To ban or not to ban?

With the fun and games over in Warsaw at the moment with the Global Forum on Nicotine, things have been relatively quiet on the anti or scaremongering front, but a couple of articles did catch my eye, one of which I’m a little hesitant to talk about simply because the underlying subject has such a wide range of opinions from the vaping community.
The first of these articles or stories would be this one:

Mental health patients smoke more than three times as much as the general population, a Public Health England and NHS survey of 105 care units suggests.

Pretty much every time I see an article like this, they always focus on one particular group. Be it the LGBT community, the black community or any other community they have conveniently given a label. This time around they’ve focussed on the mental health patients. In many ways, this particular article makes me more uncomfortable than reading any other article, and I think the main reason for that is I cannot, and most likely will not ever understand what these patients are actually going through.  Does this mean they should be treated any differently from those classed as “normal”? Of course not. So why the big red bullseye over how much they smoke?

Smoking can increase depression and anxiety and reduce the effectiveness of medication by up to 50%, experts warn.

Ah, the “experts” are warning that smoking can increase depression and anxiety and reduce the effectiveness of medications. Well, as for the depression and anxiety part, I as a former smoker can attest to the exact opposite. Whenever I lit up, it was either out of some kind of ritual (first one of the day, after a meal etc) or because my emotional state was out of kilter. Did I ever feel depressed or anxious prior to lighting up? I can honestly say, yes I did on occasion feel anxious and more often I would definitely feel moody. Am I unique in that respect? Probably not, but don’t forget I do not knowingly suffer from a mental illness.

I would suspect then that the “increase depression and anxiety” is likely to be part made up, or at least mis-interpreted.

PHE wants all mental-health hospitals to be smoke-free zones.

Of course, Public Health England (a registered charity) wants all mental-health hospitals to be smoke-free zones. This would no doubt include a ban in the grounds, and if we’re unlucky some jobsworth ushering smokers out of the gates. So whose bright idea is this then?

Kevin Fenton, PHE national director of health and wellbeing said the organisation wanted to “reduce the unacceptable inequalities in health experienced by people living with mental-health problems”.

Oh yes.  National director of health and wellbeing. What I do not get is exactly how this buffoon is expecting a ban on smoking will bring about a change in the ‘unacceptable inequalities’. According to the article, a care worker has stated it is commonplace for staff to purchase smokes, accommodate smoke breaks and so forth, rather than trying to encourage them to quit.  Many patients most likely do not want to quit, also many most likely depend on smoking so enforcing a smoke-free policy is really not going to help much is it?

A report by the RCP estimates that 30% of the current UK smokers suffer from mental health problems at a cost of up to £40M per year. There be the supposed “link” between an increase in depression and anxiety and the reduction of drug effectiveness. As a charity, PHE should be looking at ways to accommodate both sides rather than calling for outright bans, especially given that mental health sufferers are possibly the most vulnerable.

Forest, said: “Smoking is not just about health, although many smokers believe it helps reduce anxiety and stress. If some mental health patients enjoy smoking why should they be denied that pleasure?

A stance that I completely agree with, for those that smoke it is about the enjoyment, pleasure and relaxation factors. Some of it may be to satisfy cravings, surely a compromise can be reached? Either that or patients will just do a “screw you” to the ban. I do hope it’s the former, but I wouldn’t say no to the latter either.

On the subject of bans, another piece appeared in Chappers favourite place, The Conversation. Although this time it wasn’t penned by the scrotum-faced head-banger himself, it was actually penned by three vape-positive Queensland University boffins. These three speak a lot of common sense:

the ban on e-cigarettes is ethically questionable. It’s a paternalistic policy that denies adult smokers the right to use a less harmful form of nicotine.

Banning a less harmful product (e-cigarettes) while allowing the most harmful (tobacco cigarettes) to be freely sold is an incoherent form of risk regulation. It also disadvantages smokers who may have difficulty quitting but want to reduce the risks of smoking.

It all seems rather good so far right? But wait.

We propose allowing adult smokers to buy approved e-cigarette products from a restricted number of licensed sales outlets. Any promotional material for these products could be restricted to information supplied to smokers purchasing these products.

This sounds awfully familiar doesn’t it? Whilst it is good that they want to see vapour products sold, the level of restrictions they want to see are almost on a level with “prescription only”. In the opinion of this humble vaping blogger, that’s too restrictive.

Consumer law could be used to ensure a reasonable level of safety to users and others, such as requiring child-proof containers for nicotine, electrical safety and appropriate labelling.

I keep seeing “child-proof” and “child-resistant” being bandied about. Trouble is, they are in fact completely different things. It is another set of terms that are seemingly interchanged at will. Trouble is, most medications already have child-resistant tops and some of those even I have trouble opening. Me. A 35-year-old male, struggling to open a bottle of medication. Go figure.

This brings me to regulation. What exactly would be a “best fit”? Well to be honest, no existing proposal can be classed as a ‘best fit’. The EU TPD, absolute cobblers, over bearing, burdensome and totally inappropriate. The FDA, same again. Total ban on nicotine? Ridiculous. So what is it we want? What follows are my opinions:

Point of Sale & Sales

Restriction for U18’s is a reasonable step, however this would of course preclude any existing U18 smoker from being able to switch unless the regs allow existing U18 smokers to switch. This is probably the trickiest of the lot to address as there are still a reasonable proportion of smokers under the age of 18.

