The British Medical Association (BMA) and Ecigs

I’m going to reproduce correspondence between Fraser Cropper from ecig vendor and liquid maker ‘Totally Wicked’ and Baroness Finlay, President of the BMA. I trust that Mr Cropper will not object since he has himself shared this information. Here is the link:

http://www.totallywicked-eliquid.co.uk/news/2015/june/letter-to-baroness-finlay-bma.html

Cropper wrote to Finlay to complain about the statements made by the BMA’s representative, Mark Temple, on BBC Radio 4. Yesterday, I listened to that broadcast. Here is the link:

http://www.bbc.co.uk/programmes/p02tkhcs

Cropper’s letter in full:

10^th June 2015

 

Dear Baroness Finlay,

I am writing to you in your capacity as President of the British Medical Association.

In response to proposals published today by the Welsh Government to ban the use of electronic cigarettes in enclosed public places, I was interviewed on BBC Radio Lancashire alongside Dr Mark Temple from BMA Cymru.

During the interview Dr Temple made a number of statements relating to the use of electronic cigarettes in public and e-liquid that I would like to bring to your attention.

Dr Temple stated that the use of electronic cigarettes in enclosed public spaces undermines the smoking ban.  This is simply not true.  The Chartered Institute of Environmental Health stated that there is a 99.7 per cent compliance rate with the smoking ban[1], and they have found no evidence to support the idea that the use of e-cigarettes in public is undermining this.

Dr Temple then went on to argue that the use of electronic cigarettes in public leads to a renormalisation of smoking.  Again, this is simply not true.  Professor Robert West, Professor of Health Psychology and Director of Tobacco Studies at University College London’s Department of Epidemiology and Public Health, following his latest research concluded: “Despite claims that electronic cigarettes risk re-normalising smoking, we found no evidence to support this.”[2]  ASH have also carried out extensive survey work and research that renormalisation is simply not happening.

Following on from this, Dr Temple stated that electronic cigarettes were a gateway into smoking and that they are regularly used by a growing number of children.  Once again, this is simply not true.  Recent research produced by ASH[3] demonstrated that children are not using electronic cigarettes in significant numbers.  The survey found that regular use of these devices amongst children and young people is rare and is confined almost entirely to those who currently or have previously smoked[4].

Research undertaken by Queen Mary University in London[5] found that a child trying a tobacco cigarette for the first time is 50 per cent likely to become a regular smoker.  The same research found no evidence that a child trying an e-cigarette for the first time goes on to become a regular vaper.  A recent study by John Moores University found that, ‘Overall seven out of eight young people had never accessed e-cigarettes’[6].

Recently Cardiff University themselves came to the same conclusion, “E-cigarettes are popular with teens, including those who have never smoked, but few of those who try them become regular users, with most of those who do so also being smokers.”[7]

Cancer Research UK looked in detail at two major studies into e-cigarette use amongst young people in Wales, they concluded, “Looking specifically at two studies dedicated to the use of e-cigarettes amongst young people in Wales only a minority of teenagers who try e-cigarettes go on to become regular users.  And the majority of those who do use the devices regularly were already smokers.”[8]

On the issue of gateway, Deborah Arnott, Chief Executive of ASH, said: “There is no evidence from our research that e-cigarettes are acting as a gateway into smoking.”[9]

Finally, and perhaps most worryingly Dr Temple stated that if a child spilt e-liquid on their hand they would die and stated that nicotine in and of itself was dangerous.  On the first point, electronic cigarettes have been in use for almost a decade now and used by nearly three million in the UK alone.  To date I know of not one case of a child dying as a result of spilling nicotine on their skin, either in the UK or globally.

As a responsible business owner I would be very grateful if you could please provide me with the evidence that the BMA and Dr Temple have used to support this statement?  On the second point that nicotine is dangerous, Professor Peter Hajek, Director of the Tobacco Dependence Unit at the Wolfson Institute of Preventative Medicine, Queen Mary, University of London, concluded, “Nicotine itself is harmless.  Nicotine itself is on a par with drinking coffee in terms of health risks.”[10]  The MHRA and NICE have also both made clear long-term nicotine use is not harmful.

