Hi Alicia,
Thank you for your interest.
You asked for opinions on the text quoted, so please allow me to reply with a UK-oriented critique as that's where the MEP concerned is. The UK vaping community will be very pleased to see this approach and will assist wherever possible. There are are some points below where the factual accuracy can be improved; and where some of the usual propaganda needs to be refuted. I will provide links to the relevant resources, at the foot.
Thanks again.
Now, after a couple in Staffordshire were barred from adopting because one of them had used an e-cigarette, we learn that North Tyneside and Durham councils have similar rules – flying in the face of advice from Public Health England and the Fostering Network, depriving children of loving families.
We hope this will be addressed as it is political correctness gone mad. The idea that prospective parents will be penalised for giving up smoking but in an unapproved manner is ridiculous. PHE will probably ask for this policy to be reversed - and if they don't, we will ensure that the media are fully informed of the incompetence of everyone concerned.
From proposals to make e-cigarettes into pharmaceutical products to the notion of adding punitive taxation like we do with traditional cigarettes, we need to think very carefully indeed before taking action.
If we discourage e-cigarettes through taxation, we will stop the move from traditional cigarettes to e-cigarettes.
Perhaps you may not realise that:
1. Smoking is one of the UK government's largest single revenue channels. Government is likely to make or save over £20 billion after all costs and expenses are paid. The UK government is a greater than 90% stakeholder in tobacco sales [1]. A smoker buys 18 cigarettes out of the 20 in a pack directly from the government. Loss of tobacco tax revenues together with the savings on the backend [2] is a crucial issue for the exchequer.
2. In the UK, the pharmaceutical industry makes more from smoking than the tobacco industry does - and it is easy to calculate this. In fact they probably make about 50% more [3].
Because of this, government and the pharmaceutical industry are the main beneficiaries of the tobacco trade in the UK. Pharma is especially keen to protect the cigarette trade as it generates about 15% of gross revenues, via drug sales for the treatment of ill smokers [4]. In practice, the pharmaceutical industry are the most important and effective protectors of the cigarette trade as they control so many health-related lobbying and publicity channels [5]. Because everyone makes more from smoking than the the tobacco industry does, a valid argument can be made that, at least in the UK, the tobacco industry's main function is simply to provide logistics for their majority partners, and to act as willing scapegoat. This is a well-paid role, but ultimately less profitable than that of their partners in the cigarette trade, the government and the pharmaceutical industry.
Yet my experience in the European Parliament is that is exactly what MEPs across Europe are desperate to do. But then, the European Parliament itself is perfectly happy to have indoor smoking areas. It’s one rule for us MEPs, and another for the general public.
You may wish to know how the ex-smoking community see the EU issue.
1. We are grateful to MEPs for rejecting the pharmaceutical licensing proposal as this would have been equivalent to an outright ban. However, this ban would not have survived legal challenge, for numerous reasons including the fact that every court in Europe has unanimously rejected this proposal from national governments, when implemented and challenged (around 7 or 8 decisions in EU countries, to date, all overturning their government's imposition of medical licensing, but this number is rising all the time) [6]. A pharmaceutical licensing imposition on a consumer product cannot survive legal challenge; this leads to the conclusion that (since this was already absolutely obvious to all) a tobacco products classification was the designed objective all along, and achieved by misdirection. In fact it appears to be a classic case of
maskirovka.
It allows ecigs to be gradually strangled by regulation then eliminated, and crucially without any significant opposition. No real opposition can be presented within the EU, as its structure is specifically designed to eliminate democratic process and resistance to central policy since all important policy is made in committee, not in parliament [27]; the real opposition comes from the courts, who require facts as against baseless propaganda. Therefore the courts have to be removed from policy challenges - a difficult task unless vaping can be somehow be artificially conflated with smoking. This has now been successfully achieved.
2. The 23-year old Snus [7] ban in the EU is currently responsible for at least 10% of the death toll from smoking, by removing access to the most successful proven THR product. Note that Sweden, the home of Snus, is the world leader in reducing smoking prevalence, the world leader in reducing smoking-related deaths, the world leader in reducing smoking-related disease, and has the lowest smoking-related mortality (death rate) of any developed country by a wide margin. Governments (probably under strong pressure from pharma) appear terrified of this, and desperate to stop the Swedish scenario spreading: huge reductions in tobacco tax revenues and drug sales for treating ill smokers, and significant increases in pension payments as people do not get sick and die from Snus consumption. It would be a disaster of hitherto unseen proportions for pharma if Snus and ecigs were to become freely and cheaply available in Europe - their vast revenues from drug sales would crash. They have three separate income channels from smoking, and all would essentially disappear [8] - and in the UK that would be around a £3 to £4 billion loss.
The EU claim the smoking-related death total is 700,000 a year, and therefore after 23 years of the ban of the highly successful Snus alternative, it is impossible that any less than 10% of these deaths would be easily preventable by free access to THR (see how fast ecigs have been taken up). That is therefore 70,000 annual deaths that are preventable by access to Snus; we can now clearly see how cigarette taxes and pharma profits trump public health. Prof Rodu, though, says the deaths caused by the Snus ban are far higher -about one-third of the total - and therefore millions of lives are lost in order to protect tax revenue, pharma profits and cigarette trade profits.
