Author: Hendry

For years, smokers have paid higher premiums for health insurance, but those rates are climbing even higher thanks to the Affordable Care Act, more commonly known as ObamaCare. Since the new healthcare policies took effect, insurers can now set premiums up to 50% higher for smokers. It makes sense that smokers pay higher rates considering their increased likelihood for major medical problems like strokes, cancer, and heart disease. However, the sky high premiums are creating a financial strain for many smokers, giving them just one more reason to switch over to electronic cigarettes.

As more smokers stop using tobacco cigarettes in favor of ecigs, it is causing a lot of conflict for insurers. E-cigarettes really squeeze through a hidden loophole in the Affordable Care Act. Each insurance company has to make a decision on how to handle vapers and whether to charge additional premiums as they would for tobacco use. But there really is no easy solution. While vapers argue that using ecigs is safer and will lower the odds of expensive medical bills, some insurance companies just are not convinced.

To make things even more confusing, ecig users might not even report vaping on their applications for healthcare coverage. After all, ecigs are not tobacco products so vaping is not using tobacco. Furthermore, the FDA has not approved ecigs for smoking cessation, so they technically do not fit in that category either. It’s pretty easy to see how ecig users can fly under the radar. Do you use tobacco products? No. Do you use any smoking cessation products? No. These are both truthful answers for ecig users, at least until the FDA takes legal action to classify electronic cigarettes as tobacco products or smoking cessation products.

It all boils down to how you legally define a “smoker”. If insurance companies consider vapers to be smokers, then they doll out higher premiums. On the flip side, insurance companies that group ecigs in with smoking cessation products could eventually choose to cover the cost of vaping as they would cover the cost for nicotine patches or Chantix. Each insurance company has a different reaction and some ignore vaping altogether because it is just too confusing.

According to the American Cancer Society, ObamaCare has no formal policy that insurance companies have to follow in regards to ecig users. “The Affordable Care Act does not specify e-cigarette use for purposes of cessation coverage or tobacco surcharge application.” Of course that could quickly change once the FDA regulation for ecigs is officially in effect.

For now, each insurance company is choosing their own approach. Carrie McLean, director of customer care of eHealth, said some companies are already opting to penalize vapers with a surcharge. “If a consumer indicates they use e-cigarettes, the carriers are expecting them to be uprated just as if they are a smoker,” she said. However, she also mentioned that consumers are not directly asked about what type of tobacco products they use during the application process.

According to America’s Health Insurance Plans Association, your rate will ultimately depend on how you answer the application questions and what questions you ask in response. McLean indicated that agents will typically ask about tobacco use in the last six months, but they will not directly ask if the consumer used cigarettes or ecigs. If the consumer specifically asks if ecigs count as tobacco or volunteers the information about ecig use, then the agent will most likely add a surcharge. However, if the consumer fails to ask if ecigs qualify, the surcharge is left off. Sometimes it pays to avoid asking questions.

“The problem arises because most people fill out their applications online and, as of now, most applications don’t ask specifically about e-cigarettes,” McLean said. “Consumers are left to decide on their own whether or not they consider themselves a tobacco user.” If thousands of dollars in extra insurance surcharges is resting on your decision, it’s pretty safe to assume that you will classify yourself as a non-tobacco user when you vape.

The financial consequence of a smoking surcharge is nothing to laugh about either. According to ABC News, the typical premium for a 40-year-old nonsmoker with an income of $35,000 is around $3857 per year with a $532 tax credit. But if that same individual is classified as a tobacco user, the rate automatically goes up to $5,254. That is nearly $1400 more just because the person reported tobacco use. Of course, some companies might charge even steeper surcharges for smokers.

Cynthia Cabrera, executive director of the Smoke Free Alternatives Trade Association, told reporters that ecig users should not be classified as tobacco users, regardless of how they answer questions on the application. “The SFATA does not agree with any policy that positions users of electronic cigarettes and other vapor products in the same category as smokers,” she said. “These products do not emit smoke and do not contain tobacco, tar, or any of the many carcinogens known to exist in combustible cigarettes.”

