The Scottish government has launched a new consultation on vaping. If the suggestions are put in place, they could hamper the ability of vaping to denormalise smoking.
While well-meaning, the consultation is based on a number of incorrect premises, threatens to penalise law-abiding businesses and fails to tackle the crux of the problem.
In this post I’ll cover some of the premises and how the proposals could damage harm reduction. I’ll also present an alternative action the Scottish government can take which will both protect young non-smokers and ensure existing nicotine users have access to safer, better quality vape products.
The core of the argument in the Scottish consultation is that vaping is essentially smoking, just not quite as bad. In fact, as we’ll see, it’s a very different beast - a beast that could, if allowed, kill smoking.
To start with, the Scottish government argues that we still don’t yet know enough about vaping and that it could have a negative effect on health in years to come. The spectre of smoking, which for centuries was considered harmless or even beneficial, hangs over vaping. In fact, we know far more about vaping than we did about smoking, and we also know far more about vaping today than we did when current regulations were brought in.
The accumulation of thousands of studies has led both the UK government and the Royal College of Physicians to state with increasing confidence that vaping is at least 95% better than smoking (replacing their original statement that said it is around 95% safer). The estimated cancer risk of vaping is just 0.5% that of smoking. We are also now starting to see the first long term data on vaping in people who haven’t smoked, which continue to show that vaping is far less harmful than smoking.
The consultation also emphasises the harm from nicotine - a substance that the Royal College of Physicians says is no more harmful than caffeine. Many of the harms of nicotine have allegedly been ‘found’ since the advent of vaping - yet UK scientists are finding problems with studies that link nicotine to harm. For example, at the E-Cigarette Summit this year, Professor Peter Hajek of Queen Mary University of London pointed out that links between nicotine and harm to the brain were only found when animals were subject to huge quantities of nicotine and considerable distress.
The Scottish government is concerned that young people are taking up vaping. While the data show that few young non-smokers are vaping on a regular basis, this is something we will need to monitor. Still, and despite the fact the Scottish government argues that nicotine is more addictive than heroin, there is strong evidence that vaping is less addictive than smoking. Nicotine is not the only addictive element in tobacco smoke, and perhaps that’s why experimentation with vaping does not usually turn into regular use among ‘never-smokers’. Even better, as vaping denormalises smoking, fewer and fewer young people are smoking cigarettes.
That’s not to say we should rest on our laurels. As we’ll see later, there are actions we can and should be taking to minimise the risk of young non-smokers using nicotine, even if it is in a safer form.
What’s suggested in the Scottish vaping consultation?
Vaping is already subject to severe advertising restrictions which, for example, forbid advertising on the internet, TV or newspapers. The Scottish government aims to further extend these restrictions.
One possibility mooted is a ban on in-store promotional displays. Vape shops are often staffed by ex-smokers with vast experience in helping people switch from cigarettes to vape devices. But these shops are already reeling from multiple blows - including a trend towards internet shopping, misinformation and Covid. By further reducing their ability to sell effectively, the Scottish government would be damaging these shops, and therefore their ability to help smokers.
The government wants to end free distribution of e-cigarettes. While this could have some value in limiting the ability to give vapes to under 18’s, it doesn’t make sense to stop distribution of vaping devices to smokers or allowing smokers to try a device or e-liquid before they buy it. At the very least, this suggestion needs to be refined further.
The consultation also wishes to end nominal pricing. I understand that what they mean by this is stopping the sale of goods below cost price (the exact wording is ‘at greatly reduced prices.’). This can hamper the ability of businesses to turn older devices, which will not sell at full price, back into cash. That again harms businesses while increasing environmental waste.
The Scottish government also wants to restrict usage of vapes to smokers, but don’t define what a smoker is - for example, does the term smoker include social smokers, occasional smokers or people who have tried cigarettes but don’t regularly use them?
The consequences of restrictive vape laws
Let’s remember vaping products do not exist in isolation. They exist alongside a product which is both highly addictive and is so harmful it eventually kills half the people using it. Smoking is both orders of magnitude more harmful and more addictive than vaping and, in contrast with electronic cigarettes, experimentation with tobacco cigarettes often turns into regular use.
Vaping has the potential to displace smoking. So until smoking has been eliminated, it makes no sense to place further restrictions on vaping while any adult over the age of 18 can walk into a shop and buy cigarettes. After all, the biggest obstacle in displacing smoking is that people don’t realise vaping is safer than smoking.
For the most part, the restrictions proposed in Scotland will reinforce the mis-perception that vaping is worse than smoking. They will further hinder vaping’s ability to denormalise smoking. There are certainly areas which could do with finesse - for example, currently free e-cigarettes can be given out to under-18 year olds, which makes no sense outside of a stop smoking setting - but for the most part these regulations will not help reduce smoking rates or improve the nation’s health.
Finally, let's remember that history has shown us that whatever restrictions we put in place, humans will try things which are enjoyable but harmful. When people decide to experiment with nicotine, should they really be stopped from trying vaping while cigarettes remain freely available?
An alternative suggestion
Scotland already has strong laws to stop the sale of vape products to young people. The only reason young people are able to access vaping devices when they are under 18 is because some businesses are willing to break the laws on vaping, just as they break the laws on alcohol and cigarette sales.
Creating more regulations to solve a problem caused by businesses which don’t follow existing regulations won’t work. Instead, it will just make things more difficult for legitimate businesses that do follow regulations. At worst, it could put some legitimate businesses out of business while allowing rule breakers to thrive.
The solution, therefore, is to enforce existing regulations - with harsher penalties than already exist. Businesses which sell illegal vapes are gambling with the health of their customers, as they are not emissions tested and we don’t know what ingredients are used, while those which sell to children undermine the very concept of harm reduction.
Businesses which knowingly sell age restricted products to children, which don’t conduct age checks online or in shops, whether it’s cigarettes, alcohol or e-cigarettes, should be vigorously prosecuted and fined - with repeat offenders removed from Scotland’s register of tobacco and vape retailers and disallowed from selling any age restricted products in the future.
Sounds harsh? I don’t think so. Many vape shops that have helped smokers were set up by smokers, and are driven by a passion to help other smokers. In contrast, businesses that make a profit by selling to children or selling illegal vapes don’t give a fig about their customer’s health. They are damaging the reputation of the vaping industry and in turn harming smoking cessation and public health - and there is just no way such businesses should be allowed to profit from illegally selling vapes.