Ashtray Blog: An Electronic Cigarette Blog

There’s an interesting post from the Tobacco Harm Reduction blog which points out the absurdity on banning something because it won’t be used. (See It’s more about options given than options taken.)

The post follows an argument from Stanton Glantz that smokeless tobacco should be banned because it won’t become popular. (Stanton’s the one who thought Avatar should be banned because it has a cigarette in it).

I mention the post because it it reminds me of another argument from the anti-smoking movement.

They have argued that e-cigarettes should be banned on the basis that they do not contain enough nicotine and therefore won’t satisfy smokers.

There are several problems with this line of thought:

1. As we have pointed out before, part of the very success of the e-cigarette is that, unlike most smoking cessation aids, it replaces smoking stimuli rather than merely replacing nicotine (in a way that is often unsatisfying). In fact, some of our customers choose to buy our zero nicotine kit because they want to continue smoking but without the nicotine!

2. As the Tobacco Harm Reduction blog points out, banning something because it might not become popular is absurd – products should be allowed to find their own success or otherwise.

3. If just a few people switch from smoking to e-cigarettes, that would still be a benefit – and one which is not paid for by the state.

4. For thousands of smokers, e-cigarettes have already become a preferred option. We don’t know how many people have tried them and not switched (and it’s true that the market is dogged by low quality devices) but any look at the e-cigarette forum shows there are thousands of happy users.

5. Other arguments against the e-cigarette is that it contains nicotine, which some anti-smokers have suddenly decided is the root of all nicotine. (In contrast, the UK NHS states that nicotine does not cause smoking diseases – that’s according to the MHRA document which argues the e-cigarette can save lives and should therefore be regulated into non-existence.) So why is a smaller dose of nicotine suddenly a problem?

We remain convinced that the real reason for the opposition to the e-cigarette is a financial conflict of interest – for the e-cigarette is a very real threat to the profits of both the pharmaceutical companies and tobacco companies.

The UK Regulatory Policy Committee (RPC) has issued a withering criticism of the Medicines and Healthcare products Regulatory Agency (MHRA)’s consultation letter calling for the regulation of electronic cigarettes as a medicine, pointing out out that there is insufficient evidence that the electronic cigarette poses a risk to public health.

The MHRA, while acknowledging the device has the potential to save lives, has recently called for the regulation (by themselves!) of e-cigarettes in a move which is likely to lead to a de-facto ban on the device. (In contrast to MHRA claims that the devices are not regulated, Trading Standards currently oversees the safety and supply of these products in the UK.)

However, the RPC’s opinion issued on the letter criticised the MHRA on a number of grounds, including the following:

• there was insufficient evidence that the device poses any risk to health;
• the MHRA has failed to consider how their regulation will affect tobacco products;
• the MHRA has failed to provide a robust assessment of costs and benefits;
• the MHRA has failed to state the legal case for regulation;
• the MHRA has failed to estimate the impact upon competition, and the implications of raising new barriers to entry.

Key Quotes:

Health

The RCP argues that the MHRA does not:

“provide sufficient evidence to suggest that there is a sufficient risk to public health from currently unlicensed NCPs which would justify the future regulation of these products.”

Tobacco

As we said in our own response, regulating e-cigarettes on the basis that they contain nicotine and affect the metabolism could affect tobacco. The RCP agrees, stating:

“…it is not clear from the consultation letter how this will affect tobacco products (e.g. cigarettes), which also contain nicotine and hence will be within the scope for these new regulations.”

Impact on Competition

The RCP stated that the consultation had failed to take into account the effect of the regulation on competition.

“The IA [Impact Assessment] does not provide an appropriate assessment of the impact of the proposed regulations on competition…”

“The regulations are likely to create additional barriers to entry…”

Who are the RCP?

The RCP (link) are a government advisory committee set up in 2009 to provide “strong and effective external scrutiny throughout the policy making process,” which they certainly seem to be doing so here.