The chief medical officer of New York’s Blue Shield tends to disagree until long term research can back those claims. “Until you have some long term data and some actuarial differences to health outcomes such as lung cancer, emphysema, heart disease and other conditions which are significantly impacted by smoking, and likely to be impacted by e-cigarettes as well, you have to rate them the same,” he said.

These conflicting viewpoints could potentially escalate to a legal battle at some point in the near future. If vapers fight back against surcharges from health insurers, it could be up to a judge to determine the official definition of “smoking” or “tobacco use”. This is probably a big reasons why the FDA is pushing forward to try to regulate ecigs are tobacco products. It will eliminate any question about how to classify electronic cigarettes and instantly sentence vapers to higher insurance premiums.

How do you feel about this loophole? Is it unethical to simply leave out your ecig habit on an insurance application? Should vapers have to pay a surcharge on their rates or is it unfair?

*Disclaimer: This article is not intended for legal advice. Do your own research and make an informed decision when you complete any insurance application.

Source : Churnmag

After years of studying tobacco addiction and how it impacts public health, Professor Peter Hajek is launching an unapologetic public defense of vaping. In a recent report to Wales Assembly Members, Hajek said that vaping bans were pointless and ecigs should actually be embraced and celebrated for their potential to help people quit smoking. “At the moment, all vaping does is potentially save lives,” he said.

Hajek believes that by banning vaping indoors, it will ultimately discourage smokers from switching to ecigs. He told Assembly Members that indoor ecig bans are actually quite pointless because there is no health threat associated with secondhand ecig vapor to put the public at risk.

Critics have taken a hard nosed to approach to ecigarettes at times, often claiming that they would lure nonsmokers into using tobacco products and potential nicotine addiction. But Hajek said this argument is completely unfounded. “At the moment the evidence we have is that e-cigarettes are remarkably unattractive to non-smokers,” he told the National Assembly’s Health Committee. “Nicotine by itself is not that addictive. What is addictive is cigarettes.”

Hajek explained that nonsmokers do occasionally try ecigs out of curiosity, but they very rarely progress to regular use. In fact, he said it was “almost impossible to find a young non-smoker who would be a daily vaper.”

The professor also expressed concerns that bans on public vaping would discourage smokers from trying ecigs out of fear for their health. “We have data year after year that more and more smokers believe that e-cigarettes are harmful. That puts them off doing something which would save their lives,” he explained.

When asked about potential ecig regulation, he said that he personally would vote against any rule that banned vaping in public areas. “One reason is that e-cigarettes do not harm bystanders. The rationale we had for banning smoking is that there is a risk of passive smoking. There is no risk of passive smoking (with ecigs).”

Hajek went on to explore why people wanted to ban vaping in the first place. “It becomes a questions of ‘I don’t like it, so I don’t want people to do it.’ You get into shaky ground. The dictator in North Korea – if he doesn’t like a certain type of haircut he can ban it. If somebody doesn’t like people vaping it’s not a good enough reason to ban it.”

The Royal College of Physicians also stood in opposition to a public vaping ban. “The RCP does not support a comprehensive ban on the use of e-cigarettes in enclosed and substantially-enclosed public places. The recent report published in Public Health England clearly demonstrates that smoking e-cigarettes has become a popular method to quit smoking tobacco. There is no evidence that smoking e-cigarettes in enclosed spaces poses a significant risk to other people from inhalation of vapour.”

Do you think the warnings from Professor Hajek and the Royal College of Physicians will be enough to stop a public vaping ban in Wales? Will the rest of the world pay attention to the comments from these health experts?

Source : Churnmag

WATERLOO — While e-cigarettes seem better than regular cigarettes when studied in the lab because there are fewer chemicals, little is actually known about the effects on a person’s health and behaviour.

