Norcia begins by contrasting the hospitals of America and Britain. While the Sandwell and West Birmingham Trust has allowed vape stores to open on hospital sites, in the U.S., “now you have people going to vape shops and telling the owners that they're killing people. It's crazy," said Culley.
Dave Cross, a trustee of the New Nicotine Alliance charity and writer for Planet of the Vapes news, was posed three questions:
1. In your view, why did the so-called "vaping crisis" fail to reach the United Kingdom as it has the United States? How did it all develop so differently? I understand there are obviously far more regulations — which, of course, please expand on — but I'm curious if there's a broader, cultural element to point to as well? (The fact that the country has vape shops attached to hospitals is particularly jarring when compared to what's happening to them in the United States.)
The answer to this is multi-levelled, and I’ll probably miss one or two points out, but it all comes down to a key factor: The U.K. has not seen any lipoid pneumonia-like hospital cases due to the use of THC products.
This in itself displays the clear fact that what you are dealing with in the U.S. is an illegal product being sourced on the black market – which ought to give the prohibitionists pause for thought given that one of the outcome of their bans will be vapers sourcing currently legal products on the black market.
In the 1980’s, 1,000 people in Spain died from a batch of toxin tainted olive oil. In addition, 25,000 seriously injured and some were left with lifelong disabilities. Nobody called for a ban on olive oil because it was recognised for what it was. The U.K. views the lung outbreaks in the United States as serious and sad but appreciates that this is, as the chief executive of ASH UK recently said, “an acute outbreak, it’s not due to chronic vaping over many, many years. It’s something due to some substance in a limited number of products.”
It starts with this: we don’t call vaping “a tobacco product” because there’s no tobacco. Terming it a tobacco product is dishonest. People wear their ignorance for all to see when they repeatedly refer to vaping as “smoking an e-cig”. There’s no smoke. They do it on purpose.
Where we differ most strongly is that we have some excellent politicians and people at Public Health England (PHE), all committed to evidence-based decision making and legislation. In addition, our leading charities who speak out on smoking matters all appreciated the simple fact that vaping is orders of magnitude safer than smoking.
These bodies looked at the evidence with open minds and listened to genuine experts – vapers. The New Nicotine Alliance (NNA UK) formed good working relationships with them and, as a wholly independent charity, was able to convey the need for common sense. It helped decision makers who were ignorant about vaping understand the process, the benefits and the sound research that backed it up and was invited to present evidence to (or advised) government committees. Maybe the U.S. government should be doing the same with American consumer groups? If they had I doubt the USA would now be in the pickle it’s in.
The NNA also formed alliances with international consumer groups to share resources, information and coordinate tactics. The recent formation of the European Tobacco Harm Reduction Advocates (ETHRA) is a case in point, as we gear up to influencing the next iteration of European vape legislation.
I feel that we have a historical affinity for harm reduction, it’s rooted in the United Kingdom’s psyche. This comes through loud and clear with PHE’s pronouncement that if you smoke you should consider switching, if you don’t smoke then don’t start.
We work within the Tobacco Products Directive, laid down at a European level, but have enjoyed a far greater level of support from our legislators than other countries nearby. Some would argue, and I would, that the current framework is too restrictive, but where we are is a league in front of the U.S. It was a surprise to me a few years ago that something as simple as childproof caps was voluntary in the States.
Then there’s the question of how much the Tobacco Master Settlement Agreement has impacted your situation. There are states in dire financial positions because they borrowed against then frittered their TMSA money (North Carolina gave $42 million to tobacco farmers for goodness sake). You have someone in the CDC resigning as it came to light she bought shares in tobacco stock, you have an ex-commissioner of the FDA jumping ship – straight into the arms of a pharmaceutical company developing its own “medical” (so it’s got to be so different, sure) vaping product. These vested interests have to come into play – and we see it with every ridiculous public statement.
You also have a billionaire throwing money at “charities” who used to campaign against smoking but now appear to want people to stay smoking…or at least only quit using the traditional, flawed pharma-approved route.
And then there is the research.
From this side of the Atlantic, it appears that far too many academics are more concerned about securing funding than carrying out good science (and I say that as a physicist). Some of the misdirection, fundamental errors and outright lies genuinely shocked me over the years. Time and again, back in the early days, we (vapers) would point out the flaws in dry burning coils and yet we were either dismissed as “astroturf” or “trolls”.
Finally, I think, there is the vast difference between your for-profit health system and our free at point of delivery National Health Service. Our doctors, and the bodies they belong to, generally do not appear to work at the behest of the pharmaceutical industry. We have some who may not have had the time to keep up to speed with information, but they are on board with harm reduction by and large.
It’s a different kettle of fish in the States. Some of the ignorance on display (and I’m being very generous terming it such) would lead one to assume that you can become a qualified clinician simply by collecting tokens from cereal boxes.
2. Do you think the US is too late to learn from the UK? And do you fear other countries, like India and China, which have already adopted a pretty prohibitionist stance, will copy the US, instead of the UK?
In truth, I don’t think the will is there at a political and public health body level to own up to the errors in judgement that have been made. You should have had sensible legislation governing manufacture, sale and distribution, you could have called out the clearly paid-for studies, and you ought to have denounced the overblown claims of “epidemics” and the rest of the nonsense that only exists through selective data manipulation.
I’m paraphrasing here, but New York’s Governor Cuomo recently said something along the lines of: “Vaping is safer than smoking? Yes…but so what?!” There’s not a hope that someone making a pronouncement so amazingly stupid as this is ever going to reverse his position.
A number of us predicted in January that this would be the year vaping all but died in the U.S., and we were sadly correct. I think it will bounce back – eventually truth has to win out. The evidence is there that vaping is safer, it exists to support vaping’s efficacy as a quit tool -and it highlights that the basic fact that teens who vape used to or still smoke. Your teenagers are just like ours. People talk about rates of increase, forgetting that if it was a low number to begin with it’s not that bad. Plus, actual smoking is falling which means lives have been saved.
You mentioned India and China; two countries with an absolute interest in protecting tobacco income in the same fashion as with the individual U.S. states and the TMSA. It’s corrupt, it’s obvious and we can see it happening. Both India and China have nationalised or semi-nationalised tobacco industries, and the Chinese government is the biggest manufacturer of cigarettes in the world. The financial imperative has overtaking the duty of care towards their respective citizens.
I believe some opposed to vaping genuinely believe they are correct. They can have their own opinions, they are welcome to them, but they can’t invent their own facts. At some point China, India and the USA will have to face that. Hopefully, those who have condemned smokers to further years of tobacco use will be held to account for their actions.
3. Additionally: Do you fear that policy in the UK might be affected by the seemingly knee-jerk reaction in the US?
I don’t think there’s even a remote chance we will go down your road of banning flavours. The government, Public Health England, the Royal Colleges all support vaping’s role in tobacco harm reduction. ASH UK, the leading anti-smoking body, supports vaping. Cancer Research UK and the British Heart Foundation support vaping. We have vape stores being opened in public hospitals and a legitimate tax-paying industry acting responsibly.
Recently, the UK celebrated the number of new vapers growing and the latest dramatic drop in smoking rates. Vaping is working here, as it would around the world given the chance, nobody is going to take that away from us.