Full Opinion

For their full opinion on the MHRA consultation, see The Regulatory Policy Committee opinion: Consultation on regulation of nicotine containing products.

Thanks Kate!

Thanks to Kate from Vapers Network for forwarding the RCP’s opinion to me!

Many of the 150 electronic cigarette users in our recent survey had a lot to get off their chest.

Here’s some of the comments that were made.

Anger:

“Banning these devices would be a travesty. There has been no other option that I’ve tried that has completely made me quit smoking except e-cigs. I feel healthy, I run quite a bit now, my sense of taste and smell has returned. Why in hell would you ban such a thing?”

Defiance:

“I refuse to give the government, big tobacco, or the pharmaceutical companies any more money.”

Dismay

“If electronic cigarettes are banned or become difficult to obtain, the efforts made by people who have worked hard to give up smoking would be undermined. I would estimate that 60-70% of these people would return to smoking within a month.”

Going illegal

“Having freed myself from a 30 year+ tobacco dependancy with e-cigs I would take whatever steps seemed necessary to secure my supplies.”

“I am basically a law abising citizen – but a Ban or other type of removal from the market would be totally unjust – I havge educated myself about the facts am well aware of the misinformation and fear-mongering
being disseminated by the FDA, ALA, AHA, ACS and others and it is shameless!! This corruption will eventually come to the light – if it is the Last thing I do, I swear that the entire truth will be made Very Public! I am a 56 yr old professional in the health care industry (for the past twenty-six years) I am not a fanatic, nor do I make idle promises.”

“The slim chance of being caught, slim chance of being punished and the modest nature of that punishment is not comparable to the alternative (a highly likely relapse into years of cigarette smoking.”

And we have to get this compliment of our e-cigs in

“Anything I can do to thwart a ban of electronic cigarettes, let me know. They are GREAT! Especially NJOY’s.”

To read more comments see Electronic cigarette user comments and Black market comments.

There’s a great US site well worth checking out which is dedicated to stopping the electronic cigarette ban.

On the front page video they explain how, after an FDA attempt to ban the e-cigarette failed in court, Lung Cancer America has taken the battle to the individual states, pushing in each state for  a ban on the electronic cigarette. And as we show on our page Anti-Electronic Cigarette Funding, organisations like Lung Cancer America have received grants totaling millions of pounds from the big pharmaceutical companies that currently control the non-tobacco nicotine market.

Check out the site here: Electronic Cigarette Ban, or watch the video below.

One week to go to the MHRA meeting. Plane tickets have been bought. Consultants, scientists and experts due to fly in from Canada, NJOY’s CEO Jack Leadbetter from America – and what do the MHRA do?

Postpone the meeting!

Is the MHRA meeting a con, with a decision already taken to ban a device which scientists say is more than 99% safer than cigarettes?

This is what we have seen so far:

• a suggested two weeks to allow a product to be registered as a medicine with an “MA” licence (usually two years!)
• emails telling interested people that the MHRA consultation committee doesn’t have time to answer questions
• refusal to answer questions even after freedom of information requests
• refusal to allow world experts on tobacco harm reduction to attend the meeting
• failure to provide an agenda, despite requests, even one week before the meeting
• postponing a meeting with less than a week’s notice, despite knowing that extremely busy people are flying in from all over the world to attend the meeting
• suggested two hours for a meeting to decide the fate of people’s lives and livelihoods – and whether thousands of people in the UK will return to cigarettes

Here is the reaction from one industry Company Director who emailed us in disgust:

“Not surprised the country is in such a state with these morons running it. Less than a weeks notice??, and the deadline only moved one day? what the hell is going on.”

Here’s the reaction from one of our customers upon learning the electronic cigarette might be banned shortly:

Wow, what a surprise! Something that saves lives and the government are trying to get a piece of it. I’m stunned.

