the other hand, youth nicotine addiction and dual use start to increase and cessation drops, we can all learn from the UK's mistake.

 

Comments

e-cigarettes

In addition to the broader concerns about promoting e-cigarettes, we also need to be wary of phrases such as "marketing to children" - much used by alcohol companies now as they once were by tobacco companies trying to defend themselves against ad bans. The line we are supposed to accept is that if marketing is not specifically targeted to children, we don't need to worry about or restrict it, as it will only impact on adults. That is why alcohol companies speak fondly about their voluntary codes and processes that supposedly preclude marketing "to children". The reality is that even if we set aside our well-justified cynicism and accept that various forms of promotion are not even in part primarily directed at children, there is a mass of evidence showing that children are exposed to and influenced by them. With e-cigarettes (as with ordinary cigarettes or alcohol) our concern should not be about constraints on "marketing to children", but about protecting children from exposure to marketing. We learned that lesson decades ago about cigarette advertising; we should not have to re-learn it about e-cigarettes, especially when so many of the key industry players are the same. Mike Daube

ScotRail policy on e-cigarette usage in trains and stations

'After careful consideration, we have decided not to allow customers
      or staff to smoke e-cigarettes on our trains or at stations or train
      depots.  Here’s why:
         Their use may unsettle other passengers and cause people to think
         that smoking real cigarettes is allowed.
         The British Medical Association (BMA) believes that e-cigarettes
         should be included in the ban on smoking in public places.
         The BMA says there is a lack of rigorous, peer-reviewed studies to
         support the use of e-cigarettes as a safe and
         effective nicotine-replacement therapy.
         It also says these devices may undermine efforts to prevent or
         stop smoking by making cigarette use seem normal in  public and at
         work.
         In June 2013 the Government announced that it will introduce
         legislation that forces these products to be licensed in response
         to scientific and market research into their safety and quality.
         The Medicines and Healthcare Regulations Authority (MHRA) says
         that in the meantime people should use licensed nicotine
         replacement products – gums, patches, mouth sprays etc – to reduce
         the harms of smoking.

      If, in future, new information comes to light about the efficacy and
      health implications of e-cigarettes we will be happy to review this
      arrangement.'

Source: personal communication to Allison Brisbane, Senior Information Officer, ASH Scotland, Edinburgh

e-cigarette promotion

In addition to the broader concerns about promoting e-cigarettes, we also need to be wary of phrases such as "marketing to children" - much used by alcohol companies now as they once were by tobacco companies trying to defend themselves against ad bans. The line we are supposed to accept is that if marketing is not specifically targeted to children, we don't need to worry about or restrict it, as it will only impact on adults. That is why alcohol companies speak fondly about their voluntary codes and processes that supposedly preclude marketing "to children". The reality is that even if we set aside our well-justified cynicism and accept that various forms of promotion are not even in part primarily directed at children, there is a mass of evidence showing that children are exposed to and influenced by them. With e-cigarettes (as with ordinary cigarettes or alcohol) our concern should not be about constraints on "marketing to children", but about protecting children from exposure to marketing. We learned that lesson decades ago about cigarette advertising; we should not have to re-learn it about e-cigarettes, especially when so many of the key industry players are the same.