“It fully depends on how it’s being used,” said David Hammond, an associate professor in the School of Public Health and Health Systems at the University of Waterloo.

Hammond launched a study — the first of its kind in Canada — to figure out whether there is any benefit to e-cigarettes, which are often touted as a great option for smokers who want to quit.

“We’re recruiting smokers and basically seeing what happens when they smoke e-cigarettes,” Hammond said.

People in the study, which is funded by the Ministry of Health, will be followed for six months to learn about the chemical levels in their bodies and about their smoking habits. Not much is known about whether people replace smoking with e-cigarettes, or if they only use e-cigarettes in situations where smoking is not allowed.

“We don’t know to what extent there is a benefit at all,” Hammond said. “There’s all this decision-making at the provincial and federal levels, but they have little information to go on.”

E-cigarettes have caught many governments off-guard. Just five years ago, the devices were virtually non-existent. Now, nearly one in 10 Canadians age 15 and older report having tried them. Use is particularly high among young people, most of whom never smoked, and smokers.

“It’s really a consumer driven phenomenon,” Hammond said.

E-cigarettes have fewer chemicals than regular cigarettes, which top 5,000 to 7,000 including about 70 carcinogens.

“Nothing is quite as dirty as a cigarette,” Hammond said.

Most cigarette chemicals come from combustion, while e-cigarettes heat liquid enough to vaporize but not reach the point of combustion. It’s unknown, though, exactly what level of chemicals people get from e-cigarettes.

E-cigarettes are a closer experience to smoking than nicotine patches and gums and could compete with cigarettes, which is why it’s vital to know more about their effect on users.

“These things actually have the potential to help people quit, but they have the potential to bring more people into the market,” Hammond said.

Waterloo researchers are aiming to recruit 200 smokers. The data will be published and shared directly with the government.

“It has the potential to really inform new regulations,” Hammond said.

Source : http://www.therecord.com/news-story/5930653-waterloo-study-aims-to-better-understand-e-cigarette-effects/

To say electronic cigarettes ignite controversy is an understatement.

For some, e-cigarettes offer the prospect of disrupting the $800 billion global cigarette trade by providing a satisfying alternative to smoking. Nicotine itself is not a carcinogen, and e-cigarettes do not have all of the toxins and carcinogens produced by burning tobacco that cause half of all long-term smokers to die prematurely.

For the other side, e-cigarettes look more like Big Tobacco bouncing back with a dangerous new way to hook kids and keep people smoking.

Who’s right?

E-cigarettes have been on the market since 2007, but only now are we starting to see their impact. For anyone willing to take a dispassionate look at the emerging data, the news is good for those inspired by the prospect of e-cigarettes crowding out tradition smokes. Consider five important observations:

First, in the mid-2000s, the share of Americans who considered themselves current smokers declined to about 20 percent. Then that decline in smoking stalled, picking up again with the advent of e-cigarettes.

Second, during the rise of e-cigarettes, smoking rates in the US adult population have fallen to their lowest rates in recent history. According to new data released last week by the Centers for Disease Control and Prevention, the proportion of American adults who smoke has fallen each of the past six years, from 20.6 percent in 2009 to 15.2 percent in early 2015. In the past year, the smoking rate fell by 10 percent — the largest single-year decline in the last 18 years.

Third, fears of young people becoming addicted to e-cigarettes or e-cigarettes serving as a “gateway” to smoking remain speculative. To the contrary, youth smoking rates have continued to drop at unprecedented rates, and are already below the government target for youth smoking for 2020, more than five years ahead of what had been a very ambitious schedule.

Fourth, there are now at least 2 million ex-smokers using e-cigarettes in the United States. While we can’t be certain that they are ex-smokers because they are using e-cigarettes, there are thousands of powerful testimonies of “vapers” who quit smoking using e-cigarettes after having tried everything else.

And fifth, though we can’t yet be certain of all of the long-term health impacts or benefits of e-cigarettes, that doesn’t mean we know nothing.