It makes me sick. I’ve seen a lot in the american forums about the fda banning devices in certain states and they all seem to be the biggest tabacco growing states, what an amazing coincidence!

I hope it goes your way – if they stopped these from been sold it would be an absolute insult and kick in the teeth to so many reformed smokers.

Thanks to Mike Mawe for his comments.

That’s the message from the American Lung Association, which, according to a recent blog post by Wisconsin’s Vapers, is lobbying to have the device banned.

Crucially, the American Lung Cancer acknowledges the electronic cigarette contains fewer chemicals than the electronic cigarette. (According to some testing, the vapour actually contains no toxins at all.)

What the society does not acknowledge is that it has a conflict of interest: it receives funds from the companies that manufactures competing nicotine cessation aids. (See anti-electronic cigarette funding.)

The Nicorette is targeted at children.

That’s the implication of public health group claims such as ASH that the e-cigarette, safe chewing tobacco such as SNUS and other ‘tobacco candy’ appeal to children.

Safe alternatives to cigarettes – e-cigarettes, smoking tobacco and others – have been repeatedly attacked on the basis that their flavours make them more attractive to children.

(In response, NJOY have stopped selling these flavours.)

Yet, as the commerical below shows, the Nicorette inhaler also uses flavours – Fruit Chill.

The same public health groups are unlikely to attack the nicorette inhaler, though.

The reason? Because pharmaceutical groups like GlaxoSmithKline pay them money, whereas the manufacturers of other safe alternatives like the electronic cigarette do not.

A certain Dr Mintz seems to be changing his mind on the electronic cigarette!

As we recorded at the time, in his original post he wrote:

“…the electronic cigarette is dangerously being promoted as safe alternatives to cigarettes that contain tobacco as well as possible aids to smoking cessation. Make no mistake: these products are not safe, in some ways could be riskier than cigarettes, will not be effective smoking cessation aids, and are scarily unregulated by the FDA and far too available in the US.”

Now he writes he admits that:

“E-cigarettes are likely a healthier alternative to tobacco smoke…Electronic cigarettes are probably less carcinogenic, than tobacco cigarettes.”

He is still attacking the electronic cigarette, however. Here are his arguments, and our replies.

A Rebuttal

1. Regulation

My objection is not that I am opposed to the existence of electronic cigarette. It’s more that e-cigarettes are not regulated.

We strongly agree that electronic cigarettes should be regulated. We’ve actually had to jump through hoops for the Trading Standards to be able to sell them here in the UK (how other companies manage to get away with selling crap I don’t know; I presume these companies are doing so from abroad.) And we believe that one of the biggest dangers to the e-cigarette industry comes from the cheap and poor quality devices being sold all over the net.

Our problem is not with regulation, it’s how the FDA intends to implement it. And that’s by banning the devices until several years of studies and hundreds of millions of dollars have been spent on them – possibly never. As Judge Leon said, it absurd to impose a more onerous system of regulation on devices which are safer than cigarettes.

While these devices are off the market, users will either use smuggled/home made devices, or stop using them and return to cigarettes.

And some of them will die because of it.

2. Nicotine

Dr Mintz writes:

By vaporizing nicotine, and inhaling it, this will lead to very rapid absorption, and high levels of addiction; possibly even higher than real cigarettes themselves.

Actually, every study done so far suggests that the nicotine delivered to users is far lower than that delivered by cigarettes.

i. A New Zealand study found that the electronic cigarette delivered less nicotine than cigarettes, and Dr Murray Laugeson’s main concern is that they do not contain enough nicotine.

ii. The FDA study found that levels of nicotine were lower than those found in cigarettes.

iii. A more recent study found that electronic cigarettes were delivering very low levels of nicotine – as much, claimed the professor, as sucking an electronic cigarette. This has given risen to the discussion that the main success of the electronic cigarette is in acting as a placebo, and that the role of nicotine in cigarette has been overestimated (perhaps deliberately by those with a financial interest in promoting nicotine cessations aids.)