3. The Snus ban therefore kills at least 10,000 a year in the UK (at least 10% of the 100,000 UK deaths from smoking claimed). The ex-smoking community is justifiably afraid that the incoming TPD Article 20 regulations will force many vapers back to smoking - as that is clearly what these regulations are designed to do. Since modern THR products are obviously capable of taking 50% of the cigarette market or more (Snus took 66% of the market in Sweden: there are twice as many Snusers as smokers there now) - we can confidently claim that eventually half the smoking death toll will be due to the EU forcing people to smoke [9]. This of course is entirely what the regulations are designed to do, in order to (a) protect government revenues and (b) pharmaceutical industry revenues. Since the only threat to cigarette sales (and taxes, and drug sales for disease, and the substantial savings on pensions etc.) is THR once smoking prevalence is reduced to 20% in a developed country where prevalence was originally double that or higher [10], it follows that if THR is blocked then drug sales and tax revenues are safe.
The medical science behind e-cigarettes is not yet fully settled. It seems to be generally agreed that e-cigarettes are not fully safe. It seems to be generally agreed that the health risks are much lower than those of regular cigarettes.
In a manner of speaking this is true. The only conclusive evidence is that from multiple 30-year studies, extensive epidemiology, and national health statistics. However, it should be carefully noted that we have all that and more from Sweden - whose national health statistics are unique in the developed world - and the rather obvious results are still denied by those paid to protect cigarette sales. This tends to indicate that no matter what evidence exists, THR will be resisted since it is not about science anyway: it's about money.
Still, it is clear to any reasonable person that there is a difference between smoke and mist. There is a difference between 9,600 ingredients [11] and 20 or so [12]. There is a difference between hundreds of toxic and carcinogenic materials in significant quantity [13] and none in any significant quantity [14]. There is a difference between toxic smoke, and ingredients that have been used in asthma inhalers for decades without any serious issues [15].
There are hundreds of studies of ecigs, refills and vapour now - anyone who says different needs to be exposed (Farsalinos reports his team found over 300 just on PubMed [31]). There are so many studies that a Cochrane Review [25] has now been possible. It concluded there are no significant issues.
Professor Robert West and Doctor Jamie Brown of UCL have claimed in the British Journal of General Practice that for every million people who switch from traditional cigarettes to e-cigarettes, 6,000 lives will be saved every year.
Note that Prof West's figures represent a worst-case scenario, as he makes clear. Even the maximum possible mortality rate by his calculations is statistically invisible when you look at the proportions [16]. Since it is a worst-case figure, any realistic figure for vaping-created mortality is not just invisible but insignificant. In addition to that, almost all such deaths would need to occur in subjects with known co-morbidities such as emphysema from smoking: flavoured mist doesn't kill the average person.
When I pointed out on Twitter that I oppose EU plans to slap more taxes on e-cigarettes, I was directed to a study which finds that e-cigarette vapour damages the immune systems of mice. It speculated that the unexpected presence of free radicals might account for this.
A search just on PubMed reveals hundreds of studies on ecigs and refills [31]. You could probably ask why your correspondent directed you to some pharma-funded junk science rather than the Cochrane Review of ecigs (this is the gold standard for medical reviews and should always be the first item inspected if it exists), or the accepted senior toxicological analysis (Prof Burstyn's review [14]), or any of the dozens of other independent studies that report no significant health issues for ecigs.
You might also ask why anyone would want to tax smoking avoidance and cessation. Could there possibly be some ulterior motive?
You could also ask how it is possible that a regulatory instrument created by the EU Commissioner with the worst reputation for corruption ever experienced in the EU (who was sacked for corruption) can survive unaltered even though the reason for his dismissal was connected with this new Directive?
You might also ask how it is possible that an EU Commissioner can accumulate a vast personal fortune, with no visible source of income of that magnitude, and subsequently be discovered moving undeclared personal funds of $100 million between offshore banks?
You could also try asking why, when commercially-important regulatory policies that have an enormous effect on public health are implemented in a climate where €10 million bribes are solicited by EU officials, no action appears to be taken to prevent votes being bought on a massive scale, and the public interest is routinely ignored, and public health is sold to the highest bidder?
However, as we all recognise very well, asking embarrassing questions in the world's most sophisticated corruptocracy is not likely to be successful.
But the same study also pointed out that, with cigarette smoke, the levels of free radicals are roughly 100 times as high.
Even the NHS has stated (and therefore it must be obvious to any technical investigator) that ecigs are 1,000 times less toxic than cigarettes [21]; and, let us be fair, it is hardly likely that the NHS will exhibit hyperbole in this area - the opposite is surely more likely.
Tobacco and tar aren’t generally present in e-cigarettes either; they contain fewer toxins and carcinogens overall.
You could say that. Since ecigs are tobacco-free, smoke-free and combustion-free, this is a given. Death and disease caused by smoking is caused by the smoke. Tobacco that is not smoked, and that is manufactured to a high standard - like Swedish Snus (a specially-processed oral tobacco made to an exceptionally high standard called the 'Gothiatek Standard') - has no reliably statistically-identifiable health impact; the health outcomes for smokers in Sweden who either totally quit or who switch to Snus are the same. This is what is so terrifying to pharma and its partners in government: no disease, no monster sin taxes, no early deaths with the attendant significant saving on pensions [17].
As regards nicotine alone, inhaled in a flavoured mist: anyone claiming that there is a clinically significant health impact has lost touch with reality or is seriously financially conflicted [26]. In any case, ecigs only have to be safer than smoking. They can't be 'safe', as inhaling anything other than pure air is not harmless. Something that has somewhere between 0% and 5% (at the absolute maximum) of the risk of smoking needs to be encouraged, not blocked in order to prop up other industries. We don't need to enforce "a level playing field for the pharmaceutical industry", as has been laughably suggested as a desirable result - we need to stop the torrent of lies and the endemic corruption that protects their drug trade and the cigarette sales that enable it.
