ASH Daily news for 28 August 2015


  • E-cigarettes: Public Health England’s evidence-based confusion
  • Hertfordshire County Council backs e-cigarettes
  • Lancashire: Health bosses refuse UKIP request to allow patients to use e-cigarettes
  • New law on smoking in cars ‘doesn’t go far enough’
  • US: California lawmakers act to raise smoking age to 21, restrict e-cigarettes
  • US: FDA issues warning letters to “natural” tobacco makers
  • Radio: E-Cigarettes: Another Puff
  • Video: The great vape debate

    E-cigarettes: Public Health England’s evidence-based confusion

    An editorial in the Lancet has criticised some of the data used in the expert review of electronic cigarettes published by PHE (and accuses PHE of “falling short of its mission”). The criticism focuses on a paper by David Nutt and colleagues published in European Addiction Research which was used as reference to the headline statement that e-cigarettes are around 95% less harmful than tobacco.

    In addition to thinking the evidence leading to this figure of 95% is weak, The Lancet accuses PHE of omitting in its report to make references to links between Nutt and his colleagues and the electronic cigarette industry.

    ASH comment:

    ASH was saddened to see the Lancet editorial today attacking Public Health England (PHE) for having ‘fallen short of its mission’.

    To criticise Public Health England for quoting an estimate, contained in the expert review it commissioned, that e-cigarettes are 95% less harmful than tobacco on the basis that the methodology behind the estimate was weak is to miss the point.

    To quote Professor Michael Russell in the BMJ in 1976 “People smoke for nicotine but they die from the tar.” [1] As the expert review concludes, electronic cigarettes do not contain most of the toxic and carcinogenic constituents of smoke. Any they do contain are in very low doses, mostly far below safety limits for occupational exposure.[2]

    Furthermore from May 2016 a new regulatory framework is being put in place [3] which will ensure that in future there will be greater transparency about the contents and emissions of electronic cigarettes and stricter controls on product standards.

    There is therefore no question that electronic cigarettes are substantially less harmful than smoked tobacco and that smokers can significantly reduce their risk by switching. Whether the reduction in risk is 95% or slightly less (or slightly more) is not the key point. What is of much greater concern to ASH (as shown by the YouGov smokefree Britain polls for ASH) is that a growing number of smokers are failing to understand the relative risks and may as a result be put off switching from smoking.

    Public Health England has a statutory responsibility to ‘promote the health and wellbeing of the nation’. It has not fallen short. It has fulfilled its mission by putting the message out clearly – while electronic cigarettes are not risk free, they carry only a fraction of the harm caused by smoking.

    [1] Russell MJ. Low-tar medium nicotine cigarettes: a new approach to safer smoking.BMJ 1976;1:1430–3
    [2] PHE E-cigarettes: an evidence update. A report commissioned by Public Health England. PHE, August 2015.
    [3] EU Tobacco Products Directive. Article 20

    See also:
    – E-cigarette ‘safety’ study was written by industry funded scientists, Lancet warns, The Telegraph
    – Official advice is based on research scientists in the pay of manufacturers, Daily Mail

    Source: The Lancet – 28 August 2015

    Hertfordshire County Council backs e-cigarettes

    Following the publication of the recent PHE report, Hertfordshire County Council (HCC) has issued a statement saying that electronic cigarettes can be a good way of quitting smoking.

    Source: Hertfordshire Mercury – 27 August 2015

    Lancashire: Health bosses refuse UKIP request to allow patients to use e-cigarettes

    UKIP’s Lancashire vice-chairman James Barker has written to the chairmen of health trusts covering hospitals in Nelson, Burnley, Blackburn, Accrington, Clitheroe, and Chorley to query their policy banning patients from using electronic cigarettes in the grounds of the hospitals.

    Dr Rineke Schram, chief medical officer at East Lancashire Hospitals NHS Trust has responded that East Lancashire Hospitals NHS Trust is a smoke-free trust banning both smoking and the use of electronic cigarettes, and that it has no plans to alter its stance.

    Source: Lancashire Telegraph – 27 August 2015

    New law on smoking in cars ‘doesn’t go far enough’

    A UK-based car leasing company is warning that the new law on smoking in cars carrying children set to come into force on 01 October doesn’t go far enough. is calling for a blanket ban on in-car smoking, which it calls one of the greatest safety risks on the road today. It believes a total ban would be easier for police to enforce, rather than having to determine whether any passengers are minors.

    A blanket ban would also help put an end to accidents caused by distracted drivers; to the potential for fires – both in-car and on verges – caused by dropped cigarette butts; and to anti-social littering and ‘poisoning’ of the countryside resulting from thrown cigarette packets and dog-ends.

    See also: 
    – Exeter drivers reminded of new smokefree cars law, Express and Echo

    Source: Fire Risk Management – 27 August 2015

    US: California lawmakers act to raise smoking age to 21, restrict e-cigarettes

    The California State Senate has approved six anti-tobacco bills, including measures that would raise the smoking age in California from 18 to 21 and bar electronic cigarettes from restaurants, movie theaters and other public places where smoking is banned.

    Meeting in a special session on healthcare, the Senate also sent the Assembly bills that would allow counties to impose tobacco taxes, outlaw tobacco use at all schools, plug loopholes in a smoking ban in workplaces, and boost the licensing fee for tobacco retailers. All of the bills next go to the Assembly for consideration.

    Source: LA Times – 27 August 2015

    US: FDA issues warning letters to “natural” tobacco makers

    The Food and Drug Administration issued warning letters to three cigarette makers over their “additive-free” and “natural” label claims, saying that the claims may lead consumers to believe the products pose a lower risk. This would have tobe scientifically proven.

    In a statement, the FDA said it has determined that the products under the warning letter need what is called a “modified risk tobacco product order” before they can be marketed in that way. It has not issued any orders for modified-risk products to the market and this is the first time it is using its authority to take action against “natural” or “additive-free” claims.

    The companies have 15 days to respond with a plan or dispute the warnings.

    Source: Yahoo! News/AP – 27 August 2015

    Radio: E-Cigarettes: Another Puff

    BBC Radio 4’s investigative programme, The Report, asks why the Welsh and UK governments have different approaches in respect of electronic cigarette and tries to decide who is right.

    Source: BBC Radio 4 – 27 August 2015

    Video: The great vape debate

    Deborah Arnott from ASH and journalist Kelly Rose Bradford discuss electronic cigarettes on This Morning.

    Source: ITV – 27 August 2015