Clive Bates writes that the government of the Netherlands, “by taking measures to make vaping less attractive, threatens to degrade the appeal of a low-risk rival to cigarettes, provide regulatory protection to the cigarette trade, prolong smoking, obstruct quitting, and add to the burden of disease and death.”
Consequently, 24 world-leading experts have sent a detailed submission to explain the problems with Secretary of Health Paul Blokhuis’ proposals.
The twenty-four signatures on the document are from:
- David Abrams, New York University
- Karolien Adriaens, KU Leuven
- Clive Bates, advocate
- Frank Baeyens, KU Leuven
- Ron Borland, University of Melbourne
- Sharon Cox, University College London
- Lynne Dawkins, London South Bank
- Jean-François Etter, University of Geneva
- Konstantinos Farsalinos, University of Patras
- Peter Hajek, Queen Mary University of London
- Martin J Jarvis, University College London
- Lynn T. Kozlowski, University at Buffalo
- Eva Kralikova, Charles University of Prague
- Christopher Lalonde, University of Victoria
- Jacques Le Houezec, Consultant in Public Health
- Karl Erik Lund, Norwegian Institute of Public Health
- Bernd Mayer, University of Graz
- Raymond Niaura, New York University
- Caitlin Notley, University of East Anglia
- Lars Ramström, Institute for Tobacco Studies, Sweden
- Lion Shahab, University College London
- Andrzej Sobczak, Medical University of Silesia
- David Sweanor, University of Ottawa
- Professor Umberto Tirelli, Tirelli Medical Group
The document sets out that the proposals constitute a “war on drugs” style approach to nicotine meaning that tobacco harm reduction products can’t be included in the Dutch ambition of achieving a Smokefree 2040 target.
They detail the “false and misleading claims about the risks of e-cigarettes”, failing to acknowledge and consider “the overwhelming evidence showing e-cigarette use is much less harmful than smoking”.
They say: “It is clear from toxicology and exposure studies that e-cigarettes are, beyond any reasonable doubt, far less harmful than cigarettes. It is simplistic to apply the precautionary principle to use long-term uncertainties to justify excessive regulation. This ignores the substantial body of science suggesting much lower risk and neglects the problem that excessive regulation can cause harm by protecting the cigarette trade, which is known to be highly harmful.”
The group point out that too much reliance has been placed on the EVALI lung outbreak in the United States and that this is a misplaced fear due to the fact it wasn’t vaping that caused it.
“EVALI was caused by the addition of a cutting agent, Vitamin E Acetate, to illicit cannabinoid (THC) vape pens. This substance cannot be added to nicotine liquids and would serve no purpose if it could. There is no other credible evidence of material risks of severe lung injury.”
They add the government misunderstands “dual-use” and it should be seen as a transitory step towards smoking cessation. They also decry the concept of a gateway from vaping into smoking: “Regulating based on assumptions of a gateway effect where none exists is not responsible or ‘precautionary’. Over-regulation of e-cigarettes, the far safer product, could prevent e-cigarettes functioning as a diversion from smoking for young people.”
The government, they add, “takes a simplistic approach to youth risk behaviours and fails to demonstrate benefits to adolescent public health … Illicit drugs are subject to prohibitions and strong sanctions yet are still widely used and supplied by criminal enterprise.”
They continue, the government “Ignores perverse consequences of prohibition, even though these are foreseeable”, “Fails to show benefits for adolescents or address concerns it may cause harm to young people”, and “Ignores the harmful effects of a vaping flavour ban on adults”.
The group concludes with strong words of caution about what the prohibition would mean in that it creates regulatory protection for the cigarette trade, “violates important regulatory principles, including those underpinning the European Union internal market”, and constitutes an illiberal policy which fails to recognise and build upon the major global public health opportunity that is vaping.