Science And Technology Committee Get To Grips With Tricky Issues Around Vaping
In yet another meeting of the Science and Technology Committee UK MPs have gathered more evidence around the use of e-cigarettes.
This time they targeted specific groups looking at issues around vaping whilst pregnant – the use of e-cigarettes in mental health hospitals and prisons.
The committee – made up of cross-party MPs – is currently taking oral evidence from experts around all aspects of vaping.
This is the third time they’ve sat with experts – including those from Big Tobacco – you can read my coverage of the previous committee sessions below:
- Big Tobacco Tells UK MPs Short Fills Are A Health Concern
- Experts Lecture UK MPs On The Positive Benefits Of E-Cigarettes
OK as always the debate was split into two sessions and took evidence from:
- Michelle Jarman-Howe, Executive Director, Public Sector Prisons South
- Heather Thomson, Smoke-free Lead, Nottinghamshire Healthcare NHS Foundation Trust
- Deborah Arnott, Chief Executive, Action on Smoking and Health [ASH]
- Hazel Cheeseman,Director of Policy,Action on Smoking and Health
The committee also touched on the sensitive subject of Heat Not Burn products which I’ll get into later.
You can watch the full debate on the Parliament TV site or on the embedded player above.
Smoke Free Prisons and Use Of E-Cigarettes
The prison service has been working towards becoming ‘smoke free’ for the last couple of years and MPs were interested in hearing how that had been implemented – the effect it had had on discipline and how e-cigarettes were playing a part in the policy.
Michelle Jarman-Howe is responsible for all of England’s prisons geographically below the Midlands and said that of the 102 ‘closed‘ [as in secure prisons] 96 were now smoke free with those left mainly in the Greater London area banning smoking as of next week.
In open prisons there are still designated smoking areas however this too is under scrutiny.
Back in 2016 the prison service introduced ‘disposable e-cigarettes‘ – similar to cig-a-likes I guess – to good effect and has recently brought in the more popular re-chargeable vape devices.
A quick note here – I’m assuming the tamper proof vape devices she’s discussing are coming from e:burn a UK company that is the only one approved by the prison service and suitable for secure mental hospitals.
Incidentally I contacted them a while ago for an interview and indeed how to get samples for review – sadly I have had no reply.
As to any issues around implementation and any problems with prisoners rebelling against the smoking ban she said:
The reality has been that, while there have been some low-level local issues, as you might expect during any policy change, we have not had any significant issues of disorder that are entirely related to smoking.
It is far more likely that, where we have had incidents of any type, if smoking has been a factor, it has been one of a number of contributory factors.
We have not lost in prisons as a result of introducing non-smoking, for example.
A number of prisoners have and are taking the prison service to court over the smoking ban because as they are classed as part of the Crown Estate they should be excluded.
However none of the legal actions have been successful.
She also told MPs that both prison staff and indeed prisoners say the air ‘feels fresher‘ and she plans to conduct more detailed air quality studies.
Does Quitting Smoking Have Adverse Effects On Mental Health?
This is a tricky one and open to much debate particularly with the UK’s Tobacco Control Plan saying “some professionals mistakenly believe that stopping smoking could negatively affect their patients’ mental health.”
This was a question put to Heather Thomson, Smoke-free Lead, Nottinghamshire Healthcare NHS Foundation Trust who said:
It is a regular challenge when delivering training.
Staff are very uncomfortable about removing yet another choice from patients who may have been detained under the Mental Health Act and who see smoking as having been their coping strategy for many years.
As to how e-cigarettes were being used specifically in mental health hospitals she could only comment on those within her trust and said a recent pilot scheme across just three units proved very successful.
This was rolled out to all 23 units last summer and she says early results are promising:
More than 80% of our patients who smoke have used and are using the e-cigarettes that we are providing.
Nicotine replacement therapy, which is licensed and research based, is still the first-line offer, but we are also enabling the e-cigarette, which has proven very popular.
The Trust is currently monitoring the effects the smoking ban and use of NRT and e-cigarettes is having on patients and it would seem it’s a case of so far so good:
Over 60% of patients felt that they had had benefits in terms of mood and health. They noticed things like being less breathless, having more energy and having a better appetite—which, obviously, we do not want to go the other way.
There are lots of health benefits that start. One of the things we look at closely—I am sorry that I do not have the numbers, because we have not evaluated them—is how frequently somebody’s carbon monoxide reading is reduced.
That happens very quickly.
The evidence is there, but we have not gathered it.
The benefits of the lowering or removal of carbon monoxide in the body of vapers was also brought up in the next session which we’ll get onto now.
Is Action On Smoking And Health Positive About Vaping?
Next up were the Chief Executive of the Action on Smoking and Health [ASH]Deborah Arnott and Hazel Cheeseman who is the Policy Director of the charity.
I have to say from the start this was an extremely polished performance from the pair who came across extremely well indeed.
It was good timing too given ASH had that very morning released findings from their annual ASH Smokefree GB survey – larger article on that soon.
In a nutshell Deborah told MPs they were seeing a ‘small but steady‘ rise in the number of smokers switching to e-cigarettes which she said was a ‘good sign‘.
She also reported that slowly but surely the public perceptions over the safety of e-cigarettes was turning the corner particularly among older people – so much for the media’s constant attack on vaping!
There’s more evidence too that vaping is NOT a gateway to smoking among the young with Hazel Cheeseman saying:
From our survey data, the young people who are using electronic cigarettes appear to be the young people who are smoking and trying other things.
That seems to be supported by data from elsewhere in the UK.
Deborah Arnott went a step further saying later in her evidence:
…the proportion of young people smoking has continued to decline over the period where e-cigarettes grew most rapidly in popularity.
Smoking remains the key problem, not vaping.
