5 March 2020

The US import that really is putting lives at risk


Forget chlorinated chicken, if you want an example of a US import that actually presents a health threat, look no further than the spread of anti-vaping hysteria.

According to a frustratingly popular narrative, e-cigarettes have caused an outbreak of lung injuries and deaths across the pond, so we Brits should be worried.  Certainly, if you followed the story on the news, you would be forgiven for thinking vaping isn’t as safe as we thought.

But when it comes to the UK, this story is pretty much a work of fiction. The US authorities have now confirmed that the chemical responsible for the problems in the States was vitamin E acetate, which had been added to some illicit cannabis vaping liquids. British vapers need not be alarmed, however, as it’s already banned for use in nicotine vaping liquids sold in the UK. Indeed, Public Health England remains confident in their claim that e-cigarettes are at least 95% less harmful than smoking.

The fallout from this baseless alarmism is deeply concerning. PHE’s latest evidence update on e-cigarettes finds that our perceptions of the harm caused by these devices have become increasingly divorced from scientific reality. Shockingly, only one-third of British adults think vaping is less harmful than cigarettes, and among smokers—the ones who really need to know—the situation is even worse.

Even teenagers, who tend to be more familiar with emerging technologies, are increasingly out of step with the best available evidence. Almost half of those aged 11 to 18 do not believe that vaping is less harmful than smoking. The end result is that smokers are discouraged from making the switch and instead stick to cigarettes.

It is particularly concerning that younger people are not aware that vaping is much less harmful than smoking. The Adam Smith Institute report that I authored on e-cigarettes last year, Up In Smoke, found that young people are relatively less likely to have tried reduced-risk products and have maintained stubbornly higher levels of cigarette usage. Among those aged 16-24 in the UK, the smoking rate remains at 24% – compared to 17% for the population as a whole.

These trends show no sign of abating and concerted action is desperately needed. Unfortunately, the Government’s best efforts so far have had only limited success.

Granted, most smokers aren’t regular readers of Public Health England’s blog – but they are likely to come across vaping adverts on billboards, buses and elsewhere. Commercial advertising offers a golden opportunity to correct common misperceptions about vaping. However, current advertising regulations effectively prevent e-cig marketers from making any statements about relative risk. For example, they can’t advertise that “e-cigarettes are significantly less harmful than smoking”.

Admittedly it has recently become technically possible to make a reduced-risk claim when advertising  e-cigarettes. But in order to do so a manufacturer must undertake a breathtakingly expensive, time-consuming randomised control trial for each of their products. Put simply, regulators are imposing an enormous cost on any company wanting to tell smokers that Public Health England thinks its product is significantly safer than cigarettes.

It would be very easy to change this without any real downsides. For one thing, E-cigarettes sold in the UK are already tightly regulated by the MHRA for quality and safety. If you are worried that unscrupulous marketers might exploit the potential reduced-risk claims, Public Health England can work with those who have expertise in changing consumer behaviour to create a list of approved health statements. If the evidence changes, they can update the list. If independent research continues to show that other smoking alternatives like heated tobacco and snus are demonstrably safer, a similar framework should apply.

Public Health England and other bodies should be commended for their robust response to the moral panic about vaping in the USA. But they’re not going to correct the damage until advertising regulators adopt a more sensible approach on communicating the potential of safer alternatives to smoking. Until they do, smokers will continue to live—and die—in ignorance.

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Daniel Pryor is Head of Programmes at the Adam Smith Institute