In the absence of a definitive study, we have to accept that the risks associated with e-cigarettes are substantive but that they are much less bad than smoking traditional cigarettes.
We don't have to accept that 'risks are substantive' at all. If the strict meaning of 'substantive' is applied, then it simply means a risk exists even if minuscule, and is therefore correct. In other words, the same as the risk from getting up in the morning, which is substantive, and non-zero, but likely to be about 100 million to 1 in terms of dying or presenting with serious illness that day as a result of getting out of bed. However it is easy to confuse 'substantive' with 'substantial', and since this is a typical rhetorical ploy used by the commercial liars paid to attack vaping, we need to address it robustly: there is no substantial risk from vaping whatsoever, and the risks are so small that, when a suitable time has passed (maybe 20 years), they are likely to be statistically invisible. We should also note that we are already nearly halfway to that point, and no disease vector has emerged. As Prof Rodu has pointed out, the lack of any significant number of credible adverse events is remarkable.
The materials have been inhaled for decades, without issue, in medical inhalers. People have been inhaling PG in asthma inhalers for decades, for example. Just because they are now in a consumer product does not suddenly create some kind of deadly risk, and that argument is clearly ridiculous. Dow Chemical, the world's largest manufacturer of pharmaceuticals for inhalation, has produced PG and glycerine for inhalation for a very long time; their licenses have not been revoked anywhere; and they have introduced even more products in this line for inhalation. PG is used as the carrier in the nebulisers used by lung transplant patients - ask a senior thoracic / transplant surgeon. If these materials are prescribed deliberately for their beneficial effects, and can be inhaled without issue by those with the most serious lung conditions and in the most fragile health, is it really possible that as soon as the same materials are used in a consumer product a terrible health epidemic will ensue?
The suggestion that this is something new, or somehow dangerous, is not just ridiculous but clearly fraudulent if promulgated by anyone with specialist medical knowledge. Perhaps it might be useful to examine the references to pharmaceutical industry criminal fraud and criminal corruption that we can show - there is certainly no shortage of them [18]. They operate the largest propaganda machine the world has ever seen, and it is remarkably effective. Even doctors can be persuaded to believe utter rubbish that is completely opposite to their official guidance from the national clinical guidance authority [19].
There is even a case to be made that government allows pharma to fund propaganda that results in medical negligence (if a doctor believes the opposite of the facts, and advises patients accordingly, and treats accordingly, this is medical negligence: the patient is clearly in danger of receiving injurious treatment that can be classed as iatrogenesis). There is a very clear issue here: if a doctor wrongly believes that nicotine is associated with cancer or is otherwise harmful (directly opposite to the fact, as made clear in NICE PH45), then s/he may prescribe Chantix instead of NRTs for smoking cessation, as it is wrongly believed the elevation of risk is about equal. Then, when the patient commits suicide as a result of being prescribed Chantix (the 'murder drug'), instead of a harmless dietary supplement such as an NRT, the doctor has in effect killed the patient.
This situation has without doubt already occurred.
Likewise, if there is a danger with passive inhalation of vapour from e-cigarettes then it is clearly of an order of magnitude much lower than that of second-hand cigarette smoke.
To get technical about this, an order of magnitude is 10 times; two orders of magnitude means 100 times; three orders of magnitude means 1,000 times; and four orders of magnitude is 10,000 times.
Suggesting that inhalation of 2nd hand vapour is just 10 times less toxic than smoke is far from technically accurate. A more reasonable and defensible evaluation is 3 or 4 orders of magnitude. There are some unwanted ingredients in 2nd hand vapour that are discernible in tiny amounts under certain circumstances, such as formaldehyde; but the amount of formaldehyde exhaled by diabetics is normally higher. Perhaps we should therefore prevent diabetics from visiting public places? The only way to create significant quantities of these types of compounds in ecig vapour is to deliberately burn up the atomiser - this produces measurable quantities of unwanted compounds as it's smoke. No one can inhale it, so the exercise is pointless (apart from the purpose of public health fraud - a profitable new industry funded by commercial opponents of THR).
Nicotine is an addictive substance, there’s no doubt about it. The European Union claims to be concerned that e-cigarettes will become a gateway to traditional cigarettes, but this seems to be an overstated concern.
Nicotine is certainly a dependent material after smoking. The problem with your statement is that it is clinically impossible to create nicotine dependence without tobacco. Many clinical trials of nicotine have taken place to examine its beneficial action on prevention and mitigation of cognitive dysfunction, degenerative and auto-immune diseases; it is necessary to use never-smokers and non-smokers in these trials as smokers cannot be used, for obvious reasons (nothing can be measured correctly if they are already receiving the treatment in some form). The whole point of all these clinical trials, then, is to subject never-smokers to large amounts of nicotine for a long time. No person has ever become 'addicted to' nicotine after any of these trials (the correct term is 'dependent on' [20]).
