Comment: This puritanical attack on electronic cigarettes will cost lives
You could see it coming a mile off. Yesterday, the inspirationally-titled Medicines and Healthcare products Regulatory Agency (MHRA) decided to regulate electronic cigarettes as a medicine, opening the door to a flood of rules to be imposed on the nascent industry.
It's all terribly well planned. The UK government will push for an EU-wide legal position through the revision of the Tobacco Products Directive, which should all be stitched up by 2014. The MHRA has already said that no electronic cigarette currently on the market would qualify for a medicines license.
This is a grossly irresponsible attack on one of the most successful smoking-related products we've ever seen. One survey found that electronic cigarettes helped almost nine out of ten smokers quit tobacco completely. Admittedly, it was probably an exaggeration. It was an online poll on the websites of two leading manufacturers. The group was self-selecting and it's likely that those with a positive experience were more likely to fill in the survey.
But more convincing studies point to similar – albeit more limited – conclusions. Riccardo Polosa, professor of Medicine at Catania University, did a study for the Italian Non-Smoking Association which found that 55% of the 40 committed smokers in his experiment had significantly reduced or eliminated their use of tobacco cigarettes by the electronic alternative.
MHRA instead encourages smokers to try to quit using nicotine replacement therapies, like patches, gums and mouth sprays. These products have been around for years. They have a failure rate of 90%. They simply do not work. But they are accepted by the anti-smoking lobby because they come with the trappings of medicine. What threatens the lobby is that electronic cigarettes do not. They replicate smoking – from the mist the user breathes out, to the nicotine hit – but without the harm of tobacco.
The joy of electronic cigarettes is that they can be sold as a smoking supplement for users to enjoy while on a train journey or in a restaurant. The TV advert for the product showed a man missing his baby's first steps because he was outside smoking a fag. They do not carry with them that sense of dread which smokers feel when the big choice of quitting hurtles towards them. They do not carry the baggage of medicinal misery, which replacement therapies have. They mimic the behavioural elements of smoking, including that vital 'having something to do with your hands'. It is because it offers smokers a chance of declining use, rather than the quasi-religious self-punishment demanded of anti-smoking groups, that it is so effective.
It is not a medicine. It should not be classed as a medicine. MHRA warns that nicotine levels in the product can be different to the level stated on the label. It also found nicotine per product differs from batch to batch and suggested this cast doubt on how helpful it was for people trying to quit. This conclusion shows how little conception the regulator has of the limited role of chemical addiction to nicotine, next to the social and psychological weight of habitual usage. As an addiction, nicotine is very light. As a habitual occupation, it is very strong indeed.
If the MHRA is concerned that the product which is being advertised does not satisfy its trade description, we have laws for that. If it is concerned about potential health impacts, we have laws for that. Those laws fall far short of needing to classify it as a medicine.
Instead, an industry which is just bubbling into life will face a damaging new regulatory regime, pushing smaller, innovative companies away from the market. This is potentially highly damaging. One of the most important elements of the electronic cigarettes is how closely they can resemble real cigarettes. Work needs to be put into making them lighter and controlling the strength of the inhale so that it closely replicates the real thing. Currently, they are often considered too strong or too weak, but rarely quite the same as tobacco cigarettes.
"It's not about banning products that some people find useful, it's about making sure that smokers have an effective alternative that they can rely on to meet their needs," Jeremy Mean, MHRA's group manager of vigilance and risk management of medicines, said. In that case they should get their noses out of an industry that has shown promise in cutting down smoking.
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