Many times more young people smoke than vape. We need to continue to monitor.
In papers such as the Daily Mail in particular, you see headlines that vaping is a gateway into smoking for young people, but currently the evidence is not there.
Yet another nail in the coffin of the ridiculous theory that vaping leads to youngsters taking up smoking…
ASH On Heat Not Burn Products
Deborah Arnott said ASH was wary about the risk factor around HNB products and pointed out there was currently very low use in the UK compared to Japan where e-cigarettes are currently banned adding:
I am slightly cautious about heated tobacco products.
They have been very successful in Japan, but in Japan e-cigarettes are not allowed.
My view is that the transnational tobacco companies, from which you have heard, have designed heated tobacco products to replicate the smoking experience and their stranglehold on the market.
With IQOS, the most widely known product, you buy a device and then packs of 20 heat-sticks, which you use in it.
Those are proprietary products that are difficult to copy and quite expensive.
E-cigarettes are much cheaper.
Cheaper – undoubtedly much much safer and most importantly e-cigarettes do not contain or have anything to do with tobacco…
Incidentally the UK Treasury is currently looking at what level of tax excise duty to apply to HNB products with many suggesting they will be taxed slightly lower than regular tobacco.
Things that make you go ummmm….
ASH On Dramatic Cuts To NHS Stop Smoking Services
As I’ve reported on in the past the use of the NHS Stop Smoking Services up and down the country is falling however health professionals keep banging the drum beat that it’s still the best way to quit smoking along with nicotine replacement therapies and of course e-cigarettes.
The MPs were more than a little shocked to hear of the drastic cuts made to such services over recent years as Deborah Arnott pointed out:
At its peak, the Government were spending nearly £25 million a year on those campaigns in 2009-10, which was pretty much in line with best practice.
In the most recent year for which we have a figure, 2016-17, it was only £4 million.
I do not have a figure for the current year.
Wow that is indeed a savage cut…
ASH On E-Liquid Flavourings
This is yet another bone of contention in the anti-vaping world and surprisingly ASH were pretty upbeat about the lack of harm and indeed the use of the sweeter flavours enticing kids into vaping.
Deborah Arnott said:
There are concerns about flavours that appear to be attractive to young people.
I do not think we find it is a massive factor in young people trying e-cigarettes; they are trying them more because they are there.
This was backed up by Hazel Cheeseman who said:
They report they are trying them because peers are trying them and just to give them a go.
Flavours are not a very big factor in young people’s use, but they appear to be important in adult use.
In addition, the range of flavours means people can move away from tobacco flavours, which for some smokers or ex-smokers is really important.
Let’s hope the “what about the poor kiddies” brigade is listening…though again I somehow doubt it…
ASH On Vaping Whilst Pregnant
Sadly the last year hasn’t seen a reduction of smoking during pregnancy and the worrying figures show it is between 10% and 11%.
According to the most recent studies the mothers to be who continue to smoke during pregnancy tend to be younger and from poorer backgrounds.
Hazel Cheeseman is ASH’s expert on this and told MPs:
…we have to recognise that for some women using an e-cigarette is how they will be able to abstain from smoking in pregnancy, and it is much better for both mother and baby than continuing to smoke.
She pointed out the joint service leaflet advising midwives and other health professionals on how to tackle smoking during pregnancy and more specifically vaping whilst pregnant which I covered here: Vaping When Pregnant – Report For Midwives On E Cigs As A Smoking Alternative.
Despite this there is still a misconception among both professionals and expectant mothers about the safety of vaping whilst pregnant.
Hazel told MPs:
We want health professionals to give women advice about using evidence-based stop smoking services and medications, but if women do not want to access the service, or cannot access it, or the services are not working for them and they want to use an electronic cigarette as a way of abstaining from smoking, they need to be given the advice that all the evidence we have suggests that using an e-cigarette will be safer than continuing to smoke.
Despite research still being scant on the possible effects vaping could have on the mother and unborn child – what is known is that regular e-cig users see a marked drop in carbon monoxide levels compared to smokers as Hazel explained:
One of the concerns out there is whether we know enough about e-cigarettes and whether the evidence is specific to pregnancy.
We do not have a great deal of evidence that is specific to pregnancy, but we do know a lot about the toxins in tobacco smoke and how they are dangerous to the unborn baby.
One of the most dangerous toxins in pregnancy is carbon monoxide, a by-product of combustion, which is obviously not found in e-cigarettes because there is no combustion.
When a woman is inhaling carbon monoxide she is oxygen-starving her baby, which results in the illnesses and abnormalities.
As I said in my piece covering this it’s far far better for a pregnant woman to quit smoking and vaping – however if they really can’t then the experts say vaping is much safer.
This was an extremely interesting committee hearing that covered a ton of topics all of which deserved much more time spent on them.
I was extremely pleased to see the positivity towards vaping and e-cigarettes from ASH who it’s fair to say were extremely slow out of the supporting vaping starting blocks – but appear to be making up for lost time.
However one worrying aspect of their evidence was a leaning towards the ‘medicalization‘ of e-cigarettes for want of a better word.
Deborah Arnott whilst pleased to see regulation via the TPD did think the whole vaping phenomena might rest easier with medical professionals if they were licensed.
I’m pretty much against this as you can see in my piece: No…E-Cigarettes Should Not Be Available On Prescription and Here’s Why.
But hey if we agreed on everything it would be a very boring world 😉
The more of these committees I’ve watched and covered the more I’m impressed with the grasp the majority of sitting MPs have on the subject of e-cigarettes and this has to be a good thing.
Incidentally even more MPs turned out at the launch of the UK vape industry’s month long campaign VApril – a sign that this could become known as the season e-cigarettes finally became accepted by all….dare I say the Vaping Spring maybe?
Let’s hope so.