EU UK first to embrace tobacco harm reduction

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Bill Godshall

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In an historic first for public health, the National Institute for Health and Clinical Excellence (NICE) of the UK's National Health Service overwhelmingly approved tobacco harm reduction as a key component in England's ten year plan to reduce cigarette smoking by half.

The US FDA and health agencies of other countries should follow the UK's lead, which can be further improved by including e-cigarettes and smokefree tobacco products.

The announcement and a news excerpt are below, and the full report "A Smokefree Future" is at http://www.dh.gov.uk/dr_consum_dh/g.../@en/@ps/documents/digitalasset/dh_111748.pdf

Bill Godshall
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Citizens Council vote in favour of harm reduction in smoking

Citizens Council vote in favour of harm reduction in smoking

The Citizens Council, a group which brings the views of the public to NICE’s decision-making, has voted overwhelmingly in favour of the use of harm reduction as a way to reduce the dangers of smoking.

The 30 members of the Citizens Council met in October last year for three days to discuss the pros and cons of harm reduction. Whereas smoking cessation aims to help smokers quit smoking and break their reliance on nicotine completely, the idea of harm reduction involves reducing the harm associated with cigarettes for smokers who find it too hard to quit. This could include replacing cigarettes with a clean form of nicotine, or with cigarettes which intend to deliver lower levels of toxins.

Overall, the Citizens Council supported the use of harm reduction in smoking but the idea of considering harm reduction as a way to provide a less harmful alternative to smoking - while accepting that nicotine addiction continues - proved relatively unpopular.

Sir Michael Rawlins, Chair of NICE, said: “The concept of harm reduction conflicts with traditional smoking cessation as it does not necessarily seek to help people stop smoking altogether, nor does it treat nicotine addiction. What would this approach mean for the goal of having a smoke free society?

“The Citizens Council’s view will help guide our independent advisory committees, should they be required in the future to make recommendations about harm reduction in smoking.”

The findings from the Citizens Council come as the Department of Health launches a Tobacco Control Strategy for England which aims to halve the number of smokers, from 21 to 10 per cent of the population by 2020.
This latest strategy, A Smokefree Future, builds on the previous 1998 strategy and sets out to ensure that every smoker will be able to get help from the NHS to suit them if they want to give up. This includes introducing new approaches to reducing smoking such as harm reduction.
The Department of Health will also work with NICE to encourage alignment of the Quality and Outcomes Framework (QOF), so as to encourage more smokers to use the NHS Stop Smoking Services.

The 30 members of the public that make up the Citizens Council are drawn from all walks of life, and provide NICE with insights into the public's views on challenging issues that often involve values such as fairness and need.
It meets twice a year and reports directly to NICE's Board. Its recommendations inform a wide programme of work. When the Council was set up in 2002 it was the UK’s first advisory body made up entirely of members of the public.

The public is now invited to comment on the Citizens Council members’ views on the use of harm reduction in smoking, before the report is presented to the NICE Board. The report on the Council’s views is available for public comment, at www.nice.org.uk . Comments must be sent in by 5pm on Wednesday, 31 March 2010.
see this link

1 February 2010
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Shift in status for anti-smoking aids

By Nicholas Timmins, Public Policy Editor
Financial Times
February 1 2010
FT.com / UK / Politics & policy - Shift in status for anti-smoking aids

A major shift in the government’s anti-smoking policy has been quietly announced, allowing nicotine products to be sold as a long-term substitute for smoking, not just as an aid to quitting.

The announcement acknowledges that some smokers are nicotine junkies, who find it close to impossible to give up the addictive element in cigarettes.
(excerpt)
 
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Bill Godshall

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Per my note above, it would be helful if e-cigarette users (especially those in England) submit comments to the UK NHS (weblink provided above) applauding its embrace of tobacco harm reduction, and urging the inclusion of e-cigarettes and smokefree tobacco products. Comments are being accepted till March 31.
 

River

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Finally, a victory for common sense.

I don't even have a real problem with being labeled as "nicotine junkies" since in this case it just looks like the last desperate gasp from the old guard who still believe they can shame people into quitting by playing the I'm morally superior to you card while they still can.

Congratulations to the UK on making this a public health issue as opposed to a morality issue.
 
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harmony gardens

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This is indeed great news! So in exchange for them calling me a nicotine junkie, they will approve harm reduction,,, I can live with that.

What they don't seem to get is that ecigs are smokeless, and therefore are 100% compatable with the goal of a smokeless society. That's for another council or some other anti smoking group to figure out.
 
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Vicks Vap-oh-Yeah

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They're getting 'smokeless' mixed up with 'nicotine-less', and, realistically, what is all the furor raised about us being 'nicotine junkies' anyway?

It's a vice - the thing that we know we could be better people without, but have chosen to ignore the (insert doom and gloom message here).

