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Leading academic insists #ECigarettes are less harmful than tobacco

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A leading academic says that electronic cigarettes are “considerably less harmful” than smoking tobacco. In a Q&A interview with this website, Italian academic Dr. Riccardo Polosa (pictured, below), said that such products are “unlikely to raise significant health concerns”, writes Martin Banks.  

EU Reporter:  Millions of Europeans are now using electronic cigarettes, but are you convinced that they are safe alternatives to traditional cigarettes? What is the science to back this up?

Dr Polosa:  “Even the most stubborn opponents in the tobacco control movement now acknowledge that e-cigarettes, although not risk-free, are considerably less harmful than smoking tobacco. Emissions and exposure data are unequivocally showing that their toxicological profile is of immaterial concern compared to tobacco smoke. Clinical findings on e-cigarette users who have been using these products long-term do not show any early sign of damage to the lung. Also, our work in patients with respiratory conditions shows that e-cigarettes can help reduce cigarette consumption, are very well tolerated and can improve respiratory outcomes in patients with asthma and chronic obstructive pulmonary disorder (COPD) that have switched to regular vaping. This positive evidence is in agreement with many other research studies on the subject. To name just a few, well-respected authorities, such as Public Health England (PHE), Cancer Research UK (CRUK) and Action on Smoking and Health (ASH), recognize the potential of e-cigarettes to reduce the negative health effects of smoking. I am confident that, under normal conditions of use, these products are unlikely to raise significant health concerns.”

EU Reporter:  The manufacturers claim these e-cigarettes could save thousands of lives each year as they help smokers beat their addiction. Is it possible to verify the claim that they are less harmful for those who want to quit smoking?

Dr Polosa:  “There is now growing scientific consensus that e-cigarette use carries much lower levels of risks than smoking; a recent report from Public Health England estimates that vaping an e-cigarette is likely to be at least 95% less harmful than smoking a regular cigarette. Existing tobacco control policies to reduce cigarette use have been only modestly effective and integration with a strategy of switching cigarette smokers to e-cigarette use to accelerate tobacco control progress should be now considered. Recent estimates indicate that replacement of tobacco cigarette by e-cigarette use over a 10-year period may prevent 6.6 million premature deaths, in the US alone. In collaboration with LIAF (Italian Anti-Smoking League), we have started a series of scientific and regulatory initiatives that promote the potential benefits of e-cigarettes with the goal of accelerating the declining trends of smoking prevalence in Italy.”

EU Reporter:  E-cigarettes can be used legally in those public places where real smoking is illegal but some countries and companies have banned them. How would you criticize such moves?

Dr Polosa:  “Unlike second-hand tobacco smoke, there is no direct evidence that passive exposure to vaping may cause significant harm to bystanders. Public Health England and Action on Smoking and Health UK have both produced evidence-based guides to help public places and workplaces make local policy. In consideration of this, I am personally critical of any irrational enforcement of indoor vaping bans. Questions of ‘etiquette’ are relevant as bystanders may find e-cigarette aerosol unpleasant. Some businesses may therefore choose to limit the use of e-cigarettes not for health and safety reasons but because of concerns that customers or employees will be annoyed by their use. Hospitals, schools and airplanes would be environments suited to a vaping ban. But on the other hand, there is no justification for outdoor vaping bans. Banning e-cigarettes sends the misleading message that they are just as harmful as smoking and could deter switching from smoking to vaping. Bans may drive vapers out with smokers and encourage them to restart tobacco smoking. Last but not least, allowing e-cigarette use in some workplaces and public places undermines smoking behaviour by favouring vaping.”

EU Reporter:  The e-cigarette market is regulated under the Tobacco Products Directive. This was done to address fears that unregulated, pirate products could threaten human health. Do you support such regulation?

Dr Polosa:  “Article 20 of the EU Tobacco Products Directive 2014/40/EU (TPD) allows the marketing of e-cigarettes, subject to a number of conditions and restrictions. The regime largely mirrors the medicines regulation without the benefits, namely, without the ability to advertise the product. Furthermore, the TPD was guided by an arbitrary adoption of the precautionary principle, taking no notice of the existing scientific evidence. An example is provided by Article 43, which literally states, "electronic cigarette can develop into a gateway to nicotine addiction and ultimately traditional tobacco consumption, as they mimic and normalize the action of smoking. For this reason it is appropriate to adopt a restrictive approach to advertising electronic cigarettes and refill containers". Moreover, TPD implementation at member-state level has put additional obstacles for consumers to access products that may be beneficial to public health. In Italy for example the government has enforced an unpopular taxation on e-vapor products and prohibited their sale via internet. It is clear is that including additional marketing restrictions for e-cigarettes will put these products out of reach of many consumers and thus it will be an impediment to European public health. My opinion is that TPD is in need of corrective measures.”

EU Reporter:  In the US, the share of middle and high school students who use e-cigarettes doubled in 2017 from the previous year. One of the biggest concerns among health officials is the potential for e-cigarettes to become a path to smoking among young people who otherwise would not have experimented. How would you react to such fears?

