Dear Canadian Smokers: Please Follow Britain’s Guidance

 

I sent the following message to Canadian smokers.  It appeared in a Maclean’s magazine health supplement, with sponsorship by the Canadian Vaping Association (available here).

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You may wonder why an American professor accepted an invitation from the Canadian Vaping Association to author an article about e-cigarettes. In part, it’s because I want to apologize to you for the way my government, which is engaged in a coordinated, expensive campaign to create a tobacco-free society, has wrongfully destroyed the prospect of a smoke-free future for millions. Don’t listen to American health officials, who emphasize only the negatives, untruths, and urban myths. Don’t let their campaign stop you from stepping away from the fire.

Instead, you should follow the lead of Britain’s Royal College of Physicians, one of the world’s oldest and most prestigious medical societies. Nearly 20 years ago, it advised, “as a way of using nicotine, the consumption of non-combustible tobacco is on the order of 10-1,000 times less hazardous than smoking, depending on the product.”1

In 2007, the Royal College published a report2 challenging governments to consider “that smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved. This report makes the case for radical reform to the way that nicotine products are regulated and used in society.” It described its ideas as “controversial and challenge many current and entrenched views in medicine and public health. The principles behind them have the potential to save millions of lives. They deserve consideration.”

Unlike their American counterparts, British authorities have consistently told smokers the truth about vaping since 2011 (here, here, here and here). In fact, their Department of Health helps smokers switch from combustibles to vapour. As a result, the U.K. vaping population ballooned from 700,000 in 2012 to 3.6 million in 2019.

The Royal College (here) provided the perfect reason for you to switch from cigarettes to vape in 2016: “The hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5 percent of the harm from smoking tobacco.”

Nothing has changed the Royal College’s hazard assessment, so don’t be fooled by the tsunami of exaggerated and outright fictitious vaping “dangers” concocted by prohibitionists.

Note: I have restored some links that were removed by the publisher.

 

 

Vaping in the U.K.

Comedian-cum-philosopher Stephen Colbert has opined, “Facts matter not at all. Perception is everything.”  Actual British researchers have gone a step further, finding that, with e-cigarettes and vaping, perception changes behavior.

British health authorities have consistently told smokers the truth about vaping since 2011 (here, here, here and here), while American officials, in their pursuit of a “tobacco-free society” or a “tobacco endgame,” have emphasized the negative, or simply perpetuated untruths and urban myths. 

Survey data in the U.K. and U.S. demonstrate that truth-telling results in more accurate perceptions about vaping than do obfuscation and scaremongering (here).  Now, a survey from the U.K.’s Action on Smoking and Health (ASH) (here) shows that favorable perception translates into positive behavior.

In this case, facts do matter.  The U.K. vaping population has ballooned, from 700,000 in 2012, to 2.9 million this year.  Importantly, the majority (52%) are former smokers – a sharp contrast to American data showing that most vapers are current smokers (here).

Within these encouraging U.K. figures are reasons for concern.  First, the prevalence of vaping is currently 5.8%, which is only a 12% increase since 2015.  This suggests that e-cigarette use may be leveling out.  With some nine million Brits smoking today (here), vaping momentum will have to grow in order to drive down smoking.

A major barrier to the success of e-cigarettes is misinformation (here).  The ASH report documents that 22% of smokers believe that e-cigarettes are more or equally harmful than cigarettes – a 9% increase from four years ago.  Anti-vaping propaganda, discussed here, may be a contributing factor.  Interestingly, 16% of smokers who tried but don’t use e-cigs said they would try them again if they were sure they were safe to use.

The ASH report also documents that e-cigs don’t work for all smokers.  Of smokers who tried but no longer use e-cigarettes, 25% said the devices didn’t feel like smoking, and 20% said they didn’t help with cravings.  Smokers should be given access to a range of safer smoke-free substitutes, including smokeless tobacco and heat-not-burn products, in order to help them quit their deadly smoking habit.   

         

British Government Tells Smokers & Vapers the Tobacco Truth

While U.S. government health agencies include e-cigarettes in their decades-long attack on tobacco harm reduction and safer tobacco alternatives, public health leaders in Britain are telling the truth about e-cigarettes. 

The UK’s National Centre for Smoking Cessation and Training last week issued e-cigarette recommendations for practitioners and services via a “briefing” document.  As Clive Bates noted (here), it “represents a new worldwide high point in the blending of evidence with empathy in official public health advice.”  Furthermore, it represents a powerful antidote to the dangerous misinformation campaign being waged by the FDA, CDC, NIH and other U.S. agencies and organizations.

The new briefing follows positive British government reports on e-cigarettes issued in 2011 (here), 2014 (here) and 2015 (here).

Britain’s message is clear: “We begin by acknowledging that e-cigarettes are considerably safer than smoking cigarettes, are popular with smokers and that they have a role to play in reducing smoking rates.”  The briefing dispels dark myths that are the staple of tobacco abolitionists, including the shibboleth about nicotine.

“Nicotine does not cause smoking related disease, such as cancers and heart disease. These are caused by other chemicals found in tobacco smoke. Nicotine is addictive however and it is why people continue to smoke despite knowing about the harmful effects of tobacco. Nicotine in e-cigarettes poses little danger to adult users.”

The briefing addresses, in common sense terms, the risk of e-cigarette-related poisoning of children, a subject that is wildly exaggerated in the U.S. (here):

Should health professionals recommend e-cigarettes to smokers?  This is anathema in the U.S.; in Britain, practitioners are encouraged to:

“Familiarise yourself with e-cigarettes…Be positive when speaking about e-cigarettes. When you say: ‘We can’t recommend e-cigarettes’, people hear: ‘E-cigarettes are no good’. Instead choose words that convey a positive message such as: ‘We can’t supply them, but we can certainly offer the extra support that will help you stop smoking if you buy your own e cigarette’… Don’t push people to come off their e-cigarette…Some practitioners feel it is important to get people off nicotine as soon as possible, but in fact longer-term e-cigarette use can be a protective factor against relapse back to smoking.” (original emphasis)

 Regarding the chance of exploding e-cigarettes, the briefing advises:

“As with any rechargeable device, like mobile phones and laptops, it is important to charge with the correct charger and not to leave an e-cigarette unattended whilst charging. Ensure that you buy from reputable suppliers and avoid generic charging equipment.”

What about harmful chemicals and secondhand vapor?

“Some studies have detected chemicals in e-cigarette vapour that are known to cause health problems. However, these chemicals have been found at very low levels that are unlikely to represent a serious risk to health. When e-cigarettes are used within normal operating levels (e.g. not overheated), there are far fewer harmful chemicals present in their vapour than in tobacco smoke. If the e-liquid is being overheated it tends to produce an acrid, unpleasant taste – you will know if this happens!...There is no evidence that secondhand vapour is dangerous to others; however, it helps to be respectful when using e-cigarettes around others, especially non-smokers.”

These are only a few examples of the “evidence and empathy” offered in this enlightened British report.  Available here, it should be required reading for all federal, state and local authorities in the U.S.