Applying the Precautionary Principle

We all know the arguments. Applying restrictions to avoid “potential harms”. Well we’ve seen how ludicrous that is in Wales recently where vaping is to be banned (yes Duckford, it is a ban. You might not think it is you daft old duffer, but it is) everywhere where smoking is currently banned. Ban in workplaces to protect the health of non-smokers & colleagues, ban in public places to, erm protect the health of workers and non-smokers. Ban in playgrounds, erm for the Cheeldren™.

It gets pretty annoying doesn’t it? There are a few causes of such draconian measures, ranging from “we just don’t like it” to “think of the Children™”, swinging past “protecting the health of others” and landing at the doorstep of the Precautionary Principle.

In a nutshell, all statements referencing the Precautionary Principle usually includes a version of this:

When the health of humans and the environment is at stake, it may not be necessary to wait for scientific certainty to take protective action.

So basically, if there is the potential for harm (to humans or the environment) then take protective action. Seems reasonable enough doesn’t it? The trouble is, many in the public health and tobacco control industries are likely to invoke the PP simply because it is the easiest course of “action” to take. The “we don’t know what’s in them” style argument. Admittedly it goes much deeper than that, but you get the point. So, why have I decided to look at the precautionary principle? Well an article in The Conversation a while ago sparked the thinking that basically says:

We’re unsure if e-cigarettes are harmful, but it still makes sense to restrict them

That right there is the principle at work. We don’t know, there might be harms to humans (or the environment) so let’s take protective action. Here’s the paragraph that caught my eye the most:

Given that vaping has been around for barely a decade and studies into the long-term effects take time, we cannot answer these questions with certainty yet. The benefits of e-cigarettes’ continue to be debated – and the potential risks to non-smokers and young people remain under-explored.

A statement that cannot truly be refuted. We don’t know enough about the long-term effects from a scientific point of view. However, there are several vapers that I know that have been vaping for 5 or more years and have suffered no ill effects. With that in mind, and armed with the science that we have (over 200 studies both positive and negative) you can feasibly extrapolate any harm potential or health benefit using sophisticated computer modelling.

After all, the public health researchers use the same modelling to “predict” whether teens taking up vaping will progress to smoking or not, why not use the same technology on current known short-term effects to extrapolate into the future. Obviously, the further down the road you go the less accurate the results are likely to be as vaping in general is evolving at a remarkable pace and research performed last year will have little or no benefit in “long-term” predictions.

This makes it difficult to make recommendations, but politicians across the world are nonetheless having to decide what to do. The latest country to confront this question is Scotland, where the parliament has just voted to ban under-18s from using e-cigarettes. One of a raft of restrictions, this imposes the same age limit as for traditional cigarettes, bringing Scotland broadly into line with England and Wales. Was it the right thing to do?

The burning question for me is, why are politicians having to decide at all? Let’s face it, vaping as we know it now is a consumer driven industry and has (to an extent) unwittingly addressed a “problem” that politicians, public health and tobacco control activists have been trying to solve for decades. Smoking prevalence. This is one of, if not the key factors in the widely accepted (though not by me) reasoning that vapour products are used only for cessation – i.e. become “nicotine free” (yes that’s a thing apparently), sadly folks that think along those lines are missing the point entirely.

We’re not talking precautionary principle here, but the pleasure principle. A simple fact that is missed by a lot in public health and tobacco control is that many people enjoy smoking, I certainly did as did many other vapers, and those same people are thoroughly enjoying vaping. Not just the ritualistic motions, there’s a hobbyist side to it too which gives vaping a whole different philosophy to the practice.

Amusingly, the author of this Conversation article has co-authored a paper which amounts to reading the snoozepapers and determining the general feeling or attitudes towards regulations for vapour products.

Summed up:

In the UK between 2013 and 2014, governments and tobacco control advocates frequently commented on e-cigarettes in UK-wide and Scottish national newspapers. Almost all commentators supported e-cigarette regulation but there was disagreement about whether e-cigarette use should be allowed in enclosed public spaces. This appeared to be linked to whether commentators emphasised the harms of vapour and concerns about renormalizing smoking or emphasised the role of e-cigarettes as a smoking cessation aid.

Think about it, pretty much any and all commentators that have been referred to from the tobacco control industry are fairly consistent in their calls for regulation with some (notably ASH and the BMA) having preference for the lipstick-on-a-pig TPD2; which as we know will have severe consequences both economically and socially for the vapour industry in the UK and EU.

Not forgetting of course this paper where the same co-author involved 14-17 year olds and asked them what regulations there should be. Amazingly, or perhaps that should be unsurprisingly

a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas

Yet another example of an extreme implementation of the precautionary principle. Strictly regulate and/or ban until more is known. Of course the consequences of such strict regulation (as we’ll no doubt see in Wales) is the use of vapour products is likely to decline, uptake of NRT for cessation will increase, use of Stop Smoking Services will no doubt go up again, as will the smoking prevalence rate.

Applying the precautionary principle to something that has proven to be a major public health benefit on the basis of theoretical harms is counter-productive, especially when current science doesn’t support it.

The precautionary principle or precautionary approach to risk management states that if an action or policy has a suspected risk of causing harm to the public or to the environment, in the absence of scientific consensus that the action or policy is not harmful, the burden of proof that it is not harmful falls on those taking an action.

Despite the ongoing scientific debate, including subversive studies of social media, there is indeed a large body of scientific evidence which is not nonsensical (are you listening Mr Duckford?) that highlight a tiny element of risk of vapour product use (when used correctly and not carrying 18650s loose in your pocket you dolts) and extreme mis-use of the product does pose an increased level of risk.

On balance then, there is cause for some caution but, if you take all the scientific literature into account from both sides of the debate, applying the precautionary principle to justify strict regulations and bans is, in this case utterly ludicrous. The benefits far outweigh potential harms, and in any sensible mind that alone should be enough to strike down the majority of these silly regulations and bans that are popping up.

Ten years ago it may have been prudent to apply the precautionary principle to justify bans and strict regulation, but the decision makers didn’t, they couldn’t predict the impact that vapour products would have on millions. Now there’s plenty of scientific fact, these same decision makers are now trying to apply the principle to justify their ideology in restricting an alternative to smoking.

But I forget, it’s never been about health.