The WHO’s war on e-cigs

The World Health Organisation (WHO) is currently holding its annual anti-tobacco jamboree in Delhi, where thousands of anti-smoking health officials, wonks and activists get together to think up new ways of stopping us from enjoying a cigarette. But in the abbreviation-heavy world of UN events, the seventh session of the Conference of the Parties (COP7) to the Framework Convention on Tobacco Control (FCTC) seems to be FUBAR (ask someone who’s seen Saving Private Ryan).

A report on electronic nicotine delivery systems (ENDS, or e-cigs to normal people), prepared earlier this year for the Delhi event, has caused consternation among anti-tobacco types who believe in ‘harm reduction’. The WHO report claims that e-cigs contain numerous toxicants, sometimes in higher levels than cigarettes; that ‘the absolute impact from passive exposure to electronic-cigarette vapour has the potential to lead to adverse health effects’; and that ‘given the scarcity and low quality of scientific evidence, it cannot be determined whether ENDS may help most smokers to quit or prevent them from doing so’. It also suggests that non-smokers are taking up e-cigs in significant numbers, raising the possibility of ‘gateway’ effects – that is, that vaping may lead to smoking.

All of this flies in the face of both research and anecdotal evidence. A quick search of Twitter for hashtags like #ecigs and #vaping will soon reveal a positively evangelical enthusiasm for e-cigs among long-standing smokers who have found vaping to be a perfectly adequate and complete substitute for smoking cigarettes. Indeed, for the truly committed, the range of options in terms of kit and flavours of liquids has provided an opportunity to become a complete vaping anorak. These are the people for whom a 100-watt sub-ohm tank rocking a 0.2 ohm BTDC coil is likely to inspire excitement rather than bewilderment.

The claims the report makes about exposure to second-hand e-cig vapour are just ludicrous. Claims about the harm caused by ‘second-hand smoke’ have been routinely overblown by tobacco prohibitionists. But a vague mist, mostly containing the same stuff they use in smoke machines in theatres and pop concerts, really is no threat to anyone. When the WHO report talks about ‘toxicants’, it invariably leaves out the most important factor: the dose. Yes, e-cigs can produce substances that can be poisonous, but they do so in tiny quantities that are irrelevant to human health and only have some effect when tested in unrealistic scenarios.

As for ‘gateway effects’, all the evidence points in the opposite direction to that implied by the WHO report. Many smokers are quitting and cutting down on tobacco cigarettes thanks to e-cigs. Meanwhile, young people who would otherwise be inclined towards smoking are now often trying vaping, too. Many don’t bother with tobacco at all, or quickly realise that e-cigs are just much more convenient to use than cigarettes. There is vanishingly little evidence of e-cigs getting youngsters ‘hooked’ on nicotine and leading them to take up smoking where they wouldn’t have done so otherwise.

Vaping is no panacea for those who want to see the end of smoking, known in public-health circles as the ‘tobacco endgame’. As mentioned above, many people are ‘dual users’, who smoke or vape in different circumstances according to their mood or the situation they are in. There are many smokers who have tried vaping and found it really isn’t for them. For example, the vapour produced can feel very dry on the throat and lungs, even to a hardened smoker.

Nonetheless, to claim, as the WHO report does, that the jury is still out on the health benefits of vaping is utterly ludicrous. (It’s also ludicrous that a tobacco-control convention is even discussing e-cigs, which don’t contain tobacco.) Many people who would have died of a smoking-related illness in the past will now be spared thanks to e-cigs. As one response to the WHO report, penned by a group of anti-smoking harm-reduction advocates, concludes: ‘Overall, the WHO report does not correctly position ENDS primarily as an alternative to smoking, and instead focuses excessively on risks of ENDS use without adequately recognising the deep reductions in health risks when a smoker switches to ENDS. The FCTC itself recognises “harm reduction” as a key strategy in tobacco control. But with minor exceptions, the WHO report discusses ENDS as a threat, whereas in fact they represent a major opportunity for public health.’

E-cigs have emerged in a political environment where leading officials, politicians and activists simply want nicotine use obliterated. For some, this is killjoy puritanism. For others, it expresses a childish, anti-big-business outlook which assumes that anything remotely associated with Big Tobacco must be evil and should be crushed by a kind of public-health world government. A fair number of the world’s wannabe Stalinists, adrift since the end of the Cold War, have ended up in public health. Indeed, they are such control freaks that another storm erupted over the COP7 meeting after the conference unanimously voted to ban the media.

But we must reserve some criticism for those harm-reduction advocates who have rightly lambasted the WHO report. These are the people who spent years demanding bans, taxes and other regulations on smoking on the grounds that, as experts, they were perfectly placed to decide what is good for us. Now they are confronted with the reality of siding with a bunch of ban-happy megalomaniacs like the WHO: they have empowered people who seriously believe that smokers should quit or die, people who are immune to the idea of less harmful alternatives. If the result of COP7 is that further changes to the convention are agreed – for example, banning e-cig advertising or restricting the flavours that can be sold – that would be very bad news for a new and rapidly innovating industry.

It would be far better if we were left to make our own lifestyle choices. Then we could make our own individual calculations about risk vs pleasure, about tobacco vs e-cigs, and so on. Instead, a major innovation – the e-cigarette – that manages to be both just as good as cigarettes and much healthier wouldn’t be in danger of being killed off by the junk science and illiberalism of the global public-health lobby.

Rob Lyons is campaigns manager at Action on Consumer Choice.

Picture by: Vaping360