Thousands of experimental measurements have been made that show that the important hazardous chemicals in combustion cigarette smoke are mostly not present in e-cigarette vapor, or are present at levels that give less cause for concern. Based on what we know today, there is broad agreement that e-cigarette use is significantly safer than cigarette smoking.

The American experience is mirrored across the Atlantic. In August, Public Health England, an agency of Britain’s Department of Health, issued a 111-page report on electronic cigarettes that carefully addressed every significant concern that has ever been raised about these products.

PHE found that e-cigarettes are almost exclusively used by those who have already smoked and rejected the claim that they are attracting nonsmokers. They also showed that both adult and youth smoking continued to decline while e-cigarette use has grown.

And based on the available information, PHE concluded electronic-cigarette use is likely to be around 95 percent less harmful to health than smoking.

PHE is the first public body to declare its support for e-cigarettes. PHE declares its ambition to achieve a tobacco-free generation by 2025, and it believes that “e-cigarettes have the potential to make a significant contribution to the endgame for tobacco.” I share their ambition and believe that many of my colleagues in public health do as well — as do many in the private sector.

We now need to agree on how to make this work. The time has come for such responsible companies within this industry (with one of whom I am now affiliated), and the government and public health (where I have spent a good part of my career) to work together to find ways to accelerate the historic obsolescence of traditional smoking with rapidly advancing cleaner new technologies.

Millions of lives depend on it.

Former US Surgeon General Dr. Richard Carmona authored many federal warnings regarding tobacco use. He serves on the board of NJOY, an independent electronic-cigarette company that has the mission of rendering the tobacco cigarette obsolete.

Source : http://nypost.com/2015/09/22/e-cigarette-hysteria-is-hazardous-to-your-health/

KUALA LUMPUR, Sept 23, 2015.

The risks of e-cigarette use, or “vaping”, have been exaggerated by a health specialist concerned with the matter.

Public Health England (PHE) expert Prof Gerry Stimson said substantial international research on the toxicology of e-cigarettes — summarised in the recent Public Health England report — showed that they were considerably less risky than smoking tobacco.

“Electronic cigarettes are attracting very few people who have never smoked.

“The sale of e-cigarettes containing nicotine is illegal in Malaysia, but that ban is clearly unenforceable and not working.

“Banning e-cigarettes is not a good policy option as the government has no control over safety and quality,” he told The Rakyat Post recently.

However, Stimson said the answer was to regulate e-cigarettes as consumer goods.

Stimson — who was keeping track of the issue in Malaysia — said while vaping may not be 100% safe, most of the chemicals causing smoking-related disease were absent and the chemicals which were present posed a limited danger.

Stimson pointed to existing e-cigarette standards from the British Standards Institution and Afnor, the French standards organisation.

“Within a year, all European countries will be able to approve e-cigarettes on the market. The UK and Ireland now have codes of advertising practice for e-cigarettes.

“E-cigarettes are a sensible choice for smokers who can’t do without nicotine. Proper consumer standards will give Malaysian e-cigarette users assurance about the products they buy.”

National news agency Bernama recently quoted a University of Malaya Specialist Centre consultant psychiatrist and smoking cessation specialist as saying that the use of electronic cigarettes was dangerous due to the nicotine content in its liquid.

Dr Amer Siddiq Amer Nordin told reporters at the International Conference of Addiction Prevention and Treatment 2015 (ICAPT 2015) that it was a matter of concern that dealers “mixed the liquid, based on demand by clients without knowing its contents”.

“There is no proof saying that vape is safe for use… and we are worried when the dealer mixes the liquids without knowing it will have adverse effects on the consumer’s health,” Dr Amer Siddiq had said

Dr Amer Siddiq said enforcement of the law against using vape was necessary to prevent the public, specifically youths, from starting the smoking habit.

