In what is an astonishing about-turn, the UK’s Royal College of Physicians (RCP) has advocated for policies which are the polar opposite to its previous guidance.
In 2016, the RCP’s report, “Nicotine without smoke”, was ground-breaking. Recognising that the harm from smoking came from combustion. Following on from Dr. Michael Russell’s contention that “people smoke for the nicotine but die from the tar,” it emphasised the importance of moving people away from combustible tobacco use and onto products which deliver nicotine in a far safer form.
Within the text was a warning from the RCP:
“[If regulation] also makes e-cigarettes less easily accessible, less palatable or acceptable, more expensive, less consumer friendly or pharmacologically less effective, or inhibits innovation and development of new and improved products, then it causes harm by perpetuating smoking."
Sadly, the college has now completely abandoned this stance. Its response to the government consultation on “Tobacco and vapes: packaging, appearance and display” breaks almost every part of its previous advice.
Making e-cigarettes less easily accessible
The RCP states “that tobacco products should only be shown to customers in limited circumstances and that display regulations should apply consistently across all tobacco-related products.” This shows that the RCP supports vaping products being hidden behind screens so smokers cannot easily see them. Furthermore, it does not even “support allowing community pharmacies to be exempt from restrictions on the display of non-medicinal vaping and nicotine products.” This is strong support for making e-cigarettes “less easily accessible.”
Less palatable or acceptable
In its press release, the RCP proudly backs “restrictions on bright packaging” and “promotional imagery.” It also “supports banning concept names, confectionery-inspired flavour descriptions” despite many of those being vital for adults as a way of distancing themselves from the taste of tobacco. Along with restrictions on palatability, the government’s proposals can only make the public’s acceptance of vaping worse. Currently, a majority of the public wrongly believe that vaping is as harmful or more harmful than smoking. Banning advertising, implementing plain packaging and banning flavours will just convince the majority that they are correct.
More expensive
The RCP supported raising “the price of disposable vaping products … by implementing an excise tax.” It has also gone on record supporting “The Vaping Products Duty … to discourage non-smokers and children from vaping.”
Less consumer friendly
The RCP strongly supports tightening regulations on vape and tobacco packaging. It pays lip service to less harmful products by saying that “policymakers must maintain a clear distinction between combustible tobacco and less harmful alternatives that can help adults quit smoking” but applying plain packaging and prohibiting the display of safer products in the same way as cigarettes comprehensively throws that distinction away.
Pharmacologically less effective
This was arguably done by the European Union in the Tobacco Products Directive 2014 when restricting nicotine strength to 20mg/ml and, to its credit, the RCP did warn that over-regulation, such as excessive restrictions on nicotine concentration and tank sizes, might discourage smokers from switching or reduce product effectiveness. However, it also said that it was sceptical of EU advertising bans that treat e-cigarettes identically to combustible tobacco. It has now abandoned that stance and backs proposals to “tighten rules on the way vapes and nicotine products are marketed.” The government’s proposals are to ban advertising completely.
Inhibits innovation and development of new and improved products
A wealth of research has shown that banning or severely restricting advertising routinely stifles innovation and cements the market share of existing leaders. The RCP response advocates restrictions on packaging, advertising, and product qualities, all of which will impact innovation and product improvement.
One must wonder if anyone at the RCP even remembers the 2016 report. Its latest statements effectively render its previous announcements obsolete and, disappointingly, throw vapers and smokers who were thinking of switching to safer products under the bus. Arguably the RCP’s approach now, by its own words, “causes harm by perpetuating smoking.”
Sadly, this ignores where the true burden of smoking lies, considering its entire reasoning in supporting these anti-vaping measures is to discourage youth use. Its 2016 report (page 182) stated that “it is the adults smoking today, particularly those in middle and older age, who will generate most of the burden of death and disability caused by smoking in the short- and near-term future, and it is these adults whom tobacco control policies need to target in particular if this burden of harm is to be reduced.” Perhaps the RCP should remind itself of that and re-read their own report.
Martin Cullip is International Fellow at the Taxpayers Protection Alliance's Consumer Center and is based in South London, UK.