Dr Polosa:  “What fears? There are no such fears! Some anti-vaping advocates are concerned about vaping being a gateway for youth smoking - that is the risk of renormalising smoking and undermining tobacco control. However, the evidence does not support these arguments. Also, the “gateway” theory is a political construct that has been used for decades to fuel drug panics and defend drug prohibition. All the “gateway” nonsense shifts attention away from the social determinants of drug use. Most importantly, in countries where use of vapour products has been particularly common (such as in US and UK), youth smoking rates continue to decline at a faster rate; this clearly negates the very occurrence of a gateway into tobacco smoking.”

EU Reporter:  What do you think the EU should do in relation to e-cigarettes?

Dr Polosa:  “The EU should consider integrating the existing tobacco control policies with a pro-vaping strategy in order to accelerate tobacco control progress and that regulation of these products is better focused on standard for safety and quality to safeguards consumers’ best interest.  Our experience suggests that many former smokers who transitioned to using e-cigarettes believe that the main goal for regulators should be to keep the products available and acceptable as a cigarette replacement. Excessive and ill-conceived regulation will conflict with these basic requirements; it will marginalize e-cigarettes by making them unattractive to smokers and less competitively priced compared with tobacco products.  The silence on the benefits of electronic cigarettes in the EU cannot continue. The European Parliament should work together with the scientific community in order to protect the European citizens, smokers or not, by implementing an effective harm reduction strategy.”

Dr Polosa is director of the Institute for Internal and Emergency Medicine of the University of Catania in Italy, Chief Scientific Advisor to Lega Italiana Anti Fumo (LIAF - Italian Anti-Smoking League).

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Why there should be no harmonized excise duties on nicotine-free e-cigarettes in the EU

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Since 2016, the European Commission has been working on a revision to the Tobacco Excise Directive, the ‘TED’, the legal framework ensuring excise duties are applied in the same way, and to the same products, throughout the Single Market, writes Donato Raponi, honorary professor of European Tax Law, former head of excise duties unit, consultant in tax law.

Member states, through the Council of the EU, recently asked for a range of new products to be contained within the TED. It includes e-cigarettes which contain no tobacco but do contain nicotine. However, there are also e-cigarettes with no nicotine in them and their fate is unclear.

But why should a directive that has, until now, been only for tobacco be extended to include products which contain neither tobacco nor nicotine? Isn’t this a step too far?

The EU's constitution, enshrined in the Treaties of the European Union, is very clear that before proposing any legislative initiative, some key questions must be addressed.

The EU rules1 explain very clearly that products should be included in the TED only to ensure the proper functioning of the internal market and to avoid distortions of competition.

It is by no means clear that a harmonized excise treatment of nicotine-free products, such as nicotine-free e-liquids, across Europe will help to alleviate any such distortions.

There is very limited evidence on the extent to which consumers view e-liquids without nicotine as a viable substitute for e-liquids with nicotine in them. The European Commission’s recently published Eurobarometer study on the attitudes of Europeans towards tobacco and electronic cigarettes has nothing to say on this question. And the evidence from the available market research experts is limited at best.

It is, consequently, virtually impossible to know how many consumers – if, indeed, any at all – would switch to e-liquids without nicotine if only nicotine containing e-liquids were subject to an EU level excise duty.

What we do know, however, is that almost everybody who consumes tobacco products already covered by the TED does not view nicotine-free e-cigarettes as viable substitutes for them. And that is why most cigarette smokers who switch to alternative products look for other products containing nicotine.

There may be parallels between this and the excise treatment of alcohol-free beer, the latter not being, covered by the EU Alcohol Directive. Although it is designed to be an alternative product, this does not mean that alcohol-free beer is viewed as a strong substitute by most of the people who drink alcoholic beer. Member states have not applied a harmonised excise on alcohol-free beer and so far, the effective functioning of the Single Market has not been damaged.

Even if the absence of a harmonized excise on nicotine-free e-cigarettes were to distort competition, it must be material enough to justify any EU level intervention. Case law from the CJEU confirms how distortions of competition must be ‘appreciable’ to justify any changes to EU legislation.

Simply put, if there is only limited impact, there is no rationale for EU intervention.

The market for e-cigarettes without nicotine is currently very small. Euromonitor data shows that nicotine-free e-liquids for open systems represented only 0.15% of all EU tobacco and nicotine product sales in 2019. Eurobarometer reveals that while nearly half of Europe’s e-cigarette consumers use e-cigarettes with nicotine every day, only 10% of them use e-cigarettes without nicotine daily.

With no clear evidence of any material competition between nicotine-free e-cigarettes and the products already covered in the TED, together with the low sales of nicotine-free products, the test of there being an ‘appreciable’ distortion of competition is not – at least at the moment – obviously being met.

Even if there is no case for new EU-level legislative measures for nicotine free e-cigarettes, this does not stop individual member states from levying a national excise on such products. This has already been the practice across member states so far.

Germany does not, for instance, need an EU Directive to levy its domestic excise on coffee, while France, Hungary, Ireland and Portugal levy a tax on sugary drinks without any EU Soda Excise Directive in place.

