It is always better to “take the small risk of the unknown than the known risk of large hazards”, said Lord Matt Ridley, medical scientist, author and member of the House of Lords. He was urging acceptance of vaping to help people quit smoking, at the Global Tobacco and Nicotine Forum (GTNF) held in Britain last week, writes Chris Bateman for MedicalBrief.
Lord Ridley, a tobacco harm reduction lobbyist and best-selling science author, began his keynote address at the GTNF with an audience poll – on COVID-19 vaccination.
A show of hands revealed the vast majority of the participants to have been vaccinated, which he said demonstrated that they’d calculated that the risks of vaccination to be far smaller than those associated with contracting COVID-19.
“And that’s harm reduction right there. You identified something less risky to avoid something more risky – and that’s the argument for vaping,” said Lord Ridley, who sits on the British all-party parliamentary group on vaping.
A member of the House of Lords and the parliamentary science and technical committee, Lord Ridley said life was replete with examples of activities less harmful than the alternative, yet politicians banned and overregulated harm-reducing nicotine replacement products.
“Driving is dangerous, killing 1,580 people per annum in the United Kingdom [2020]. Let’s say someone invented a new car, far more environmentally friendly and safe – would you ban the car? Yet the reaction of politicians would be to choose a ban. Why? Because they’d rather you not drive a car at all,” he scoffed.
Expanding on his satirical theme, he cited the Mayor of San Francisco, London Breed, recently fulminating about tobacco killing more than 480,000 people per year in the United States, more than all the major diseases combined – yet none of these deaths were caused by e-cigarettes – which she wanted to ban.
Lord Ridley, a highly respected medical scientist whose latest book Viral chronicles the search for the origin of the coronavirus, said politicians and regulators accused innovative, safer nicotine replacement products of expanding health risk. They based this on the long term “precautionary principle”, which he said “they have backwards”.
History’s naysayers
“By the early 1940s most states in the US had banned margarine. The umbrella was once denounced by the organised taxi industry because it reduced cab rides with people able to walk in the rain. The natural ice harvesting industry warned against the danger of fridges,” he said.
“They said the telephone would destroy private life. The New York Times once even wrote that something needed to be done about Mr Edison who’d invented too many things of ‘deleterious character’.”
The modern vaping revolution began in China in 2006, Lord Ridley said. Britain had seen “massive declines” in combustible cigarette use since it was allowed, with more than three million British vapers at present, half of whom had given up cigarettes altogether.
“E-cigarettes are now the most popular and successful way of quitting tobacco – it’s putting stop-smoking outfits out of business. Yet there’s talk of banning e-cigarettes and vaping. An opportunity to drive innovation will be stifled. It’s paternalistic – a nanny state that thinks it knows best,” he complained.
Lord Ridley said England wanted to be smoke-free by 2030, with a focus on cracking down on younger smokers. The headline proposal is banning sales of e-cigarettes to under-21s, in the hope that 18- to 21-year-olds would no longer be able to vape. However, the reality was the opposite.
Vaping helps quit cigarettes
Several speakers concurred with him that vaping is 200 times less likely to cause cancer than smoking, citing Public Health England as saying vaping’s overall health risks were around 95% less than those of traditional cigarettes.
Surveys showed that vaping was consistently the most effective quitting tool, working in 74% of cases – a much higher success rate than nicotine patches, going cold turkey and every other smoking cessation method. The result was that 52% of Britain’s vapers – roughly 1.7 million people – were now former smokers.
Lord Ridley said he neither smoked nor vaped and had no financial interest in either. Rather, he was “more interested in the beautiful case histories of innovation, of which vaping is one”.
He said it was always better to “take the small risk of the unknown than the known risk of large hazards”, and posited several motivations for the powerful anti-tobacco lobby’s stance.
“Firstly, a general hatred of all things’ nicotine is deeply ingrained in the culture – prohibitionists cannot accept the harm reduction argument and when they see tobacco companies buying vaping companies, they reason that everything emanating from the evil empire must be evil,” he added.
The war on vaping by the World Health Organisation was “positively unhinged” and flew in the face of all the evidence. Britain’s Minister of Economic Affairs was “doubling down on his hostility” against vaping when real world evidence showed that smoking rates declined when vaping increased.
Other drivers of the anti-tobacco lobby were private enterprise challenging ‘big pharma’ with non-subsidised alternative harm reduction products, and “a simple urge to ban”.
“People love to disapprove. They come with specious arguments that e-cigarettes smell, the risk to children – when there’s no good evidence of them taking up vaping at any higher rate than smoking. They even talk of the fire risk. These are problems to regulate, not evils to ban.
“It drives it underground, making products unsafe, creating lucrative black markets and violent methods. Allowing hygienic free needles for heroin addicts seems to condone dangerous illegal activity, yet it worked. Criminalising use results in higher death rates, prevents quality control, and loses tax revenue,” he added.
‘Epidemic of bad thinking’
Lord Ridley was introduced by Patrick Basham, founding director of the London and Washington based think-tank the Democracy Institute. He said COVID-19 had resulted in a “measurable uptick” in cynicism towards political leaders – and a loss of trust in technical expertise.
“Like disease, new ideas may spread quickly, but only in a suitable environment. The GTNF is one such suitable environment where we have robust, uncensored dialogue. However, that is no panacea for policy formulation and revision. We may conclude that in the next year or three we’ll have initiated a new era or age.
“But we have an epidemic of bad thinking,” Basham said.
“We need rigorous cost-benefit analysis with all its uncomfortable challenges. A new disruptive contribution to the public health debate is really valuable.”
The Global Tobacco and Nicotine Forum, launched in Brazil in 2008, is an international conference on tobacco, nicotine and public health held in different world cities annually. Its advisory board comprises representatives from the tobacco and vaping industries.
GTNF 2021 – Global Tobacco and Nicotine Forum (Open access)
See also from the MedicalBrief archives
FDA approvals of e-cigarettes must be based on evidence, not politics
FDA delays Juul e-cigarettes’ decision but culls almost a million products
E-cigarettes: Misconceptions may prevent people from quitting smoking
Anti-tobacco group wants ‘balance’ in vaping policies and media coverage
Tobacco harm reduction – Patients before prejudices
E-cigarettes: What we know and what we don’t – Cancer Research UK
WHO versus Public Health England over e-cigarettes
Anti-vaping advice by World Health Organisation ‘risks lives of millions’
Vaping products make significant economic contributions – VPASA study