E-cigarettes on the NHS

 

The British government is going to start giving e-cigarettes to some smokers, particularly pregnant women. It is also going to start clamping down on underage sales.  

I've been calling for the latter for some time. I've been sceptical of the former but I'm coming round to the idea. I still think that if you can afford to smoke, you can afford a disposable cigarette, but the biggest problem with e-cigarettes at the moment is that people think they are much more dangerous than they are. That has led to fewer smokers switching to them than would be the case if people were well informed.

As I wrote in a report for the IEA last year...

 

Consumer ignorance is a major barrier to the consumption of low-risk nicotine products. Myths about vaping causing ‘popcorn lung’ and other diseases have proliferated on social media. Scare stories regularly appear in the press. As a result, a report from Public Health England concluded in 2021 that ‘Perceptions of the harm caused by vaping compared with smoking are increasingly out of line with the evidence’.

Four out of ten smokers in England wrongly believe that nicotine causes cancer and the proportion of smokers who wrongly believe that vaping is as dangerous or more dangerous than smoking rose from 36 per cent in 2014 to 53 per cent in 2020.

 

In other words, there is a market failure. The blame lies with charlatans in the 'public health' racket, mostly in the USA and at the WHO, often funded by Mike Bloomberg, but it justifies a government response. If the NHS essentially prescribes e-cigarettes, it sends a clear signal to the public that vaping is vastly safer than smoking. As a bonus, vaping advocates in backwards countries like Australia can point to what the UK is doing to illustrate the absurdity of banning e-cigarettes.

The cost of the free vape scheme is not enormous (£45 million). In any case, smokers massively subsidise nonsmokers through tobacco duty so why shouldn't they get a bit back? On balance, it is a good policy.

This was all announced yesterday by the public health minister Neil O'Brien at Policy Exchange (where he used to be the director). You can read his speech here or watch it here. Mostly, it was toe-curlingly awful. I suppose that having to abase yourself in front of the 'public health' lobby by parroting their ridiculous tropes goes with the territory in his job, but I felt embarrassed for him all the same. 

He didn't have much choice other than to repeat the myth that smoking places a net burden on the taxpayer, since the 'evidence' for this came from a Policy Exchange report published while he was in charge of the think tank. He described the report as excellent. As I said at the time, it isn't.

 

But did he really have to repeat this idiotic canard from ASH? 

Current smokers are 7.5% less likely to be employed compared to never smokers and ex-smokers are 5% more likely to be employed than current smokers.

In places like Birmingham, an additional 6,000 people are out of work because of smoking. Quitting could help to put that right.

 

Smoking is much more common among lower socio-economic groups these days. Unemployment is always more common among lower socio-economic groups. A correlation between smoking and unemployment is therefore hardly surprising, but the idea that someone will suddenly get a job if they quit smoking is so dumb that O'Brien can't possibly believe it.

He also used the old 'stop hitting yourself, smoker' argument...

As well as the productivity impact, quitting smoking would save the average person around £2,000 a year.

 

Of that £2,000 approximately £1,800 is tax, and the rate of tax went up steeply last month, so we don't need anyone from the government shedding crocodile tears about the secondary poverty of smokers.

 

If you can get past this nonsense, what he actually announced was OK. He thanked Javed Khan for his bonkers review before announcing that he would not be going ahead with its main proposal - incremental prohibition - because it would be a gross violation of people's freedom.

 

Now of course some would go further to stop people to start smoking in the first place. The Khan Review last year advocated the New Zealand approach – a full phase out of smoking, with the age of sale increasing over time to cover all adults.

This would be a major departure from the policy pursued over recent decades which has emphasised personal responsibility and help for people to quit.

The subsequent Q & A is worth watching if you want a reminder of how many parasites are involved in tobacco control. Eric Hoffer once said that every great cause begins as a movement, becomes a business, and eventually degenerates into a racket. Judging by the questions, the room was divided into those who are threatened by vaping and want the state to give them more money (smoking cessation services, Allen Carr) and those who simply want smoking banned (CRUK, ASH). Quite a few of them want smoking banned and to be given more money. Deborah Arnott from ASH was among those panhandling for a tobacco levy despite this being a matter for the Treasury, not the Department of Health (and the Treasury rejected it years ago).

It was interesting to see how aggressive some of the people asking questions were. They are obviously used to bossing ministers about. There were a lot of questions about smoking cessation clinics, which are extremely inefficient and have been made more or less redundant by reduced risk nicotine products. A woman called Penny Steed who works at Whittington NHS Trust and runs Smoke-Free City & Hackney gave a quote for the ages when she told O'Brien:

"We're a great service. We help a lot of people. We really do help them. They tend to go back to smoking and we help them again."

 

Said without a hint of irony, this was a showstopper. It brought to mind Mark Twain's famous quote about quitting smoking, as well as a more niche reference from Best In Show. 

 

She followed this up by calling on the government to make it impossible for people to smoke because "I don't think help is going to cut it." What a ringing endorsement of a service that costs the taxpayer £75 million! Let's pour some more money down that pit, shall we?