Dr Derek Yach has done more than any man alive to eradicate smoking. A former professor of global health at Yale, he developed the World Health Organisation's Framework Convention on Tobacco Control, now in effect in almost 180 countries. He has relentlessly drawn attention to the slippery tactics of the tobacco industry, which promotes its products while ostensibly lending its support to anti-smoking campaigns.
But his article in today's Spectator Health breaks ranks with former colleagues in the WHO, which disapproves of e-cigarettes and other vaping products. Their 'intransigence' threatens the lives of millions, he argues. As matters stand, a billion people will die from smoking-related diseases by 2100. If that happens, the WHO will bear some of the responsibility.
But Dr Yach goes further. His article accuses the WHO of allowing anti-vaping lobbyists to twist its arm. Here's the paragraph that will have anti-vapers hyperventilating this morning (my emphasis in bold):
Why are we in this position? One reason is that governments have become addicted to tobacco excise tax and may fear that, as e-cigs take off, they will lose a valuable source of revenue. Many leading NGOs and academics exert strong influence at WHO, within governments, in the media and among the general public. In the past, they helped bring tobacco control out of the shadows and into the mainstream of health policy. Now, alas, their intransigence threatens more profound progress.
Full disclosure: Dr Yach is executive director of the Vitality Institute for Health Promotion, and Vitality are the Spectator's partners in producing today's Spectator Health supplement. None of us has any commercial interest in promoting e-cigarettes; indeed, the article demands far greater transparency from e-cig maufacturers. In more than 30 years of doing battle with tobacco companies, Dr Yach – who advises the Clinton Global Initiative and the World Economic Forum – has learned to distrust assurances from every producer of nicotine products.
His support for electronic cigarettes and vaping products rests on what he regards as the stark truth: that they help people quit smoking more effectively than other remedies. It is therefore not just unfortunate but scary that the World Health Organisation persists in treating them as if they were almost as dangerous as cigarettes.
Many medical professionals endorse this view – that vaping hooks young people on nicotine and create new addicts. Dr Yach's response? Prove it. Because, in his opinion, they haven't:
Unsupported statements are accepted as truth by policymakers and are used as the basis for stringent regulation of e-cigs in many jurisdictions.
Derek Yach is not alone in his view. He quotes the Royal College of Physicians: 'Switching completely from tobacco to e-cigarettes achieves much the same in health terms as does quitting smoking and all nicotine use completely. Furthermore… risks associated with passive exposure to e-cigarette vapour are far less than those associated with passive exposure to tobacco smoke.’
Today's article raises troubling questions. One immediately springs to mind. What, precisely, is the relationship between Big Pharma and regulatory bodies that stubbornly refuse to deploy e-cigarettes as a devastatingly effective anti-smoking weapon?
Let's be clear about this: hundreds of millions of pounds have been invested in smoking-reduction products such as nicotine patches and chewing gum that help some people give up, but don't work in the long term for countless cigarette smokers whose habit is more stubborn. Nothing like the same investment is going in to producing e-cigs and vaping that meet the requirement of public health authorities that they should deliver a precisely measured dose of nicotine (a pointlessly high bar to set, one might argue).
Vested interests stand in the way, though the public is mostly unaware of just how entrenched and opaque these interests are. For example, do we know how much money flows by circuitous routes from tobacco companies to anti-vaping researchers?
It's a cruel irony that many impassioned anti-smoking advocates and Big Tobacco share the same agenda of restricting access to products that unshackle smokers from their deadly habit and which have, within the past decade, rendered obsolete the old template for fighting smoking. And I use the word 'cruel' advisedly. By sticking with the status quo, we are – even if unintentionally – shrugging off the prospect of a billion early deaths this century. That's an awful lot of widows.