October: Is it “Stoptober”, “Swaptober”, “Neither” or “Both”?

This is going to be a first. Normally, my posts (with one exception so far) are written entirely by me and me alone. They reflect my thoughts, feelings and opinions on the variety of subjects, points of view and “science” surrounding the topic of vaping. This time, I’ve enlisted the aid of a few other advocates and vapers to help me compile this post, as I feel this is actually a pretty big topic for just one person to cover. So, without any further ado let’s get started with commentary kindly provided with permission from Lorien, Shannon, and Fergus. The views provided by the guest commentators are their individual views and do not necessarily reflect the views of any affiliated organisations.

On with the post.

October. A month containing 31 calendar days. At the end of those 31 days there’s All Hallows Eve commonly known as Halloween. Another unique aspect to this month started back in 2012.

Smokers are being asked to give up for 28 days in the first ever mass quit attempt launched today by Chief Medical Officer Sally Davies.

(source gov.uk)

As noted in the press release, this campaign is a challenge to smokers to quit smoking for 28 days as those that can stop smoking for that period of time are “5 times more likely to stay smokefree”. The general idea is that by signing up to Stoptober the would-be former smoker receives support and encouragement throughout the 28 day “challenge”. Of course, this is a big thing, especially this year with the high-profile celebrity support. The Department of Health would like every smoker to stop smoking as soon as possible, after all it is estimated that 114,000 in the UK alone die every year from smoking-related illnesses (DoH estimations).

The first campaign cost the DoH £5.7 Million, but was considered a successful venture with an estimated 160,000 participants managing to stop smoking for the month of October. That on its own isn’t to be sneezed at, after all smoking is harmful. In 2013, approximately 250,000 took part in Stoptober, with approximately 65% of those successfully quit for 28 days.

There isn’t much follow-up data to suggest those 65% stayed abstinent, along with an overall drop in the number of smokers from 19.5% in 2012 to 18.4% in 2013 does show that the campaign may not be as successful as figures suggest. Since 2013 the smoking prevalence rate has stubbornly refused to drop below 19% for long, so to the attempts to stop have also fallen from 47% of smokers surveyed, to below 30%. Interestingly, the type of method used shows a significant increase in e-cig use as a cessation method, with NRT taking a huge nose-dive, sometime between February and March 2013.

The campaign provides those who sign up with ongoing free support including a “stop smoking pack”, a mobile app, daily encouraging text messages, tips, advice and encouragement from those who participate through social media. It is a pretty impressive set-up coming along by utilising as many of the available technologies as possible to ‘encourage’ those who sign up.

Since the advent of the humble electronic cigarette, things have gotten a little complicated. Questions on e-cigs were only just being included in some of the surveys conducted by ASH in 2012 so some of the early information on the Stoptober campaign doesn’t necessarily include how an individual “quit”. We do know that in 2012, e-cigarette use among the adult smoking population was around 6.7% and has been rising steadily since then (10.7% in 2013, 17.6% in 2014) so it reasonable to assume that a proportion of those 6.7% in 2012 participated in “Stoptober” by using an e-cig. We can probably make the same assumption for the 2013 and 2014 figures as well. We also know that the Smoking Toolkit Study has been tracking e-cig use since 2009, and it is clear that despite e-cigarettes not being designed as a cessation method, the rapid uptake of them as such is truly remarkable (see slide 4 of the monthly STS Findings), completely eclipsing all other methods.

From my perspective when I started, I saw the Stoptober campaign as an opportunity to encourage those who didn’t necessarily want to quit smoking to switch to vaping. At the time, I felt that it was the right course of action. Looking back on it now, with so much doubt in the wider public health community surrounding e-cigs, it probably wasn’t such a smart move. How times have changed.

Do I still feel that combining “stoptober” with “swaptober” is a good idea? Not really no. This, to me sends two completely different messages to those participating in the (now PHE sponsored) campaign. Even with the PHE Report basically saying “ecigs, they’re alright”, pushing a separate but similar campaign on the back of another dilutes the effect. Of course, I don’t personally view an e-cigarette as a cessation method, it isn’t what they were designed for, and although folks do indeed use them to quit smoking, I feel that the “I quit tobacco with #ecigs” statement doesn’t necessarily apply, but saying “I switched to an alternative, and as a result stopped smoking” doesn’t have the same kind of flow to it, but you get the point.

The term ‘swaptober’, I think, came from a very active (at the time, tho don’t know where he is now) vendor called Safercigs and was picked up as ‘generally a good idea’. So that is the first time it happened and I should imagine that 2014 and 2015 swaptobers have come about simply cos it is just so bloody obvious and probably not as a result of safercigs, though it might have done. — Lorien

Do I feel that “swaptober” is effectively “hijacking” the Stoptober campaign? Yes to an extent I do. From the 2014 Stoptober campaign a lot of images surfaced on social media that were incredibly similar in nature and design. Does this mean that similar campaigns such as the notblowingsmoke.org and stillblowingsmoke.org is wrong? Not at all, it’s a different campaign based entirely upon exaggeration, half-truths and spin. The Stop/Swap campaign is entirely different in its messaging, target audience and goals.

