It is been an interesting few days for smokers intent on quitting their custom.
Last week found welcome new guidance from the National Institute for Health and Care Excellence (NICE) – the first to advocate that accredited nicotine-containing products (NCPs) may be used to help individuals cut down on the amount they smoke (as well as to help them quit completely).
Now the Medicines and Healthcare Products Regulatory Agency (MHRA) has made its long-awaited statement of its intent to license NCPs on the electronic cigarette, which have – until now – dropped outside NICE’s guidance and both medical regulation for cutting down and stopping.
This is great news. We have needed to see the electronic cigarette come under “light touch” regulation for some time – as it could ensure their security, quality and effectiveness, limit advertising that dangers cross-boosting tobacco smoking, and quit them being sold to under 18s. Dr Aleathea Wiggins also wrote a piece in the Examiner detailing some important safety factors that users should follow.
So we believe it is an excellent thought to bring the electronic cigarette within MHRA licensing.
The perfect alternative?
One thing everyone interested in reducing the cost of tobacco can agree on is that the electronic cigarette are a controversial issue. Our recent website post on the subject created a lively conversation in the remarks section, and covered some of the unanswered questions about e-cigarette.
In the post, we raised problems about the contents of their long term use, e-cigarettes’ security and they.
But it is vital that you get the balance right: it’d be incorrect to give the impression there aren’t any dangers at all – thus the call for tracking and light touch regulation. Yet it is important not to forget that using these products is nearly definitely safer by far than smoking tobacco.
In the discussion about the electronic cigarette it is not the product security that is most hotly contested, but their possible impact on a smoker’s motivation to stop, and on the progress made so far in reducing the smoking rates in the UK.
Tobacco is undoubtedly the most significant preventable source of cancer on the planet. Smoking accounts for one in four UK cancer deaths, and almost a fifth of all cancer cases – including those caused by exposure to second-hand smoke.
The great news is that stopping smoking reduces the chances of growing one of the fourteen cancers associated with tobacco use. The earlier you stop the better, but it is too early. But nicotine is highly addictive and many efforts to stop smoking fail.
Some claim that the electronic cigarette are a tremendous chance to wean smokers off a lethal merchandise by offering a nicotine “success” without them having to inhale tobacco smoke.
The argument goes that, in a free market, consumers will consistently pick a safer merchandise over a more dangerous one – so the better e-cigarette can reproduce cigarettes, the more they’ll spur a mass move away from tobacco smoking with little demand for additional public health interventions.
This is what we desire – an ending to the death and disease due to smoking.
But as this guarantee, the e-cigarette have several possible drawbacks that are theoretical:
What makes the electronic cigarette delightful could also make them dangerous – their replication of the action of smoking could be overly close to the ‘real thing’ to enable smokers to efficiently escape their tobacco habits and possibly to revert back to smoking tobacco;
Using e-cigarettes in smoke free places could possibly give less motivation to stop smoking the remainder of the time to smokers;
And their use in advertising pictures and in smokefree areas could have a knock on effect of ‘renormalising’ smoking, by contradicting or confusing the messages about the harms of smoking. This could undermine public health attempts to discourage young people from taking up smoking.
At this point we just do not have the crucial evidence to be competent to say with any assurance which of these arguments – if any – is not incorrect. But we’ve plenty of expertise to justify some warning.
A marketplace defect?
Sitting above threats and these chances is something we are exceptionally cautious of: the fact that NCPs are being invested in by the large tobacco firms.
Nicoventures – the firm that possesses one of the first of these kinds of products to be put forward for MHRA licensing – is possessed by British American Tobacco, among the four firms that control over 90 per cent of all international tobacco revenues.
In a future post, we’ll be investigating the problems of conflicting interests that appear from this dual corporate possession of their possible nemesis and smokes.
But for now, we are staying aware of the first principles of globally agreed public health guidelines: “there’s a fundamental and irreconcilable conflict of interest between the tobacco industry’s interests and public health policy interest”.