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To #Vape or not to Vape? That is the question

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_85051757_e-cig_woman_gettyDespite decades of efforts to counter the problem, smoking remains a major public health risk for Europeans as the number of smokers in the world has increased rather than fallen, writes Martin Banks.

But what is perhaps less well known is that tens of thousands of people have been helped to quit smoking - by using e-cigarettes.

Some, including no less a body than the World Health Organisation, still remain sceptical of the potential for new technologies, including electronic cigarettes, to reduce smoking-related harm.

The scepticism can be traced back to the organization’s Framework Convention on Tobacco Control (FCTC), which has been pressuring policymakers to employ strict regulations and treat e-cigarettes like tobacco.

The FCTC, which operates in secrecy and bars journalists from attending its meetings, has militated in favour of a “quit or die” approach of reducing demand by raising taxes and has repeatedly stymied initiatives aimed at harm reduction. The upcoming meeting, the 7th Conference of Parties (COP7) to be held in November in India, is expected to deliver new recommendations to policymakers to that effect.

But is such pessimism misplaced?  Do e-cigarettes really have the potential to help smokers quit and, in doing so, curb the ever-rising death toll of smoking-related death and disease?

Alison Cox, director of prevention at Cancer Research UK, believes so.

She is among those firmly in the camp that insists e-cigarettes can play a key role in helping smokers to quit, suggesting that the evidence so far shows e-cigarettes are much safer than tobacco.

Indeed, Cox says e-cigarettes may help some smokers move away from tobacco entirely.

The authorities in the UK are not alone in generally supporting this relatively new product.

France recently became the latest country to come out in favour of e-cigarettes, suggesting they are an effective tool for smokers who are looking to reduce or replace tobacco.

Tabac Info Service, run by government body Public Health France, said “according to the latest work of the High Council on Public Health (Haut Conseil de la Santé Publique), electronic cigarettes can constitute a tool to help stop or reduce consumption of tobacco” and also “reduce the risk of developing serious illnesses such as cancer”.

And in neighbouring Belgium, the country’s public health minister Maggie De Block recently enthusiastically approved the sale of e-cigarettes containing nicotine.  Previously, it was only possible to purchase nicotine-free e-cigarettes. Vaping, said De Block, can help people stop smoking because e-cigarettes contain 95% less nicotine than regular cigarettes.

The overall consensus appears to be that electronic cigarettes can help smokers kick the habit and do not pose serious side-effects in the short-to mid-term.

This is evidenced by the findings of the Cochrane Collaboration, a respected medical research group which examined the best available evidence on the devices.

It estimates that in 2015 e-cigarettes alone may have helped about 18,000 smokers in the UK to quit who would not otherwise have stopped.

According to its findings, published recently in the British Medical Journal, the devices appear to be linked to a decrease in the use of nicotine replacement therapies on prescription.

While many agree on the benefits of vaping, the issue becomes ignited because of legislation, on both sides of the Atlantic that places such devices in the same category as tobacco.

This has happened in Hungary, a country of heavy smokers, where a new bill tabled earlier this year in parliament seeks to regulate electronic cigarettes and related products, treating them the same as regular tobacco products.

At the EU level, the debate on e-cigarettes is intensifying with British MEPs taking steps against what they have branded ‘restrictive’ new EU rules covering the sale of e-cigarettes.

They include UK MEP Julie Girling who has spoken of the “potential public health benefits of e-cigarettes”.

She and Tory party colleague Vicky Ford have now written to Research, Science and Innovation Commissioner Carlos Moedas asking him to examine the latest evidence on the health effects of vaping and whether it can help long term smokers give up traditional cigarettes.

Last month, Public Health England published a review, described by Cancer Research UK as a “robust piece of work”, which concluded that e-cigarettes are 95 per cent less harmful than tobacco.

Cancer Research UK says that such evidence points to e-cigarettes being “far safer” than tobacco cigarettes – a toxic product which kills up to two thirds of its long-term users.

Girling and Ford hope that if Moedas comes to a similar conclusion, the European Commission will look again at the controversial EU Tobacco Products Directive.

 Article 20 of the directive, which is currently being implemented by EU member states, will force e-cigarette manufacturers to either classify their products as cigarettes or face tight rules on advertising, or as medicinal products and sell them only in pharmacies. The EU directive also restricts the amount of nicotine cartridges can contain and introduces what some label burdensome new manufacturing standards.

