Monday, 13 June 2016

New Norwegian Tobacco Act proposal based on lies and misinformation

On Friday the Norwegian Government published their proposed changes to the Norwegian Tobacco Act. The proposal is available in Norwegian here and there are no big surprises here since Minister of Health, Bent Høie, presented the most important changes on a press conference the week before. I wrote about this last week here: Norway status update: Plain packaging and e-cigs regulated as tobacco

As the title of the proposal says, this is the Norwegian Government implementing the TPD and plain packaging: Amendments to the Tobacco Act (implementing Directive 2014/40 / EU and standardized tobacco packaging).

"The Government proposes that the current ban on the sale of e-cigarettes is repealed. We want to make e-cigarettes available to smokers who want a harm reduction alternative", said Minister of Health and Care Services Bent Høie.
So why do you propose amendments to the law that will have the opposite effect then, Høie? I've been reading through the proposal and as I said, no big surprises. This is the TPD with the limitations on nicotine content, bottle and tank size, advertising ban, pre-market registration and also a ban on vaping wherever smoking is banned. The published proposal contains a walkthrough of all the proposed provisions where they also list some of the answers they got from the hearing that was held. Although a quite a few of the critical answers, mainly from SIRUS (The Norwegian Institute for Alcohol and Drug Research) and NDS (Norwegian union of vapers), are included it is pretty obvious that the Ministry of Health choose to ignore these. The Ministry puts forward claims of risks that are not proven at all and shows little understanding of how vaping works.

The Ministry's justification of the tank and bottle size is based on a risk of poisoning that is totally blown out of proportions and of course they push the children in front of them as usual. They also refer to the "C-477/14 Pillbox"-case in the EU court of justice, which concluded that the size limits are justified because of the risk of poisoning, and list a bunch of numbers supposed to back this up. They even claim that leaking tanks may lead to a lot of poisoning, totally exaggerating the actual risks saying that "Nicotine is absorbed rapidly through the skin, and contact with skin can cause poisoning. There is thus a significant immediate risks associated with the use and handling of e-cigarettes". I'd be happy to empty one of my tanks, I think my biggest one is 7ml, on my skin to demonstrate that these risks are totally blown out of proportion. I've spilled a lot of e-liquid on myself without even noticing the effect. Of course you shouldn't do this on purpose, but the point is, you won't die if you accidentally spill some e-juice on yourself, even if it's 36 mg/ml, and you most definitely will not notice any terrible effects from a tank seeping liquid like the ministry seems to think. The justification for 10 ml bottles is also the poisoning risks, which makes no sense at all. There are a lot of household products that are immensely more dangerous than e-liquid and there are no bottle size cap on these now are there? You have to put a child-proof cap on them (I think), which is fine, but the rest of the responsibility for treating the product in a responsible, adult way is left to the user. There is no reason why e-liquid should be handled any different. Besides, there is no logic in thinking that smaller bottles will decrease the risk of children getting hold of it an accidentally getting poisoned. I'd say it will increase this risk as these bottles are much more likely to be left unattended, lost and so on.

When it comes to the nicotine content cap of 20ml/mg, they also use poisoning risks as justification for this. They refer to the EU commission saying that the most used e-cigarettes have a nicotine content lower than this. This shows that they have not bothered listening to what vapers are saying... at all. The point here is that a lot of smokers wanting to switch starts out with higher content and then gradually lowers it. This means that the nicotine content in the majority of e-cigarettes will be lower and lower as time passes since we'll have more and more long-time vapers that are using a lot lower nicotine content, pulling this number down. Høie claims he wants to make e-cigarettes a harm reduction alternative to for smokers, but this limit will work strongly against this. The 20 mg/ml nicotine cap is a limit that most people that already vape today will be quite fine with. I usually vape 6 mg/ml. In other words, this limit will probably not drive many vapers back to smoking, but it will severely limit the number of smokers that are able to switch.

