A House of Commons inquiry on Tuesday heard evidence on the health impacts, regulatory challenges and financial considerations surrounding vaping in the U.K., giving experts another chance to counter common criticisms of the technology.
The Commons Science and Technology Committee met with Prof. Riccardo Polosa, Prof. Peter Hajek, Dr. Jamie Brown and other academics for a detailed look into what we know about vaping. The inquiry was roundly positive, with experts stressing the vastly safer nature of vaping in comparison to smoking and the usefulness of vapes for helping smokers quit, and offering insight into the reasons underlying the continuing media hysteria on the topic.
The inquiry was launched to address concerns about the mixed messages surrounding vaping, and in particular to address the gaps in our knowledge about their risks and how e-cigs should be regulated.
Norman Lamb, the Lib Dem MP who chairs the committee explained, “They are seen by some as valuable tools that will reduce the number of people smoking ‘conventional’ cigarettes, and seen by others as ‘re-normalising’ smoking for the younger generation.
“We want to understand where the gaps are in the evidence base, the impact of the regulations, and the implications of this growing industry on NHS costs and the U.K.’s public finances.”
In addition to the live testimony, there were over 80 written submissions for the committee to consider, by everyone from industry associations to tobacco companies, pharmaceutical companies, professors, universities, charities (including the New Nicotine Alliance), vaping companies and interested individuals.
It should come as no surprise that these are a mixed bag. On one hand, you have detailed, well-argued and evidence-based submissions like those from Clive Bates, the Royal College of Physicians and Cancer Research UK (among many others). On the other hand you have the expected obfuscations and usual anti-vaping rhetoric from the likes of Martin McKee, Pfizer and one referenced in the hearing from Dr. Robert Combes and Professor Michael Balls.
The inquiry painted a very positive picture of vaping on the whole (and can be watched in full above). The first section saw Professors Peter Hajek, Mark Conner and Riccardo Polosa give a wide-ranging overview of the state of the evidence, and this was followed-up by more of the same from Dr. Lion Shahab, Dr. Jamie Brown and Prof. Paul Aveyard in the second section.
The researchers stressed the key benefits of vaping and gave an overview of the data showing that vaping is safer than smoking. For example, Dr. Shahab summarised his study showing that real-world vapers have reductions of around 95 percent for some of the most important toxic chemicals in tobacco. Prof. Polosa also discussed his 3.5-year study on never-smoking vapers, showing no negative impact of vaping.
Potential risks to bystanders from vaping were thoroughly quashed throughout the session. Prof. Polosa commented, “I would be more concerned to go out to breathe the air in Westminster than have a vaping person next to me.”
Dr. Jamie Brown discussed some of the positive signs seen in the Smoking Toolkit study when it comes to vaping helping smokers quit, and encouraged stop smoking services to support quit attempts with vaping. Prof. Aveyard discussed the Cochrane Review on the effectiveness of vaping for quitting smoking, saying that despite a lot of uncertainty, vaping appears to double the quitting rate compared to unassisted attempts.
The TPD regulations were also panned in the session, particularly the counter-productive nature of the nicotine limits, the wasteful packaging and the new warnings, which Prof. Hajek described as “nonsensical.” Dr. Brown also pointed out how countries like Australia, which have taken a “precautionary approach” to vaping regulation, are being forced to re-evaluate their stance as positive data pours in.
Gateway fears and concerns about renormalization were also countered effectively by the experts, many of whom pointed out the very low rates of regular use among non-smoking youth, and Prof. Aveyard stressed that vaping is largely a route out of smoking, with very few (if any) gateway cases to speak of.
The committee and the experts also drew attention to the overstatement of the risks from vaping by the news media. Dr. Shahab pointed out that press releases often overstate the findings of research, using an example of a study finding increases in arterial stiffness being painted as “e-cigs cause heart attacks,” despite the fact that exercise affects the arteries in the same way. As Riccardo Polosa pointed out, the hysteria fuels headlines and drives clicks, but doesn’t reflect the reality of the evidence on vaping.
They also drew attention to unrealistic usage conditions in some studies (we’re looking at you, Portland State University), with Prof. Polosa pulling out one golden-brown piece of toast and one thoroughly burnt one to memorably make his point. Unrealistically overheating e-liquid is responsible for many misleading headlines about formaldehyde in vapor, and burnt toast provides a great analogy for the problems in the method.
As for future regulations, there was broad agreement that excessive regulation would be likely to cause harm rather than create benefit. Prof. Aveyard commented that restrictive policies risk “increasing the perception that e-cigarettes are dangerous.”
The U.K. is still leading the way in how to address vaping as a smoking alternative. As Peter Hajek argued, the U.S. focus on nicotine as being the “big bad guy” could well be to blame for the division between the U.S. and U.K. on the issue, and concerns about youth uptake are much more prominent there.
On the whole, the inquiry looks like it may have a hugely positive influence on the U.K. vaping landscape. All we can do is hope some of the positivity finds its way to other places in the world where it’s desperately needed.