Under the draft legislation, e-cigarettes will not only be regulated - having to meet certain quality and safety standards - but if companies claim e-cigarettes help smokers quit they will have to seek a medicines license.

Girling, the Conservative environment co-ordinator, told this website: "There is great concern that the new regulations will dissuade smokers from switching to e-cigarettes. There was little scientific input when this part of the directive was drawn up and further evidence has subsequently highlighted the potential public health benefits of e-cigarettes. We believe it is time some facts were introduced into this debate and hope Moedas will agree to our request.”

Her endorsement of the potential benefits of e-cigarettes is echoed by Ford, the Conservative spokesman on the Internal Market, who told EU Reporter: “The EU restrictions on electronic cigarettes were swept into the new tobacco laws without the chance to take into account expert evidence.

"We all received thousands of emails and letters from users who argue that the products have enabled them to give up traditional smoking. The EU commissioner has now appointed a group of scientific experts and it would be useful to hear their advice on whether the restrictions are appropriate."

The EU plans would also mean e-cigarettes being placed under the same tax arrangements as cigarettes and cigars and this has sparked concerns that that could damage public health.

Deborah Arnott, of the health charity ASH, believes so, saying: “If the EU were to require states to tax electronic cigarettes like tobacco products it would be detrimental to public health. It would discourage smokers from switching.”

Jamie Hartmann-Boyce, author and editor of the Cochrane Tobacco Addiction Group, said: “Fundamentally, tobacco researchers on both sides of the argument want the same thing – to reduce death and disease. We’re in the same boat.”

Cigarettes are uniquely deadly. They kill two in three people who use them regularly. E-cigarettes are said to be safer than traditional smoking. What’s not to like?

If you’re asking whether e-cigarettes are safer than regular cigarettes, most experts certainly lean on the side of “yes”. The message is: simply because e-cigarettes are new to the scene is no reason to seek to extinguish their growth.

Cancer

Europe’s Beating Cancer Plan: Time to back vaping and beat cancer

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Europe’s Beating Cancer Plan needs bold action on tobacco, and MEPs must Back Vaping to Beat Cancer, according to the World Vapers’ Alliance. The Special Committee on Beating Cancer (BECA) today identified that  ‘tobacco use, in particular cigarette smoking is the main risk factor for cancer death in Europe’.

Commenting on the new document, World Vapers’ Alliance (WVA) Director Michael Landl said: “To succeed in its mission, the BECA committee and the European Parliament must be brave enough to endorse new approaches. Vapers across Europe are calling on policymakers to recognise the benefits of vaping, and its potential to massively reduce the harm of smoking. Policymakers cannot ignore the facts any longer.

"We appreciate the commitment from MEP Mrs. Véronique Trillet-Lenoir and the entire Special Committee on Beating Cancer to fight smoking-related cancer. The Europe Beating Cancer Plan needs to endorse vaping as an effective tool to help smokers move to a safer alternative. That’ Back vaping, beat cancer!”

The new working document presented in today’s Special Committee on Beating Cancer (BECA) by the Committee's rapporteur MEP Véronique Trillet-Lenoir states that:  “Tobacco use, in particular cigarette smoking, is the main risk factor for cancer death in Europe. Various measures to fight against smoking appear heterogeneous and inconsistently implemented. Overall, the WHO Europe region is the global area with the highest tobacco consumption, with major discrepancies between Member States, as the proportion of smokers varies by a factor of up to 5 from one country to another.”

  • The European Parliament’s Special Committee on Beating Cancer (BECA) met for the second time today for an exchange of views with Health Commissioner Stella Kyriakides.

  • As part of the Committee’s work, a draft WORKING DOCUMENT on Inputs of the Special Committee on Beating Cancer (BECA) to influence the future Europe’s Beating Cancer Plan was released by the Committee and its rapporteur Veronique Trillet-Lenoir. It identifies that tobacco is the main risk factor for cancer death in Europe. You can find the document here.

  • The World Vapers’ Alliance (WVA) amplifies the voice of vapers around the world and empowers them to make a difference for their communities. Our members are vapers associations as well as individual vapers from all over the world. More information available here. 

