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Monday 11 February 2013

E-Cigarettes and the Evil BMA

I don't write about e-cigarettes very often for a variety of reasons, primarily because others (such as Carl Phillips, Dick Puddlecote, and Christopher Snowdon to name only a few) write a great deal about them. Today, though, I've decided to write about e-cigs because I believe that the British Medical Association (BMA) is outpacing ASH and other anti-smoking groups in becoming the most dangerous organisation in Britain.

Full and necessary disclosure: My personal experience with e-cigarettes was entirely negative.  In the summer of 2010, I decided to give them a go.  With the smoking ban utterly destroying my social life and an enormous tax increase on roll-your-own tobacco that hurt my wallet considerably, I was getting angrier and angrier.  E-cigarettes seemed to offer an opportunity to address both of these things. So I ordered a kit and some extras from a company that I will not name here.

To make a long story short, the quality of the e-cigarette kit and the accessories was rubbish -- one of the two supplied batteries simply died after a few weeks and the other had a marked decrease in performance a few weeks later; the company itself proved to be exceptionally rubbish as far as customer service goes;  thus my entire vaping experience was rubbish.

And while I now know a lot more about vaping and what makes for a better experience overall (thanks to those mentioned above), I am still extraordinarily reluctant to spend my money on e-cigarettes now for fear of being immensely disappointed (ripped off?) once again.  I am also extremely at odds -- nay, extremely livid at a large number of vaping companies using the same bullshit rhetoric and propaganda that the anti-smokers have used to denormalise tobacco use in order to sway potential customers.

All of that said, I recognise that a great many people have had overwhelmingly positive experiences with vaping. From what I understand, the technology and quality has improved a great deal over the last few years, with more reputable dealers selling them.  Despite my negative experience, I fully support the use of e-cigarettes and other vaping kits, particularly as means of harm reduction, but even for recreational use.  It's patently obvious that e-cigs are several orders of magnitude safer than conventional cigarettes -- vaping is quite possibly harmless. I would never stand in anyone's way and advise them not to vape, or tell them what they can and cannot do in respect of anything. So vape all you like, and enjoy.

But for me, I'm now firmly in the "try before you buy" camp when it comes to vaping, and I haven't seen any companies offering that. I'll just say that any vaping company that wants my business will have to work for it, and that company better not be spouting any anti-smoking propaganda because I will consider it my enemy if it does.

So, for all of the reasons above, I don't write about e-cigs very often. Perhaps some day that will change.

Today I saw this article on the BBC called "Electronic cigarettes - miracle or menace?" and it is possibly the most positive article about e-cigs the BBC has ever dared to print with even ASH saying people should switch to e-cigs. Yet as you can see from the title, the BBC couldn't resist a bit scaremongering courtesy of the incredibly evil Dr Vivienne Nathanson of BMA:

So are e-cigarettes safe?

"The simple answer is we don't know," says Dr Vivienne Nathanson from the British Medical Association (BMA).

"It's going to take some time before we do know because we need to see them in use and study very carefully what the effects of e-cigarettes are."

The BMA is just one of the bodies to respond to a consultation on e-cigarettes by the Medicines and Healthcare products Regulatory Agency. The agency is deciding whether the e-cigarettes should be licensed as a medicine and more tightly regulated. The BMA thinks they should.

"I would either take them off the shelves or I would very heavily regulate them so that we know the contents of each e-cigarette were very fixed," says Dr Nathanson.

See, it's that last bit that is enormously worrying.  "I would either take them off the shelves or I would very heavily regulate them [...]."   She is basically saying, "I don't know squat about e-cigs, so they must be banned!"  But that's not the only reason, and dare I suggest that it is not the primary reason for her opinion?  Being the anti-smoker nannying tyrant she is, someone who is an ardent proponent of banning smoking in your car and homes, what really bothers her is that vaping looks like smoking.  From the BMA's web site:
"We are especially concerned that e-cigarettes might reinforce the smoking habit as they are designed to closely mimic smoking actions."

This sentiment against what "looks like smoking" so it should be banned is repeated by the BMA's Richard Jarvis, who said about e-cigarettes:
"These devices directly undermine the effects and intentions of existing legislation including the ban on smoking in enclosed public spaces." 
Now wait a second.  Wasn't the public smoking ban sold as a measure to protect workers from second-hand smoke?  Why, yes, it was presented as such, but we know now that it was really about denormalising smoking by forcing smokers to stand outside and make us third-class citizens. The smoking ban had nothing to do with workers' health.

