Lets imagine, just for a few fantasy moments, that common sense has prevailed. The EU TPD rules on e cigarettes for the consumer market have been turned into some common sense over quality, safety, content of liquid, child proof lids on bottles of juice, and we still have flavours. Sales to under 18s have been banned, e cigarettes are now as widely available to buy as tobacco, and I can buy my favourite top quality juices as easily as I used to be able to buy a pack of twenty. There are no clean air bans on vaping, but the message is to be polite and considerate when vaping in an enclosed space. Some businesses have chosen not to allow it, others have welcomed it. The dust is settling. The statistics are still showing that very few never-smokers in any age group are taking up vaping, the majority who vape are either smokers in the process of switching, or ex-smokers.
Vapers throughout the country happily donate their starter gear through a national scheme, so that people who can’t afford the set up can pick up good quality second hand equipment through Stop Smoking Services. The best advice for people just switching is added to the Stop Smoking services training, letting the best aspect of these services come in to its own by allowing newly switched vapers the complete support of lovely people like Louise Ross. Stop Smoking Services then also have the support of the vaping community, and smokers and vapers start to loose the “Them against us” mentality we’ve built up over the long years of feeling utterly misunderstood as human beings.
If instead of “quit or die!” we had “quit or switch?” the choice to cease nicotine use altogether could still be emphasised. Give those of us who can’t do without the physical benefits of nicotine use long term that viable alternative. Add to that the positive support of the most effective method of smoking cessation: the support of a trained counsellor. Include support in how to find the best set up for each individual who chooses to switch. Then vaping could normalise not smoking and do it in such a way as to avoid alienating smokers like I was even further. Smokers are not the enemy. Nicotine is not the enemy. Smokers are generally rational adults who have never really been listened to or engaged with in a way that didn’t put our backs up and make us switch the anti-smoking message off.
With notable exceptions the issue with this Utopia is very simple. The dissenting voices in Public Health are shouting so loudly that the balance between extremes can’t be achieved. The main stumbling block appears to be the precautionary principle “We don’t know the long term effects of vaping, therefore we can’t allow it to be used as a consumer product. It must be regulated, made uniform, able to be measured and tested..” In answer to this I say that your perfect product is impossible to create; there is no such thing as “ZERO RISK”. “Low risk does not mean ‘no risk'” is not a good enough argument against the benefit I get from switching to a low risk product. Your perfect product would also be of little to no use to vapers; by regulating it, and making it deliver a uniform dose it becomes a medicine with which to treat nicotine withdrawal, and NRT is not vaping. As Clive Bates has often said, “What use is a perfect product that no one wants to use?”
The precautionary principle must also seek balance. It must balance out the harm of regulations imposed with the possible harm of no regulations;
Where action is deemed necessary, measures based on the precautionary principle should be, inter alia:
- proportional to the chosen level of protection,
- non-discriminatory in their application,
- consistent with similar measures already taken,
- based on an examination of the potential benefits and costs of action or lack of action (including, where appropriate and feasible, an economic cost/benefit analysis),
- subject to review, in the light of new scientific data, and
- capable of assigning responsibility for producing the scientific evidence necessary for a more comprehensive risk assessment.
“the key guideline is the 4th in the list above: the requirement to apply a symmetric assessment of risks and benefits arising from both regulatory intervention and non-intervention. In other words, if a regulator wants to come down heavily on a product like e-cigarettes because of hypothetical dangers, it has to take into account the lost benefits that might arise if it bans, restricts or otherwise reduces the positive potential of the product. For e-cigs this is particularly salient as the benefits are to health, not just economic.”
And for the risk versus benefit statistical analysis go straight back to Carl Phillips. You know the one. I can type the quote in my sleep. This isn’t rocket science – I’m not that clever. I just don’t understand why, given the evidence, we’re still having the same fight. And, in fact we’re still having the same fight when the misapplication of the precautionary principle over Swedish Snus has already been proven to have done untold harm. I don’t want to jump up and down and scream abuse at those who disagree with me but honestly, can’t you understand why I might want to?
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Medical professionals please see M.O.V.E and add your voice.