Vaping: our policies at the time of choice
by Vincent Durieux, President of France Vapotage
Europe is engaged in revising two directives that will affect the future of vaping. In which way ? Everything depends, in truth, on the interpretation that our political leaders will make of the precautionary principle, one of the pillars of our public policies, enshrined in the French Constitution as in the European treaties.
This principle guides our public decision-makers. It consists, in the case of proven risks, in avoiding as much as possible serious and irreversible damage and, in the case of hypothetical risks, in encouraging research programs to dispel the doubt. It is therefore a question of an “enlightened” principle of public action, and not of “non-action”.
What is in fact for our subject? The risk of smoking is proven and major, the combustion of tobacco is carcinogenic, responsible for tens of thousands of premature deaths each year. The risk of vaping is hypothetical and, according to the thousands of scientific studies already carried out (already more than ten years ago), undoubtedly less important than that linked to cigarettes. Vaping is considerably less harmful because the electronic cigarette does not contain tobacco (moreover, heated tobacco is not vaping).
Logically, then, some politicians clearly point to tobacco as the absolute enemy and vaping as one of the solutions. This is the reasoning behind the UK harm reduction strategy. This is also what leads, in France, the National Academy of Medicine to recommend to smokers to switch to vaping "without hesitation", which justifies the integration of vaping in public campaigns such as the Tobacco Free Month and in communications from Public Health France and the National Cancer Institute.
Yet this precautionary principle is often misguided today. So in the name of the search for absolute security, other decision-makers turn their backs on pragmatic solutions, are wary of innovation, favor standing still or worse, lead to counterproductive measures. Vaping is the perfect example: rather than supporting the industry to allow it to develop in a responsible manner - in the interest of current and future consumers, as well as of businesses and especially of society - the temptation exists to " kill ”the product at the risk of strongly slowing down the fight against smoking.
For them, under the pretext that there would eventually and in the long term risks, vaping must be combated in the same way as tobacco. In the name of this misguided interpretation of the precautionary principle, the electronic cigarette remains the victim of attacks, denigration, anxiety-provoking messages and even untruths. Thus, in its report of May 20 on the application of the so-called TPD directive, the European Commission, in contradiction with known data, points to "the consequences of electronic cigarettes on health" and "the important role that 'they play in the beginning of smoking ”, to finally advocate“ the application of the precautionary principle and the maintenance of the cautious approach adopted so far ”.
In the end, we are in the middle of the ford. On the one hand, we encourage the practice, we stigmatize it on the other!
We let vaping develop but we do not support the industry and millions of consumers in accessing better information.
We are announcing a “tobacco-free generation” but at the same time we are considering restricting the accessibility of vaping products, or even limiting the number of flavors available, which is an essential factor in the process of reducing and stopping smoking.
We advocate a supervised and safe consumption practice but we do not allow the sector to have appropriate regulations for all e-liquids, preferring to leave the sector for 10 years… to self-regulate!
Paradoxes or even nonsense harmful to public health and which too often create confusion in the minds of smokers in search of solutions.
It is urgent to reconnect with the fundamentals of the precautionary principle. In our view, this implies acting in three directions with regard to our products:
- Do everything to accelerate and amplify the cessation of smoking.
Millions of Europeans continue to smoke despite the proven risks and all the strong measures taken in recent years: price increases, smoking ban in closed spaces open to the public, introduction of the neutral package, awareness campaigns… In France in particular , the smoking prevalence hardly changes despite these measures.
The electronic cigarette is a powerful ally: it is the most widely used tool and the most efficient to quit smoking. A solution invented by a former smoker, proven by millions of people who until now had not succeeded in quitting smoking thanks to other available aids, in particular medication.
If the priority is indeed to reduce the prevalence of smoking as much as possible, then the switch from smoking to vaping must be encouraged and supported, and not weakened by ambiguous positions that deliberately confuse tobacco and vaping, or decisions that would hinder it. 'accessibility (price, aromas, places of sale, etc.). The danger is there: the latest barometer carried out for France Vapotage by the Harris Interactive institute reveals that a majority of vapers could probably fall back into smoking in the event of a price increase (64%), restriction of the accessibility of products (61%), restriction of uses in public spaces (59%) or prohibition of flavors other than “tobacco flavor” (58%).
- Ensure the quality and safety of all vaping products.
In France and more generally within the European Union, a certain number of obligations and controls guarantee the quality of products, the safety of adult consumers and the protection of minors.
France Vapotage calls for the creation of a reinforced regulatory framework and above all specific to vaping, in order to make a clear distinction with tobacco, to completely reassure vapers, to avoid any risk and any suspicion. The ban on sales to minors must continue to be observed. It is an intangible principle.
Moreover, today, liquids that contain nicotine are rightly subject to strict supervision, which is not the case with nicotine-free products. Harmonization is necessary because the framework must cover all products and their composition. Certainly, many professionals have taken the lead. But this self-regulation is not equivalent to regulation and above all is not sustainable in the long term. For once, if the precautionary principle should guide public action, it is here: how to explain that we allow a sector to develop without giving it a clean and satisfactory regulatory framework?
Here again, our latest barometer shows public support for the measures we are proposing: 64% of French people (and 78% of vapers!) Are in favor of different regulations for tobacco-related products and vaping-related products.
- Base decision making on independent, solid and compelling research.
Many independent studies exist, which demonstrate, among other things, that the vapor produced by electronic cigarettes contains at least 95% less toxic substances than cigarette smoke.
In line with the precautionary principle, additional studies must be carried out to clarify the effects of vaping on the health of consumers and those around them, in particular in the long term. But to date, no serious and undisputed study has demonstrated a risk associated with the practice of vaping: in the current state of scientific knowledge, nothing justifies alarmist speeches.
The time has come, for France as well as for the European Union, to choose. If the public authorities declare war on vaping, the results are known, they were observed for example in Italy in 2017: increase in the prevalence of smoking, economic collapse of the sector and job cuts, development of a black market for vaping products, and ultimately tax revenues much lower than what had been estimated.
The other way is to collectively seize the historic opportunity represented by vaping against smoking, by supporting a still young sector in its responsible development to protect consumers.
BEH 14-15, May 2018, World No Tobacco Day;
Guignard R, Richard JB, Pasquereau A, Andler R, Arwidson P, Smadja O, et al; the 2017 Health Barometer group. Attempts to quit smoking in the last quarter of 2016 and link with Tobacco Free Month: first results observed in the 2017 Health Barometer. Bull Epidémiol Hebd. 2018; (14-15): 298-303. http://invs.santepubliquefrance.fr/beh/2018/14-15/2018_14-15_6.html.
 Hajek P Ph.D., Anna Phillips-Waller, B.Sc., Dunja Przulj, Ph.D., Francesca Pesola, Ph.D., Katie Myers Smith, D.Psych., Natalie Bisal, M.Sc., Jinshuo Li, M.Phil., Steve Parrott, M.Sc., Peter Sasieni, Ph.D., Lynne Dawkins, Ph.D., Louise Ross, Maciej Goniewicz, Ph.D., Pharm.D., Et al . A randomized trial of e-cigarettes versus nicotine-replacement therapy. N Engl J Med 2019 Jan 30; [e-pub]. (https://doi.org/10.1056/NEJMoa1808779)