But if you really want to be wowed by how dangerous the BMA's stance on e-cigs is, then you need look no further than their updated briefing "BMA calls for stronger regulation of e-cigarettes" (PDF 112kb). Here is a small excerpt from the section titled E-cigarettes in workplaces and enclosed public places:
Stronger controls are needed on where e-cigarettes can be used in order to:

• protect others from being exposed to e-cigarette vapours. While the concentrations of the constituents of these vapours (propylene glycol, glycerine, flavouring substances, and nicotine) are lower than with smoked cigarettes, 'passive vaping' has been found to occur with the use of e-cigarettes.

• ensure their use does not undermine existing restrictions on smokefree public places and workplaces, by leading people to believe it is acceptable to smoke. Of particular concern to BMA members is their use by patients, visitors and staff in hospitals and other healthcare settings. Exposure to nicotine from e-cigarettes (either directly through their use by an individual or indirectly from the vapours they produce) may adversely impact on patients, such as those with heart or circulatory conditions, and their use may also become a source of conflict between staff and patients. Similar concerns exist in other settings, such as the use of e-cigarettes on airplanes.

• ensure their use does not undermine the success of conventional tobacco control measures by reinforcing the normalcy of smoking behaviour in a way that other nicotine containing products do not. This specifically relates to the way these devices commonly resemble tobacco cigarettes, in terms of appearance, nomenclature and the way they are used, as well as features such as flavouring and styling that are potentially highly attractive to children, and may include cigarette brand reinforcement.
The BMA worries about passive vaping and exposure to nicotine (and "The Children!" of course), but mainly they don't want anyone to think that smoking is normal, which it certainly is normal for over 20% of Britons. Still, does the BMA truly believe that trace exposure to nicotine is harmful?  If they do then that's absurd!  And if they truly believe that, then how can they in good conscience encourage the use of Big Pharma's nicotine inhalers?  Surely, those too must pose a risk! Yes?  I must point out that even chief chump of the board of ASH, John Britton (who should resign for being grossly negligent, by the way), says nicotine is not hazardous:
"Nicotine itself is not a particularly hazardous drug," says Professor John Britton, who leads the tobacco advisory group for the Royal College of Physicians.  "It's something on a par with the effects you get from caffeine. If all the smokers in Britain stopped smoking cigarettes and started smoking e-cigarettes we would save 5 million deaths in people who are alive today. It's a massive potential public health prize."

Yet the BMA insists in their briefing that doctors should only prescribe Big Pharma NRT such as gums, inhalers and patches, all of which have hugely crap efficacy rates in helping smokers quit, and to have doctors discourage smokers from using e-cigs unless the patient really wants to use e-cigs, then and only then admit there is a lower risk for e-cigs than tobacco cigarettes:
Advice for health professionals
In light of the lack of scientific evidence about the efficacy and safety of e-cigarettes, coupled with the absence of a robust regulatory framework in the UK, health professionals should encourage their patients to use a regulated and licensed nicotine replacement therapy to help quit smoking. Where a patient is unable or unwilling to use or continue to use an approved and tested nicotine replacement therapy, health professionals may advise patients that while e-cigarettes are unregulated and their safety cannot be assured, they are likely to be a lower risk option than continuing to smoke.
This is enormously dangerous behaviour and advice by the BMA.  They are saying that since e-cigs are not Big Pharma licensed products, and since we didn't do any studies on them, then e-cigs should not be used -- they should banned and taken off the shelves. By this logic, we should all give up coffee and tea too, because Big Pharma doesn't have any licensed caffeine-replacement therapy products on the market.  Perhaps we should also give up breathing air unless Big Pharma has licensed it and supplied it to us via our health care professionals. The BMA needs to seriously reconsider its stance on e-cigs and vaping immediately.

But really, it's a cover. I doubt they really believe what they've said about the dangers of vaping. What the BMA hates about e-cigs the most is that it looks like smoking. Anything that mimics smoking behaviour must go. These Big Pharma puppets at the BMA are insane. I suspect they'll change their tune once they manage to regulate and monopolise the "clean nicotine" market, which is what ASH is currently attempting to do by embracing e-cigs. But until the BMA does retract their views on e-cigs, I'm going to say that they're evil and dangerous.

The Incredibly Evil Dr Vivienne Nathanson
"We are especially concerned that e-cigarettes might reinforce the smoking habit as they are designed to closely mimic smoking actions"