Archive | September 2013

E-Cigs The TPD and Health

Summing it up
By David Dorn
October 2013

The present situation
The European Parliament is due to vote on the Tobacco Products Directive on 8th October in Plenary session in Strasbourg. The Commission’s preferred stance is one of defining Electronic Cigarettes (ENDS) as a kind of NRT, and, thus, making them subject to Medicines licensing throughout Europe. As a Public Health measure, this is a disaster.

The History
In 2007/2008, both ASH and Cancer Research UK advocated that NRT should not be controlled as licensed medicines, but should be removed from that arena and treated as consumer products: In 2009, though, Electronic Cigarettes came onto the market in a much more obvious way, and, from small beginnings, users of them now number in excess of 1.3 million, a number which is growing exponentially year on year.

The Present
Now, in 2013, we see a situation where both CR UK and ASH support the Government’s position that Electronic Cigarettes are to be captured by regulation which is patently a very poor fit. Both organisations have changed their stance. Why? Well, basically because E-cigs, according to CRUK, “normalise” the act of smoking a lit cigarette. They use terms like “Glamorise” and worry about young people (a term very vaguely defined, but usually denoted by “children”) taking up a smoking habit – the very widely debunked “gateway theory”.
The ASH position is that the market is not to be trusted to work as they would wish it, and that government must step in to ensure that the right path is taken, that quality, safety and efficacy are assured.
In all of this, both organisations miss the most vital point. Electronic Cigarettes – of any shape, size or colour – are orders of magnitude less risky for both the user and the bystander than the current market leading nicotine delivery device – the tobacco cigarette.
Both organisations would like to see an end to the smoking of lit tobacco – they term it “the end game”, and yet targets for such are almost risibly low. However, Wells Fargo and Bloomberg, amongst others, have predicted (quite reasonably, in my view) that within ten years, e-cig users would be in the majority over lit tobacco users. Within 20 years, over 95% of nicotine users would be using e-cigs, leaving only 5% using lit tobacco. That is, of course, if e-cigs are left unfettered by over-regulation.

7. They want to substitute their own view of ‘efficacy‘ (what works) for the consumers’ view. Markets work by
people buying the good products and the poor products failing, not by regulators deciding what works. It would
be different if they were making health claims, and could be tested to see if the claim are valid. But the e-cig
vendors aren’t making any claims. The truth is they don’t know what efficacy means with e-cigarettes.
8. What the e-cigarette sector doesn’t need is ‘boring’. That has been tried and failed with NRT. It needs marketing verve, style and buzz, not the dull deadening hand of bureaucratic approvals. That applies to product
design, packing, marketing, sponsorship – the works… the public health challenge is to get as many smokers to
switch as possible, not to make perfectly safe products that no-one wants.
9. They will focus on eliminating minute risks but obstruct great potential. There is great danger they will make
the products less attractive to smokers who might otherwise switch. So they get the risk down from 99% lower
than cigarettes to 99.5%. Big deal… and harmful if it means more people stay smoking as a result. There is no
evidence at all of gateway effects – those exist mainly in the imagination of health lobbyists. E-cigs are a major
gateway out of smoking, and an alternative to ever smoking.
10. This will give a boost to the home-made and black market – all likely to be more dangerous than a lightly
regulated commercial market. So it will fail anyway.

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