The End Game: Collaboration

There is an unfortunate conflict in the realms of public health, tobacco control and the vaping community. All sides effectively want the same thing, to an extent or so they say. Public health would like the general public to be as healthy as possible, and where necessary follow the rules they think are best for all of us. Tobacco control are so ingrained in their “fight” against ‘Big Tobacco’ that anything that vaguely resembles tobacco or smoking must be stopped at any cost. While us vapers just really want to be left alone to enjoy our choice.

Sadly, there seems to be a big old division in how to achieve each goal. Some in tobacco control would dearly love to extol the virtues of vaping as a means of reaching the ‘End Game‘ for tobacco. Others view vaping as the second coming of the tobacco industry and seek to destroy it at all costs. Public Health, in general are cautiously optimistic of the benefits of vaping, though a more generic view would be that they are only embracing the industry (at arm’s length in some cases) because the smoking prevalence rate is falling as the number of those vaping increases.

So you would think that those in Public Health and Tobacco Control would absolutely love to work alongside vapers to cautiously promote vaping as a viable option both as a lifestyle choice and where folk choose, a means to stop smoking. Some would like to think there is much common ground between the three groups. They are wrong. Let’s face it, on our side we have the freedom of choice argument and a health benefit argument. From the view of the Public Health industry and Tobacco Control, they only really see one of those arguments – the health benefit.

Neither of these two industries support the freedom of choice argument. But there is one industry that does – Big Tobacco and their groups.

So now we have four groups all trying to state their point with vapers and in most cases smokers, all reaching consensus on the freedom of choice argument. We all believe that individuals have the right to choose to live how they see fit. If that means they have the freedom to smoke, or vape than so be it. Unfortunately, Public Health & Tobacco Control don’t quite see it that way. After all, what they want is for everyone to be “smoke-free” by 2035 or some other arbitrary date. They want an end to the Tobacco Industry, and rest assured if the Tobacco Industry falls, the vaping industry will be their next target – we’ve already seen how some in Public Health and Tobacco Control have switched from “tobacco cessation” to “nicotine cessation”. The writing is on the wall folks.

So, in a recent spate of ‘discussions’ on Twitter and in various other places, a news article caught my attention listing “possible common ground positions” for the vaping community, Public Health and Tobacco Control as starting points for discussion:

• Quitting all nicotine is much better than continuing to smoke combustible cigarettes or even using e-cigarettes. Nicotine is an addictive substance that can disrupt cellular metabolic processes, damage the genome, inactivate tumor suppressor genes, amplify oncogenes and promote a cancer-supporting environment.

Right there. “Quitting all nicotine is much better than continuing to smoke or even using e-cigarettes”. This is their game plan in black and white. They view vaping as a means of smoking cessation similar to nicotine replacement therapies, with the view that those quitting smoking using an e-cigarette should step down their nicotine level until they hit zero, then they should stop vaping too. Don’t get me wrong, there are some out there that have done just that and you know what? It’s their choice. The levels of nicotine in e-liquid aren’t anything to truly worry about, the trouble is nicotine has been demonized for decades (remember Nick O’Teen ?) and it is only now, and the last few years that science is catching on to the idea that nicotine may indeed be beneficial.

So no, no common ground there.

• E-cigarettes are a safer and viable competitor to combustible cigarettes and may be a practical option for those who fail to quit with FDA-approved cessation products.

On this I do tend to agree, but. Why must the use of e-cigarettes be limited to cessation methods only? There’s a substantial number of dual-users who have no intention of quitting tobacco, they quite enjoy smoking (something that Public Health & Tobacco Control still don’t get), they might only be using an e-cigarette where smoking is currently prohibited, or they do intend to switch eventually. Who cares?

So not really common ground there for me, I don’t view e-cigarettes as a cessation product. Never have, and certainly never will.

• Quitting of combustible tobacco is essential when switching to e-cigarettes. Cigarettes are so harmful, continued use at any level is unlikely to substantially reduce health risks.

