Neil McKeganey | 22 June 2015
The recent announcement from health officials in Wales that the use of e-cigarettes in public spaces will be banned has been received with a mix of enthusiasm from some, puzzlement from others, and downright dismay by many -including within the "vaping" community itself.
The argument for such strident action seems to be that e-cigarettes are serving to renormalize smoking. For anybody seeking to promote evidence based public policy that anxiety, and the interventionist public policy that flows from it, must be a matter of enormous concern since one looks in vain for the evidence of renormalisation actually occurring. It seems sufficient here only to claim that a possible harm may be occurring to usher in a whole swathe of interventionist policies and restrictions. What confers that power on public health officials' is the fact that the health harm they are voicing is the ultimate folk devil - smoking.
In this case though the policy being implemented is nothing short of perverse since it is now widely accepted that whatever the harm of e-cigarettes they are a good deal less harmful than smoking combustible tobacco. As a result public health officials in Wales find themselves announcing a ban that in the long term may well increase not decrease the harm from smoking through impeding individual's access to what many millions of smokers are seeing as their preferred means of stopping smoking. In a country where there are no shortages of environmental pollutants exerting a terrible toll on public health it is bizarre that the Royal Environmental Health Institute for Scotland has called for a similar ban to be imposed on the use of e-cigarettes.
If e-cigarettes turn out to be associated with some level of long term harm then those same public health officials will likely pat themselves on their collective backs, loudly proclaiming the prescience of their actions. However there may be a more immediate consequence of their actions that will provide no equivalent cause for celebration. We know that smoking kills around one in two smokers and that e-cigarettes are being used as a way of reducing smoking. That being the case in the event that this ban leads to a reduction in the number of those using e-cigarettes in Wales we may see a slowing down in the rates of smoking cessation and an increase in tobacco related health harm.
If the policy of banning the use of e-cigarettes in public spaces leads to a reduction in the use of e-cigarettes then those same officials who have confidently announced that ban should resign their positions because in their actions, if not their intentions, they will have added to the sum of public health harm. Will they act in this way if that evidence emerges- don't hold your breath. More likely we will hear that their interventions were based on the best available knowledge at the time and it is only in hindsight that the policy has been seen to be hugely regrettable.
The actions of these officials will afford them a short lived celebrity- rushing from media interview to media interview fired with an almost religious zeal that they are correct in what they are doing. Doubt it seems is a long way off in the distance if it is on their horizon at all. I am neither a smoker nor a vaper, but I sincerely hope that the actions of these officials do nothing to stem the wishes of vapers to vape and smokers to switch -and that we see no diminution in the use of e-cigarettes in Wales or elsewhere.
We are living in a dangerous time when the inclination to intervene in public life is almost without restraint with the two demons of health harm and terrorism affording public officials limitless access to our lives. We may find it increasingly hard to come to a position where we recognise that simply because we believe something is harmful that does not give us the right to intervene in individual's lives. Championing the freedom of individuals to do what they wish can seem a flimsy cause against the ranks of serious minded officials who are there to protect us from – ourselves. But if we afford those officials unbridled power to intervene in our lives whose to say that the health promotional nirvana that is delivered will actually turn out to be a place where many of us want to live.
Neil McKeganey Ph.D
Centre for Drug Misuse Research