This is not the first time the BMA has appeared in the media making alarmist statements about electronic cigarettes.  In March Dr George Rae, Chairman of BMA North East, appeared on the BBC[11] and stated that, amongst other things, electronic cigarettes contain “even more cancer forming chemicals than what you’re getting within cigarettes themselves.”  In other words: electronic cigarettes are more dangerous than tobacco cigarettes.  This is of course factually incorrect.  We know that according to research undertaken by Professor Peter Hajek that electronic cigarettes are at least 95 times safer than tobacco products.

There is never a situation where it is safer to smoke than it is to vape.

As Professor John Briton from the Royal College of Physicians said, “If all the smokers in UK stopped smoking cigarettes and started using e-cigarettes we would save five million deaths in people who are alive today.  It’s a massive potential public health prize.”[12]

Why does all of this matter?  It matters because your people speak with the authority that comes with representing an organisation like the BMA.  In other words, people sit up and take notice of what they say, in a way they would not if they were not speaking on behalf of the BMA.  Therefore representatives of the BMA have a responsibility to think very carefully about what they say in public, as their words will lead to changes in people’s behaviour and this is especially true when it comes to vapers and smokers.  Professor Robert West has said that “misleading” and “sensationalist” reports were putting smokers off switching to e-cigarettes[13]

We know from research undertaken by Dr Konstantinos Farsalinos[14] that smokers’ perceptions of risk are very far from accurately aligned with reality.  This affects their smoking/vaping behaviour.  As Dr Konstantinos Farsalinos makes clear, it is relatively easy for a vaper to go back to being a smoker!  The authoritative Eurobarometer Survey recently published figures showing the percentage of people surveyed who consider electronic cigarettes to be harmful has risen from 27 per cent to 52 per cent in only two years.[15]

In taking the stance that it does in relation to electronic cigarettes, the BMA is at odds with Public Health England, ASH, the Scottish Government, the Royal College of Physicians, Cancer Research UK and many other internationally respected bodies.

I run a responsible business.  I want to see electronic cigarettes robustly and proportionately regulated.  Like you I trust, I care about evidence.  All those with an interest in public health should be focussed on the bigger picture of reducing the number of smokers.  Electronic vapourisers have a legitimate role to play in this.  It is therefore deeply depressing and worrying that the BMA continues to seek routinely to discredit vaping and to try and dissuade smokers from switching to these products using spurious evidence.  What public health gain do the BMA hope to achieve with this approach?

I hope that you will consider the evidence put forward in this letter and that you will think again about electronic cigarettes, the proposals for a ban on vaping in enclosed public places, and in particular the public statements your organisations makes on electronic cigarettes in general.  I look forward to receiving your reply.

We will be publishing a copy of this letter on our company website,

Yours sincerely

Fraser Cropper on behalf of Pillbox38 UK Ltd

Managing Director.

There is a list of references which I have not bothered to reproduce.

Here is Finlay’s reply:

Dear Mr Cropper

I am writing in response to your letter dated 10 June 2015. We are aware of the concerns about the broadcast on BBC Radio Lancashire, so I would like to clarify the British Medical Association’s position one-cigarettes [sic]. While we recognise that the health risks associated with the use of e-cigarettes are significantly lower than the well-established risks associated with smoking tobacco, our members have repeatedly expressed concerns about their use and proliferation. These include the lack of conclusive evidence of effectiveness as a smoking cessation aid, the safety and variability of the components of e-cigarette vapour, and the absence of a significant health benefit associated with dual use of e-cigarettes and tobacco cigarettes. We are also concerned that some of the ways these products are being promoted are likely to appeal to children, young people and non-smokers. Specifically in relation to the use of e-cigarettes in enclosed public places, we believe that stronger controls are needed in order to:

• protect others from being exposed to e-cigarette vapours

• ensure their use does not undermine existing restrictions on smokefree public places and workplaces by leading people to believe it is acceptable to smoke

• ensure their use does not undermine the success of conventional tobacco control measures by reinforcing the normalcy of smoking behaviour in a way that other nicotine containing products do not.

Further details on our position can be found in our briefing paper ‘BMA calls for strong regulation of ecigarettes’, published in November 2014, which is available on our website as follows: http://bma.org.uk/working-for-change/improving-and-protecting-health/tobacco/e-cigarettes

Yours sincerely

Professor Ilora the Baroness Finlay of Llandaff

BMA president.

