Wednesday, 5 February 2014

The consequences of over-regulating

I picked up on this article via Scoop.it (Check out http://www.scoop.it/t/vapehalla guys, lots of good stuff there). Legal and public health experts Daniela Saitta, Giancarlo Antonio Ferro and Riccardo Polosa from the University of Catania, Italy have written an article (published in Therapeutic Advances in Chronic Disease on February the 3rd) where they are arguing that over-regulation of e-cigarettes is counter-productive and hypocritical. They write about the difficulties implementing good policies, mainly because of big tobacco and big pharma working against this, as this will lead to substantial losses in their sales of cigarettes and NRT.

So what would the consequences over-regulating e-cigarettes (and other smokeless tobacco like the Swedish "Snus" for that matter). We don't really need science and a lot of long-term research to dig into this matter, so lets just use some common sense and look into the future a bit.

While the sceptics are worried about the long term effects of vaping I have still never heard anyone claiming that they might be as harmful as cigarettes. Even the most sceptical say that e-cigarettes are 99% safer than regular cigarettes, but they are worried there might be some lesser harm that we'll see in the future. Actually some extremists might disagree but lets forget about these and stick to common sense for now. Lets cut the sceptics some slack and for now just say that e-cigarettes are 75% (or 50% for that matter) safer than normal cigarettes. What will happen if such a product is over-regulated?

The most obvious and most harmful consequence is that it will stop a lot of current smokers from switching to e-cigarettes and half of these will DIE from not doing so. We said that for now e-cigarettes are 75% safer, meaning (this is a bit absurd but stick with me ok) if these guys did the switch, only 12,5% would die from their habbit, which again means we saved a lot of lives, and the life quality of the survivors would be drastically increased. Now I just read that the number of smokers in the world is close to a billion (http://www.bbc.co.uk/news/health-25635121). Let's cut the sceptics some slack again and say that only 1% would have managed to quit with e-cigarettes (that are not able to without), but can't now that it's over-regulated. That means 10 million smokers, 5 millions of them will end up dead. With our 75% safer e-cigarettes 3.75 million lives could have been saved. But we were not talking about banning here, just over-regulating so say only half of these we're not able to quit, the rest managed with the regulated e-cigs. But that is still over 1.85 million lives saved... quite a big number. So even if we make completely absurd assumptions on the safety of e-cigarettes you see that the consequence of over-regulating is severe and works completely against the goal of harm-reduction. With this in mind, imagine what the real consequences are, when we look at the real safety of the e-cigarettes. Yeah, some might disagree but there is a lot of unbiased research out there proving they are virtually harmless, you just have to look for it. If you can't find it, it's because you don't want to find it, and I'm not going to go into the reasons people might have for not wanting to find it. I think my readers can figure that one out themselves.

So let's look at the consequences for the current vapers. I couldn't find a world-wide number right now but 2.5 million in the US, and I think I've read around 1.3 million in the UK so I think we can safely assume 5 million +. And it's expected to quadruple during 2014 (http://digitaljournal.com/pr/786599). I think some might revert to smoking, so that's lifes lost. But I think most will try to continue with e-cigs even if over-regulated. So what happens then? We'll get a black market. We'll have more dangerous products, that is unsafe batteries, unsafe atomizers and e-liquid with ingredients you probably shouldn't vape (and that is not put on the label). All of these potentially dangerous. There will be less research on the area, less tax-money and it would seriously tie down a growing industry that potentially could have offered many people work.

Then there is all those teens experimenting with e-cigs that I've written about earlier. Will over-regulating or banning e-cigarettes make them less attractive to young adults and children? Anyone answering yes to that question hasn't been a teenager, which would basically rule out most of my readers I would think :) I mean, I don't want my children to be addicted to nicotine, but I do that by educating them, not by forcing them. I don't live in the illusion that the fact that they are not allowed to buy alcohol until they are 18 will keep them from drinking until then. And I don't tell them they are not allowed to drink alcohol because it's illegal either, that would only make them want to try it. So I educate them, tell them how it works and tell them that IF they end up trying it, they can always call home and at least be safe. Try to think about what you found exciting when you were a teenager. Was it all legal? Did you stick to the rules at all times?

In conclusion we can see that over-regulating e-cigarettes (or as I said other alternatives to smoking) is in fact counter-productive and potentially very dangerous. And you really don't need all kinds of scientific reports and long term studies to see that either, just use common sense. I get a feeling that all this focus on empiric evidence for this and that in this matter is undermining value of common sense. So, now lets look at the consequences of the opposite, to NOT over-regulating e-cigarettes: We run a very small risk of discovering some minor harmful effect in the future and some children will probably start vaping (but ask yourself, could it be that those would have taken up smoking if they couldn't vape?). And we run the risk of saving millions of lives. I might have missed something so if anyone has something to add to this side of the scale that will make it tip the other way, please tell me.

4 comments :

  1. Great piece again. The figure for UK has now been established at 2.1 million vapers, so I would imagine the figure for the US has been grossly under-estimated. Factor in the rest of the EU and that's a lot of lives on the line. Isn't it a shame that Governments don't give a damn about Public Health just as long as they keep the Drug cartels onside?

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