In fact, dozens of clinical researchers have administered very high doses of nicotine daily to hundreds of never-smokers for up to 6 months, and no person has ever exhibited any sign of withdrawal or dependence [29]. It is impossible to create nicotine dependence clinically. The leading researcher in this field, Dr Newhouse of Vanderbilt, says the risk of dependence on nicotine alone is "virtually nil" [28]. Since he has administered more nicotine, in bigger doses, to more never-smokers, for longer than anyone else, and has never seen a single subject exhibit the smallest sign of reinforcement or withdrawal or dependence or continuation - ever - then we can probably accept that he knows what he is talking about.
So you can see there is a fundamental difference between the propaganda and the truth. Indeed, the propaganda is so powerful that even doctors are shown to believe it. Nicotine has no association with cancer [30] or heart disease and cannot cause dependence without tobacco.
The propagandists are often careful not to tell a direct lie. "Nicotine is an addictive drug" is technically correct in one respect: it is true after smoking. The powerful cocktail of potentiators, synergens and boosters (there are 9,600 compounds identified so far in tobacco/smoke [11]) causes a type of chemical 're-wiring' of the brain, so that nicotine dependence is often subsequently created. People are commonly dependent on nicotine after smoking; but it is impossible to make them dependent on pure nicotine unless they have consumed tobacco.
The nicotine dependence created by smoking is believed to be caused by co-administration with aldehydes known as MAOIs. Smoking appears to create more, and more powerful versions of these chemicals, which potentiate nicotine. At least one other tobacco alkaloid, anatabine, has also been implicated. It is correct to describe smoking as addictive, in the modern idiom, as it is a dependence with a significant elevation of risk. Nicotine dependence created by smoking is best referred to as dependence, as no harm can be identified.
This dependence is neither universal nor permanent. It does not affect all smokers, as some can cease nicotine consumption immediately and with no significant withdrawal effects. It is not permanent, since we have conclusively demonstrated within the vaping community that, for those who start out dependent, the nicotine strength is routinely reduced, and vapers may transition to a zero-nicotine group if they find no personal benefit from supplementation of dietary nicotine (everyone consumes nicotine in the normal diet and everyone tests positive for it). They may even totally cease all inhaled materials if that is their desire (sometimes when it was impossible for them to quit smoking). Therefore it may be best to describe the chemical changes that smoking makes in the brain as 'common and persistent': that is to say, subsequent nicotine dependence is common, and may be hard to counter, but can normally be gradually reduced as the smoking history recedes [33].
Thus, anyone with medical knowledge or technical knowledge of this area who says something like, "Ecigs will make people addicted to nicotine" is a liar on multiple levels:
a) It is impossible to create nicotine dependence clinically and therefore not only there is no evidence for it, but the contrary evidence is substantial;
b) No one has ever published any clinical trial of the potential for dependence of ecigs;
c) The terms 'addiction' and 'dependence' are not interchangeable in modern usage, they have different meanings: dependence means an essentially harmless compulsion, such as birdwatching or coffee-drinking; addiction means a dependence with significant risk of some kind of harm, be it to health, personal finance or social status;
d) No clinical epidemiology exists to link nicotine with any reliably measurable harm, therefore even in cases of nicotine dependence resulting from smoking, a term implying harm cannot be used by any honest commentator;
e) Thus, the use of the term addiction in circumstances where dependence is the correct term is a deliberate attempt to incite emotional response, and consequently dishonest. Dishonesty is the trademark of paid anti-THR propagandists.
You should be extremely careful about describing nicotine as associated with dependence
unless it is very clear that this has resulted from smoking. Dependence is created by and results from tobacco consumption.
There is not a single shred of evidence that demonstrates otherwise. Vapers routinely reduce the strength of their refills over time, and some progress into a zero-nicotine group as a result of this process. Smoking can create dependence on and tolerance to nicotine, and non-smoking (and this clearly and demonstrably includes vaping) can reduce it over time.
Let's repeat this once more as it is crucially important, and the subject of endless propaganda (or perhaps more accurately lies):
- It is impossible to create nicotine dependence clinically - it is created by delivery in a tobacco vehicle and especially by smoking.
- No person has ever been demonstrated to become dependent on nicotine or show any signs of withdrawal in medical trials - and not for want of trying.
- If people can be given large quantities of it every day for 6 months at a time with no result, ever, for a single person, in many clinical trials, then we should be extremely suspicious of the motives of anyone lying about this issue - and especially if they phrase it carefully enough that they cannot be directly accused of lying, since they clearly know exactly what what the issues are.
- If ethics panels (the committees who approve medical trials) clearly have
absolutely no problem with the administration of very high doses of nicotine to unexposed individuals for several months - exactly what would your analysis be of how this issue is perceived by the real experts (as opposed to the public image created by the propaganda?) If you reply anything other than, "They obviously know there is no problem", then you are simply not being reasonable. They don't approve medical trials of addictive drugs with no health benefits, and that is that.
Commercially-funded propagandists are more active in the anti-THR area than any other area related to health - because there is more money at stake, and their funding sources are many and substantial, and the rewards are immense: one famous propagandist is known to receive $6 million a year [22]. These commercial lobbyists can become multi-millionaires, and we should ask: what is being sold that is clearly so immensely valuable? One answer is: the consumer and medical goods markets; another equally viable one is the enormous tax revenues and pension savings at stake [1]; and a more accurate one would be public health. Public health is for sale, and the greedy and unscrupulous can earn millions by lying about it for profit.
According to the Office of National Statistics, just 0.14% of those who use e-cigarettes have never smoked traditional cigarettes. If we forget about the millions who are now doing something much less unhealthy because of the 0.14% (and many of them might have tried traditional cigarettes anyway in that time if e-cigarettes weren’t available), it’s not bad science but bad policy making.