Source : http://www.therakyatpost.com/news/2015/09/23/risks-of-e-cigarette-use-exaggerated-says-uk-health-expert/

THE debate over e-cigarettes is one of the most volatile and fast moving in public health, as scientists attempt to navigate the constantly shifting landscape – and the public tries to make sense out of all the hot air.

Only last year there were calls for fierce regulation, alongside panic that the eye-catching devices could act as a ‘gateway drug’ to teenagers taking up smoking traditional cigarettes.

New studies are published almost daily on the harm or benefits of vaping, as both sides struggle to regain control of the debate.

The devices have proliferated into daily life, as passers-by barely blink now when they catch sight of someone puffing away on something which would not have looked out of place on the Starship Enterprise.

Health charities cautiously, and then more loudly, have called for greater support for their use as a cessation device, or a less harmful alternative to traditional cigarettes.

Public Health England (PHE) recently made the landmark recommendation that the devices should be prescribed on the NHS, once regulated, based on a study which found e-cigarettes were 95 per cent less harmful than normal cigarettes due to lower levels of carcinogens.

However, it emerged that the study had been funded by the e-cigarette industry, revealing a glimpse of the vested interests on both sides of the chasm.

Some studies have found the flavourings in e-cigarettes can cause respiratory problems and the World Health Organisation has said there is not enough robust evidence to show the devices helped committed smokers to ditch the fags.

If more research is done, then one of the major benefits of prescribing e-cigarettes could be the reduction in health inequalities.

In Scotland, smoking rates are highest in the most deprived areas and products such as nicotine patches and chewing gum can be costly.

The harm caused by cigarettes is exceedingly well documented, so the argument for smoking becomes one about freedom of choice.

Providing people with more options could be a positive thing, particularly if e-cigarettes live up to their hype.

More research is clearly needed before e-cigarettes can be backed fully but a blanket ban must be resisted.

The Scottish Government’s proposals to prevent under-18s from buying e-cigarettes are sensible, as for whatever their merits, these devices are not toys.

But rising levels of cancer and heart disease loom large over our ageing population and any opportunity to tackle the problems should not be wasted.

Source : http://www.scotsman.com/news/lizzy-buchan-time-to-address-e-cigarette-confusion-1-3893020

Study suggesting e-cigarettes are less harmful ‘backed by groups linked to tobacco industry’

A fierce row has broken out over the extent to which e-cigarettes are harmful. Pro-“vaping” campaigners, who believe the new technology can help wean smokers off cigarettes, claim that attacks on e-cigarettes could become a threat to public health – leading people to believe that the electronic devices are as bad for a person’s health as normal cigarettes.

However, two academics behind the attacks on e-cigarettes – who used an article in the British Medical Journal to question some of the claims made in the products’ favour – fear the benefits of vaping are being hyped by vested interests. It has triggered an inflamed online debate among leading addiction and cancer experts.

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, and Simon Capewell, professor of clinical epidemiology at the University of Liverpool, have criticised comments by Public Health England, based on a review that suggested e-cigarettes were “95% less harmful to your health than normal cigarettes”. McKee and Capewell said the study was sponsored by two groups with links to tobacco companies and e-cigarette manufacturers. They argued that “directors of public health and the wider community desperately need advice on EC [electronic cigarettes] that is evidence-based and free from any suspicion of influence by vested interests”. They concluded that “no firm conclusions can be drawn on the safety of e-cigarettes and warned that branding e-cigarettes “safe” will have consequences for the ban on smoking in cars, which comes into force next month.

McKee and Capewell wrote: “If e-cigarettes are so safe, presumably there will be no restriction on using them in cars. This will make the forthcoming ban on smoking in cars with children virtually unenforceable because it will be extremely difficult to determine what is causing a cloud of smoke or vapour in a moving car.”

E-cigarettes advertising ‘very much along the same line as the old tobacco industry’

The Irish Cancer Society has welcomed the introduction of new rules for the advertising of e-cigarettes while reiterating the need to create a clear distinction between e-cigarettes and the tobacco industry.