One of the key outcomes of the PHE Report backlash was the phrase “the need for clear communication on relative risks”. In my opinion “hijacking” the Stoptober campaign doesn’t provide the clear communication needed, in fact it does the opposite.

For the first time since the campaign’s inception, e-cigarettes are being included as a valid method to quit, although they aren’t officially supported or endorsed, they are welcomed. Partly because of the National Centre for Smoking Cessation and Training and it’s 2014 e-cigarette briefing, also the NICE (National Institute for Health and Care Excellence) guidelines for tobacco harm reduction and of course the PHE Report itself.

Stop Smoking Services across the UK are welcoming the use of e-cigarettes as a valid cessation method, coupled with the professional support offered by their trained advisors, those that attend them have a far higher success rate than traditional NRT and support. Figures from Leicester suggest a 60%+ success rate of supported e-cigarette use, which when compared with NRT (52 week quit rate estimate tops out at around 20% – STS 2012) is outstanding. Jumping on the back of the Stoptober campaign with Swaptober would really be limited to social media and forums, only serves to add confusion.

Do I have a problem with it? Not particularly. Is it a hijack, yes it is. Do vapers need to do it? Up to them really. Is it right that vendors do it? Absolutely. Does it matter when there is now official support? Yes it does cos that official support affects the smokers who would have ignored vendors etc and gone straight to SSS without a thought about ecigs, for the large part anyway in terms of the stoptober message. So for a vendor it is a nice catchy poster headline, and why not?

— Lorien

Sadly, a Google search for “stoptober e-cigarettes” or any variation of “e-cigarettes” brings up a large proportion of e-tailers “jumping on the bandwagon” in promoting their wares as part of the “Stoptober” campaign, now I have no real problem with vendors offering starter-kits at discounted rates, nor do I have an issue with vendors working with the Stop Smoking Services in a referral, exchange like program. But openly advertising “Are you ready for Stoptober”? That I have a bit of a problem with. On the one hand some of them are actually doing it for the good of the campaign and are working with Stop Smoking Services. Others, well let’s just say aren’t doing it for the good of the campaign, instead they seem to be offering “additional” discounts or prize draws as soon as you land on their “dedicated stoptober” pages. There doesn’t seem to be many (if any) that fall in between the two by supporting Stop/Swap-tober without discounts and giveaways and so forth.

The question is, with the state funded campaign getting so much attention are vendors and the community doing the right thing by pushing “swaptober” instead of “stoptober”? Should vendors be working with Stop Smoking Services to provide vapourisers to potential quitters, considering that the product wasn’t initially designed as a cessation product? Should vendors be supporting Stoptober at all?

To my mind, vendors should support Stoptober to those participating, but not in the way some vendors are. Help the Stop Smoking Services, but don’t capitalise on it. Make it clear the products being offered are part of the Stoptober campaign, and don’t try to up sell. Should the community in general “hijack” the campaign, my personal feeling is no, it dilutes the main message but on the flip side it might encourage more to switch, especially with the PHE report being a stake in the ground positive and let’s face it, it is typically English, tongue-in-cheek humour towards the official campaign, which is never a bad thing really is it?

I asked Lorien, Fergus and Shannon the exact same questions to get their thoughts on this. I chose those three because:

Lorien is perfectly eloquent in describing points of view I might not have otherwise considered. Fergus is straightforward and is far wiser than I, plus he offers a perspective as an ex-pat, whilst Shannon provides a unique view from across the pond.

Personally I like the idea. Yes, it’s hijacking another message, but why not? I see it as a light-hearted dig at the annual October bullying campaigns, while also promoting a healthier alternative. Let’s face it: “Stoptober” isn’t going to produce many quitters, but Swaptober might. — Fergus

I prefer the term swaptober over stoptober, we’re adults and we have the right to make the decision ourselves. Giving us the opportunity to change something harmful for something less harmful, gives us the control rather than being told by the state that we’re doing something wrong and it must be fixed. — Shannon

As an aside, this years stoptober is going to be interesting. The numbers have been dropping year on year for people signing up to it so now this year they have stated that ppl using ecigs are officially welcome I suspect that they will see far greater numbers than previous years. Funnily enough, I did see Clive tweet something about whether this was just a number grab rather than true support from stoptober. I suspect, in part, that he is right there.

Other than this, I feel kinda apathetic towards it. It WILL benefit people to have vendors use the term, whether or not the industry gets away with it for the 3rd year running given current scrutiny remains to be seen. But, it is not like some big scheme when you think it might have been started by one guy using a hashtag in 2013 and a bunch of vapers picking up on it. Nothing sinister or even cynical, more a statement of fact cos at the time we were really hard on never using the word ‘stop’ or ‘quit’ and pushed ‘swap’ and ‘switch’ really really hard. — Lorien

I really want to express my utmost thanks to the contributions from Fergus, Lorien, and Shannon for their input on this opus of a post, without their input this would have been so much more difficult to put together and get it anywhere near vaguely right.