If somebody invented a pill that could cure a disease that kills five million people a year worldwide, 100,000 of them in this country, the medical powers that be would surely encourage it, pay for it, perhaps even make it compulsory. They certainly would not stand in its way.
A relentless stream of data from around the world is showing that e-cigarettes are robbing tobacco companies of today’s customers — and cancer wards of their future patients. In Britain alone two million now use these devices regularly. In study after study, scientists are finding e-cigarettes to be effective at helping people quit, to show no signs of luring non-smokers into tobacco use and to be much safer than their noxious competitors.
So what in heaven’s name explains the fact that Dame Sally Davies, the government’s chief medical officer, when asked by the New Scientist in March what was the biggest health challenge we face in Britain, named three things, one of which was the electronic cigarette? That’s like criticising contraception because you prefer abstinence.
The NHS is confident that these devices are about 1,000 times less harmful than cigarettes. The government confirmed this figure in a parliamentary answer to me. It’s the tar in smoke that kills, not the nicotine — a substance that is about as harmful as caffeine.
We know vaping (as it’s known) works better than any other method of giving up smoking. A forthcoming study by Professor Robert West of University College London finds that e-cigarettes proved 60 per cent more successful as a method of quitting than nicotine patches, gums or going cold turkey. By a country mile, free enterprise devices are outstripping the health results of medicinally regulated devices. And for many vested interests that is the problem.
We know that most people use e-cigarettes to cut down or give up smoking. This has been confirmed by three big surveys, the latest of which, conducted by Ash, the anti-smoking group, was published this week: two thirds of users in the survey were smokers and one third were ex-smokers. That means in the few years since the products first appeared, hundreds of thousands of people have used them to give up or cut down.
We know that e-cigarettes are not proving to be a gateway into tobacco. In the biggest global survey, 0.4 per cent of vapers were non-smokers and not one of them went on to smoke. In the UK, 20 per cent of 15-year-olds are regular smokers: they are mostly the ones who try vaping, so even in the young the technology is a gateway out of smoking, not into it. (And it makes snogging taste better.) Yet what is the UK government’s main legislative response to e-cigarettes so far? To ban sales of e-cigarettes to children.
Do the maths. If e-cigarettes are 1,000 times less harmful than cigarettes, then for every youngster who goes from smoking to vaping, there would have be a thousand going the other way before there is net harm. If anything, the ratio is the other way round: in one American study, nine out of ten school-age vapers had started as smokers.
The firms that make e-cigarettes — which are mostly small start-up companies, the technology having come from China — are not allowed to claim they can save your life. Imagine what they could sell if they could. Instead their adverts try to hint that vaping is cool, which feeds the puritan suspicion that somebody somewhere might be enjoying themselves.
This argument that vaping is going to ‘renormalise’ smoking is the one the British Medical Association has been pushing, and, as Ash is now saying, it is clearly nonsense. With that gone, what arguments are left to justify regulating the advertising, public use and product strength of this life-saving technology to the point of discouraging it?
Some medics probably just hate the thought that a near-miraculous cure for a big cause of death came from the private sector and not from the nanny state. The people selling these things are doing so for — gasp! — profit, not because they want to save lives.
In several conversations I have had with senior medics, they immediately raised the horrifying fact that the tobacco industry has recently started producing e-cigarettes. For them this was a clinching argument against the technology.
No, I replied, that is the best news of all. The fact that even the tobacco industry is going to be competing against tobacco is great news. It shows that big tobacco can read the writing on the wall and is trying to get out of selling smoke before it goes the way of Kodak film. The number of people smoking is falling fast. Imperial Tobacco recorded a 16 per cent decline in UK sales last year. One US investment broker reckons vaping will be bigger than smoking by 2023. The tobacco industry is panicking.
It means you have won, I tell medics. Forget your bans on smoking in cars with children in, or banning brand names on packets. These were never going to make more than a marginal difference anyway. The cigarette is going the way of the top hat and the crinoline, if we encourage the safer, cleaner alternative. Here’s a life–saving technology on a massive scale that needs no funding. Are you sure that you — swearers of the Hippocratic oath — want to be the last people standing in its way, when everybody else can see the benefits?
The opposition to vaping has had an unfortunate result already. By insisting on including e-cigarettes in the EU’s tobacco products directive, the opponents have left them unregulated till the directive comes into force by 2017. And then over-regulated, pushing up prices and reducing choice after 2017. So unless the UK government makes its own helpful intervention, for the next two-and-a-half years there is little to stop rogue operators importing fake or adulterated vaping fluids from some crook. Plus the battle over regulation, as so often, helps the big guys and hurts the little guys.
By the way, where’s the left in all this? Smoking is increasingly concentrated in lower socioeconomic groups. How can we get e-cigarettes into the hands of the poor quickly? The high up-front costs of e-cigarettes (followed by lower ‘running’ costs) means their take-up by poorer people has been slower. Why are libertarians doing all the hard work?
Next time you hear somebody say that they worry about the potential risks of e-cigarettes, remind them of Voltaire’s dictum — don’t let the best be the enemy of the good.