I'm also sad to see the damage done by the Norwegian Institute of Public Health (NIPH) in this matter. Høie and his ministry puts a lot of faith in the report NIPH published a year ago on "Health risks associated with the use of electronic cigarettes". I wrote back then that this report will cause more harm than health. This report is actually a really strong documentation that there are very little harm in e-cigarettes, it basically concludes that harm from all substances in vapor are negligible... except nicotine. The report totally exaggerates the risks of nicotine, especially in second hand vapor, and now we see the damage done by this. This report and it's totally wrong conclusion on how the nicotine in second hand vapor affects people is now the justification that the Ministry of health uses for the ban on vaping wherever smoking is prohibited. The report concluded that the nicotine content in second hand vapor is about the same as in second hand smoke, which is true, and hence it will cause harm to bystanders... which of course is not true. It's a lie. Nicotine has never even been mentioned as a potential problem when second hand smoking. Dr. Farsalinos demanded that NIPH retracted these false statements, because "such a levels is not only harmless but has absolutely no biological effect, even according to the strictest regulatory definitions". When answering Farsalinos they just repeated that the levels of nicotine in second hand vapor was the same as in second hand smoking, totally missing the point, something that Farsalinos told them straight out here. It seems that NIPH just ignored this last request from Farsalinos and I think I remember them just dismissing this with some statement that this might be a questionable conclusion but that it was just a small part of it and so on and so on. Well now it turns out that the whole ban on vaping in Norway is resting on this misinformation by the NIPH. Ultimately, by refusing to retract a statement they know very well (or should know at least) is wrong, the NIPH is responsible for a lot of premature deaths. Being able to vape where you cannot smoke would have encouraged a lot of smokers to switch, or at least try e-cigarettes, which in turn might have turned them into accidental quitters.

I could go on about the lies and misinformation that the government use as justification for the proposed changes to the law for quite a while. A lot though is based on the alleged risks of nicotine. It seems to me, even if there is some concerned expressed about other substances and they want a lot of reporting to monitor this, that nicotine is the main concern. And all of this is based on an old lie, that nicotine by itself is very addictive. This is one of the reasons that the gateway theory also lives and gives the government reason to protect the children from e-cigarettes that they still seem to believe can tempt our teens into a life long cigarette addiction.  
It is the Ministry's opinion established knowledge that nicotine is among the most addictive substances contained...
There is no evidence, or indication, that nicotine without tobacco is very addictive. I've discussed this with my friends Sanner and Grimsrud earlier and they could not come up with anything either... other than "this is well known" and a reference to the old lie. As you can see above, the Norwegian Ministry of Health didn't even bother to refer to science at all, it's just common knowledge. For some reason the evidence that nicotine by itself is not very addictive never seem to get much publicity, but try to do a google search and you'll get a lot of good hits. Today most real scientists agree on this as well, but still the old lie seems to be believed by most people. Sad but true.

In addition to all this the government intend to registration and reporting systems to monitor and control the market. This means everyone wanting to put any e-cigarette product on the market in Norway, be it cross-border or not, will have to register the products 6 months in advance. Exactly how this will work and what will be needed to get their products approved is not quite clear, but what is clear is that the government intends to charge fees to get approved. Which of course will limit the availability, slow down innovation of safer products, drive costs through the roof and again, smokers are the ones that have to pay for this with their lives.

When it comes to the advertising and sponsoring ban, things are a bit more fuzzy. I'm not an expert on reading these kind of texts thought, but what seems clear is that sponsoring, that's free giveaways, will be prohibited. Vending machines are also included in that paragraph for some reason. It also seems like advertising will be banned but a representative from governing party FRP said last week that e-cigarettes will not be affected by the display ban so vendors will be allowed to display their product in stores. Then the whole paragraph about advertising and sponsoring ends with this:
Regarding the proposal for exceptions for e-cigarettes from the display ban and the ban on advertisingthe ministry aims to follow up this issue in the regulations.
Again, I'm not an expert in reading this, but I think this means it will not end up in the law but rather as regulations in addition to the law which means it will be a lot easier to change later on. I think I'll just get back to that later on if I can figure out or get someone to explain what it will actually mean. (Any expert on Norwegian law, feel free to comment)

I discussed in my post last week how the Norwegian government justify their plain packaging by referring to the lies of the Australian government. Their implementation of the TPD is mainly justified by the myth of nicotine addiction and grossly exaggerated risks of poisoning. Sadly, it seems like these lies are extremely hard to get rid of. To be honest I don't think that it matters much to Høie and the Ministry of health whether the myth is busted or not, cause to them they are just excuses. What this actually is all about isn't really the Norwegian government working to improve public health as much as possible, this is about the Norwegian government making the EU happy... nothing more. But that doesn't mean we will stop fighting to expose the lies ... and eventually they will regret this when the heads start rolling.

Vapour UK

10 comments :

  1. Thank you as usual for a very lucid and concise walk-through. How do you feel about plain packing snus? Is elevating the perceived harms (non demonstrated) from snus going to incentivize vaping to the extent that it gives a net health benefit, or will Norway also in this respect be worse off by having young, non smoking and idealist ministers in Cabinet? (In all fairness we have a lady in the Swedish Parliament who is a Medical Doctor, pushing 82 and representing the liberals - who would like to see both snus and e-cig banned in entirety :(

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