  • Michael Landl is the director of the World Vapers’ Alliance. He is from Austria and based in Vienna. He is an experienced policy professional and passionate vaper. He studied at the University of St. Gallen and worked for several public policy outlets and as well in the German Parliament.

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Cigarettes

Backing #Vaping to beat #Cancer

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The upcoming European Union's Beating Cancer Plan is a historic chance to improve public health in Europe. Cancer is the second leading cause of death in the EU. 1.3 million people die from cancer each year in the EU and 700,000 of those deaths are associated with smoking. Despite these terrifying numbers, approximately 140 million Europeans are still smoking. The European Union is right to tackle the disease with a holistic approach, writes Michael Landl (pictured).

A comprehensive approach needs to include prevention and harm reduction. While it is important that lawmakers do everything, they can to prevent people from starting smoking, it is equally important to support current smokers in their quest to quit. Including e-cigarettes (vaping) in the EU Beating Cancer Plan will help millions of European who are struggling to quit smoking and consequently prevent many deaths associated with cancer from smoking.

E-cigarettes contain liquid which is heated and turned into vapour. There is no tobacco nor tar in e-cigarettes and many of the toxins in cigarettes are not present in e-cigarettes. In 2015, Public Health England declared that vaping is 95% less harmful than smoking and began recommending that current smokers switch to electronic cigarettes. Countries like Canada and New Zealand followed their lead and have helped save millions of lives. In fact, these policies promoting vaping arguably achieved more in a short period of time than what lawmakers tried to accomplish for years: fewer people smoking cigarettes. 

We know that abstinence is not as effective as alternatives, such as vaping. According to a 2019 study from Queen Mary University London of 100 smokers trying to quit cold turkey, only three to five succeed - while according to the same study, vaping is even more effective for smoking cessation than nicotine-replacement therapy, like patches or gums.

Despite the weight of evidence, a number of governments have considered new restrictions on vaping, rather than make it more accessible. While often well intentioned most newly proposed regulations, such as flavour liquid bans or higher taxes, would disproportionately harm smokers who are trying to quit. This runs directly against the goal of beating cancer.

The EU Beating Cancer Plan is a massive opportunity to ramp up the fight against smoking. Lawmakers should include vaping in the plan as a harm reduction tool to prevent cancer. The European Union's institutions and governments should follow the lead of countries like the United Kingdom, Canada and New Zealand and encourage the use of vaping as a less harmful alternative for adult smokers.

If the European Union is serious about improving health, we must back vaping to beat cancer.

About the World Vapers' Alliance

The World Vapers’ Alliance (WVA) amplifies the voice of passionate vapers around the world and empowers them to make a difference for their communities. The alliance partners with 19 groups representing vapers worldwide and represents individual vapers. Michael Landl, the WVA’s director, is an experienced policy professional and a passionate vaper.

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Does #COVID-19 represent a mortal threat to the tobacco sector?

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The SARS-CoV-2 pandemic has spelled bad news on the whole for smokers and the industry which supplies them. The most recent developments include the debunking of research that suggests smokers are supposedly less susceptible to the virus – accompanied by revelations that in fact the habit exacerbates the effects of the disease – as well as a public smoking ban in Galicia that has now spread across the whole of Spain.

With over one million smokers in the UK having reportedly kicked the habit since the onset of COVID-19, how great a threat does the current crisis represent to the industry which profits from their addiction? Public awareness of the dangers of smoking have never been higher, meaning the time is ripe for authorities in Europe and elsewhere to introduce measures aimed at curbing the deadly practice – but they must be wary of interference and prevarication from the ever-tenacious tobacco industry itself.

Big Tobacco under threat

At the outset of the coronavirus outbreak, smokers may have been initially cheered to hear the results of a study from China, where they were disproportionately underrepresented among sufferers of Covid-19. Subsequent research has not brought nearly such positive news; more than one peer-reviewed paper has found smokers are roughly twice as likely to experience coronavirus symptoms as non-smokers. This aligns with other studies, which found that smokers with the virus were twice as likely to be hospitalized and 1.8 times more likely to die than their non-smoking counterparts.