The case of non-nicotine e-liquids is no different.

There is nothing to stop any member state from taxing non-nicotine e-liquids at its own pace without the unnecessary intervention of the EU.

1 Article 113 of the Treaty on the Functioning of the European Union

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Illicit tobacco trade: Nearly 370 million cigarettes seized in 2020

EU Reporter Correspondent

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International operations involving the European Anti-Fraud Office (OLAF) led to the seizure of nearly 370 million illegal cigarettes in 2020. The majority of the cigarettes were smuggled from countries outside the EU but destined for sale on EU markets. Had they reached the market, OLAF estimates that these black market cigarettes would have caused losses of around €74 million in customs and excise duties and VAT to EU and member state budgets.

 OLAF supported national and international customs and law enforcement agencies from across the world in 20 operations during 2020, in particular providing vital information on the identification and tracking of lorries and/or containers loaded with cigarettes misdeclared as other goods at the EU borders. OLAF exchanges intelligence and information in real time with EU member states and third countries, and if there is clear evidence that the shipments are destined for the EU contraband market, national authorities are ready and able to step in and stop them.

OLAF Director-General Ville Itälä said: “2020 was a challenging year in so many ways.  While many legitimate businesses were forced to slow or halt production, the counterfeiters and smugglers continued unabated. I am proud to say that OLAF’s investigators and analysts played a vital role in helping to track and seize these illegal tobacco shipments, and that OLAF’s cooperation with authorities across the globe has remained strong despite the challenging conditions. Our joint efforts have not only helped save millions of euros in lost revenues and kept millions of contraband cigarettes of the market, they have also helped us get closer to the ultimate goal of identifying and closing down the criminal gangs behind this dangerous and illegal trade.”

A total of 368,034,640 cigarettes destined for illegal sale in the EU were seized in operations involving OLAF during 2020; of these 132,500,000 cigarettes were seized in non-EU countries (primarily Albania, Kosovo, Malaysia and Ukraine) while 235,534,640 cigarettes were seized in EU member states.

OLAF has also identified clear patterns with regard to the origins of this illicit tobacco trade: of the cigarettes seized in 2020, some 163,072,740 originated in the Far East (China, Vietnam, Singapore, Malaysia), while 99,250,000 were from the Balkans/Eastern Europe (Montenegro, Belarus, Ukraine). A further 84,711,900 originated in Turkey, while 21,000,000 came from the UAE.

The main cigarette smuggling operations reported by OLAF in 2020 involved collaborations with authorities in Malaysia and Belgium, Italy and Ukraine, as well as a number involving authorities from across the EU and elsewhere.

OLAF mission, mandate and competences

OLAF’s mission is to detect, investigate and stop fraud with EU funds.

OLAF fulfils its mission by:

  • Carrying out independent investigations into fraud and corruption involving EU funds, so as to ensure that all EU taxpayers’ money reaches projects that can create jobs and growth in Europe;
  • contributing to strengthening citizens’ trust in the EU Institutions by investigating serious misconduct by EU staff and members of the EU Institutions, and;
  • developing a sound EU anti-fraud policy.

In its independent investigative function, OLAF can investigate matters relating to fraud, corruption and other offences affecting the EU financial interests concerning:

  • All EU expenditure: the main spending categories are Structural Funds, agricultural policy and rural
  • development funds, direct expenditure and external aid;
  • some areas of EU revenue, mainly customs duties, and;
  • suspicions of serious misconduct by EU staff and members of the EU institutions.

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Tobacco Excise Directive consultation: 83% of submissions warning about higher taxes on vaping

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The World Vapers’ Alliance strongly urges policymakers to stay away from equating smoking tobacco and vaping, especially when it comes to taxation. This comes off the heels of a recently ended consultation on the update of the Tobacco Excise Directive, which specified the European Commission’s intention to tax vaping products similarly to how cigarettes are taxed. 

Commenting on the consultation, WVA Director Michael Landl said: “Making vaping less appealing to smokers by higher prices will discourage current smokers from switching to less harmful alternatives. This is certainly not going to be of any public health benefit. Additionally, high taxes on vaping products are particularly harmful to the lower income brackets of the population, which make up the largest proportion of current smokers.”

The consultation ended on 5 January and out of 134 responses from citizens, associations and industry, 113, or 84% referenced the positive impacts of vaping and the serious negative impact that taxing it the same as cigarettes would have.

Michael Landl added: “I am delighted by the overwhelming number of responses in favour of vaping to this consultation. It shows that many people know the potential for harm reduction of vaping. . What policymakers need now to understand is that tax hikes on vaping will lead to people switching back to smoking, an outcome absolutely nobody wishes for.”

Therefore, for the WVA it is important that non-combustible products are not regulated and taxed the same way combustible tobacco is. Lawmakers need to follow the scientific evidence and abstain from tighter regulation and higher taxation of vaping products.

“If we want to reduce smoking induced burdens on public health, access and affordability to vaping products need to be guaranteed,” Landl concluded.

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