Scotland’s Smoking Plan

Posted 11th July 2018 by Mawsley
The new paper on Scotland’s planned approach to tobacco harm reduction has been described as “hopelessly confused” and “a missed opportunity”. Most measures amount to nothing more than a coat of paint and support for vaping remains, at best, lukewarm.

NHS Scotland compliments the report, and says in its consensus statement: “There is now agreement based on the current evidence that vaping e-cigarettes is definitely less harmful than smoking tobacco. Although most e-cigarettes contain nicotine, which is addictive, vaping carries less risk than smoking tobacco. Thus, it would be a good thing if smokers used them instead of tobacco.”

It goes on to add: “Using e-cigarettes without stopping smoking (dual use) does not provide health benefits. Anyone who is using both should be strongly encouraged to stop smoking tobacco as soon as they can.”

But, rather than admit the success of a consumer-driven revolution in public health, NHS Scotland argues: “Access to e-cigarettes needs to be controlled carefully.”

Also, it sticks resolutely to the use of varenicline and NRT products: “expert support and medicinal treatments have the strongest evidence base to help people stop smoking.”

“While the World Cup is currently taking place, the Scottish Government has marked the feast of sport taking place in Russia by scoring something of an own goal” – New Nicotine Alliance

The New Nicotine Alliance (NNA) has responded to say that although the paper merits a guarded welcome it scores an own-goal and, “we feel that health professionals are not the best source of guidance on vaping products and that consumers should be consulted far more than we currently are.”

The lack of experts means that Stop Smoking services still over-rely on the use of medical treatments, something that will continue with NHS Scotland’s tone, the NNA adds: “if the Scottish government truly wishes to reach a smoke-free future, they should be utilising the skills and knowledge of vaping consumers instead of placing faith in organisations who have scant understanding of the products.”

The full Scottish plan of attack:

  • “Getting Through 72”, a different name for a quit smoking campaign
  • “Green Curtain”, a different name for a campaign to stop smoking near hospitals
  • A continuation of a project to stop smoking in school grounds, near school gates or around play parks
  • “Take it Right Outside” – a campaign to stop smoking in communal stairwells
  • Posters for Pharmacy shop windows
  • The annual No Smoking Day, already happens
  • The annual World No Tobacco Day, already happens
  • Proxy purchasing to check for underage sales, already happens

These action points will be backed up by a continuation of the budget allocated to research, the provision of training already that’s already taking place, the production of a new leaflet for midwives and a commitment to “ensure the action plan is monitored by the Ministerial Working Group on Tobacco Control and is robustly evaluated.”

Less caution; more enthusiasm” - New Nicotine Alliance

As can be seen, there is nothing different, innovative or compelling about these measures. In fact, some would say it’s a management-driven fop to targets that pays nothing but lip service to the notion of tobacco-harm reduction.

The NNA comments: “We are concerned that the NNA has worked hard with NHS Greater Glasgow and Clyde (NHSGGC) over the years in overturning vaping bans in hospital grounds. It would be helpful if this were to be extended to all Scottish hospitals following the lead that NHSGGC were brave enough to make having listened to the evidence.

“Smokers are not ill, they do not require a medicine. The entire reason for the success of e-cigarettes is because they are pleasurable. That is what is driving the huge boon to public health in Scotland as well as the UK in general. Scottish authorities can never begin to comprehend e-cigarette use if it refuses to understand it is because they are not medical products.

The reason that Scottish stop smoking services are e-cigarette friendly now is not because of the success of tobacco control policies, but because they have had to react to where consumers were going without their government’s help. Rather than try to stop that, we should be heartily encouraging it. Less caution; more enthusiasm.”

It appears that the only thing the Scottish government is currently enthusiastic about is paying consultants money to come up with snappy new names for health campaigns.