People of all walks, from the squeeky clean moralist to the filthy drunk sleeping under an onramp, have vices. It's part of the human condition. There are sex addicts, alcohol addicts, people addicted to caffine, chocolate, fat, sugar, salt, bananas, and small stuffed animals.... let us HAVE our small comforts in this life, and we'll let you have yours!

Ooooo - someone help me down from this soapbox now :D

And Bill - the reason your post is askew up there is because a URL you posted can't be broken up into 2 lines....no worries.
 

Kate51

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Vicks I always love your rants, they're so spot on!
Rant away. And, I totally agree, we're getting messed up with smoking/not smoking nicotine is the villain??/not the villain...cripes. If there always must be a label on everything at least use the right one. Just leave that in the suggestion box I guess.
I guess I'm a junkie too......but I keep getting this recurring picture of a poochy-face old guy with a stogie and a Brandy telling the world we need to have a smoke-free society...what, the ozone hole healed up and they found out it doesn't make the atmosphere better, maybe that means it needs a breath-hole vent somewhere...for all the stogie smoke to get out. With maybe a little of the man-caused hot air.
"Those were the Days, my friend" keeps popping in my head too, for some reason. Love that song.
Problem is, this man-caused disaster called smoking has made us all villains instead of victims, so I just wish they could come up with a name suitable for all those people who now want to live in a sterile society so no one ever needs to be sick, but don't make my kids take immunizations. We used to call that Paradise, but then where are all those addicts that were caused by Society gonna go?? I just don't get it. No answer here, so I must've just ranted too.
 

westcoast2

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Bill Godshall noted:
n an historic first for public health, the National Institute for Health and Clinical Excellence (NICE) of the UK's National Health Service overwhelmingly approved tobacco harm reduction as a key component in England's ten year plan to reduce cigarette smoking by half.

Tropical Bob noted:
Very encouraging development, and surprising from a country that bans snus.

There are many steps that could be taken to move smokers from a dangerous addiction to an enjoyable recreational practice. E-cigs, snus and nasal snuff immediately come to mind. All should be part of any harm reduction strategy.

What at first glance looks welcome, could easily end up taking all e-cig products off the UK market. It will put some and could put all e-cig companies out of business in the UK. The e-cig would be classed as a medicinal product and be licensed. The cost of this could be prohibitive for small companies. The actual costs are high enough if they covered a class of product. If it is per product licensing then this would certainly have a dramatic effect. It is a little unclear at the moment.

The 'harm reduction' seems to refer to products that lead to quitting nicotine rather than the more general 'harm reduction' you would expect.

Snus was discussed in the NICE consultation, where it was recognised that it seemed to be less harmful, but NICE recommended continued support for the EU wide ban.

The headlines are cleverly worded to appeal to a variety of people, the detail seems to appeal mainly to the tobacco and pharmaceutical indistries.
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deewal

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Download this pdf from MLXs: Medicines consultation letters : MHRA
and get as many people especially Doctors if possible to respond.(mine is going to write about my condition ) The more professional people the better but every Vaper in the UK should do it straight away then work through your friends. Talk to your MP's. Remember there is an Election coming up. It cannot be a Medicine if it's in an E-Cig and and a recreational drug if it's in a Cigarette. That is Insanity and Hypocritical to say the least.
This is what it says

"This consultation seeks your views on whether to bring all nicotine containing products (NCPs) – with the exception of tobacco and tobacco products - within the medicines licensing regime. This would require all currently unlicensed NCPs on the market, such as electronic cigarettes containing nicotine and nicotine gels, to apply to the MHRA for a medicines Marketing Authorisation (MA).
The deadline for comments is 4 May 2010. "
Response form for MLX 364
 

Kitabz

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I'm sorry, but this could be very bad news for UK Vapers. The proposals could see regulation of e-cigs which would place them entirely in the hands of the pharma industry.

See: MLXs: Medicines consultation letters : MHRA

Hmm, that's not how I read the public consultation document on the page linked to above. It appears that should NCP (nicotine containing products) come under the remit of the MHRA, they anticipate that 50% of current businesses will apply for appropriate licences in order to continue to trade these products. All of the well known UK based e-cigarette companies are on the consultation list (pages 8-12).
 

deewal

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Hmm, that's not how I read the public consultation document on the page linked to above. It appears that should NCP (nicotine containing products) come under the remit of the MHRA, they anticipate that 50% of current businesses will apply for appropriate licences in order to continue to trade these products. All of the well known UK based e-cigarette companies are on the consultation list (pages 8-12).

Read the Drug Safety Update Febuary 2010. Nicotine Replacement Therapy and harm reduction.

http://www.mhra.gov.uk/home/idcplg?...068577&RevisionSelectionMethod=LatestReleased
 
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