E-Cigarette Politics

This is an online resource for materials related to ecigarette politics, legal issues, regulatory issues and health-related topics.

We aim to provide reference materials for EV (electric/electronic vaporiser or 'ecig') and THR advocates, and for those involved in the regulation and health debates. There are useful information resources here including a reference list, quotes, politics-related terminology, vaping-related terms and in-depth explanations of various issues. The current state of knowledge of nicotine, nutrition and health is a main feature.

What's it all about - and why all the fuss?

The answer to that question is simple:

"If all the smokers in Britain stopped smoking cigarettes and started [using] e-cigarettes we would save five million deaths in people who are alive today. It’s a massive potential public health prize."

- Prof. J Britton, Royal College of Physicians

It's as simple as that. Britton's statement doesn't really need much in the way of explanation: it is clear and concise, and the benefits he outlines are self-evident. There are no ifs, buts, maybes, caveats, or dramatic unintended consequences: it really is as simple as that.

No one has ever questioned his statement in print, in debate, or in reported comment.

Location

This is a UK-centric resource, and the facts and figures discussed are usually those relevant to UK or European issues. Although most of the issues are global, some financial issues do not transfer since countries can be grouped according to factors such as tax arranagements, the degree of social support provided by the state, the relative wealth of the population, and the size of the money supply; as a result, the various factors and their effects tend to differ by country. One of the clearest differences is that between the UK and USA: the US money supply is so enormous by comparison with the UK that there are few similarities in the practical financial aspects; and, unlike the UK, the US has a very substantial oral tobacco userbase (8 million, according to Prof Rodu's analysis of raw CDC data), which has an interesting effect on some of the numbers.

It's not about health

It is now very clear that placing artificial restrictions on access to ecigarettes has no relation to health, since there is an overwhelming weight of evidence that tells us there are no issues requiring action in any country where consumer products are effectively regulated. Moves to block access to electronic cigarettes in such countries are based firmly on economic pressures and ideology. Policy-making is a trade-off between saving lives and maintaining current income streams, and the simple fact is that where you stand on life versus profits determines where you stand on the ecig issue.

The immense revenues created by smoking

Smokers who cannot or will not quit deserve safer alternatives. The basic problem here is that smoking generates fabulous wealth for government and giant transnational industries, and there is intense pressure to protect that revenue stream. For example, the UK government currently benefits by around £26 billion per year before costs, and therefore clears around £20bn a year from cigarette sales and the subsequent revenues and cost savings. It can immediately be seen that regulators must be under great pressure to remove any threats to this giant revenue generator - which in practice is the world's biggest gravy train - since vaping will shut much of it down. In a nutshell, that's the problem.

Something that causes no measurable amount of disease and by comparison with smoking is harmless cannot be supertaxed and cannot create any gigantic cost savings by killing millions of users on average 8 years early, thus creating massive cost savings on pensions, healthcare and social support for the elderly at the most expensive time in their lives for the state.

Add to this, the enormous revenues created by disease for the pharmaceutical industry, who probably earn double the revenues of the tobacco industry from smoking in the UK, together with their very strong influence on health policy (if not outright control), and perhaps the core problem can now be seen: the money that smoking generates is so vast, and so vulnerable to removal by THR approaches, that the prospect of ecigs being allowed to destroy those revenues unhindered is unlikely.

For every 10,000 smokers who switch to vaping, 9,999 of them will be removed from the government's supertax generator; from the government's pensions and elderly healthcare early death savings bonanza; from the pharmaceutical industry's disease and drug sales gravy train; and from the cigarette trade's addiction model and cash machine (which, by the way, is by far the smallest of all these revenue channels). And therein lies the problem: there is obviously a very powerful machine in place to protect those revenues. We call it the Smoking Economy.



The Smoking Economy

Smoking has created one of the world's biggest money machines - a machine that benefits innumerable people in multiple industries, organisations, and government departments. The smoking economy is worth more than one trillion dollars a year globally; it is immensely powerful and well able to protect itself. Its power is obvious from the way that, now a way to finally remove smoking has been invented, that solution is being blocked at every turn. It is the ultimate gravy train and in essence a licence to print money: a 25% section of the population can be oppressed and killed for profit, entirely legally, and with the full consent of the other 75%, enabled by the world's largest propaganda campaign.

A major public health crime

There is no possible excuse for preventing access to low-risk consumer products, and the political processes whereby government and the pharmaceutical and cigarette industries protect their incomes to the detriment of public health should be exposed.

We believe that, in time, and given the opportunity, more than half of smokers will switch (since this has already happened in Sweden with an alternative product). Artificial restrictions on this process purely for the benefit of those who earn vast incomes from the smoking money machine are essentially criminal because they are hugely detrimental to public health.

