them , he points out . ‘ But it is a fundamental problem that none of these products have come from a public health laboratory – or even from a pharma company . That ’ s a genuine challenge , and it has fuelled a lot of the “ it ’ s all a plot ” thinking . Tobacco companies were – quite rightly – seen as big , bad , evil and wrong , and have been exposed in court and so on . But even
‘ We do need to be careful , because if we impose so many barriers that a legitimate , regulated market is undermined then a lot of this stuff isn ’ t that difficult to manufacture .’
DAVID MACKINTOSH
though the companies in China that make the vast majority of the world ’ s vapes have no connection to them , ultimately it ’ s still industry . And there have been some huge missteps in the marketing , no doubt .’
One example is the marketing of fruit flavours , something the forthcoming tobacco and vapes bill intends to regulate . However , an evidence review commissioned by OHID found not only that vaping products were associated with the highest rates of success in helping people to quit smoking , but that fruit flavours were the favourite option for most current vapers . ‘ There ’ s certainly scope for better regulation , but the risk is that you end up banning all flavours apart from tobacco , and then you ’ re really setting people up to fail ,’ he says . ‘ Fruit flavours start breaking the association with cigarettes . Why you would want to maintain that association , I have no idea .’
Having a wide range of products is important , he stresses . ‘ Lots of people use different products at different times , and as long as it ’ s adults I really don ’ t think we should care . And we do need to be careful , because if we impose so many barriers that a legitimate , regulated market is undermined then a lot of this stuff isn ’ t that difficult to manufacture .’
SHIFTING ATTITUDES In terms of media reporting , however , things might finally be beginning to shift , he believes .
‘ When the new government figures came out the BBC TV news report was actually quite a balanced piece , which is kind of not what I ’ m used to seeing . They had a pulmonary specialist consultant and he was very clear that vapes aren ’ t good for you – your lungs are designed for clean air – but compared to smoking they ’ re much better , and we mustn ’ t lose that message that smokers would be better off vaping . There are echoes of that across a lot of the other media at the moment , so I think we ’ re perhaps getting to a more mature media position .’
Ultimately , the prize is the smokefree 2030 target , which aims to get the smoking rate down to 5 per cent or less . Is it something we ’ re likely to achieve ? ‘ If we can show the same kind of ambition we put behind the swap to stop stuff , put in targeted supported for people , and don ’ t balls up access to products , I think we definitely can ,’ he states . ‘ Look at what we ’ ve already achieved , and the pace of change in other countries . But we need to get the messaging right and targeted at the smoking population .’
This means looking at groups
‘ I swapped to stop ’
York City Council are among the many organisations to join the Swap to Stop nationwide campaign , encouraging smokers to switch to vaping to improve their health . York residents who are smokers aged 18 plus can now get free , confidential support for up to four weeks – or up to ten weeks if they join the smoking behaviour change programme . Alternatively they can access the Swap to Stop Vape offer , where a free four-week vape starter kit will be posted to them . Kevin Spencer ( pictured ) gave up smoking after 50 years by switching to vapes , with the support of a health trainer . She explained the effect smoking was having on his body , gave him a simple breath test to show the amount of carbon monoxide in his blood , then talked though different nicotine therapy options , keeping in touch to check his progress . He took to vaping easily : ‘ I ’ ve never looked back , and haven ’ t had a cigarette since ,’ he said .
where smoking rates remain extremely high . ‘ We still have populations where smoking is the norm , so we need a good focus on that . If you can knock it down from say 60 per cent to 40 per cent in some of those populations , you ’ ll see quite rapid change .’
Some of this could be achieved through peer-topeer engagement , but it also means getting professionals fully engaged . ‘ Most health professionals have very limited understanding of the lives of a lot of the people where smoking is concentrated , so we need targeted support for those areas , making sure the GPs have all the information . And there ’ s still much more we can do in drug and alcohol services . Staff could – while emphasising the primary importance of giving up smoking – be encouraging service users to try vapes . It does wonders for people ’ s self-confidence , so these are quick wins .’
Crucially , it ’ s also something that costs almost nothing , he stresses . ‘ Most smokers could easily experiment with vapes themselves at no cost to the public purse . We don ’ t have many public health outcomes with such a significant gain that require so little investment , so we really need to focus on the gains to individuals and communities . Fifty per cent of people who smoke regularly will die prematurely as a result , and we can significantly turn that around – even for people who won ’ t give up nicotine – by supporting them to get on a safer product .
‘ So we ’ ve made a lot of progress and if we embrace the potential of tobacco harm reduction we can reach the 2030 target . It really is one of the great public health wins , and one that ’ s within our grasp .’ DDN A smokefree UK ? How research , policy and vapes have cut smoking rates at https :// gsthr . org /
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