Medicines for a Consumer Problem

There’s a problem that those in power want to solve. Or more to the point, they don’t want to “solve” it at all. They want to “control” it. That “problem” is smoking, which to my mind isn’t a problem at all. It’s a choice people make. Yes there’s an “addictive” side to it, yes there’s a big cost to it, and yes there are some risks associated with it. But you know what? I don’t care. If folk want to smoke than that is down to them. Their life, their choice end of story. Almost.

I get it, there’s been millions spent (nigh on all of it from the taxpayer) on various campaigns, social drives and all that shenanigans to “persuade” people to stop smoking. For a time, the campaigns did work, the smoking rates did drop. Only now there is this core group that, rightly or wrongly, just don’t want to give up at all. Don’t get me wrong, some do indeed want to give up, and should that be their choice to do so there should be the widest possible range of options to help them. Snus, patches, inhalators, gum, lozenges, Zyban, Chantix, and e-cigs are all valid options to aid said smoker should they so choose. There’s also professional help from the stop smoking services and so forth. Frankly, there is no end of “help” for the smoker to quit smoking. Then along comes an e-cigarette/vaporiser/electro-fag whatever folk choose to name them is up to them and suddenly, almost overnight that damnable smoking prevalence rate starts to drop. Only this time it’s dropping a lot quicker than before. This drop isn’t just a UK thing, it’s worldwide.

You can picture it can’t you, those ivory tower residents have been trying for years to get that rate to drop with various campaigns, stigmatization, and bans that when it starts to drop almost on its own overnight. Imagine the panic that sets in. Don’t forget a lot of these organisations get their funding (directly or indirectly) from taxation and grants. Most of the taxation is from the very thing they want to eradicate. Bit of a conundrum that isn’t it?

These oh-so-benevolent ivory tower residents discover that a humble e-cig is the possible cause for this decline in smoking rates, they find that it was a Chinese pharmacist that invented it, they find it’s not regulated. Cue the hysteria. The Children™. We don’t know what’s in them! and my favourite, “they should be regulated as a medicine”.  We know that the MHRA intended to regulate the entire market in 2010, which was subsequently defeated.

We know that the TPD has its own rules for “medically approved” devices, plus we also know that many politicians (yes McAvan I’m looking squarely at you here) actually want medicines regulation for e-cigs. Thing is, McAvan has done her bit. She got e-cigs shoehorned into the dogs-dinner that is the TPD and now she has sat back to bask in her glorious moment of success, knowing full well that the devices could never reach compliance with the TPD let alone Medicines Authorisation.

Trouble is, she was wrong.

Let me rewind a bit. The Framework Convention on Tobacco Control (FCTC), Article 5.3 says an awful lot about protecting “public health policies with respect to tobacco control from commercial and other vested interests of the tobacco industry”. So no interference from the likes of British American Tobacco, Japan Tobacco International, Altria, R J Reynolds and so forth. Most of that is of course in relation to tobacco control policies such as the plain packs debacle (still waiting to hear from those down under as to why it hasn’t worked!), smoke-free legislations (bans in other words) and taxation. The same taxation that is responsible for the sock-puppet organisations we have to put up with telling us what we can or can’t do.

Look I get it, those with policy making powers want to see the things we use made as safe as possible. That’s what everyone wants. As Lorien puts it:

If the e-cig isn’t going to blow up in your face, then it is going to jump out of your pocket and poison everyone within a mile radius! If either of those two things don’t happen then it is going to fill you so full of formaldehyde that Damian Hirst is going to be banging on your door demanding to split you in two and hang you in a perspex box! And if THAT doesn’t happen well it won’t help you quit or change habits cos they just don’t work – and anyway, they are more dangerous than cigarettes don’t you know with all those ultrafine particles burning holes through the lining of yours lungs! Assuming, of course, they can get through the layers of oil that are causing lipoid pneumonia or that your lungs haven’t leapt out of your MRSA riddled body and run down the road smelling slightly of popcorn. Not that you’ll be running anywhere cos that vapour restricts the ability to breath and that mouth and throat cancer you are going to get are DEFINITELY going to stop you even walking up the stairs!