There is a direct model for this in any case: the Swedish experience - about 20% of the population are Snusers and 10% are smokers. It's not as simple as saying "20% switched" since Snus is a traditional consumer product in Sweden (so that many started with Snus as against cigarettes), but in effect it is the same as if 20% of the population switched to Snus but 10% remained smoking. As a result - since any overall health impact from Snus is too small to be reliably identifiable - smoking-related disease and mortality is the same as for a 10% smoking prevalence. Of course many new tobacco consumers took up the habit via Snus not cigarettes, but since the health effect is so small it cannot be measured, in practical terms the net result is non-smoker status.
Male smoking prevalence in Sweden falls at 1% per year due to the mass switch to Snus, and has done since 2003. It looks as if smoking will be all but eliminated, at least for men (women are not so keen to use oral tobacco, even in the hygienic non-spit packaged version sold in Sweden), as male smoking prevalence is moving to a sub-5% level. Given a product attractive to all such as ecigs, to be freely available in addition to Snus, it does not seem unrealistic to suggest that smoking can be reduced to insignificant proportions by THR, at least in developed countries. If you examine this situation carefully, you will see that none of the arguments used against THR have any value: clearly, if smoking is reducing toward a zero point in Sweden and their national health stats show there is no measurable health impact from THR products (in this case Snus), then spurious objections such as 'gateway effects', 'flavours attract kids', 'non-smokers move on to smoking', 'nicotine is bad', and all the rest are shown to be irrelevant. Smoking and disease moving steadily toward a zero point mean that none of these hypothetical objections to THR hold water.
There are multiple benefits to the THR approach. It costs the state nothing to implement free access; it is all carrot and no stick - smokers don't have to be forced into anything, they are simply offered viable alternatives (and therefore it is ethically preferable); it eliminates smoking-related disease and death. The downside to THR is that no one makes any money. The consumer subgroup involved cannot be demonised, taxed till the pips squeak, forced to require expensive drugs, and killed off before they reach expensive old age. In fact it is the worst possible outcome for a corruptocracy such as the EU, which depends for its existence on being able to protect government tax revenue, protect giant transnational industries from competition from small business with better, cheaper and safer products, increase the profits of giant transnationals and prevent change from affecting them, remove any threat to taxation and corporate revenues, and insulate the production and revenue channels from interference from the public.
Incidentally, the Swedish model is why we know it is wrong to describe smoking-related mortality and morbidity (death and disease) as "tobacco-related". It has little to do with tobacco and everything to do with smoke. If people were to smoke tea instead, the result would be virtually identical. Describing a smoke problem as a tobacco problem is a typical logical fallacy rampant among paid anti-THR propagandists; although describing this practice more accurately as blatant lying has a certain attraction.
Eventually, as smoking is reduced by THR in the UK, new nicotine consumers will start via ecigs. Because any health effect on these consumers will not be measurable, smoking-related morbidity and mortality will reflect the shrinking number of smokers, not the total number of nicotine consumers. This prospect is terrifying for all the established industries and the government departments that rely on them for funding and the government departments that balance tax vs expenditure. It is going to be very, very painful for all of them - unless they can successfully block THR, of course. Once the 20% Prevalence Rule operates, cigarette sales are safe, as long as THR can be blocked [10].
The nature of those health risks, in any case, will vary somewhat from one e-cigarette to another. I have no objection to the right regulation: to inform about the health risks, to avoid glamourising e-cigarettes to teenagers, to minimise those health risks, and to have reasonable common standards to provide consumer confidence.
This is true, as long as it is clearly recognised that we are talking about a tiny risk versus a microscopic risk. There are already more than 17 statutes that apply to ecigs in any case, and an army of local inspectors who ensure they are enforced (in the UK). It is correct to state - in practice - that ecigs are unregulated in the USA; we should be careful not to apply US propaganda to the UK situation because the situation is obviously 180 degrees different in the UK: ecigs are already well-regulated.
Any additional regulation and taxation needs to be extremely careful not to reduce availability and protect cigarette sales. This will almost impossible to accord with, unless independent experts draw up such rules (such as for prohibited ingredients in refills), because if the usual pharma staff do it (as at present), the end result will be to restrict sales, destroy all the independent vendors, and give any remaining trade to the cigarette firms.
Ecigs and refills should be totally tax-free in any case, to encourage the switch away from cigarettes. Current policy is clearly to protect cigarette sales at any cost.
It’s to do with saving lives. And where legislation is proposed that would stop people moving from cigarettes to e-cigarettes, there is a serious danger that tens of thousands of lives would be lost as a result.
Millions, according to Prof Britton of the RCP, who is probably the world's senior tobacco control spokesman [32].
The enormous torrent of propaganda that protects cigarette sales
It is up to the individual how they wish to view or describe the commercially-funded propagandists who are fighting to block THR and protect cigarette sales. These people work with government grants facilitated by pharmaceutical industry pressure on certain government departments they have influence with, together with grants often routed through third parties but originating with pharma (this process is called
greenwashing - the cleaning-up of toxic funds - and uses foundations and universities controlled by pharma). In the end - with delicious irony - a major winner from all the hypocrisy, propaganda and subversion is the cigarette trade, as their business is protected. In general this arrangement can be honestly and accurately described as the sale of public health to the highest bidder. The fake charities promoting the propaganda are significant beneficiaries of this arrangement, which explains the enormous salaries those running them receive.
