Nicotine Science & Policy | 28 December 2013

In the wake of all the debates about new nicotine products and regulation in 2013, NSP asked leading commentators to let us have short statements on their hopes and aspirations for policy and practice in the coming year. Below are some of the responses we received.

Prof. Peter Hajek - UK

I would like to see a year in which common sense and science trump ideology and vested interests and e-cigarettes are allowed to continue to replace combustible tobacco as a consumer product. Sadly, given the stance of powerful and influential organisations that really should know better, WHO in particular, this may not be easy. The planned crippling of e-cigarettes would remove the biggest hope we ever had of removing smoking related death and disease rapidly and with little government expenditure. I do hope regulators will be able to listen to reason and data rather than to ideology and misinformation.

Dr Derek Yach – USA

January 2014 will be 50 years since the first US Surgeon General's report on Smoking and Health. That started the steady evolution of tobacco control that has led to steep declines in consumption and associated harm due to tobacco in the US and many countries in the world. But the pace of change for a known risk is inadequate with smoking rates increasing in many countries. We need to raise our ambition levels in 2014 and separate the harm caused by tobacco from the addiction caused by nicotine to build a new way out of tobacco. That requires considering the implications of new non combustibles for core policies that underpin tobacco control: excise tax, bans on smoking in public places being two; and investing in research that will guide needed changes to policy in ways that do not undermine the potential positive impacts of new technologies.

Prof. Chris Bullen - New Zealand.

“…selected nicotine replacement products [should] be made as palatable and acceptable as possible and actively promoted on the open market to enable them to compete with tobacco products. They will need health authority endorsement, tax advantages and support from the anti-smoking movement if tobacco use is to be gradually phased out.” E-cigarettes may be the breakthrough product Michael Russell envisaged when he wrote these words almost a quarter of a century ago in an article in the British Journal of Addiction entitled ‘The future of nicotine replacement’. His wise recipe for success should be heeded: regulatory agencies should back down from making hasty decisions restricting access to safer nicotine delivery products. Instead, they should hike tobacco taxes while taking measures that encourage the e-cigarette industry to improve the quality, safety and reliability of its products. And I’d like to see the tobacco control community coming on board in greater numbers to support the many smokers who want access to safer nicotine products.

Prof. Richard Ashcroft - UK

Smoking and tobacco control provoke a lot of quite extreme reactions in public debate and in private conversations, but one thing that always baffles me is when the debates take a civil libertarian turn. It’s actually pretty easy to show how a good mainstream liberal response to smoking can support both the smoker’s freedom to smoke and fair limits to where the smoker should be able to exercise that freedom. But if you read the newspapers, there is a steady stream of articles about how smokers are being oppressed, that society is becoming more illiberal and intolerant, and that that what is really at stake in tobacco control is not health, or the mass retailing of a dangerous substance, but freedom itself. We’re often told that tobacco advertising is a freedom of speech issue, for instance; and we’re also told that doctors or health promotion agencies telling smokers about the harms of smoking and ways to quit is somehow “nannying” or “healthist”. The incoherence of these arguments is breath taking. So what I would like to happen in 2014 is, first of all, a bit less “Astroturf Libertarianism”, whereby the industry uses fake “grassroots” campaigns to work up a sense of outrage about governments trying to promote the health and wellbeing of their citizens through democratically accountable means, while these entirely unaccountable corporations whine about their customers’ “freedom” to be poisoned, hooked, and lied to. And secondly, I’d like a really good expose of who funds the “libertarian” groups that promote the causes of Big Tobacco.

Scott D. Ballin - USA

As I echo some of the statements already made, I want to spend my words talking more about a possible path forward. The tobacco, nicotine and alternative products environment has changed substantially over the last several years. New players have entered, along with the growing spectrum of new products. The need for a more comprehensive regulatory scheme for all tobacco and nicotine products is being recognized by a growing number of people. Yet many, and in particular the traditional mainstream organisations (and many policy makers), still want to fight the black and white 'tobacco wars' as if this were the 1990's. The level of noise, rhetoric, and infighting has reached an all time high and I don't see it subsiding unless new approaches are advocated and undertaken. In 2014 we will need to undertake a more deliberate and sustained educational campaign about the critical importance of tobacco harm reduction as a national, regional and global strategy, laying out the various elements that can make this effort successful. To do so we will need the leadership to build bridges to and between stakeholders, convene dialogues and actively participate in meetings to have these important issues discussed in a more productive and civil manner. There is a lot of common ground to be found. Thus I would guess, I am suggesting something that would be tantamount to a 'call to action' in 2014.

Dr Miroslaw Dworniczak (‘Stary Chemik’) - Poland

Let me put it this way: politicians - stay away from e-cigarettes. And this is my biggest dream for 2014. Alas, that's not likely to happen. Anyway - I'd love to see, by the end of next year, a consensus about norms for e-liquids. It's not a trivial task, requires many talks and arguing, but setting such norms will be something really good for the safety of vapers. Another dream of mine - many scientific papers covering wide areas - from chemistry to health to psychology/sociology. I'd love to see media aiming at presenting those data in plain language to the society. Quoting Lennon (well, with one minor change) I would probably say: "you may say I'm a dreamer, but I'm not the only one, I hope some day you will join us, and the world will vape as one."