—-

Cropper’s letter speaks for itself and needs no comment (other than that I was surprised that he did not mention the barmy comment from Temple that because ecigs are called ‘….cigarettes’ they are cigarettes). Finlay’s reply demands some attention.

“We are aware of the concerns about the broadcast on BBC Radio Lancashire,…”

I wonder what that sentence means? “WE are aware of the concerns about……”. You could read a lot into that phrase. Of course, nothing will happen, regardless of Temple’s flippancy. The fact is that the BMA almost certainly has no power over Temple.

The rest of the reply shows similar flippancy, even though it is not couched in flippant terms. No attempt is made to refute Cropper’s claims. Finlay merely restates the BMA’s uncorroborated ‘concerns’, which Finlay then uses to demand fierce regulation and bans.

I must admit to being amused by the phrase:

“…our members have repeatedly expressed concerns about their use and proliferation…”

It is a sort of ‘reverse appeal to authority’. “It isn’t me saying this, it is our members”.

What we see is arrogance. Look at this phrase:

“These include the lack of conclusive evidence of effectiveness as a smoking cessation aid”

Erm…. Why should they be a cessation aid? Why should they be effective as such? Who says so? If people enjoy using ecigs, why should they be stopped from doing so? They use their own money to buy them, chose the model and the liquid and the nicotine strength. Why should they not? What business is it of the BMA?

“…..and the absence of a significant health benefit associated with dual use of e-cigarettes and tobacco cigarettes”

Wait a minute, Ms Finlay. Should she not included the words ‘evidence of’? For how could she possibly know whether there are health benefits of dual use or not? These buggers believe their own propaganda.

And the three bullet points are the product of what can only be a sick mind, if that mind really believes what it is thinking. ALL the toxicological evidence says that there is no danger in the vapour, even to the user, never mind a bystander; some people use them precisely to avoid restrictions on tobacco use: how can avoiding tobacco use lead to tobacco use?; is sucking anything at all, like a lollipop, likely to appear to be smoking a cigarette, pipe or cigar?

Only a scoundrel could write such a letter, if it is intended to be a serious reply. I read it with an open mind without expectations, but I could almost feel the disdain. You would think that Cropper was CEO of British American Tobacco. Of course, Finlay will be aware of Totally Wicked’s action in the EU court. She has no compunction in brushing him off, along with the hundreds of thousands of vapers. Chapman, Glantz, Finlay are all part of the same ‘World Hegemony’. They do not give a shit about the health of ordinary people. They care only about destroying tobacco companies. When and if they succeed in that endeavour, then prohibition of tobacco products will have been achieved by stealth.

Be in no doubt, the anti-ecig stance is ENTIRELY about giving tobacco companies nowhere to go. These people know that Big Tobacco will start to buy out and incorporate small ecig companies. They have already done so in a couple of cases. In fact, it would not surprise me one bit if tobacco control actually wanted this to happen so that they could clout Big Tobacco with massive taxes on ecigs and liquids by classing them as ‘sinful luxuries’ or something.

—-

Anyway, just for fun, let’s rewrite Finlay’s letter as it should have been:

Crapper, or Cropper, whatever your name is, how very, very dare you, a mere tradesman, write to me, a member of the Nobility? 

Listen, your piffling one-cigarette liquid making business is no concern of mine. Just listen up carefully: “WE DO NOT CARE!!” Right? Just get this into your head. If we want to frighten people by making stupid propaganda claims, we shall do. You can do nothing about it. We are NOBILITY, get it? If we want to claim that ecig vapour may be dangerous, and that, because we don’t want the serfs and slaves enjoying themselves when they should be working or sleeping, that these liquids must be rendered unpalatable, we shall do so. Surely, even a tradesman can understand we have ‘droit de seignor’ (is that spelt right? What does it matter – how I spell it is how it should be spelt). 

OK. Now you’ve got the general idea, I’ll spell it out. The fewer serfs and slaves that go to ecigs, the more money that we NOBLES make. So…. it is in our interests to spread rumours – like, ‘ecigs are as bad as tobacco cigs’, like ‘cheeeldren might get a taste for ecigs’, like ‘advertising might suggest that ecigs are enjoyable’. 

So get this into your thick skull, Mr Crapper, WE DON’T GIVE A SHIT ABOUT YOUR OPINIONS! SOD OFF!

This an email, which I shall deny sending. My official reply is in the post. ARSEHOLE!”