The crux of the article is a call for action - here
http://www.dh.gov.uk/health/2012/11/eu-balance-competence-review/
A response:
I write with respect to evidence of the EU Competencies regarding the Tobacco Products Directive.
In 1992 the EU banned the sales of snus – without full and proper research. There was no evidence that properly prepared snus created the major health risks of smoking, Sweden, refused to implement this law and as a result, has the lowest adult male lung cancer rates in the developed world.
The EU is now proposing to implement a similar directive on electronic cigarettes. The main components of the vapour in these is proplylene glycol and / or vegetable glycerine. Both these are known to be benign and are used, for example in inhalers and nebulisers produced by the pharmaceutical industry and in wide use. The third component is nicotine, typically at a dose of 12 mg/ml to 36 mg /ml. At these dosages the toxicity is low and as users are ex (or current) smokers with high tolerance ,the LDA levels for nicotine are not an issue. The forth component(s) are flavourings and those produced by major flavour houses within the EU are tested for toxicity and potentially harmful materials such as diacetyl excluded or removed. The potential benefits of this emerging market are substantial – the health risks several thousand times lower than smoking. Additionally the products are self adopted self purchased and self administered and proven to have a far more effective result at keeping users off cigarettes than any of the NRT products on the market and are far less dangerous to use than some of these. The EU proposes to remofe the efficacy of these and hand the product over to the pharmaceutical industry to exploit.
It is difficult to see how this is either in the interest of the public or public health. The only beneficiaries will be the pharmaceutical companies that will, have an effective competitor for NRT removed and be free to adopt and develop the technologies to their own profitable ends. Users, meanwhile have indicated that their likely recourse if this takes place will be to return to cigarette consumption, increasing the health burden and presumably guaranteeing the market for COPD and cancer treatments that electronic cigarettes threatened to reduce.
The proposal under the Tobacco Products Directive can be seen to be against public interest, against public health and as illogical as the EU’s earlier ban on snus.
As a user of a personal vaporizer I have found many benefits – I have now ceased smoking and feel healthier. I had previously tried prescription and non prescription nicotine replacement therapies to little effect. Possibly the worst of these was varenicline (Champix) which made me feel miserable and led to some strange behaviour. In contrast the personal vaporizer (electronic cigarette) was easy to adopt and as I increased my usage, my desire for cigarettes fell. Over the next year I plan to reduce the nicotine levels I use overall. Having the freedom to control these is important – the most difficult cigarettes to eliminate were the work tea break ones and a high (relative) nicotine content solution (42 mg /ml) was the course to this, whereas in the evenings I found I was content with 12 mg /ml and a 24 mg /ml for general daytime use. Not only does the EU propose to deny me access to this device and the nicotine ‘e liquids’ I need to use it, it proposes to make the solutions available at such low concentrations that they will be ineffective.
I find the EU competence in this to be lacking. I question the motivation and given the recent levels of bribery and corruption within the Commission concerned, have to question whether there is a vested commercial interest behind this proposal. Electronic cigarettes may be good for the public and public health, but they pose a threat to the revenue streams of the pharmaceutical industry.
In contrast NICE has evaluated electronic cigarettes from the point of their risks, their relative risks in comparison to cigarette smoking and the potential role they could play in the Tobacco Harm Reduction strategy. It’s findings are both credible and balanced and take into account the best public interest.
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User of a personal vapourizer (electronic cigarette)
