Wednesday, 6 July 2016

Callanan's Continuing Crusade

Callanan, giving it large
Back in May, a number of Lords engaged in a debate over the Tobacco Products Directive and its degenerate regulations on vaping. This encouraged Lord Callanan to put forward a fatal motion in the Lords which - in the face of disgraceful lobbying by ASH - was beaten down into a far less powerful 'regret' motion. Even this wasn't good enough for ASH, who then attacked the regret motion too.

It was in this environment that Lord Callanan's proposals were finally debated on Monday, and boy did he do a good job of it. Here are some highlights of his introduction.
[G]iven all that evidence, these regulations will reduce by 95% the number of products on the market, ban the stronger liquids favoured by many vapers and ban virtually all forms of advertising to prevent suppliers from recruiting new smokers to the vaping cause. 
So how have we ended up with this crazy state of affairs? The Department of Health prides itself on being a “global thought leader” on tobacco, to use its words, and while the department has played a strong game on pure control measures, by which I mean the ban on public place smoking and the taxation of smoking, it has been little short of appalling on its approach to tobacco harm reduction, by which I refer to the development of much less harmful substitutes to smoking.
Indeed it has, led by the nose by ASH, the DoH has waged a long-term campaign to prohibit and/or restrict e-cigs at every turn.
A ... major blunder has been of course with the much more modern substitute of e-cigarettes. Here the Department of Health’s medicines agency, the MHRA, tried to ban them outright in 2010. It failed, so it tried again in 2013, declaring that they should all be medicines. 
The 2.8 million vapers using those products are not smoking literally billions of deadly tobacco cigarettes. Displaying a marvellous gift for understatement, the Royal College of Physicians this year declared that the MHRA’s policy had been “counterproductive to public health”. However, in 2013 the Department of Health lobbied vigorously in Brussels for a Europe-wide policy of compulsory medicinal regulation.
Turning his guns on personnel, he then had a perfectly justifiable pop at Anna 'ministerial car crash' Soubry and Sally "backbone" Davies.
Not only was it a disastrous policy, it was also a disastrous policy process. In 2013 the then Public Health Minister, Anna Soubry, appeared before the European Scrutiny Committee to explain why she had decided to use a scrutiny override without informing other departments when she voted for this directive on behalf of the UK Government. The Minister told the committee in her evidence that e-cigarettes had in fact been excluded from the directive. They had not. If noble Lords can cope with viewing that cringe-making performance, it is, as they might imagine, widely available on YouTube (indeed it is, see here - DP). That level of competence was not just available at ministerial level. The Chief Medical Officer declared to the New Scientist a few months later that e-cigarettes were one of the three biggest health threats to the UK, along with obesity and binge drinking. It would be funny if the issue were not so serious.
He also issued a sage warning on why the MHRA should not be trusted.
The other issue that needs to be looked at very hard is the role of the MHRA in policy development. It is a fact that this agency derives most of its revenue from the pharmaceutical industry. It is also clear that it has lobbied very hard for a land grab on e-cigarettes, yet has signally failed to deliver with any product available for consumers. Ministers should be extremely cautious about listening to its lobbying.
And offered a withering condemnation of the Department of Health's performance and its capture by pharmaceutical interests.
Bizarrely, while the department is doing its best to restrict sales of one tobacco substitute, which costs taxpayers nothing, we are heavily subsidising nicotine-containing gum and patches, because they are given out on prescription. The difference, of course, is that these products are made by the big pharmaceutical companies, which appear to have the Department of Health as a sort of wholly owned subsidiary. 
Well, some of us have mentioned that before, it has to be said.
These companies stand to lose large amounts of money as sales of their nicotine substitutes have collapsed with the advent of e-cigarettes. The pharmaceutical industry uses its massive spending power to manipulate the harm reduction debate. It funds conferences, so-called medical charities and quasi-academic research to justify its position. If the Department of Health is to improve its performance on tobacco harm reduction, it needs to be just as cautious in its dealings with pharmaceutical companies and their allies as it is with the tobacco industry.
Quite.