4. NRT Products

Electronic cigarettes might be safer replacement for tobacco cigarettes, but are not designed to get patients off of nicotine. Generally, most of the nicotine replacement products work by giving patients a continuous supply of nicotine, and eventually weaning that level down once the patient has been off tobacco cigarettes for a few weeks.

Surveys, an informal study in South Africa, the success of the e-cigarette forum (with thirty thousand e-cigarette users) suggest that e-cigarette users can either replace cigarettes with e-cigarettes or quit. However, Dr Mitz is right in that there are no long term studies which prove that electronic cigarettes can help you quit. (And if you enjoy electronic cigarettes, why should you?)

But then, nicotine cessation aids don’t help people quit either.

In the UK the MHRA assumes a 5% success rate with nicotine cessation aids over the long term. That’s abysmal, but it’s a lot better than shown in a recent study which demonstrated a 0.8% success rate – substantially worse than the stand alone quit rate. Dr Mitz is promoting a cessation alternative which is, quite frankly, crap.

5.Chantix

Recently there’s been some concern about safety issues regarding Chantix,…  However, these safety concerns have not seemed to have panned out, and more recent studies seem to indicate that Chantix is very safe given certain precautions, specifically worsening of mental conditions.

If electronic cigarettes had caused people to commit suicide they would be banned by now! It is only because of the huge money behind chantix/champix that they are still being sold. Let’s not forget who pays the bills of the FDA and the MHRA!

See Despite 98 suicides and 188 suicide attempts, FDA favours Chantix.

6. Children

I’m also bothered that electronic cigarettes are sold in our shopping malls, and can potentially be purchased by children.

First, I don’t know a respectable retailer that sells to children. On many sites you have to enter your age before you can buy a site.

Then there’s what Adrian Payne told us:

I’m not aware of any evidence that this is, or is even likely to be, the case. In the first place, E-cigarettes are not ‘pocket-money’ devices. Secondly, I don’t think anyone has raised the same concerns about pharmaceutical nicotine inhalators which, in the UK at least, are available over the counter. Similarly I’m not aware of any evidence of adult non-smokers using either E-cigarettes or pharmaceutical nicotine inhalators in any number as a gateway to smoking – if there were I’m sure we would have heard of it by now. Bad news travels fast!

Read more: http://www.ecigarettedirect.co.uk/interviews/adrian-payne-interview.html

One objection I have to the gateway to smoking argument is that if children are going to go out and buy this sort of device, wouldn’t they be the type of children who are going to buy cigarettes anyway?

7. Conflict of interest

We understand that it is quite normal for opinions to be given by people receiving money from companies with a financial interest in the issue. (We certainly have a financial interest in electronic cigarettes!) However, Dr Mitz perhaps ought to declare  his pharma ties. His failure to do so has caused problems in the past, when he defended the pharmaceutical products on a Forbes blog without declaring that he had been paid funds by the companies that manufactured the products (see A Forbes Guest Blogger and His Pharma Ties.)

The government is currently trying to decide what to do about the electronic cigarette.

And they are inviting the public’s views.

By letting them know, you can decide the fate of the electronic cigarette.

What could happen:

1. The government could ban the e-cigarette.

2. The government may only allow it to be sold as a quit smoking aid.

We invite regulation that will help safe electronic cigarettes, but ask that smokers be allowed to enjoy an alternative to smoking that contains no tar or tobacco, and which (for some models) has been tested free of toxins.

Professor Michael Siegel recently said (in a comment on the FDA in America):

To deprive them [the public] of the choice to continue vaping and instead, force them to return to smoking, would severely harm their health. I simply do not see the public health protection resulting from a policy of forcing thousands of vapers to return to cigarette smoking.

Please click here to comment – and stop them from depriving smokers of the electronic cigarette!

http://www.mhra.gov.uk/Publications/Consultations/Medicinesconsultations/MLXs/CON065617

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