Advertising & Marketing

In some ways, the UK may actually have this one right. Vapor products can be advertised under certain guidelines, the issue we have is the ASA are incredibly inconsistent with their rulings. This is not the fault of the vendors but of the ASA. No doubt some of the complaints originate from certain folk within tobacco control or certain elements of public health.  The other aspect is one of our own doing, using sex, trademarks and child attractive designs. All three need to stop if this industry is to be taken seriously.

Device Safety

To my mind, device safety falls squarely under consumer electronics. Most UK standards for consumer electronics are pretty stringent and are generally more than enough for most devices.

Liquid Safety

This is probably the biggest achilles heel we have as a community. There are hundreds upon hundreds of flavours and strength variants of flavours out there. A definitive method of testing for inhalation nasties needs to be put together and all vendors should abide by it.

Efficacy

I hate the word with a passion, but many in public health and tobacco control insist on comparing vapor products with cessation products even though they are not intended as such. This comes down to the EU’s interpretation of “consistent dose” which is pure speculation as everyone uses their devices differently. I doubt that there can be any effective regulation in this area.

Regulating e-cigarette sales respects smoker autonomy and reduces the inconsistency in preventing smokers from accessing e-cigarettes while allowing them to freely buy cigarettes. It would also provide better consumer protection of e-cigarette users, regulate promotion of these products and probably reduce the black market for e-cigarette products in Australia.

Only if the regulation is ‘light touch’ allowing the growth and innovation of the market. Implementing licensed outlets is a surefire way of adding a burden to vendors looking to sell these products. Here’s an option, allow specific vape stores to sell the products and stop them being sold elsewhere. That could put the dampers on the tobacco industry selling their crap in corner shops and gas stations, whilst still allowing the ‘smoker autonomy’ and allowing the powers that be to track the progress of the products.

Bans to regulation, both very difficult topics as there are a multitude of consequences that can happen. It’s pretty much guaranteed that the implementation of the TPD and the FDA ruling will hand vaping to the tobacco industry, the incessant need for elements of PH to ban anything it doesn’t like or regulate it to the point where it is pretty much pointless

This policy could be readily reversed if e-cigarettes prove to be as disappointing as their critics predict. If e-cigarettes prove to be attractive to most smokers and much safer substitutes for combustible cigarettes, as their advocates claim, then these regulations could be relaxed by increasing the number of outlets allowed to sell them.

The thing is, once a policy is implemented it is incredibly rare for it to be reversed. The proponents for the policy are obviously reluctant to yield, whilst the opposition for the policy often can’t make up its thrice damned mind what to offer in its place. Not to mention the crap tonne of paperwork.

Tricky.

7 thoughts on “To ban or not to ban?

  1. In Australia we have media laws which prevent any one individual or company from owning too much of the media. Why don’t they just implement laws making it illegal to sell electronic cigarettes if one has any financial interest in selling or manufacturing tobacco cigarettes.

    You can sell one or the other, but not both. Simple.

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    • I suspect that is likely to be part of the “endgame” that those in TC down under keep banging on about. At least here in the UK, the ASA only monitors behaviour and investigates complaints. It’s down to the advertiser (of which there are many) to abide by the rules.

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  2. I agree with most of what you presented here, with one possible correction regarding your view below:

    Quote: [I would suspect then that the “increase depression and anxiety” is likely to be part made up, or at least mis-interpreted.]

    Just about all psychoactive drugs will have different effects on different people, due to brain chemistry or other factors. For example, someone like me (with A.D.D.) had one reaction to Ritalin (a rather dramatic effect, in fact), while others not afflicted with that condition will often experience the opposite effects. I’m not sure where they came up with their 50% number, but they are at least mixing some truth with the lies they tell.

    Quote: [The other aspect is one of our own doing, using sex, trademarks and child attractive designs. All three need to stop if this industry is to be taken seriously.]

    I agree with the trademarks, but almost every product these days is sold with sex to target an adult market. Why should vapor product advertising be crippled when they are much less harmful than other products (beer, for example) that are allowed to use that marketing technique? Also, beyond the obvious use of recognizable character cartoons (which in itself is a copyright issue), what is a “child attractive design”? I get the idea of trying to be proactive in an attempt take some steam out of the anti campaign, but at the same time, isn’t that also giving them credence?

    As for efficacy, we really need to find a way to control the conversation and stop TC from putting these products squarely in the cessation basket. They’re only doing it to manipulate public perception and to support junk science studies. I really don’t know how to counter it, except to continue to insist that it’s not now, nor has it ever been, a cessation product. It’s not allowed to be marketed as such by law without medical approval. It’s a consumer nicotine product which is orders of magnitude safer than smoking cigarettes, and cessation is simply a pleasant byproduct of its use.

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    • Glen,

      Thank you for your comment, especially regarding the psychoactive drug portion, that adds to my relatively meagre knowledge on the subject.

      Although I would point out that most mobile phone and/or laptop advertising and marketing does not rely on the use of sex to sell, yet phones especially end up in the hands of teenagers anyway. Maybe there can be a delicate balance there?

      As for efficacy, I hate the word with a passion. Vapour products in my mind are not, never were and never will be cessation products. Cessation is simply a beneficial effect of the devices. (Pretty sure I’ve said that elsewhere on this blog ;-) )

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      • I can appreciate your view on sex in advertising, and I sincerely wish there were less of it all around and product advertisement was more about the products themselves. However, as long as it’s socially acceptable for other adult consumer products, such as alcohol, then I don’t see a reason why it should not be the same for vapor products. To limit one and not the other, in my mind, is just hypocritical, and it gives at least some credence to the ANTZ argument.

        In any case, I thoroughly enjoyed reading your article.

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