Obscured by clouds

The past decade has seen a dramatic rise in the popularity of vaping, i.e. using a non tobacco-based nicotine delivery system, often somewhat misleadingly described as “e-cigarettes”. From the outset, it was clear that this had the potential to bring about major health benefits if large numbers of people switched from tobacco. It could be the long-sought game-changer in reducing tobacco use worldwide.

However, vaping has never been welcomed by the public health lobby, for a variety of generally spurious reasons:

• It wasn’t invented here, i.e. by Big Pharma
• To some extent it mimics tobacco smoking, so it must be bad
• Some people may view it as a recreational activity, because of course any human pleasure has to be discouraged
• It acts as a gateway to “proper” smoking
• It may involve a small level of health risk

But there’s a growing body of evidence that the health risks involved in vaping are hugely less than those of tobacco. Even if the risk is greater than zero, then discouraging people from vaping is in effect encouraging them to continue smoking tobacco. We often hear of “harm reduction” in relation to drug policy, so why shouldn’t it apply here too?

Last week a report was published by the respected Royal College of Physicians arguing that there was no proof that vaping acted as a gateway to tobacco, and that the evidence that it was safer than tobacco by several orders of magnitude was overwhelming. Given this, the correct response should be to encourage it, or at least facilitate it, not demonise it.

"The ideal is for people to use nothing," said Linda Bauld, a professor at Stirling University, deputy director of the U.K. Centre for Tobacco and Alcohol Studies and a co-author of the RCP report. But when the alternative is smoking, people should be encouraged to use nicotine "delivered in a cleaner form than in deadly cigarettes."

"This is what tobacco harm reduction is — it reduces the harm from tobacco while recognizing that some people will still use nicotine in other safer forms."

The anti-smoking group ASH UK welcomed the report, saying it showed "that switching to vaping is a positive and sensible life choice" for smokers.

"Electronic cigarette vapour does not contain smoke, which is why vaping is much less harmful," said Deborah Arnott, ASH's chief executive.

Ooh, I bet saying that stuck in a few craws, but if such militant anti-smokers are saying it, you have to assume the case is pretty overwhelming.

I wrote here about how many major pub operators, particularly Wetherspoons, had decided to impose a blanket ban on vaping inside all of their venues. The reasons given were that it could be difficult for staff to distinguish vapour from tobacco smoke, and that the sight of vapour might cause some customers to feel uneasy, but really those are just excuses. With a bit of thought, it shouldn't be difficult to manage it, and why couldn’t pubs have distinct vaping and non-vaping zones? Now, where have I heard of that kind of idea before?

In the light of these research findings, isn’t it time these pub companies reviewed their stance to started to take a more accommodating line. As it stands, by forcing vapers out into the cold with the smokers, they could be seen as standing in the way of improving public health. And they might even find that their business benefited too.

Let us hope it also means that the Welsh Assembly Government’s draconian plans for indoor vaping bans, including all food-serving pubs, which were recently narrowly defeated, are now dead in the water. In any case, after next week’s elections, the Welsh Assembly may have a rather different political complexion and include more supporters of individual choice.

(For the avoidance of doubt, I haven’t smoked tobacco this century, and have never vaped, although I know a lager drinker who has)