It's only fair to share…

There is an old adage that politics makes strange bedfellows. The E-cigarette debate in Australia has given a new twist to this with the Tobacco industry and Tobacco control effectively on the same side when it comes to people continuing to smoke.

Sound bizarre? Well it is. Unquestionably neither side would agree with my summation but many outside observers do. So how has it come to this?

E-cigarettes allow smokers to obtain nicotine without burning tobacco. Liquid is put into a small cylinder producing vaper and the liquid is “vaped” For those who like or need a fix of nicotine, this method of delivery has been shown in UK research to be 95% less harmful than cigarettes. Even if that figure is over stated by 100% a near 50% less harmful alternative sounds good to me.

Many ex-smokers are passionate about vaping and this is hardly surprising. In the UK, Canada, Japan, USA, EU and New Zealand, E-cigarettes are legal. In the UK in particular their use is encouraged as a way for smokers to reduce harm.

In Australia, they remain illegal. A report by the TGA recommended this continue but the parliament set up an inquiry and this has received written submissions (I have made one) and last week started hearings.

Tobacco companies have seen that their cigarette products are in decline and have bought out start up e-cigarette companies. Thus, they continue to make a profit after smokers quit cigarettes for e-cigarettes. This is hardly surprising.

Yet the public health lobby cannot wrap its head around this. They remain fixated on the evil empire narrative. To be fair tobacco companies deserve their bad reputation. However, it is not who is right but what is right. Opposing e-cigarettes on the basis that they are made by tobacco companies ignores the benefits to smokers.

The end result of a ban on e-cigarettes is that tobacco companies continue to sell more regular cigarettes. In this, they are being helped by the very same public health lobby which despises them.

It actually gets worse. Ex-smokers who gave evidence based on their experience with e-cigarettes were labelled as stooges for the tobacco industry. Doctors who support harm reduction through use have also been smeared by innuendo of being puppets of “big tobacco”.

One prominent public health person refused to attend hearings because someone from an e-cigarette maker would be there. You can draw your own conclusions about this.

Whilst there are medical models for quitting smoking, they do not work for all. The highest rates of smoking are in the homeless, indigenous, those with mental health illness and prisoners. Making e-cigarettes as available as regular ones enables these people to have a choice to use a less harmful product. Some might choose not to but others will. The College of Psychiatrists has supported the legalisation of e-cigarettes as they see that many of their patients continue to smoke.

What we have seen on display is a triumph of ideology over science. There is good evidence for e-cigarettes in harm reduction. Who makes them is irrelevant. Whilst certain elements in public health might like virtue signalling, the collateral damage is the lives of smokers who could be helped.

To quote Dr Michael Segal of Boston University “I am now convinced that in order to preserve a certain misguided ideology in tobacco control (the idea that addiction itself is unacceptable under any circumstances), anti-tobacco groups are willing to sacrifice the health and lives of smokers”.

I have joined with other like-minded doctors who seek to bring Australia into line with most of the rest of the world. The battle is not lost.