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s2smodern

Harry Shapiro Director DrugWise

So obviously the big news of the week comes from New Zealand where  a government proposal will be put to parliament  next year which would legalise the sale and supply of nicotine e-cigarettes and e-liquids as consumer products.

The law would also regulate nicotine and non-nicotine e-cigarettes and e-liquid by:

  • prohibiting sale, and supply in a public place, to under 18 year olds
  • restricting sale via vending machines to 18 rated settings (R18)
  • allowing all retailers to display e-cigarettes and e-liquid at point-of-sale
  • allowing R18 retail settings to display e-cigarettes and e-liquid in-store (including window display), promote products on the outside of the store, and offer discounts, free samples, loyalty awards etc.
  • prohibiting broader advertising, e.g. billboards, radio, TV, Internet (the rules above will apply to retailers’ websites)
  • prohibiting vaping in workplaces and other areas where smoking is not allowed under the Smoke-free Environments Act 1990 (SFEA)
  • setting requirements for product safety (e.g. nicotine concentration, child-resistant closures etc.)

So far so good, but a ban on e-cigarette advertising only goes to protect the cigarette trade , while treating public vaping the same as public smoking (and not allowing site owner discretion) is unjustified as there is no evidence yet for the harmful effects of passive vaping. There will also be a nicotine concentration limit yet to be fixed.

Even so this is huge step forward and one far more likely to take off than the abortive attempt by the NZ government to create a legal and regulated market in new psychoactive substances (aka 'legal highs'). A story for another day perhaps. Meanwhile NZ health minister Nicky Wagner told Parliament journalists

"I have [tried vaping]. But I'm not very good at it but I don't smoke either. I suggest anyone who smokes here has a go at vaping, too.”

As Tolkien's classic book was filmed in New Zealand, there is probably a joke about Lord of the (Vape) Rings, quitting the smoking Hobbit and Elf and Safety, but it just isn't coming. Good job I hear you say!

Here is a short term outcome measures survey which should be food for thought for the tobacco control hard liners as it suggests that tough control regimes undermines the efficacy of e-cigarettes as a route to quitting. The authors conclude, “The findings underscore the need for careful consideration on how best to regulate this emerging product so that EC benefits for smoking cessation are maximised and its risks to public health are minimised”. Then again, maybe they don't care.

Yong H-H, et al, Does the regulatory environment for e-cigarettes influence the effectiveness of e-cigarettes for smoking cessation? Longitudinal findings from the ITC Four Country Survey. Nicotine Tob Res. 2017 Mar 4;  [link][PubMed]

Snus is leading the charge in Sweden towards the end game for cigarettes; new data shows that only 5% of men aged 30-44 now smoke and the main reason for the dramatic fall is snus. WHO data reveals that the lung cancer death rate in Sweden is less than half the EU average. It also has the lowest rates of oral and pancreatic cancers in Europe, diminishing fears that snus use might boost the risk of other cancers.

https://www.newscientist.com/article/2124671-swedish-men-on-target-to-be-first-to-completely-stub-out-smoking/

Writing in The Spectator, Christopher Snowdon suggests that following the Swedish example, one major benefit of Brexit would be to pave the way to legalise snus in the UK.

Reflecting on the history, Snowdon says, “The UK has to take its share of the blame for this reckless act of folly as it was (health minister) Edwina Currie who started the whole panic in the late 1980s. But what Britain started, it can finish. If legal action fails, repealing this idiotic law should be on the to-do list of the Department for Exiting the European Union. When it comes to benefiting from Brexit, fruit does not hang any lower than this”

https://health.spectator.co.uk/if-we-want-to-benefit-from-brexit-the-first-thing-we-should-do-is-make-snus-legal/

The London Fire Brigade is now endorsing vaping over smoking. “Mr Daly, assistant commissioner for fire safety, said: “Our preference is that you stop smoking altogether. But if you must smoke, vaping holds fewer fire risks than cigarettes as butts, ash and matches are often carelessly discarded which leads to fires.”  There have been no recorded deaths or injuries through vaping and only four fires last year compared to 1,000 caused by cigarettes.

http://www.standard.co.uk/news/health/switching-to-vaping-cuts-fire-death-risk-london-fire-brigade-safety-chief-tells-smokers-a3497141.html

Came across this by accident – a story on the BBC website highlighting concerns over 'fake research'. “Official data points to about 30 allegations of research misconduct between 2012 and 2015. However, figures obtained by the BBC under Freedom of Information rules identified hundreds of allegations over a similar time period at 23 universities alone. There are growing concerns around the world over research integrity”.

http://www.bbc.co.uk/news/science-environment-39357819

The co-founder of a US blog called Retraction Watch was also interviewed, a site I had not heard of, but which may be familiar to the academics among you. http://retractionwatch.com/

I did a search on e-cigarettes and came with the furore over the NEJM paper

http://retractionwatch.com/?s=e+cigarettes

I leave you with a thought from David Abrams who among various roles is Executive Director of the Schroeder Institute for Tobacco Research and Policy Studies concerning harm reduction “hard won battles have to be supported actively every day -- or they can easily erode or disappear. Ideology and moralistic reasoning can easily win out (dogma and emotional passion can trump data and rationality)”. There is a lot to say about the disgraceful history of opposition to harm reduction, not only in drugs and tobacco, but alcohol too and the saga of controlled drinking research.