The biggest propaganda campaign the world has ever seen - without any ifs or buts - is being directed at THR. The money at stake is enormous: the smoking economy is worth at least $1 trillion a year. The world's best black propaganda operators, astroturfers and funding greenwashers are being employed to protect cigarette sales at any cost. We know that the eventual outcome is that the new technology always prevails, simply because you can't put the genie back in the box. In terms of the eventual outcome, smoking is finished. What is at issue is the timeframe: how long the established players can defend the cigarette trade against interlopers with new technology that will permanently finish off smoking diseases and the incredibly profitable drug trade they create, and how long governments can protect their tobacco tax revenues and significant savings on pensions from obliteration by THR.
In the end they are all working to prop up the cigarette trade and defend it against all comers, and this process is co-ordinated by government as they are by far the biggest beneficiary. That's why we call it the government tobacco trade.
You buy government tobacco. If you describe it in any other way you are just deluding yourself.
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Assorted links & refs
Clive Bates on how the EU wants to protect cigarette sales:
http://www.clivebates.com/?p=2876
Bates is an ex civil servant and ex director of ASH UK.
Useful quotes:
http://www.ecigarette-politics.com/vaping-quotes.html
General references, lists of sources:
http://www.ecigarette-politics.com/references.html
How the vaping community perceives the political elite:
http://www.ecigarette-politics.com/who-protects-smoking.html
UK voters and vaping:
http://www.ecigarette-politics.com/uk-politics-and-ecigs.html
Who is responsible for protecting cigarette sales?
http://www.ecigarette-politics.com/personal-gain.html
http://www.ecigarette-politics.com/who-protects-smoking.html
What is the impact of vaping on individuals and society?
http://www.ecigarette-politics.com/the-impact-of-vaping-on-individuals-and-society.html
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Notes
[1]
http://www.e-cigarette-forum.com/fo...-analysis-government-stake-tobacco-sales.html
THR advocates have calculated that since smokers are reported to die 10 years early, on average, then the saving on UK pensions is about £7.5bn. If smokers don't in fact die early, then there is no saving.
THR advocates have calculated that the other savings on end-of-life care are about $5bn. These include the cost of NHS care for the elderly, social care in the community, and similar types of support.
Therefore it is our view that government makes £12bn on the front end and the same on the backend, making £24bn. We must add to this all the other government revenues that derive from smoking: pharmaceutical taxes, income tax from all workers anywhere connected with tobacco, retail and pharmaceutical sales; and so on. The total will clearly exceed £25bn and may even approach £30bn. It is obvious that the UK government clears around £20bn from tobacco.
[2] Savings on the 'backend' - when smokers die early and save the government vast sums on pensions and social care - probably equal the frontend OTC tax revenue. See above, #1.
[3] The NHS cost of treating smokers is variously estimated as from around £3bn to any figure the pin sticks in. There seems to be general agreement that a figure of £3bn was supported two years ago. Allowing for inflation and a safe margin, we might guess that the current cost is £4bn.
Drug costs were 40% of overall treatment costs when the figures were last published in full, and a general trend of an increase of 0.5% to 1% per year was also seen. Allowing for this rise, we could now estimate NHS drug costs as 45% of the overall cost of treatment. However, drug costs for the treatment of ill smokers are especially high (patients who have to pay for chemotherapy in the USA before being reimbursed by their insurance report that a single drug treatment can cost over $1,000). Therefore, drug costs for ill smokers are likely to be higher than average, not lower.
This tells us that the pharmaceutical industry earns more than $2bn from NHS treatments of ill smokers.To this we must add the massive boost to the overall disease burden of the population due to smoking (a smoker is >40% more likely to be diabetic - the same applies to blood pressure, high cholesterol and many more conditions). Therefore, a proportion of general disease treatment costs must be assigned to smoking. ASH UK tell us that for every smoker who dies from a smoking-related disease, another 20 are sick; so that if 100k die per year in the UK (their figure) then 2 million smokers are sick and under treatment at any given time. So, it would be a little unrealistic to assign less than £1bn here, assuming that the Public Health industry's calculations are correct.
Now we must add the NHS SSS costs and all others associated with smoking cessation and smoking cessation services. We know the SSS (stop smoking services) cost £200 million a year. Half of this can be assigned to drug costs, as the NRTs and psychotropic drugs prescribed are the foundation of the service now (it was fully pharmaceuticalised in 2000, after which the results are reported to have fallen).
We know that the tobacco industry makes £2bn a year in the UK, and we have just seen that the pharmaceutical industry makes at least £3bn, although this is probably an under-estimate.
[4]
https://fullfact.org/factchecks/does_smoking_cost_as_much_as_it_makes_for_the_treasury-29288
[5]
http://www.forces.org/News_Portal/news_viewer.php?id=2303
http://www.civilsociety.co.uk/gover..._and_squander_taxpapers_money_think_tank_says
http://www.iea.org.uk/sites/default/files/in-the-media/files/The sock doctrine.pdf
http://scienceandpublicpolicy.org/images/stories/papers/commentaries/march_of_zealots.pdf
[6]
http://ecita.org.uk/legal-rulings-opinions
[7] Snus is a specially-processed Swedish oral tobacco, mostly used in small packages, that is produced to the Gothiatek standard, meaning that most of the carcinogens are removed. Swedish men are the main consumers, and as a result Sweden has the lowest male oral cancer rate in the EU (Snus consumption has no association with oral cancer).