The addiction isn’t just damaging to those holding the cigarette, either. With bar patrons urged to keep their voices down and even theme park goers warned against screaming for fear of transmitting the virus orally, the huge clouds of smoke emitted by tobacco enthusiasts could be an ambient epidemic waiting to happen. Aware of the danger, South Africa took immediate action to ban tobacco sales in late March, although it has since revisited those restrictions. More recently, the Spanish region of Galicia and the Canary Islands archipelago both announced public smoking would be prohibited, with the rest of the country considering following suit.

The pandemic hasn’t just prompted a response from lawmakers – smokers are also reconsidering their relationship with tobacco in light of the dangers posed by the highly contagious and deadly respiratory disease. In the UK, over a million smokers have quit in the last six months, with 41% of those claiming fears of coronavirus were their primary motivation for doing so. Meanwhile, the University College London found that more people have given up smoking in the year up to June 2020 than in any other 12-month window since records began over a decade ago.

Underhanded tactics at play

Never one to take such setbacks lying down, Big Tobacco has resorted to its tried and tested tactical playbook. Among other machinations, that playbook involves obfuscating and influencing the science by funding favorable studies on the subject of coronavirus and smoking, delaying anti-tobacco regulations and claiming the industry comprises an “essential business” to avoid lockdown measures in places as diverse as Italy, Pakistan and Brazil.

At the same time, major tobacco firms have been accused of crisis-washing. Philip Morris International (PMI) donated a reported $1 million to the Romanian Red Cross and 50 ventilators to a Greek hospital, as well as an estimated €350,000 to a Ukrainian charity, with other big players reportedly having done the same. Critics claim these apparently altruistic contributions are nothing more than opportunistic PR stunts which capitalize on a global tragedy to paint Big Tobacco in a positive light – something which the industry itself vehemently rejects.

Regardless of the intent behind the donations, there are heavy suspicions that they may have contravened the Framework Convention on Tobacco Control (FCTC) protocol, which specifically prohibits governments or government-owned bodies from taking funds from the tobacco industry. Unsurprisingly, this kind of chicanery is nothing new for Big Tobacco, who have been ploughing a similar furrow for decades. Unfortunately, it’s one that continues to yield advantages for those behind the yoke, despite efforts to curb their influence.

Ineptitude and inefficiency in the EU

EU policymakers have, disappointingly, demonstrated themselves to be particularly susceptible to the tobacco industry’s malignant influence. As detailed by the OCCRP, the EU has effectively handed over large parts of its track and trace (T&T) system for illicit tobacco to firms with close ties to the industry. The system, which the FCTC has highlighted as an integral step in clamping down on a black market that costs the bloc over €10 billion per annum in lost public revenue, is intended to monitor a packet’s progress at each stage of the supply chain via a unique identifier, thus eliminating any opportunity for wrongdoing.

A central element of any successful T&T system, as defined by the Illicit Trade Protocol (ITP), is its complete independence from the industry itself. However, the OCCRP investigation has uncovered how key firms developing T&T software and handling the process have ties to the tobacco industry, including seven out of eight of the companies tasked with storing the all-important cigarette data. Meanwhile, one of the main companies monitoring hundreds of supply lines into the EU – Inexto – appears to be at least partially funded by Big Tobacco, while the very software it uses to carry out its obligations was purchased from PMI themselves for a rumored fee of just one Swiss franc.

The whole process is so riddled with inefficiencies that nine months after its implementation, insiders have said they have no idea how effective it has been in clamping down on the illegal trade, while one official from the UK’s trading standards office has called it “completely useless”. Nonetheless, EU officials have travelled the world touting the benefits of their system and several nations have already bought into the myth, with Inexto winning contracts from Mexico, Pakistan, Russia, and governments in Western Africa to date. The Pakistani contract, at least, has since been invalidated by court order.

A vaccine for industry influence

At a time when the Covid-19 crisis has thrown health concerns into sharp relief, governments and health groups should be taking a page out of the obesity debate book and generating momentum towards cutting smoking rates in their territories. While that momentum does seem to be gaining ground, it sadly does not appear to have escaped the pervasive and pernicious influence of the industry itself, which undermines the entire process.

Big Tobacco’s stratagems are widely documented and well understood – but this knowledge does not seem to be capable of preventing their success all the same. In addition to a vaccine for this deadly new coronavirus, it seems immunity against industry intervention should also be on the EU’s priority list.

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