If someone argues against THR then you can be assured that their employment depends, ultimately, upon smoking. Otherwise, no one would be arguing against something that will destroy smoking and obviously save millions of lives when nothing else can do so: once the 20% Prevalence Rule operates, the usual methods for reducing smoking no longer work.

"We have such a massive opportunity here. It would be a shame to let it slip away by being overly cautious. E-cigarettes are about as safe as you can get."

- R West

The effect of a technology change point

Technology advances, though, and life changes inexorably as a result. Progress can be slowed by those whose employment depends on smoking - but it cannot be stopped. There are massive public health gains here for the taking; our job is to help sweep aside those who are deliberately slowing progress.

The smoking economy is far too powerful to be easily defeated. However, we are at a technology change point: at such a break point the world changes, and no other factor can override that change. It means that nothing can stop electronic vaporisers now the technology is in use - only the timescale to full implementation can be affected by external factors, no matter how powerful they are. We know that this must happen within thirty years as it is always so; for maximum benefit to public health we should aim for a 20-year conversion period. Industries that benefit from smoking will fight hard to protect their domain from destruction by vaping; but we already know the outcome. Nothing stops a new technology: it eventually replaces the old system and nothing can stop it doing so.

Tobacco Harm Reduction

The focus of this resource is to provide access to truthful information about THR, and specifically the EV (electric/electronic vaporiser or 'e-cigarette'). The volume of propaganda generated by commercial rivals and their dependents is unprecedented, and clearly designed to obscure the facts. THR advocates who support free and unhindered access to the full range of e-cigarette products will help to enable the single most important advance in public health since the discovery of antibiotics: in one small country alone, full support for this approach has the potential to save millions of lives just among those alive today [1]. There is a sharp contrast here with the current approach to the reduction of smoking morbidity and mortality, which has stopped being effective and cannot produce further significant gains in countries such as the UK due to the 20% Prevalence Rule [2][3].

Although smoking prevalence fell dramatically during the final decades of the 20th century, it slowed, and all progress stopped around 2008. There has been no progress at all in recent years. In many countries such as the UK, smoking prevalence has remained static at around 20% of the adult population for many years.

"The rate of smoking in Great Britain has remained largely unchanged over the last five years."

- ONS, UK official statistics, 2014 (referring to the period 2008-2013) - see References page, Smoking.

Despite the huge sums spent on reducing smoking in the UK, the number of smokers increased between 2008 and 2013. A rough calculation - since such statistics are very well hidden indeed - is that, at the start of 2013, there were approximately half a million more UK smokers than five years before (because smoking prevalence stayed the same at around 20% and population size increased significantly). By early 2014, smoking prevalence had started to fall again, due to the 'ecig effect': the fall in smoking prevalence equals the number who switched to vaping.

We can expect smoking prevalence to continue to fall: through 19%, 18%, and possibly 17% in the foreseeable future - as long as no hindrance is placed on smokers switching to vaping.

Just as technology has radically changed many aspects of our lives, it has now changed tobacco use, and this advance cannot be stopped. It can be slowed, perhaps considerably, by regulations designed to protect existing industries and government revenues; our focus is to assist the removal of such artificial impediments designed to slow the process of change and that are so massively detrimental to public health. The ultimate outcome is immutable but the timescale could be considerably prolonged by delaying tactics.

The prospect of stopping death and disease from smoking is now a reality for the first time, because we now have the tools to reduce morbidity to insignificant proportions. The THR approach is supported in Sweden, where male smoking prevalence will soon be just 5%, with the number of smokers falling by 1% per year, and consequently with the lowest smoking-related mortality of any developed country by a wide margin. We should be able to achieve the same or better with ecigarettes, since these are more popular with smokers than Snus, and because ecigs have the same or less risk than Snus.

Do smokers have rights? We think they do: smokers' rights. Perhaps even more important are ex-smokers' rights: the rights of those who are ex-smokers not to be forced back into smoking. This right is completely ignored by current legislative proposals; many ex-smokers only manage to avoid smoking by use of an EV, and removing their free choice in this area will inevitably cause many to revert to smoking.

Does the law have the right to compel people to smoke?



Smoking Harm Reduction

It should probably be pointed out that we are talking about reducing the harm from smoking here; tobacco is not really the problem, smoking it is [7]. For that reason a more accurate term would be 'Smoking Harm Reduction' or 'SHR', and not Tobacco Harm Reduction / THR, which is now the accepted term for this area of public health improvement and is probably too well established to change.

"Three months of additional smoking poses a greater risk to someone’s health, on average, than a lifetime of using a low-risk alternative."