It was banned in the EU in the early 90's for various reasons, but when by 2003 it was obvious that this was a public health disaster, the ban was not revoked. It is the most successful piece of cigarette sales protectionist legislation in the world. Billions of cigarettes and vast quantities of smoking illness treatment drugs have been sold, and hundreds of thousands have died (perhaps millions), as a direct result.
http://www.clivebates.com/?p=1561
http://www.clivebates.com/?p=1575
http://www.clivebates.com/?p=857
[8] The pharmaceutical industry has two important revenue channels from smoking; one minor channel; and a multiplicity of small channels. The two major revenue channels are:
1) The drug market for treatment of serious disease caused by smoking: chemotherapy drugs, COPD drugs, CVD drugs, and so on.
2) The massive boost to overall drug sales caused by the increase in general sickness generated by smoking (for example, a smoker is >40% more likely to develop diabetes; and this increase applies to many conditions). Diabetes drugs, cholesterol drugs, bronchitis drugs and blood pressure drug sales will be significantly boosted by this factor, and these drugs are not the cheapest types.
The minor channel is:
3) Smoking cessation meds: current smoking cessation practice is based on drug therapies. Psychotropic drugs and NRTs are the main classes used. This revenue channel, though significant, is tiny by comparison with the two major revenue channels.
The small channels are numerous but include:
OTC meds - just one of the drug markets that see a boost from smoking, as smokers make chemists (pharmacists) rich. Cough meds and other types of chest medications get a significant boost from smoking.
[9] Rodu posits that the Snus ban deaths in the EU may now be as high as 290,000 of the total 700k. Since Snus has clearly saved more than half of smoking deaths in Sweden, it is a valid opinion. What cannot be argued is that ecigs will perform the same role in other countries as Snus has in Sweden, and therefore it is crystal clear that more than half of EU smokers would eventually transit to Snus or ecigs if allowed. Therefore the 23 year old Snus ban, together with the planned elimination of ecigs in the EU, will eventually be responsible for at least half of the 700,000 a year smoking death toll (and probably more than half). This policy will continue to make fortunes for government and the pharmaceutical industry (together with the cigarette industry, their partners); and will eventually make such incalculably vast sums for them that we might almost say the EU economy is part-based on smoking. (In actuality, based on taxing and making ill and killing smokers addicted by the government tobacco business.)
http://rodutobaccotruth.blogspot.co.uk/2013/11/what-eu-snus-ban-means-290865.html
[10] The 20% Prevalence Rule:
http://www.ecigarette-politics.com/the-20-prevalence-rule.html
[11]Rodgman, Perfetti 2013
The Chemical Components of Tobacco and Tobacco Smoke, 2nd Edition.
http://www.crcpress.com/product/isbn/9781466515482
[9,600 compounds identified to date]
[12] There are 5 basic ingredients in the refill liquid - PG, VG, flavour, water, nicotine (usually). A flavour may consist of up to (usually) 10 separate synthetic or extracted compounds, such as menthol.
[13]
http://www.pmi.com/eng/our_products/whats_in_smoke/pages/whats_in_smoke.aspx
[14] Systematic review of ecig chemistry:
http://www.biomedcentral.com/1471-2458/14/18/
Burstyn, 2014
This is recognised as the most comprehensive review of the evidence by a senior toxicologist. Also at:
http://www.biomedcentral.com/1471-2458/14/18/abstract
http://publichealth.drexel.edu/SiteData/docs/ms08/f90349264250e603/ms08.pdf
http://publichealth.drexel.edu/~/media/Files/publichealth/ms08.pdf
[15]
http://onlinelibrary.wiley.com/book/10.1002/14356007
http://www.drugs.com/inactive/propylene-glycol-270.html
[16]
http://www.ecigarette-politics.com/blog/r-west-ecig-fact-and-faction-update.html
[17]
http://www.ncbi.nlm.nih.gov/pubmed/21163315?dopt=Abstract&holding=f1000,f1000m,isrctn
http://www.tobaccoharmreduction.org/faq/healtheffectsofst.htm
http://www.ncbi.nlm.nih.gov/pubmed/14660766?dopt=Abstract&holding=f1000,f1000m,isrctn
[18]
http://www.ecigarette-politics.com/references.html
- scroll down to: Pharmaceutical industry - criminal activity
[19]
http://www.ecigarette-politics.com/references.html
- scroll down to: Nicotine #5
[20]
http://www.ecigarette-politics.com/e-cigarette-terminology.html
- scroll down to 'dependence'
[21] Hansard - NHS asserts that ecigs are 1,000 times less toxic than cigarettes, and reasserts it in Parliament:
http://www.publications.parliament.uk/pa/ld201314/ldhansrd/text/131120w0001.htm
[search: Smoking]
[the NHS citation is Cahn, Siegel 2010]
[22]
http://rodutobaccotruth.blogspot.co.uk/2015/02/nih-funding-stifles-tobacco-harm.html
[23] The total revenues generated by smoking are greater than $1 trillion a year.
Annual tobacco sales are about $800 - $850 billion including tax. Add the pharmaceutical industry's smoking-generated revenues, plus the business taxes paid by any entity with any tobacco connection, plus the MSA payments, plus the income taxes paid by any employees whose work has a main or part existence because of tobacco.