In fact, they are SO (possibly maybe we don’t know yet) dangerous that not ONLY must they be banned like cigarettes but we can’t see or smell or even get a suggestion of marketing and by golly it is best that they are taxed immediately!

So what exactly is the answer to the “smoker problem” (and I’m using quotes there simply because I do not see smokers or smoking as a problem) that these folk see? Well, from my perspective the “answer” isn’t quite as clear-cut as they’d like it to be. Assuming that the smokers I’m talking about actually want to stop smoking, there’s NRT with its dismal failure rate, there’s Chantix & ZyBan, both of which can have pretty nasty side-effects, there’s cold-turkey which, having tried that method is pure hell, and now there are e-cigs. These little battery-powered devices (OK Graham, they aren’t always little) mimic the act of smoking down to the inhale/exhale, but they weren’t created by a pharmaceutical company nor from the public health industry. They weren’t even created by the “evil Big Tobacco” industry. So a consumer driven product has succeeded where decades of propaganda have failed. Go figure.

Only now with impending regulations, the very thing that has driven a significant decrease in smoking prevalence is set to become history, unless of course a manufacturer can achieve the holy grail and get a medicine authorisation. Which brings me to the whole point of this post.

Here, here, and here are the “news” articles about e-cigs being made available on the NHS. I’m not going to go into all the details of each article, but suffice it to say that there are several flaws. Imagery on each article shows 2nd Generation devices, whilst the device that actually received authorisation is a First Generation device, specifically a 401. They mention “pharmaceutical grade” nicotine, which we know to already be used in current e-liquids.

I’ve had a gander at the MA for this device, as have others. Some believe that the device in question isn’t actually an e-cig. Sorry folks, it is an e-cig. As some of you will know, I am against a medical e-cig for a variety of reasons, not least of which any device that meets the requirements is likely to be bland, ineffective and not very fun to use or to talk about. Oddly enough, the e-Voke is not the first e-cig like device to get an MA, it’s just the first actual medicalised e-cig.

Even odder than that is the fact that despite Article 5.3 of the FCTC, the tobacco industry now has a seat at the table. British American Tobaccothrough its e-cigarette arm Nicoventures (subsequently Nicovations) now have an MHRA approved vaping device in the “e-Voke”. Let that sink in for just a minute. A tobacco company has now got an e-cigarette through the “light touch” MHRA licensing which can now be prescribed via your GP or the NHS to help you stop smoking.

Just think about that, post-TPD when 99% of the current market is deemed to be “non-compliant” the only option for smokers wishing to quit smoking is a dull, boring, tobacco industry device.

Vaping works because it is led by the consumer for the consumer. It is clear from research that the “tank” devices commonly used are the most effective, and that the “cig-a-like” type devices are less effective than NRT.

A Whitehall source said: “We didn’t want to make a song and dance about it because GPs would be overrun by people demanding it. But this is something we’ve been pushing for.”

Ms Ellison had to spill the beans when asked a direct question by Labour MP Steve McCabe.

She told him: “The Government believes vaping is ­significantly less harmful than smoking. We encourage ­medicinal license applications.”

Trouble is, the UK Government isn’t content, they want to encourage other manufacturers to apply for medicinal licenses, which for me is a terrible thing for the community, smokers wishing to quit and the industry as a whole.  This is what they’ve wanted all along. MHRA failed in 2009/2010, now they’ve been handed oversight by the UK’s draft implementation of the TPD and have (rightly or wrongly) approved a medical e-cig made by the Tobacco Industry.

The timing of this, the fact that Ellison wanted to keep it quiet stinks to high heaven. Why would we want a “medical solution” to a problem that doesn’t actually exist except in their minds? Instead, they’ve handed us a device that is, frankly a steaming pile of Shite. Just, for fuck sake leave us alone!