Wednesday 2 March 2022

Scottish consultation on e-cigarette advertising

The Scottish government is running a public consultation on banning e-cigarette advertising. It's exactly the kind of thing the SNP would do. Devolution doesn't give them many levers of power to pull so they tend to pull them all. And since they don't have much ability (or inclination) to liberalise anything, it's a one-way ratchet of illiberalism. 

Obviously, they shouldn't do it, but let's look at their reasoning...

Reducing exposure to the advertising and promotion of vape products is the best way to protect non-smokers, young people and children from being enticed to experiment with these products.

They don't give a citation for this claim and I doubt any evidence exists for it. 

Early indications from studies have shown a potential link between use of e-cigarettes containing nicotine and the development of lung diseases such as chronic obstructive pulmonary disease (COPD).

They do give a citation for this claim. The study's participants were mice. 

The clinical impacts of long-term use could take decades to manifest. In addition, there are mixed views among academics, health professionals and scientists about the amount of harm these products could pose to human health. However, evidence does exist to suggest that the long-term use of these products could cause potentially life-threatening illnesses such as COPD.

A citation is also given for the claim about COPD. It is the same experiment carried out on mice as above. The Scottish government seems to find this study strangely compelling.

In July 2020, the UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment published a paper on the potential toxicological risks from e-cigarettes. It found no immediate risks to health from exposure to the glycerol and propylene glycol used in vape liquid. However, it did emphasise that “the long-term effects from repeated exposures are unknown.”

E-cigarettes were invented twenty years ago and have been widely used for more than ten. As we have failed to find evidence of harm among people who have been vaping daily for over a decade, can we not extrapolate from the absence of short-term and medium-term harm? Surely that makes more sense more sense than extrapolating from studies on rodents.

"But cigarettes take decades to kill!", I hear you say. True, but you can see the biological markers for harm long before that. If cigarettes were invented today, we would be able to tell very quickly that they are potentially lethal. 

The Royal College of Physicians believes that “the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.” Whilst the College promotes the use of e-cigarettes as a safer alternative to smoked tobacco, we do not consider that degree of harm acceptable to young people or adult non-smokers.

What degree of harm? Leaving aside the fact that non-smokers can decide what level of risk they find acceptable, "unlikely to exceed 5%" includes the possibility of zero per cent. It is very clear from epidemiological and toxicological evidence that the true figure is well below 5% and is almost certainly a small fraction of one per cent, with zero per cent being a realistic possibility. 

It is crucial to remember that these are all the risks relative to smoking. The relevant question is what impact, if any, a ban on advertisements for an alternative to smoking will have on smoking and on overall harm. That question is never really addressed in the consultation document.

As it is currently understood that using vape products is less harmful than smoking tobacco, we recognise the benefits in these products as a cessation tool. We would like to ensure that smokers are able to access a range of accessible and understandable information about vapes to inform them about the potential benefits of these products as an aid to stopping smoking. This will help counter significant levels of misinformation and misunderstanding about the respective risks of smoking and vaping.

This is a bit more like it. There is a vast amount of misinformation about vaping which has led to public understanding about the relative risks going backwards in recent years
‘Perceptions of the harm caused by vaping compared with smoking are increasingly out of line with the evidence’.
The proportion of adult smokers in England who think vaping is as dangerous or more dangerous than smoking rose from 36 per cent to 53 per cent between 2014 and 2020. If this is how misinformed people are in a country where health agencies have been broadly supportive of tobacco harm reduction, it is easy to see why vaping is facing a backlash in other places.
With a growing number of people believing that vaping is as dangerous as smoking, allowing e-cigarette advertisements is a good way of signalling that they are not.
The proposed restrictions already apply to tobacco products.

Exactly. Surely you want to differentiate them?
There is limited evidence on the impact on e-cigarette advertising, but two studies have looked at the issue in relation to smoking cessation. The first found that "e-cigarette advertising reduces demand for traditional cigarettes" and the second found that e-cigarette advertising on television - which is now banned in the EU - reduces the number of smokers.

The Scottish government says it is inviting responses to the consultation until March 31 but, rather confusingly, says that responses must be submitted by April 28. To be on the safe side, get your response in by the earlier of these two dates. If you want some tips on what to say, see this from the New Nicotine Alliance.

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