DDN 0715 - page 8

News Focus
8 |
| July/August 2015
For the stories behind the news
lthough the treatment sector is
slightly less polarised than it was,
the harm reduction/abstinence
argument has raged for so long
that’s it’s become the field’s background
music. So it’s interesting to see similar
debates played out – sometimes bitterly –
around electronic cigarettes, with some seeing
them as a powerful harm reduction tool and
others as a cynical attempt by the tobacco
industry to recruit more consumers while also
winning over the health lobby.
went to press, Oil and Gas UK
became the latest organisation to enter the
fray, advising its companies to ban the use of
e-cigarettes on offshore installations. But the
most high-profile intervention is last month’s
Public Health (Wales) Bill, which includes
plans for a country-wide ban on their use in
enclosed public spaces. The legislation is
scheduled to come into force in 2017 and has
divided the health sector, with organisations
including the BMA and Public Health Wales in
favour, while ASH and Cancer Research UK –
neither friends of the tobacco industry, to put
it mildly – are among those lining up against.
The Welsh Government’s stance is that the
law would help to stop smoking becoming ‘re-
normalised’ after the positive impact of the
2007 ban, and also prevent e-cigarettes acting
as a ‘gateway product’ to tobacco. Both Cancer
Research UK and ASH refute the ‘gateway’
argument, however. ‘We can’t see any evidence
that electronic cigarettes are re-normalising
smoking, certainly in the UK,’ ASH’s director of
policy, Hazel Cheeseman, tells
. ‘We’ve
seen this steady drop in the number of young
people smoking, which is great, and those who
are using electronic cigarettes are largely
young people who are already smoking. Our
own research found that – as did large school-
based surveys in Scotland and Wales.’
Among those young people who’ve never
smoked but have tried e-cigarettes, most of
the use seems to be short-lived
experimentation, she says. ‘They’ll say they
tried electronic cigarettes once or twice, but
we aren’t at the moment seeing that translate
into regular use of electronic cigarettes, let
alone regular smoking.’
There’s no guarantee that experimentation
won’t translate into regular e-cigarette use, she
concedes, but questions whether that would
necessarily be an entirely bad thing. ‘If
electronic cigarettes turn out to be a replace-
ment for smoking, then over the longer term
what you would expect to see be would be
young people who might otherwise have
smoked taking up electronic cigarettes instead.’
Does this mean that they really are effective
harm reduction tools? ‘They certainly would
appear to be at the moment. In the adult
population you’ve got 2.6m regular users of
electronic cigarettes, according to our research,
and about two out of five of those have quit
smoking altogether, while pretty much all the
rest tell us they’re either actively trying to quit
or cutting down on the amount they smoke
and using electronic cigarettes instead.’
There’s also little evidence that vapour
from e-cigarettes is harmful to bystanders,
says ASH, and they have mass appeal in a way
that nicotine-replacement never did. The risk
then, presumably, is that the Welsh ban could
discourage smokers from switching? ‘That’s
one of the reasons why we wouldn’t support
the decision – it gives a false perception,’ she
states. ‘People aren’t always out there looking
at all the evidence – it’s not their job to do
that – so they use shortcuts to understand
how harmful something is. If you say
something’s banned people will automatically
assume that’s because it’s bad for you.’ What
about the argument that widespread use of e-
cigarettes undermines the positive impact of
the smoking ban? ‘If they’re concerned that
kids and adults are going to see people using
these products and think it’s OK to smoke, I
guess that’s a hypothesis, but I don’t know of
any evidence that supports it.’
The treatment sector is used to its harm
reduction versus abstinence debate being
bitter and divisive – is this debate heading in
the same direction? ‘It’s obviously been a
difficult one, and people have disagreed, but
in the UK we’ve actually had much more of a
rounded debate than other countries, because
we’ve had this tradition of harm reduction
and we tend to be more pragmatic.’
So what about the claim that the tobacco
industry's involvement is little more than a
cynical ploy to get the health lobby onside – a
Trojan Horse? ‘Tobacco companies have
actually been quite late to the party in terms
of electronic cigarettes,’ she states. ‘They
certainly weren’t the people that invented
them, and it’s only in the last couple of years
that they’ve started investing in them. We
should definitely be suspicious of their
motives, as – obviously – they’ve never
previously demonstrated that they’re
interested in public health. But the products
on the market that seem to be most effective
at helping people quit and have growing
appeal – the ones that you refill yourself –
aren’t really owned by the tobacco industry
yet, though that might change.
‘However, one thing is clear. While tobacco
companies continue to make billions from
selling a lethal product, there’s no room round
the table for them, whatever else they’re selling.’
Bill at gov.wales
With a controversial ban on the use of e-cigarettes in public places in Wales
now looking likely,
hears from anti-smoking charity ASH on why, perhaps
surprisingly, it thinks the plan is misguided
have mass
appeal in a
way that
never did.
‘We can’t see
any evidence
that electronic
cigarettes are
certainly in
the UK.’
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