One of the strangest features of modern public health policy is that governments increasingly say one thing while doing another. Nowhere is that contradiction clearer than in the United Kingdom's latest consultation on vaping.
Throughout the latest documents published by the government about its new ideas for reducing youth vaping, ministers acknowledge that vaping is less harmful than smoking and can play an important role in helping smokers quit. This reflects the overwhelming consensus of the evidence and the advice given for years by Britain's own health authorities.
Despite these proclamations, almost every proposal contained in the government’s announcement on its proposed policy towards vaping and other reduced risk nicotine products communicates precisely the opposite.
If the public were asked to guess which products are most dangerous, they would naturally look at how governments regulate them and the signals being sent by the Department of Health could hardly be clearer.
Plain packaging, products hidden behind screens, advertising bans, restrictions on flavour descriptions, devices limited to bland, or no, colours, removal of branding and a huge increase in excise taxes. Collectively, they communicate one unmistakable message that vaping products are so dangerous they should be treated exactly like cigarettes.
The same inconsistency extends beyond vaping. Heated tobacco products are substantially less harmful than cigarettes because they eliminate combustion, the primary source of smoking related disease. Nicotine pouches are among the lowest risk nicotine products currently available. Yet both are also now being drawn into regulatory frameworks originally designed for cigarettes.
This contradiction would be worrying at any time, but it is especially so because we know the public is already deeply confused. This week, Action on Smoking and Health (ASH) reported that more than half of adults now believe vaping is as harmful as, or more harmful than, smoking. Among smokers who have never tried vaping, that figure rises above sixty percent.
ASH itself acknowledges that smokers who believe vaping is as dangerous as smoking are less likely to switch and more likely to continue smoking or even return to cigarettes. Yet, government policy appears almost perfectly designed to precisely confirm that misunderstanding.
Applying the same approach to products that health authorities accept pose only a small fraction of the risk inevitably blurs the distinction between them.
That is more than just poor communication, it is also appalling public health messaging. Reducing smoking requires more than discouraging cigarette use. It also requires encouraging smokers to move towards substantially safer alternatives. If every safer alternative is regulated as though it were the same as smoking, smokers can hardly be blamed for concluding there is little point in switching.
The greatest tragedy is that even though the policy is supposed to help teens avoid and quit smoking, the people most affected are not teenagers. Smoking remains overwhelmingly concentrated among adults, particularly older adults who have smoked for decades and face the highest risk of cancer, heart disease, stroke, emphysema, and chronic lung disease.
These are the people who stand to benefit most from switching. Instead, they are being presented with a regulatory system that increasingly treats safer nicotine products as though they belong in exactly the same category as combustible tobacco. The government insists it is striking a careful balance between protecting children and helping smokers to quit, but it most definitely is not doing that.
Public health depends upon restricting harmful products but also upon clearly communicating relative risk. Quite apart from any other concern, the public deserves to be told the truth. The UK once led the world in tobacco harm reduction because it embraced that principle. Smokers were told honestly that while vaping was not risk free, it was far safer than continuing to smoke.
But the government now risks undermining its own success. Taxes send a message, plain packaging sends a message, products hidden behind screens send a message, advertising bans send a message, restricting colours and branding sends a message. When every one of those messages screams "this product belongs in the same category as cigarettes," the public should not be blamed for believing that it carries the same risk.
If government actions tell the public the exact opposite of what government scientists are saying, it should come as no surprise when what the public believes is very badly informed. And when smokers continue smoking because of that misunderstanding, it should be robustly challenged because everyone loses.
Martin Cullip is International Fellow at The Taxpayers Protection Alliance's Consumer Center and is based in South London, UK.
