An economic forecasting company has estimated that if smoking in the UK declines at the current rate, nobody will be smoking by around 2050. Frontier Economics predicts that:
1. Our central forecast is for the Government to meet its smoke-free target – to reduce smoking prevalence to 5% or below of England’s adult population – around 2040. This forecast is based on a continuation of current above-inflation excise increases and known regulatory interventions.
2. If smoking then continued to decline at the same rate after 2040, it would reach 0% in around 2051.
3. Smoking is in long-run decline, but since 2012 it has declined at more than twice the rate seen between 1993 and 2011. Smokers switching to e-cigarettes appear to have made a material contribution to that recent trend.
4. We anticipate that the faster decline in smoking since 2012 will not continue indefinitely. In part this is because the growth of e-cigarettes is now slowing. Data from ASH indicates that there were only 100,000 new vapers in 2017, compared with 800,000 in 2014.
5. The Government’s target of reducing smoking to below 5% could be met as soon as 2029 if the faster rate of decline since 2012 were maintained. If that trend continued further, smoking would be eliminated in England by 2035.
6. Meeting this target by 2029 would require an additional 2.5 million smokers to quit over and above those we already expect to quit in our central forecast. This is equivalent to around 210,000 extra quitters each year.
7. This would require significant changes, such as:
- A rapid increase in the number of smokers switching to smoke-free alternatives, including e-cigarettes; and/or
- Reversing the decline in smokers quitting through NHS Stop Smoking services, which decreased to 40,000 in 2016 from a peak of 100,000 in 2011; and/or
- Finding other new and effective ways to persuade smokers to quit.
This is very simple and compelling analysis that would benefit many countries in moving towards smoking cessation and a clear indication of the benefits of safer nicotine products (SNR). The more worrying aspects is the apparent slow-down in SNP take-up as identified by ASH who reported that the key issues were product satisfaction, concerns about safety and pricing. Frontier Economic conclude that the impact of SNP on further reductions in smoking prevalence ‘may be limited without further intervention’ . I assume they mean ‘less is more’ – in other words, reducing or eliminating legislative interventions that lessen the chance of more people being able to switch. The message is that governments can do much to reach smoke-free targets by refusing to be swayed by anti-vaping zealots and, while paying due attention to product safety, getting out of the way of SNP growth.
Continuing the futuristic theme, David Sweanor has made some insightful comments about the prospects for product liability litigation against tobacco companies in light of the availability of SNP.
He makes the point that despite the billions of dollars spent on smart lawyers over the decades, the tobacco industry has been losing court cases hand over fist because they are undeniably responsible for a product that kills an estimated 50% of those who use the product as intended. But if any product liability lawyers are looking to launch a suit against Big Tobacco for trying to claim that e-cigarettes are safer than cigarettes, they will hit the problem that the likes of the WHO and the US Surgeon-General say there is no difference in risk.
But if I understand correctly, he goes onto say that as the new technologies develop and the evidence builds, it will be ever more important for all the cigarette manufacturers to keep up with the new products, and even harder for them to defend tort law cases (civil as opposed to criminal ‘wrongs;) for the continued production and selling of cigarettes. The comparison he makes is with car companies having to keep up with safety legislation not of their making or face the consequences, both legal and commercial. Now I am no lawyer, but I wonder if this can be turned around by the companies that doesn’t get them off the hook in terms of the continued availability of cigarettes, but makes the point that they would be happy to produce, market and sell as many RNPs as the market will bear, but are being thwarted by draconian legislation and the trenchant opposition of public health around the world. We have heard previously about how restraint of trade cases could be brought through breach of WTO rules, but I wonder what would happen if there were law suits on public health grounds, not about deaths caused, but deaths not prevented.
When it comes to making the case against SNP, there is a lot of bad or junk science in the world of tobacco control, which manifests itself in different ways. There are the studies which make sweeping policy recommendations based on the results of studies which are examining one small aspect of the issue. There are those that do the same on the basis on very small samples. Others will condemn SNP because of the morbidities demonstrated by vapers who had switched to vaping after decades of smoking where of course all the damage was done. And there are those which ignore real world situations and instead base findings on very unreal world laboratory experiments. Here was one famous example.
In January 2015, the New England Journal of Medicine published a study on aldehyde emissions which the authors claimed demonstrated that e-cigarettes constituted a significantly higher cancer risk than cigarettes, capturing much media attention in the process. At the time, Dr Konstantinos Farsalinos likened the research methodology to toasting bread until it was black then claiming toast caused cancer. Now he has gone one better and replicated the study, the results of which are published in the latest issue of Food and Chemical Toxicology.
The researchers used exactly the same e-cigarette devices, batteries and liquid as the NEJM study and instructed the participants to report any dry puffs that they detected. Dry puffs were detected at 4.2 V, therefore 4.0 V was the maximum realistic use voltage, and as expected the researchers found that there was a significant increase in formaldehyde emissions at dry puffs. So essentially, if your liquid does not go nuclear, you won’t be taking in any more formaldahyde than walking down the street.
Imperial have been behind the curve when it comes to investment in new technologies. But recent reported fall in cigarettes sales and the advance of their main rivals is causing the company to up its game. Imperial has acquired Nerudia, the Liverpool-based manufacturer of e-cigarette liquids. The Nerudia acquisition is the latest in a series of deals that have deepened Imperial’s commitment to the e-cigarette industry. Unlike BAT, PMI and JTI, Imperial so far has refused to enter the fast-growing heated-tobacco market, instead investing in e-cigarettes.
“It’s important to maintain optionality on both oral tobacco and heated tobacco products because there may inevitably be scenarios in which it makes sense to launch one or both, but our focus is on e-vapour,” said Imperial Chief Development Officer Matthew Phillips.
Imperial plans to launch three new vapour products and expand the number of markets from four now, to at least ten in 2018 and at least 20 in 2019.
What happens when you ban a drug that is well-embedded in society? The price goes up, the profit soars and the bad guys move in. What happens if you do that in an environment already tense and unstable? This...