The Advertising Standards Authority for Ireland (ASAI) new code of standards means e-cigarette manufacturers must refrain from using marketing tools which appeal to under 18s, must not encourage non-smokers to use their product and must not use health professionals or celebrities to endorse electronic cigarettes.

According to the code, e-cigarettes should not contain health or medicinal claims unless authorised to do so and may not use any design, imagery or logo style that may be associated with a tobacco brand.

Eoin Bradley from the Irish Cancer Society said he was pleased to see the updated rules on e-cigarette advertising, saying the marketing of e-cigarettes had been until now “very much along the same line as the old tobacco industry”.

“We have known for a long time that branding and marketing for tobacco industry are huge,” said Mr Bradley. “That’s the whole reason that plain packaging for tobacco is so important. The last thing we want to see is for e-cigarettes to mock up or pretend to be something which looks very similar to tobacco.”

Mr Bradley particularly welcomed the code which requires that e-cigarette manufacturers do not undermine the message that quitting tobacco use is the best health option for good health.

He said the use of e-cigarettes is rapidly increasing, saying the latest research carried out by the Irish Cancer Society revealed 210,000 Irish people were using e-cigarettes in March 2015, a rise from 134,000 users in July 2014.

Mr Bradley also raised concerns over the regulation of e-cigarettes. “At this moment there is no regulation on e-cigarettes, they have the same rules governing them as any consumer product,” he said, adding that “technically” an under 18-year-old could purchase e-cigarettes without repercussions.

The Irish Cancer Society warned earlier this year that without regulation, no medical or pharmaceutical advice was being given alongside the purchase of e-cigarettes.

Mr Bradley said the Department of Health was in the process of drawing up regulation on the sale of e-cigarettes which must be introduced under European law by May 2016.

The Irish Vape Vendors Association (IVVA) also welcomed the new ASAI code of advertising but added that its organisation was “not part of the tobacco industry”.

“We do not sell tobacco products, but rather an alternative that carries a vastly lower risk,” said a statement from the IVVA. “Our members therefore would have no interest in promoting our competitors’ products.”

The new ASAI code of standards will come into effect on March 1st 2016. Advertisers and marketing communication who fail to comply with the code will be asked to change the advertisement appropriately. Companies who do not comply with the regulations will not face a financial penalty.

Source : http://www.irishtimes.com/news/health/irish-cancer-society-welcomes-restrictions-on-e-cigarette-ads-1.2355507

Joint statement on e-cigarettes by Public Health England and other UK public health organisations.

We all agree that e-cigarettes are significantly less harmful than smoking. One in 2 lifelong smokers dies from their addiction. All of the evidence suggests that the health risks posed by e-cigarettes are relatively small by comparison but we must continue to study the long term effects.

And yet, millions of smokers have the impression that e-cigarettes are at least as harmful as tobacco and we have a responsibility to provide clear information on the facts as we know them to be. It is our duty to provide reassurance for the 1.1 million e-cigarette users who have completely stopped smoking to prevent their relapse.

To be clear, the public health opportunity is in helping smokers to quit, so we may encourage smokers to try vaping but we certainly encourage vapers to stop smoking tobacco completely.

We know that e-cigarettes are the most popular quitting tool in the country with more than 10 times as many people using them than using local stop smoking services. But, we also know that using local stop smoking services is by far the most effective way to quit.

What we need to do is combine the most popular method with the most effective and that is why we are encouraging those who want to use e-cigarettes to quit smoking to seek the help of their local stop smoking service.

The current national evidence is that in the UK regular e-cigarette use is almost exclusively confined to those young people who smoke, and youth smoking prevalence is continuing to fall. This is an area that we will continue to research and keep under closest surveillance. In October this year, regulations to protect children will make it an offence to sell e-cigarettes to anyone under 18 or to buy e-cigarettes for them and within a year the EU Tobacco Products Directive proposes a ban on all print and broadcast advertising of e-cigarettes as part of a full range of regulations.

