The New Scientist – (I personally owe a considerable debt of gratitude to New Scientist, since it was their article Electronic cigarettes: a safe substitute? which got me started on vaping, 4 years ago. And no, I haven’t needed or wanted to smoke since, although I do still enjoy the myriad benefits of taking nicotine by vaping) – has published a couple of articles recently about electronic cigarettes: the rather alarmist-sounding (not to mention utterly inaccurate implicating) Tobacco giant wants to help you quit smoking editorial, and the somewhat odd E-cigarettes may soon be sold as life-saving medicine.

Why ‘odd’? Well, because – and I can’t really make this point clearly enough:

Electronic cigarettes are not medicines.

And perhaps more importantly:

Electronic cigarettes were not created and marketed by the Tobacco Industry

Clear enough so far, I hope. OK, so having got that out of the way, let’s get to the far more interesting points, made so eloquently by Clive Bates (to whom, sincere thanks for permission to republish this in full), in the comments section of the online version of the New Scientist article:

“Why Should E-cigarettes Be Regulated As Medicines?

Thu Feb 21 12:16:27 GMT 2013 by Clive Bates
http://www.clivebates.com

There is a liberal argument that goes like this: if people want to sell them, people want to buy them, they are much less risky than cigarettes and they comply with norms of consumer protection – like being safe, working as intended (ie not faulty), and as-described – then why is the medicines regulator involved, and why is it necessary to set a bar before they can be placed on the market? Nicotine is a widely-used legal recreational drug that in itself is almost harmless, so why obstruct a much less dangerous way to take it with huge regulatory burdens that do not apply to cigarettes?

E-cigarettes are not a medicine, and they are not used to quit smoking in the same way as NRT (ie complete withdrawal from nicotine, with NRT providing subliminal relief from craving). E-cigarettes are used to smoke (‘vape’) in a different way, to obtain a satisfying nicotine ‘hit’ without many of the extreme disadvantages of tobacco smoke, but with some of the same ritual. The people using them do not define themselves as in treatment, and those selling them do not define themselves as health care providers. The appropriate comparator is a cigarette, not NRT smoking cessation products.

The health experts and campaigners should beware what they wish for. They could end up piling on compliance burdens, costs and disproportionate restrictions on e-cigarettes that do not apply to cigarettes – killing off the innovative suppliers. They may end up throttling an incredibly important ‘insurgent’ industry with the potential over time to transform the cigarette market. According to the WHO, one billion deaths are likely from tobacco in the 21st Century. Public health experts need to get used to the idea that changing markets for nicotine to much less dangerous products could dramatically reduce this awful toll.

Medicines regulation does have a place when therapeutic claims are made and perhaps to support health care professionals in recommending novel nicotine products to smokers. The right approach is to make medicines regulation an ‘opt in’ for those vendors who want to make health claims or who think the advantages in terms of consumer confidence, access to health care markets and assurance for retailers is worth it. Otherwise, standard consumer protection legislation has all the necessary tools to ensure e-cigarettes are safe, fit for purpose and as-described, without asphyxiating them with red tape.”

I think we would be hard-pressed to find a more common sense approach to the entirety of this issue than this.