[24] THR or tobacco harm reduction is the consumer choice of safer products than smoked tobacco. Modern THR products are not just low risk, they are ultra low risk, and any health impact is too small to be statistically identifiable with any reliability.
http://www.ecigarette-politics.com/tobacco-harm-reduction-an-explanation.html
[25] Cochrane Review:
http://www.cochrane.org/CD010216/TO...oke-and-are-they-safe-to-use-for-this-purpose
[26] Ecigs were first sold in the West in 2005 (in the UK), so we have about 10 years' experience with them at Q1 2015.
Due to the very large number of users we have around 50 million user-years of experience with them.
Due to the large userbase and the highly-engaged community, ecigs are monitored far more closely than any pharmaceutical product that has ever been marketed. If a vaper coughs in Australia, they know about it in Canada. It is absolutely impossible that any vaping-related product with even a fraction the risk of Chantix, for example, could remain on the market. Anyone selling any consumer product remotely as dangerous as that in the UK would be in prison (and this is why we know that consumer products in the UK are safer than medical products).
Prof Rodu remarked that, "Among millions of e-cigarette users, credible adverse events are almost nonexistent", when examining the 47 Adverse Event Reports the FDA had received for ecigs. This should be compared with the 10,000 Adverse Event Reports allegedly received by them for Chantix in the same time period.
http://www.fda.gov/Drugs/DrugSafety...ormationforPatientsandProviders/ucm106540.htm
[27] The EU's greatest success is the use of deception to mask its real purpose: to insulate government and major industry from any threat to revenue or control of the revenue creation and distribution system. Its twin functions of preventing intra-European war and maintaining stability are best served by this method.
The core principle of removing policy and revenue from influence by the public is the foundation of its strength: government and industry must protect the EU in order to protect revenue and profits, and therefore the work needed to protect the system is carried out by others, at their expense.
There is no name yet for this new form of federalism, specifically designed to remove democracy while at the same time claim an advance for it (which is carefully managed by propaganda), but neo-communism is about the closest. Because it is a particularly cruel system as regards the elimination of certain minorities (typically the objectors), neo-Stalinist may be more accurate.
The extensive use of deception and propaganda and the endemic corruption are important features of the EU.
It works very well for its intended purpose, though there is a cost to pay. War is cripplingly expensive, but peace still has a cost.
[28]
http://www.ecigarette-politics.com/vaping-quotes.html
- - scroll down to: On nicotine's potential for dependence
[29]
http://www.ecigarette-politics.com/references.html
- scroll down to: Nicotine #2
[multiple other refs available, if needed]
[30] NICE PH45
http://guidance.nice.org.uk/ph45
[31] Farsalinos: a search of PubMed showed 354 ecig results:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110871/
".....we searched the PubMed electronic database by using keywords related to ECs and/or their combination (e-cigarette, electronic cigarette, electronic nicotine delivery systems). We obtained a total of 354 results,..."
[32]
http://www.ecigarette-politics.com/vaping-quotes.html
- scroll to: On the potential saving of life
Prof Britton is the Chair of the Tobacco Advisory Group of the Royal College of Physicians. As such, he is the direct descendant of Richard Doll, who more or less invented tobacco control, and is therefore the world authority. He makes it clear that, in his opinion, if all UK smokers switched to ecigs, 5 million lives would be saved, just among those alive today, just in the UK.
And also see: On the safety of ecigs (on the same page)
[33] ECF is, in practice, the world's largest smoking cessation community. There are 14 million posts at the time of writing. It is the world's largest community of dietary nicotine supplementers. It is the world's largest community of pure nicotine users. It is the world's largest community of successful smoking cessation attempt makers. It is the world's largest repository of knowledge about successful smoking avoidance and cessation.
The vaping community knows far more about the practical issues of pure nicotine use than the medical profession ever will. The medical profession have been handicapped for years by the pharmaceutical industry's need to strictly control access to nicotine for commercial reasons, and are still bound by artificial conventions. The vaping community have no such restriction and could not care less about the drug industry's need to continually increase profits at any cost. Therefore we are at the leading edge of discovery in the nicotine field, and we are already able to inform the medical community of multiple issues they appear unaware of. We know more about successful smoking cessation than anyone else and we're a lot better at it. We have saved countless thousands of lives and we do what we can to oppose the immense pressures protecting smoking.
If people want to smoke, as consenting adults, they should be allowed to so so. If they pay their taxes and therefore not only pay for any medical treatment they may need but also contribute a considerable amount extra to the state coffers - for no easily-discernible reason - then it is very hard to find any justification for preventing them doing as they wish or find any reason why others should dictate to them (apart perhaps from some form of religious fundamentalism). If people want to vape, they should be allowed to do so, and it is not justifiable to charge them any extra taxes for the privilege unless we are also going to tax coffee and cream cakes. If people want to stop smoking and switch to vaping, the mere fact they will be paying a great deal less blood money is not an ethically justifiable reason for preventing them improving their health prospects. Money is not an excuse for the State to force people to act in a way that commercially benefits others. All attempts to prevent vaping displacing smoking are based on corruption - the health issues are irrelevant, the science is irrelevant, the evidence is irrelevant, has always been irrelevant, and always will be irrelevant: it's done purely for the money.
Some may think politics is about the democratic balance of management of limited resources in the public interest and the implementation of policies that best serve the needs of the population. We laugh at such a naive assessment - as far as our community is concerned, politics is about endemic corruption; and that perception will be difficult to change.
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Additional suitable references are appreciated.
This material can be quoted anywhere without restriction, and preferably use my actual name not the ECF web handle it is posted herein with. Thank you.
- Chris Price
2015-02-26
updated 2015-02-28
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