The concerns on Public Health England’s evidence review, raised by McKee and Capewell in the BMJ today, are not new and have been covered andfully responded to before.

We should not forget what is important here. We know that smoking is the number one killer in England and we have a public health responsibility to provide smokers with the information and the tools to help them quit smoking completely and forever.

PHE has always been very clear on its commitment to providing up to date information on the emerging evidence on e-cigarettes, as shown in therecent review which is the third in this area in the last 2 years. This commitment drove PHE and Cancer Research UK to set up the UK E-cigarette Research Forum. PHE is honouring its longstanding promise to monitor and share the evidence, providing clear messages to the public.

There is no circumstance in which it is better for a smoker to continue smoking – a habit that kills 1 in every 2 and harms many others, costing the NHS and society billions every year. We will continue to share what we know and address what we don’t yet know, to ensure clear, consistent messages for the public and health professionals.

Source : https://www.gov.uk/government/news/e-cigarettes-an-emerging-public-health-consensus

Several researchers have questioned robustness of data and pointed to links between some of those involved and the tobacco industry

Claims by a government-funded agency that e-cigarettes are 95% less harmful than smoking arose from a meeting of 12 people, some with links to the tobacco industry, researchers have said.

Experts writing in the British Medical Journal (BMJ) joined the Lancet in criticising the evidence used by Public Health England (PHE) in its report on e-cigarettes.

PHE published the “landmark” report last month, describing it as a “comprehensive review of the evidence”. But several researchers have questioned the robustness of the data and pointed to links between some experts and the tobacco industry.

An editorial in the Lancet medical journal last month attacked the “extraordinarily flimsy foundation” on which PHE based its main conclusion. Writing in the BMJ, two further researchers have questioned whether the claims were “built on rock or sand”.

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, and Simon Capewell, professor of clinical epidemiology at the University of Liverpool, said: “A fundamental principle of public health is that policies should be based on evidence of effectiveness.”

They said the public would expect PHE’s claims that “the current best estimate is that e-cigarettes are around 95% less harmful than smoking” would be based on a detailed review of evidence and modelling.

“In fact, it comes from a single meeting of 12 people convened to develop a multi-criteria decision analysis (MCDA) model to synthesise their opinions on the harms associated with different nicotine-containing products; the results of the meeting were summarised in a research paper.”

McKee and Capewell said one sponsor of the meeting was a company called EuroSwiss Health, whose chief executive was reported to have previously received funding from British American Tobacco for an independent study. He also endorsed BAT’s public health credentials in a sustainability report, they said.

One of the 12 people at the meeting declared funding from an e-cigarette manufacturer but not the funding he was reported to have received previously from the tobacco company Philip Morris International, they added.

“The rationale for selecting the members of the panel is not provided, but they include several known e-cigarette champions, some of whom also declare industry funding in the paper. Some others present at the meeting are not known for their expertise in tobacco control. The meeting was also attended by the tobacco lead at PHE.”

The research paper produced by the group “tellingly concedes” there is a lack of “hard evidence for the harms of most products on most of the criteria”, McKee and Capewell wrote. “However, none of these links or limitations are discussed in the PHE report.”

McKee and Capewell said PHE’s claims that “there is no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers” were premature.

Prof Kevin Fenton, director of health and wellbeing at PHE, said the claims in the BMJ had been responded to before. He said: “E-cigarettes are significantly less harmful than smoking. One in two lifelong smokers dies from their addiction. All of the evidence suggests that the health risks posed by e-cigarettes are small by comparison, but we must continue to study the long-term effects.

“PHE has a clear duty to inform the public about what the evidence shows and what it does not show, especially when there was so much public confusion about the relative dangers compared to tobacco.

“Nearly 80,000 people a year die of a smoking-related illness and smoking costs the NHS £2bn a year. By spelling out clearly the current evidence – that while e-cigarettes are not risk-free, they carry only a fraction of the harm caused by smoking – we are fulfilling our national remit.”

Source : theguardian