On the 29th of August 2015 Carl Phillips stated that his, “reading finds this (the 95% safer claim) a not-very-veiled stalking horse for medicalizing THR. On the 26th of April 2016 he continued, in his latest blog,  to elaborate on this theme stating: “Saying that e-cigarettes are 95% less harmful is a very bad idea.”

5% of the harm from cigarette smoking is still a great deal of harm

In a nutshell to claim that e-cigarettes are 95% less harmful renders them still pretty dangerous: 5% of the harm from cigarette smoking is still a great deal of harm.

Put it this way, if you are hit by a car dong 50mph it will probably kill you. If the car is only doing 2.5mph you will probably get away with a slight bruise on the leg, and most likely, nothing at all. But you see the car is not doing 50mph, it is travelling at 500mph, and dead is dead. 95% slower than 500mph is 25mph and at 25mph, you will, most likely, sustain serious injury and you could still be killed.

So, all of you who are happy with the 95% safer theory, go out and throw yourselves in front of cars doing 25mph and test the claim that it is safer.

But seriously, what are the implications of using the 95% safer argument?

It is so convenient is it not? It allows for rebuttals to the claims that e-cigarettes are as harmful as smoking. It helps deflate all of those who point to dangerous substances being found in e-cigarette vapour, and more, and more. It is so very, very convenient and dangles seductively in front of your eyes and echoes so very pleasantly, winding in and out, creating that beautiful tapestry in your mind. It is always there: always ready to be pulled out and used.

But there is a downside…

Complementing existing tobacco control policies

Remember where the idea was born: Who presented it, and who promoted it – Public Health England! The following is taken from Public Health England’s, Report, “Electronic Cigarettes.” 2014.

Conventional tobacco control approaches have by definition failed in these people, for whom harm reduction approaches, to minimise health harms until complete cessation can be achieved, are essential.

That was 2014, has anything changed? Does public health still see harm reduction as stopping smoking via, say, e-cigarettes, and then the next step, stopping e-cigarettes? Look at the wording, “complete cessation.”

Now this might mean that PHE are quite happy to see people vaping away as, blowing clouds, they disappear over the horizon, but I am afraid that the final words of the report reverberate ominously, qualifying much of what else is said in the document, “However the opportunity to harness this potential into public health policy, complementing existing comprehensive tobacco control policies, should not be missed.”  Complementing existing tobacco control policies?

And this brings us to an incident just a few days ago when Action on Smoking and Health (ASH) made an utterly appalling official, public comment with regard to the implementation of the TPD. This group are prepared to sacrifice a huge number of both present e-cigarette users and smokers who may switch to e-cigarettes in order to encourage the implementation of the directive.

“A not-very-veiled stalking horse for medicalizing THR”

They stated… “Yes. While products licensed as medicines can be at a higher strength there will be a limit on nicotine levels for products regulated by the TPD of 20mg/ml. For many people this will make little difference to their vaping experience as the most popular liquids tend to be those with concentrations of nicotine lower than 20mg/m.”  And ASH welcomed this.

Remember the words of Carl Phillps in August 2015? “A not-very-veiled stalking horse for medicalizing THR.” And what about those who wish to switch to vaping products, many need high nicotine concentrations particularly to begin with. They will be forced to use medical products and how many will choose to do that?

So we need to take care before accepting what tobacco controllers feed us. Yes, it seems like there are short term advantages… and I suppose there are… but, I fear, the marriage will be in the style of Johnny Depp.

As for ‘Cassandra,’ I used to be a school teacher, so find out for yourself – look it up! (Google, Cassandra Troy… that’s what I did.)

  • carlvphillips

    Nice job tying some of my points together. I had not done that. Also, I like the tie-in to the recent ASH kerfuffle. I did not go into that one (except to point out, in a recent post, that their estimate of the number affected was clearly an amateurishly naive (i.e., wrong; low) interpretation of their survey results. While it is a bit different, it seems to kind of “rhyme”. (Ok, teacher, figure out what that is a reference to 🙂

    • Robert Innes

      Aha! Sneaky one…. gardening.

  • dodderer1

    I must admit that my concern with the PHE report was more to do with their refusal to accept any of the circumstantial evidence of effectiveness:

    “It is not known whether current EC products are more or less effective than licensed stop smoking medications”

    The quantification and comparison of risks and rewards has already started and will,no doubt,be used as an anti-cig argument.

    However, your blog did trigger a thought that,perhaps, PHE don’t really see continuing exclusive use of ecigs as cessation – this would explain why they prevaricate on effectiveness and await the comparable figures to ‘licensed stop smoking medications’ i.e. complete abstinence

    • Robert Innes

      I have a sense that it may come to a point where some in ph accept that continued use of e-cigs is acceptable AND that it is both a pastime and a way out of smoking – Public Health will split into two distinct arms, cessationists (is that a word) and harm reductionists.

      • dodderer1

        I’m not sure there are any true THRists in mainstream TC or PH.Our ‘ground-breaking’ PH45 only specified long-term use of meds.They really wanted med-only ecigs despite acknowledging the time & cost was prohibitive.They wafted this problem away by either calling for a new nicotine regulatory body or for light-touch medregs.They must have known that neither had a cat in hell’s chance of being realised.

        They see THR only as a last resort – with long-term use of medicinal nicotine – whilst vigorously pursuing short-term use for total abstinence.

        They understand the rationale of THR and can even recite the words but,when push comes to shove,they are genetically programmed to reject nicotine use.So they just lie.

        • Robert Innes

          “So they Just Lie.” That is my fear. I think ASH have just demonstrated that capacity when they welcome e-cgs then welcome the TPD as well…

  • Dragonmum

    This is all far too cerebral for me – just a case of “Woe, woe and thrice woe” – with apologies to the late Frankie Howerd.