I recall hearing Martin Dockrell from Public Health England remark that he put ‘popcorn’ into Google and ‘popcorn lung’ came up before err…popcorn in the search bar. ‘Popcorn lung’ is so nice and catchy, like ‘hippy crack’ (nitrous oxide, honestly) and ‘zombie spice addicts’.
The media love a good bad news e-cig story. Next in line is probably death by JUULing (you read it here first), followed closely I suspect by those delicious stories about exploding devices. Mainly these are caused by human error; loose, damaged batteries in a pocket, a bunch of keys touch the contacts and whoosh – or somebody has an Elon Musk moment and tries to modify their device in inadvisable ways.
These stories are rare, but all too common are claims about the dangers of liquids, flavours and so on. It is important that the industry is seen to take production values seriously and do more to get the message out there about exactly what’s being done to ensure consumer safety – certainly more than the provisions of the EU TPD which swerved round consumer safety issues, focussing, as most legislation does in this area, on everything else.
This was brought home to me when I attended the inaugural forum of the UK Vaping Industry Association. Dr Sudhanshu Patwardhan gave a presentation on the current state of play regarding the progress towards establishing international standards. But as he said himself, once you start talking about the national (The British Standards Institution in the UK, Afnor in France), regional (CEN EU) and international (ISO) standards, it gets very technical and everybody dozes off. But actually this stuff is incredibly important covering as it does, e-liquid and device safety, and device performance. In the face of continued sensational and misleading reporting, standards help drive an alternative narrative about the quality and safety of all the elements that go in to make up the technology of the new devices.
With the plethora of companies all producing a diverse range of devices, device components and all the ‘software’ (not to mention fake and cloned devices or those just poorly made to cash in), it is all too easy to portray the whole industry as a Wild West show. Clearly the business is in its infancy, but hopefully the industry can have global reach far beyond the current buoyant markets. Hence the importance of a uniform, harmonised approach to product quality and safety. And from that it follows that while standards are not the same as regulation, standards can underpin regulations where they are now firmly in place such as in the EU and, even more importantly, provide a template for regulation, especially in lower and middle-income countries.
I was at dinner recently with a political delegation from the Philippines, whose leader was attempting to introduce pragmatic and proportionate legislation on vaping. He said that whenever he talks to health officials about this, “All I hear is WHO, WHO, WHO”. Standards don’t deal with concerns about gateway effect and addiction, but they are an important weapon in the armoury of evidence to sit alongside the welter of independent science in support of tobacco harm reduction. Some way needs to be found to get this alternative narrative front and centre before all those regulators (for whom regulation and banning often mean the same thing) and health officials who for whatever reason (and there may be many reasons) just hide behind the FCTC in very much the same way as those governments who are anti-drug harm reduction parade their moral credentials with reference to UN drug treaties.
There were other key takeaways from the UKVIA meeting. One session considered whether industry and Big Pharma could work together. The matter quickly segued instead into a debate as to whether the independent vaping sector and the major tobacco companies could work together, because the answer to the first part was a resounding ‘no’. All the evidence points to an industry doing its best to drive tobacco harm reduction companies out of existence owing to the obvious business threat to the NRT. My moles tell me a well-known Big Pharma company accused UKVIA of breaching advertisement regulations in its VApril campaign, a full evaluation report on which is due at the end of the month. Seems to be going very well though. www.vapril.org
You might also recall that the Advertising Standards Authority had announced that it was considering lifting the ban on companies being able to make health claims about safer nicotine products. Guess who has been lobbying hard for that not to happen? Now, having come from a world where every so often somebody would come up with a snake oil remedy for heroin addiction, I fully support restrictions on product health claims. But when the ASA has ready access to UK reports from PHE and the RCP about the efficacy of safer nicotine products, yet still won’t allow companies to put a highly targeted message inside a packet of cigarettes, you have to wonder if Big Pharma are supplying product as well as applying pressure.
There was an interesting presentation from Ian Hughes at Consumer Intelligence whose company surveyed 1,000 plus smokers during March 2018 covering the experience of and attitudes to vaping; awareness of public communications about vaping; and channels to influence change amongst smokers. One key message from the survey was clear - keep the communications simple - which of course leads straight back to the issue of advertising. It doesn’t matter if your message equates to War and Peace or a joke in a Xmas cracker. How on earth are you supposed to get any message across if you can’t promote or advertise? Campaigns like Stoptober and VApril are clearly very useful, but you need that drip feed of messages sifting through multiple platforms for the harm reduction imperatives to get through. As things stand only national and local health authorities can do this, but as you can count the number of Directors of Public Health who publicly support tobacco harm reduction on one hand, don’t hold your breath.
And finally on the business front, Supreme, which owns the KiK and 88vape brands, is the first UK vaping company to go public:
Believe it or not, young kids are better informed about e-cigarettes than many academics and doctors with strings of letters after their names. In a survey of primary school children conducted by the Welsh NHS and Liverpool John Moores University among nearly 500 children aged between 7 and11 years old, it turns out that they:
- know that e-cigarettes and tobacco cigarettes are not the same
- perceive e-cigarettes as less harmful than tobacco smoking
- perceive e-cigarettes as less addictive than tobacco smoking
- see e-cigarette use as inappropriate for their age group
- do not feel more positive about adult vaping than adult smoking
- had little intention of either vaping or smoking
- were better informed about e-cigarettes if family members are e-cig users.
I wonder if they would be named and shamed at COP 8 as Big Tobacco stooges?
Away from the serious stuff, here is the latest offering from UK harm reduction animator extraordinaire Michael Linnell who has created a cartoon about passive vaping:
And from the department of ‘you couldn’t make it up’, in line with Queensland, Victoria, ACT and Tasmania, New South Wales in Australia has banned public vaping. And the visionary health minister who is proud of this? Brad Hazzard.