Normally coal-mine owners don’t advise on climate change and Mcdonald’s or Mars don’t advise on healthy eating so why all of a sudden is Big Tobacco advising on health? Big Tobacco, which produces a product that has killed countless millions over the last 100 years and will kill countless millions in the coming years, is now positioning itself as a business committed to our health and well-being. You really need to applaud the nerve.
There are now more than three million vapers in England, according to David Waterfield, CEO of British American Tobacco (BAT) North-Western Europe Area, writing for the Conservative Home website. David tells us this is a great thing as these people are all switching away from cigarettes. He views vaping as the most common aid to quitting smoking and has been so since 2013. Less than 1% of vapers took up vaping without having first smoked according to David. This is great news as vaping only has a fraction of the damage associated with tobacco smoking. People given real choices will seek to change and now only fewer than one in seven UK adults smoke and this is something to be really proud of is it not. David while not explicitly claiming that his company is solely responsible for this stunning public health success wonders how we can get the remaining 6 million smokers to switch to vaping so that we can be smoke-free by 2030. At BAT, David tells us they are committed to building A Better Tomorrow, one where smokers who would otherwise continue to smoke switch to less risky alternatives, such as vaping. Sadly the many millions killed by smoking over the decades, and the ones yet to be killed, will not be able to enjoy this Better Tomorrow.
Last week in an advertisement in the Spectator David, smiling out from the full page feature, complains that government needs to regulate to stop children taking up vaping and stop poor quality vaping products getting onto the market. He is such a good and generous guy you could almost like him.
The one thing the tobacco industry knows better than anyone is that if you want children to do something you make it illegal. It certainly worked for David’s main product-line cigarettes. And we now know that e-cigarettes are a gateway to tobacco smoking due to their growing popularity among young people. A systematic review found that adolescents who have used e-cigarettes are between three and five times more likely to start smoking compared to adolescents who have never used e-cigarettes.
The European Schools Project on Alcohol and other Drugs (ESPAD) reported a 50 per cent rise in e-cigarette use in adolescents aged 16-to-17 years since the previous study in 2015. Nearly 40% of adolescents have tried them and one-in-five (18 per cent) were found to be current users. The recently-published ASH UK survey on vaping in adolescents found that the percentage of 11-17 year-olds who ever tried an e-cigarette rose from 11.2 per cent in 2021 to 15.7 per cent in 2022. The report found a seven-fold increase in the use of disposable vapes in this age group between 2020 and 2022. Almost half of the adolescents surveyed who reported seeing e-cigarettes being promoted saw them on TikTok. This is a targeted marketing strategy to initiate adolescents and young adults to e-cigarette products. The tactics are straight out of the ‘Big Tobacco’ playbook.
And the evidence does not support the claim that e-cigarettes are a tool for stopping smoking. Several reviews have been published comparing e-cigarettes with other tobacco cessation therapies. The reviews found very little evidence supporting the use of e-cigarettes as a quitting tool and identified an increased risk of relapse to tobacco smoking among e-cigarette users.
Studies have linked e-cigarettes to the long-term risk for coronary events. Although there is little evidence of increased risk of cancer there is mounting evidence that they have negative health effects on the respiratory system.
The other problem with switching to e-cigarettes is that as many as 40 per cent of e-cigarette users continue to smoke cigarettes which negate any benefits. A recent Irish Times story highlighted that smoking had declined considerably in young people but vaping has reversed this trend.
E-cigarettes and vaping are with us for the foreseeable, but we need to be clear that tobacco companies are primarily concerned with revenue losses as tobacco sales fall and so are focused on recouping these losses by offering new categories of tobacco-based products, whether they are safe or not but their main target will ultimately be children and adolescents.
I am a pharmacist in Belfast.