But he didn't just grumble, he also offered some positive proposals which - I'm sure - the Westminster wagon-circling exercise will roundly ignore, but which have at least now been put on the table.
Where should policy go now? Although contrition from the Minister would be welcome, the key is to take concrete steps to improve the situation. Critical issues to which I ask the Minister to respond this evening include measures to rebuild consumer confidence in e-cigarettes. Smokers who do not currently vape perceive e-cigarettes to be much more dangerous than scientists say they in fact are. We need serious action, not just a few warm words. We also need a clear plan to put into production medicinal supplies of the stronger e-liquid used by a quarter of a million vapers, including my noble friend Lord Cathcart. It would be unconscionable if the MHRA was to fail on this once again. The need is simple: several suppliers of base e-liquid should be approved by the MHRA before Christmas.
This is an incredibly well-drawn observation. As a result of the cavalier attitude of ASH towards higher strength e-liquid, about the highest available strength post-TPD is 18mg (1.8%) which is not strong enough to provide the throat hit that smokers find so appealing about e-cigs. If the DoH and its simpering anti-smoking offshoots are serious about being supportive of e-cigs (debatable) then they should be right behind this suggestion by Lord Callanan.

If strengths higher than 18mg are not commercially available due to the ignorant clunking fist of the EU, domestically-mixed liquids of higher strengths should be endorsed by the MHRA licensing the nicotine base which is required to facilitate them.

He also raised the possibility of Brexit being a way that the UK can escape the quite stupid TPD regulations on vaping.
Now that we are going to leave the EU, we have the opportunity to make regulations that will be evidence-based and to create a climate in which smokers can quit for safer products. We need to remove the ridiculous restrictions on product choice and the advertising of e-cigarettes and other reduced-harm products, such as heat-not-burn products. To this end, I welcome the Treasury’s consultation on the taxation of heated products later this year.
Indeed. We've seen many weasel words on the subject of harm reduction, coupled with much shrugging of shoulders that we are in a cleft stick because these are EU regulations we are legally bound to implement. So let's see how serious the DoH and ASH really are about the benefits of vaping; let's see moves to reject the TPD provisions on e-cigs the moment we leave the EU or - if we are to disgracefully remain anyway - pressure brought to bear on the EU during negotiations to secure an opt-out for the UK from having to enforce them.

Lastly, but probably most importantly, Callanan turned his attention to the WHO and COP7 in New Delhi in November.
Finally, there is the global policy-making role of the department. When the Framework Convention on Tobacco Control meets in India later this year, I hope it will consider a Department of Health advocacy paper on harm reduction free from the commercial interests of the pharmaceutical industry.
This is very astute from the noble Lord. As we know very well here, the UK representation at the debacle that was COP6 in Moscow included Deborah Arnott of ASH and Andrew Black of the DoH. Arnott has huge influence within the FCTC and will be attending this year, while representation from the DoH is thus far uncertain according to written parliamentary questions.

So it should be made very clear what the UK's negotiating position will be at start of proceedings for COP7. Arnott professes to be a big fan of vaping, so let's see her openly come out and declare that she is going to advocate for e-cigs and harm reduction in New Delhi, likewise the DoH.

The recommendations at the culmination of COP6 sought to formulate "guidance on smokeless tobacco products". If this country's proud boast to be progressive on harm reduction and vaping is to be believed, our starting position should be to publicly detail clear policy objectives that our representatives will be promoting to the FCTC and red lines over which they will on no account cross no matter the ignorance, deception and misinformation which is certain to be flung at the category by FCTC delegates in November.

If I were to suggest a next cause for vapers, it would be to write to your elected representatives and demand that ASH and the DoH do precisely that. At least then we will know where we stand if - as I suspect - the FCTC demands that e-cigs are treated as a tobacco product globally post-November. It is very heartening that Callanan has identified COP7 as a crucial indicator of the true intentions of self-professed 'public health' vaping advocates, and that a spotlight should be shone on grubby dealings in this area.

I shall turn tomorrow to other speeches in Monday's debate (which you can read in full here) but, for now, we should congratulate Lord Callanan for continuing to highlight the incompetence, chicanery and cronyism within the DoH and 'public health' while also making some common sense suggestions as to how they can be remedied.

Bravo Sir!


1 comment:

Blogger said...

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