- CV Phillips

The 20% Prevalence Rule

This is a crucial issue: once smoking prevalence is reduced to about one-fifth of the adult population (20%) in a developed country where it was previously at least double that rate, as is the case for many developed countries in the western world, then it cannot be further reduced significantly by continued application of methods that were successful up to that point. No country exists that is an exception to this rule.

Combined with the 9 out of 10 failure rate of pharmaceutical interventions for smoking cessation, it means that the only way to reduce smoking significantly below 20% of the population for many countries is substitution: replacing smoking with alternatives such as the electronic vaporiser. This is called THR.

This is not a theoretical concept, because:

Smoking prevalence has remained around the 20% mark for several years in many countries, such as the UK [3], despite immense sums of money being spent on trying to reduce it

Sweden has smashed the 20% barrier by the application of a THR solution: male smoking falls at 1% per annum and will be around 5% in 2016 - less than a quarter of the UK figure

Sweden is the world leader in the reduction of smoking prevalence and the world leader in the reduction of smoking-related mortality

Sweden's smoking-related death rate (aka 'tobacco-related mortality') is the lowest of any developed country by a wide margin; thus THR is not a theoretical concept, it is proven

Sweden is the only developed country in the world that has a realistic prospect of reducing smoking mortality to near-invisible proportions

This is absolutely out of the question for any other developed country - unless they fully support THR too

At last we can see the light at the end of the tunnel for the UK, though: in 2015 the latest smoking statistics show that - finally - smoking prevalence is beginning to fall; and the fall precisely equals the number of ex-smokers who now vape instead. The same effect can be seen in the USA, where the drop below 20% smoking prevalence is due to the 8 million smokeless tobacco users and 10 million-plus vapers. THR works when nothing else does.

Why do ecigarette bans and restrictions exist?

Simple: to protect the smoking economy.

Although there are almost too many to list, the principal beneficiaries are transnational industries, government revenues and NGOs dependent on funding by industry. Legislation is designed principally to protect existing industries, but cannot be obtained directly by them; so they use front groups instead: pressure groups funded by industry who appear to be independent 'pro-health' lobbyists, but are funded by the government and commercial interests that benefit from smoking and the disease and death it causes. Because continuation of smoking has massive financial benefits for government, they are implicitly involved in protecting it.

These are some of the important factors:

Governments in countries such as the UK are 90% stakeholders in cigarette sales - cigarettes are, in effect, bought from the government

You buy 18 out of the 20 cigarettes in a pack directly from the government, not the tobacco industry

Smoking is vigorously protected, because government cannot afford to lose the huge revenues or infuriate 25% of voters by banning smoking

The amount the UK government makes from smoking is at least double the cost of EU membership (which was £8.9bn for 2010/11 according to the UK Treasury) - after all costs are paid

all costs are paid Government is also under pressure from the multiple giant transnational industries who strongly benefit from smoking: the pharmaceutical industry, and to a lesser extent the cigarette industry.

The cigarette industry's financial strength ensures that competitors do not succeed

The disease caused by smoking is just as profitable as the cigarette sales in the first place - indeed, in socialised states such as the UK, it is more profitable. The pharmaceutical industry earns more in the UK from smoking than the tobacco industry does

Most tobacco industry players can mitigate the expected losses caused by the drop in cigarette sales due to THR, but the pharmaceutical industry cannot - it depends on the resulting disease for a significant proportion of its overall income (at least 10% and probably 15%)

The pharmaceutical industry will lose billions as THR advances, due to the concomitant fall in disease; because it has significant influence within government it is in practice the most powerful opponent of THR

The pharmaceutical industry has extremely strong influence within government and absolute control of at least one department (Health). This probably holds true in every country due to the enormous wealth of the industry, who will always ensure that its interests are protected and promoted above all others - and this most certainly includes public health

In Europe, the EU is the central agent for control and protection of cigarette sales, and will do everything possible to block any threat to smoking from THR. Described as "a vast, stinking cesspit of corruption" by a UK government adviser, the EU will ensure that THR is blocked at every step

The ideologists in the tobacco control industry provide the workforce for the commercial players who need bans and restrictions on THR in order to protect cigarette sales and the profitable disease they cause; the agendas of the two groups overlap sufficiently that the relationship is symbiotic: tobacco control does the work, industry pays the bills

