Will The Government Help or Hinder Vaping?

by Peter lam

The Government’s full plans for vaping and electronic cigarettes has been laid out, raising fears that some measures could prove to be counterproductive. With a range of measures including bans, restrictions and taxation, experts find the proposals lack reasoning or credibility and worry that they may feed into the growing levels of confusion and fear about vapes held by current smokers.

The Government’s plan for vaping in full:
·Restrict all eliquid flavours to mint, menthol, tobacco, or “fruit”,
·To ban the open display of vape products to bring them into line with tobacco displays,
·To restrict advertising of ecig products,
·To ban the importation and sale of single-use disposable electronic cigarettes,
·To tax eliquid at
o£1 for 0mg/ml strength juice
o£2 for up to 11mg/ml strength juice
o£3 for 12-20mg/ml strength juice.

The Government has decided to carry out a consultation exercise on the ‘vape tax’, announced during the Spring Budget 2024.

Government Consultation
The Government says the consultation, “sets out the proposals for how vaping products duty will be designed and implemented. The government are now asking for your views on the impact of these proposals to help determine the final design of the duty.”
 
The consultation is not considering whether the tax is a good or bad thing – or scrapping it altogether, its focus will be on if it has the correct bands and how the most efficient method of collecting the tax will be.

Harm reduction expert slates the policy to tax vapes
The decision to tax eliquids was made following the production of two reports, one being the HM Treasury / HMRC Vaping Products Duty consultation.
 
Clive Bates used to be a government advisor and has a wealth of experience on the public health strategy of tobacco harm reduction. When it comes to the HM Treasury report, he said: “I can’t do full justice to the awfulness of this paper. Using an infantile non-understanding of how nicotine use works, Britain’s brightest and best civil servants have concluded that users of stronger liquids (≥11mg/ml should face a 143% price increase. Weaker liquids (<11mg/ml) should go up by a mere 98%, and nicotine-free liquids up by 48%.

“Note that the stronger liquids will tend to be those used by people starting to vape or using the more compact and convenient devices, so the greatest barrier has been erected to those most likely to be struggling to switch.”
 
Clive worries that the tax banding will work to push smokers towards low nicotine eliquids and will prove themselves to be of no use in a quit attempt.
 
In addition, Clive raises the concept of titration – something researcher Lynne Dawkins wrote about in 2016: “Vapers engaged in compensatory puffing with lower nicotine strength liquid, doubling their consumption. Whilst compensatory puffing was sufficient to reduce craving and withdrawal discomfort, self-titration was incomplete with significantly higher plasma nicotine levels in the high condition.”
Clive says: “People using lower strengths use higher volumes to take in the nicotine they want. Higher volumes mean more energy and potentially more exposure to contaminants and thermal decomposition products.”
On one hand bans, tax and restrictions – on the other, health promotion campaigns
No Smoking Day took place on Wednesday 13th March 2024 and, once more, vaping plays a key part of it. Regional health bodies took part in the annual event, plugging their local stop smoking services and referring tobacco users to the NHS website and the twin pages of Using e-cigarettes to stop smoking and Vaping to quit smoking.
 
Meanwhile, integrated care boards and local authorities have placed orders for 379,562 vape starter kits as part of the ‘swap to stop’ scheme which aims to get one million smokers to switch to vaping.
It’s all leading to a muddled and confused message. Health bodies and councils are relying on research evidence and facts to adopt vapes as a key quit smoking tool, while the Government appears to be making decisions for motives other than evidenced-based reasons, according to Bates and other harm reduction experts.
The Healthcare Leader online magazine broke the news about starter kit sign-up, but its article went on to question “the effectiveness of vapes as a smoking alternative”, a baseless position flying in the face of all of the current evidence. It came as yet another study, this time from the University of Norwich and led by Dr Caitlyn Notley, demonstrated that using vapes worked at least twice as well as any other quit smoking alternative.
Professor Javed Khan conducted a review looking at how to make smoking obsolete. In February, he appeared before the Health and Social Care Select Committee and told them that GPs and pharmacists are crying out for clear direction from the government to “encourage them to direct their patients to use vapes as an alternative to smoking.”
 
He went on to add: “They need that clarity. If we are convinced that it is safer to do swap-to-stop – with all these kits about to go out – and if we agree with the principle that vaping is a good, quick tool because it has been proven to be relatively successful, then let’s clarify that for all of the health professionals asking for it.”
The result of a disjointed approach is confusion
A paper produced by a team from University College London and King’s College London looked at how harm perceptions of vapes and vaping compared with smoking has changed since 2014 among adults who smoke.
 
The team surveyed 28,393 adult smokers and discovered that constant media misinformation and Government policy failures have fed into a situation where “public perceptions of e-cigarettes had worsened considerably over the past decade”.
 
Lead author Dr Sarah Jackson said: “These findings have important implications for public health. The risks of vaping are much lower than the risks of smoking and this isn’t being clearly communicated to people. This misperception is a health risk in and of itself, as it may discourage smokers from substantially reducing their harm by switching to e-cigarettes. It may also encourage some young people who use e-cigarettes to take up smoking for the first time, if they believe the harms are comparable. Better communication about the health risks is needed so that adults who smoke can make informed choices about the nicotine products they use.”
Senior author Professor Jamie Brown said that vaping is new and therefore has attracted a lot of media attention, “with news articles often overstating their risks to health compared with smoking.”
He added that there is almost no coverage of the 75,000 people who die every year as a result of smoking in England alone each year.
 
“The Government plans to offer one million smokers a free vaping starter kit alongside behavioural support to help them quit. This initiative may be undermined if many smokers are unwilling to try e-cigarettes because they wrongly believe them to be just as harmful as cigarettes or more so,” he warned.
 
 
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