At some point, Rory [Sutherland] produced an 'e-cigarette'. Back in 2010, these were still very rare. I think he'd got his own on a recent trip to Japan. Almost as an aide, he waved his e-cig and proclaimed that maybe these were a good thing.
In the same year, the question of how to regulate vaping was raised in government...
It wasn't a clear call. Policy decisions are often like this. Prime Ministers and Ministers, with the aid of their advisors, often have to make decisions in the face of incomplete evidence. We looked hard at the evidence and made a call: we minuted the PM and urged that the UK should move against banning e-cigs. Indeed, we went further. We argued that we should deliberately seek to make e-cigs widely available, and to use regulation not to ban them but to improve their quality and reliability.
Enter the MHRA...
We deliberated whether we could regulate e-cigs like foodstuffs or electronics, but eventually concluded that our best route might be a 'light-touch' medical route to regulation. The inverted commas are appropriate because, as anyone who deals with regulation will know, 'light-touch' is not necessarily the default instinct of regulators. Nonetheless, we asked the body that regulated medicines in the UK, the Medicines and Healthcare Products Regulatory Authority (MHRA), to develop as light a touch regulation as they could - just enough to make sure e-cigs didn't have other toxins, and that they had enough nicotine in them to be effective.
And then the 'public health' industry came bumbling out...
The public health sector might have been caught unaware by e-cigs and our rapid action in 2010. But through 2011-12, significant sections of the policy community, and particularly the public health sector, started to turn against e-cigs in earnest. The Chief Medical Officer moved from being on the positive side of neutral to firmly against. Pharmaceutical companies that made nicotine patches and gum weren't too pleased about the new competition, and started lobbying against e-cigs. The argument wasn't helped by big tobacco companies, who moved from being bemused and slightly hostile observers, to becoming actively interested in the products and even, it was rumoured, buying up some of the e-cig companies.
Meanwhile, government regulators had decided - surprise, surprise - to over-regulate...
By the time the proposals came back from the MHRA, they didn't look quite like the light-touch regulation we had in mind. The issue was also becoming a European matter, with many countries arguing for a ban, or at least very heavy regulation. Faced with a backlash in the public health sector, one of the UK's largest retailers withdrew e-cigs from its shelves. Despite our early efforts, we were losing the battle. We were heading towards heavy restriction of e-cigs in Europe, where they might only be available on prescription. Some wanted to go further still, and to follow the Australians towards an outright ban, or availability only possible under tight medical supervision. Even the MHRA was concerned that the European position would go too far.
Halpern and his team then looked at the evidence and found that e-cigarettes were clearly helping people quit smoking and were not acting a 'gateway' to smoking for nonsmokers....
We took the evidence back to the PM and the Cabinet Secretary. As it happens, David Cameron was one of the only people in No. 10 who had been a smoker [and still it, it seems - CJS], and had even tried an e-cig (he wasn't especially impressed). We took the decision to stick to our line: to ensure that, for now at least, e-cigs should be widely available; to push for light-touch regulation to ensure that they were free of other toxins but had enough nicotine to satisfy smokers' cravings; and to legislate to ensure that they were not to be sold to the under-18s. Available, but safe, was to be our line.
Based on behavioural and other evidence, and with the help of a new Public Health Minister and our European and Global Issues Secretariat (EGIS), this is the line we took and pushed and more or less secured in the UK and Europe. It is a situation we continue to watch.
Nobody could seriously describe the EU's Tobacco Products Directive as light-touch regulation, but never mind. There's an even greater threat in the WHO...
As with much of policy, this is an unfinished story. In July 2014, the World Health Organisation published a report concluding that countries should pursue a 'two-pronged regulatory strategy - regulating ENDS [e-cigs] as both a tobacco product, in accordance with the provisions of the WHO Framework Convention on Tobacco Control, and as a medical product. They did not recommend a ban, but for many countries regulating e-cigs in this way would dramatically curtail their availability.
He concludes:
Though time will tell, the initial indications are that by helping people quit - and possibly opening the door to a future outright ban on smoking - e-cigs may prove to be the biggest boost to public health in a generation. Even more extraordinarily, much of the public health bodies [sic] would have blocked them.
Not so extraordinary when you consider that it's never really been about health. It's about control.
In some respects, it's a good news story that the Nudge Unit helped to get a relatively liberal regulatory regime in Britain, but it is also worrying that so many big decisions come down to the right people being in the right place at the right time. What would have happened if Halpern had not come across a friend using an e-cigarette in 2010? If the dice had fallen differently, we could have ended up with the mendacious 'public health' industry winning the battle and securing a ban, as has happened in other countries. Our liberties shouldn't really be in the hands of random people like this.
You can buy Inside the Nudge Unit here.
No comments:
Post a Comment
Comments are only moderated after 14 days.