The tobacco control industry's agenda is to remove all access to cigarettes, tobacco and nicotine, and to destroy the tobacco industry; the pharmaceutical industry funds them extensively as blocking access to THR products is a core part of the TCI agenda and benefits pharma tremendously (since THR is now the only thing that threatens the hugely profitable smoking disease income channels); and because they know that the TCI cannot possibly succeed in significantly reducing smoking, never mind removing it, due to the 20% Prevalence Rule; and because they know that, whatever is said to the contrary, tobacco is a government business and is rigorously protected; and because the TCI act as highly-effective drug pushers for pharma's pharmacotherapies for smoking cessation (which are never even going to make a dent in smoking prevalence as they have a 9 out of 10 failure rate, and are basically just highly-profitable placebos)

Pharma knows the TCI are in effect useless after the 20% barrier, and funds them to protect smoking by blocking THR, which is the only threat to disease levels and therefore pharma income

Therefore the pharmaceutical industry's vast income from smoking is safe: access to THR products is blocked, smoking is protected, and disease levels remain high; and the best feature of all is that the legislation to protect smoking by preventing access to THR products appears to have been obtained by 'public health' groups

Pharma's hands are clean; and government is happy because the money machine rolls on

The system that protects smoking is beyond perfect: it is armour plated, bombproof perfection

The pharmaceutical industry's most important property is the principle that it, and it alone, decides health policy. It has an iron grip on health policy, services and provision, and this control must be defended at all costs since it is the key to profitability.

People who claim they are legislating to protect public health are sentencing millions to death for the sole purpose of protecting existing industries. The use of electronic vaporisers is likely to prove 1,000 times safer than smoking - it cannot possibly be less than 100 times safer and may even be 10,000 times safer. Read the statements here from Profs. Britton, Phillips, Rodu and West, and decide for yourself; there are dozens more in the same vein from many other professors of public health, clinical research, and law, and from other independent expert public health advocates such as Clive Bates.

"Opposition to THR is an entirely dishonest enterprise."

- Phillips, Rodu

The nicotine issue

On June 5th 2013 the UK health service clinical guidance organisation, NICE, published ground-breaking advice to the medical profession [4]. It included the important advice for doctors that tobacco harm reduction is supported; that nicotine is relatively harmless and is not associated with cancer [5][6]; and that doctors may unofficially recommend ecigarettes if that seems the best option.

Nicotine, after all, is simply a normal dietary ingredient that everyone consumes and everyone tests positive for; that about a quarter of the population appear to need supplementation of (hardly an abnormal situation with active dietary components); and that is not dependence-creating unless supplied in tobacco [10]. The fact there is no published clinical trial of nicotine dependence in humans despite the huge interest in this issue indicates that it is not 'addictive': trials with unwanted results are not published.

There is no published clinical trial of the administration of nicotine to never-smokers to determine any potential for dependence. All such trials for other purposes report that it is impossible to create nicotine dependence in never-users of tobacco.

Then, in October 2013, the nicotine toxicity myth was finally demolished; a new LD50 of up to 20 times the current figure will need to be established [8][9]. This applies to absorbed nicotine only, since ingestion of very large amounts of nicotine by adults is known to be survivable without harm (due to the vomit reflex induced, which expels most of it.)

"Nicotine has about the same implication for health as coffee and fries."

- CV Phillips

"E-cigarettes are probably about as safe as drinking coffee."

- R West



We need to stop believing the propaganda published on behalf of industries who benefit substantially from smoking, and above all we need to stop them from influencing the political processes blocking THR .

It is time to stop protecting smoking; it is time to stop protecting industries that benefit from the disease caused by smoking; it is time to stop listening to front groups funded by those industries; it is time for radical change in smoking cessation practice.

It is a simple question of lives versus profits, and it is time for a change.

_________________

[1] Prof. J Britton, Chair, Tobacco Advisory Group of the Royal College of Physicians, Professor of Public Health, University of Nottingham: see quote above in green.

[2] The 20% Prevalence Rule: see menu item at right.

[3] OECD figures presented by Clive Bates: see Links page.

[4] NICE harm reduction Guidance: see menu item at right.

[5] Prof. CV Phillips, the authority on the science base for THR: see quote above in green.

[6] Prof. R West, Director of Tobacco Studies, Department of Epidemiology and Public Health, University College London: see quote above in green.

[7] The incidence of oropharyngeal cancers [mouth cancer] from modern oral tobaccos is so low it cannot be reliably identified, and smoking is by far the greater risk for such cancers (Prof Rodu, the authority on the oral pathology of tobacco consumption - private communication).

[8] Prof Mayer of Graz demonstrated that nicotine is far less toxic than previously claimed, and that a median fatal dose is between 500 - 1,000mg. The ridiculous overestimation of nicotine's toxicity, with a clearly far too low LD50 of 60mg claimed, has been obvious for a long time to those who work with it on a daily basis.

[9] www.ecigarette-politics.com/the-great-nicotine-myth.html