No it isn’t. Quitting tobacco is not essential; it’s called a “transition” from one state (i.e. smoking) to another (i.e. vaping). It doesn’t matter how long the time frame whether it’s immediate or over a year or more. It is still a transition. Yes cigarettes do carry risks, but again – who cares? Freedom of choice should prevail here.

• E-cigarettes should be used only as a replacement for smoking among current smokers, but should not lead to individuals who would never have smoked becoming addicted to nicotine.

If a never-smoking adult wants to try vaping with or without nicotine then by all means. E-Cigarettes are not solely for cessation, so you can poke that “becoming addicted to nicotine” argument where the sun shineth not.

• E-cigarette marketing should not be attractive to youth or promote a norm that nicotine addiction is healthy or common; e-cigarette marketing should only encourage smokers to switch.

Marketing should be attractive to smokers. It’s a delicate balance that needs to be struck here, but if a non-smoking teen decides he (or she) wants to try vaping then by all means. Would I encourage that? Not necessarily, but if that is what the teen really wants to do, sure I’ll support them, but I’ll be damned if I’ll encourage it.

• E-cigarette use should be disallowed wherever smoking is disallowed. This helps ensure a supportive environment for those who are trying to quit nicotine altogether while sending clear, consistent messages to children that nicotine addiction is unhealthy. Retail vape shops could be appropriately exempted from such restrictions.

No. The use of e-cigarettes should not be prohibited by legislation. If business owners decide they don’t want vaping on their premises that is up to them. What vaping needs most of all is to be visible to smokers. But this whole statement is skewed by the “supportive environment for those who are trying to quit nicotine altogether”; yet another glimpse into the inner mind of the Public Health & Tobacco Control industries. Reading between the lines there it’s a case of “you can vape where we tell you you can, but we really want you to stop vaping too, because The Children™”

Adding the “exemption” (so gracious) for retail vape shops is the PH/TC hook to say, we’ll allow you to continue trading but you must do as we say. Wibble.

• E-cigarettes need to be regulated by the FDA, including strict measures preventing youth access and ensuring the quality and ingredients of e-liquid. The FDA should be cautious not to regulate e-cigarettes to the degree that they are no longer viable as a competitor to combustible products. Ongoing research may dictate the need for additional regulation.

On this there is some agreement. Vaping does need a regulatory framework, especially when it comes to the e-liquid. But the current impending regulations (TPD/Deeming) go too far into caution. Way too far. Both sets of regulations will impose onerous and burdensome statutes that most (if not all) small independent vape shops will be unable to meet. Who does that leave? The Tobacco Industry. The very industry that Tobacco Control is afraid of, and only exists because of smoking.

• Policies shown to reduce combustible cigarette use should be pursued with renewed fervor at the national, state and local levels. In particular, the price of combustible cigarettes should be increased through taxes and/or minimum price laws.

So on the one hand, cautiously welcome vaping but at the same time attack smoking with renewed vigour to reduce prevalence rates – plain packs (abysmal failure), taxation (health & social inequalities, more cash for Tobacco Control), bans and prohibition (restrictions on the freedom of choice of the individual), applying renewed stigma (creating an even bigger rift in the population as a whole). The list goes on.

All the “measures” in place don’t do diddly squat now. Increasing taxation just feeds the beast that is Tobacco Control and lines the pockets of the Tobacco Industry, all while increasing the socio-economic gaps in society – after all, didn’t ASH say that places where smoking is more prevalent there is greater economic disparity? Their calls for increased taxation on cigarettes is one of the main causes of that.

The current ‘smoke-free’ legislations have only served to hurt other industries – how many British Pubs have closed since the introduction of the 2007 ban? Many pubs now have to provide other services (such as food) in order to survive, and yet we are still seeing the pub trade decline. There are other factors too, such as the increased availability of alcohol in supermarkets at far cheaper prices, folks have less and less “social time” with increased work demands (because pay is often shit frankly) and overall higher costs of living.

If these “starting points” are what the Public Health & Tobacco Control industries want, then they can quite frankly piss off.