Are EU Kidding Me?

Whenever there’s some “new research” being touted in the media-news-space, I often find myself switching automatically into newspeak as 99 times out of 100, what is written on these online media places has little or no bearing on what is being said. (hint look up doublethink). Tracking down the cited paper was pretty darn easy (for once) and it is currently open access – which is rare considering that it was published in the journal Tobacco Control – you know, the subsidiary of the BMJ variant.

Turns out, that this paper looks at trends, patterns and opinions of e-cigarette use in the 28 Member States of the European Union. This is, in effect a “second look” at the widely published Eurobarometer datasets. Which, if you are of any kind of mind you would probably already have seen the most recent edition, which while full of charts, graphs and explanatory stuff does carry some very useful, and leading data, such as this on use of cigarettes, cigars, cigarillos or pipe tobacco:

InterestingData

This snippet is of course for all 28 Member States. Interestingly, the percentage variation between the various year groups (2006-2014, 2009-2014 and 2012-2014) in the “non-smokers” category (which is – you used to smoke but have now stopped) remains relatively constant. This would suggest that EU wide, the number of new smokers vs former smokers remains fairly balanced despite the “war on tobacco” – a war that has only really got one casualty – the average, everyday person.

The Eurobarometer (published in May 2015) suggested in a large portion of the data relating to e-cigarettes, the products were not the first “tobacco product” to be used by young people (there goes that gateway theory again), are starting to gain ground in the cessation method (overtaking other methods such as accupuncture (yes that’s really a thing), hypnosis, quit lines and so forth – but not yet overtaken NRT on a Union level). The data really is quite revealing – especially considering the EU’s need to regulate a product that, by their own data isn’t really a problem. Natch.

Which brings me to the point of this “new paper”.

Objective

This study assessed changes in levels of ever use, perceptions of harm from e-cigarettes and sociodemographic correlates of use among European Union (EU) adults during 2012–2014, as well as determinants of current use in 2014.

In a nutshell, let’s look at the base numbers for those that have used and are using e-cigarettes, along with the perceptions of harm of their use. Judging by the Eurobarometer report, this information was already available. So was another research paper going over the same data really necessary? Probably not, but they did it anyway ‘cos, well reasons.

Oh wait.

Ever use of e-cigarettes increased during 2012–2014. People who started using e-cigarettes to quit smoking tobacco were more likely to be current users, but the trends vary by country. These findings underscore the need for more research into factors influencing e-cigarette use and its potential benefits and harms.

Natch. Crunch some numbers then come up with a statement that is effectively a “we don’t know enough” and a call for more research. Pretty standard stuff for policy based research. Of course, the devil is in the details.

Discussion

This analysis of the most up-to-date data from the whole of the EU shows that although perceptions that e-cigarettes are harmful are increasing, levels of ever use are also increasing. Those who began using e-cigarettes as a means to quit tobacco smoking or who used them in order to circumvent smoking bans were more likely to be current users of e-cigarettes.

Who knew? Despite the continuous rhetoric from dunderheads like Knapton (and I’ll get to that in a bit) that e-cigarettes are “bad don’tcha know”, their use is on the rise, mostly as a means to quit tobacco. Pointless to cover this in a research paper when it is already included in the Special Eurobarometer.

Previous research has highlighted that the majority of e-cigarette use is among smokers and that dual use is common. However, there are concerns that e-cigarettes could become popular among non-smokers and possibly serve as a gateway to cigarette smoking. Our analysis showed that non-smokers were much less likely to have ever tried an e-cigarette, compared to smokers; nevertheless, ever use of e-cigarettes increased among them as much as among smokers, between 2012 and 2014, raising concerns regarding their rising popularity in population groups not addicted to nicotine.

So, no real data to suggest a gateway theory from e-cigarettes to tobacco but there are “concerns” about never-smokers using them. Natch. Except that the Eurobarometer data suggests the exact opposite – 97% of never smokers have never used them. That is a remarkable figure which underscores the fact that e-cigarettes only really appeal to smokers, and those individuals who would probably smoke. I see no real cause for concern there, do you?

Additionally, despite its increasing popularity, those who tried an e-cigarette because they considered it attractive were not more likely to become current users, which may be in contrast to the importance of image and attractiveness for conventional cigarettes.

So things like marketing to kids (oh really?) and packaging to make e-cigarettes attractive to all and sundry – the “concerns” of never smokers using them – is a moot point. Go figure.

This may change as the market for e-cigarettes grows, and may depend on regulations around the advertising of these products.

The best available data for e-cigarette take-up in relation to advertising is the UK, where it remains very low indeed. 0.02% at last check (recounted in Dr Mosley’s recent Horizon episode by Professor West). The UK had fairly liberal rules when it came to advertising e-cigarettes, and to see the uptake by never smokers that low suggests that the “concerns” many policy makers and “scientists” about never smoker uptake are, at present, unfounded.

Headlines

As always, the media are divided in their coverage of this “new paper” (why they didn’t just report on the Eurobarometer itself which is more or less the same thing is beyond me). ITV and the Daily Mail (shockingly) stuck to the facts – the use of e-cigarettes is on the rise – despite the new regulations, but our favourite science editor hack has a bit of an axe to grind, not to mention she’s a pet mouthpiece for the London School of Hygiene and Tropical Medicine and the University of Liverpool (who works there I wonder).

E-cigarettes are still ‘a bet’ and diseases may emerge within 10 or 20 years, warns Imperial College

Once again and to no-one’s surprise Krapton has decided to run with the usual scary approach – the same approach that ASH have mentioned in their recent back-stabbing piece of crap to be the reason the public consider e-cigarettes to be as or more harmful as tobacco.

Last year Public Health England urged Britain’s eight million smokers to start vaping after a government-backed report found that the electronic devices were 20 times less harmful than traditional cigarettes.

No mention of the recent Royal College of Physicians report which gained far more coverage than the PHE report did, and surprisingly the Telegraph did cover with a positive slant, even going as far as mentioning that the new regulations would actually make the products weaker. But then it wasn’t Krapton that wrote that particular article.

However there is debate about the risks and benefits associated with e-cigarettes. For instance we don’t know whether we may start to see diseases emerge in 10-20 years’ time associated with some of the ingredients.

Seemingly a quote from the lead author – Dr Filippos Filippidis – which appears in all the articles so far, seems to take pride of place in the piece by Krapton alongside mention of the World Health Organisation and the usual useful idiots from the London School of Hygiene and Tropical Medicine and the University of Liverpool, all three of which seem to far outweigh the professional opinions of the Royal College of Physicians, Public Health England and the guidance issued by the National Centre for Smoking Cessation Training.

Unsurprisingly, there are no counter arguments in the Krapton piece – no word from ASH (well there wouldn’t be), the British Lung Foundation (as there is in the Daily Mail) or any other organisation that could (or should) provide commentary on this subject. For example, Rosanna O’Connor of PHE is emphatic in stating that the evidence is clear:

Rosanna O’Connor, director of drugs, alcohol and tobacco at Public Health England, said: ” The evidence is clear, vaping carries a fraction of the risk of smoking yet many smokers are still not aware. This could be keeping people smoking rather than switching to a much less harmful alternative.

Ms Krapton also usefully included a “timeline” of reporting, most of the articles are of course hers which highlights just how she views the subject of e-cigarettes. Science reporting at it’s worst, and our friends in tobacco control and public health wonder why the perception of harm is so high and increasing. Of course, Krapton didn’t like the press release accompanying the study, instead opting for the tasty soundbites to cause further harms and increase the harm perception rates – which is of course what her shady masters have wanted from day one.