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purplebox vapours Response to HIQA Public Consultation on Smoking Cessation Interventions in Ireland

by Steve Barrett

purplebox vapours Response to HIQA Public Consultation on Smoking Cessation Interventions in Ireland

My name is Steve Barrett, I am the owner of a small independent vaping business known as purplebox vapours, located in Temple Bar, Dublin 2.

This is my response to the request from HIQA for public consultation to its report on Smoking Cessation Interventions in Ireland with direct reference to Vaping products / electronic cigarettes. 

Background

In July 2013 I embarked on my research into the phenomena that is vaping and electronic cigarettes. I started from a skeptical viewpoint that e-cigarettes would be as harmful as regular cigarettes and that nicotine per se was one of the many toxic elements involved in smoking.

During seven months of exhaustive research – finding the initial studies into the vapour production from these devices and the available research from many health bodies into, not only the harmless aspects of nicotine, but the uses of nicotine in treating many medical conditions, my opinions changed dramatically. In fact, Robert West, Professor of Health Psychology and Director of Tobacco Studies at the Cancer Research UK Health Behaviour Research Centre, called the concept “revolutionary” and I agreed with him.

I decided to invest in this new sector, with no vested interests or big backers I opened purplebox vapours with the simple mission to help people stop smoking and guide them on how to use this revolutionary new product that could give the nicotine stimulus without the harmful aspects of smoking.

Vaping as a Smoking Cessation Aid

Currently smoking cessation methods and NRT’s (Nicotine Replacement Therapies) include:

  • Nicotine patches, chewing gums or spray
  • Zyban tablet medication
  • Hypnosis
  • Cold turkey
  • Vaping / e-cigarette use

Cochrane ReviewNicotine patches and chewing gum – 31%The 2007 Cochrane Review of NRT’s (Cochrane is a global independent network of researchers, professionals, patients, carers, and people interested in health) found that initially NRT’s have reasonable success in helping people to stop smoking:

 

  • Nicotine sprays – 42%
  • Zyban medication – 30%
  • Cold turkey – 5%

However, despite the initial success only 5% of those tested were smoke free 12 months later.

The 2016 study of e-cigarette and Vaping as a cessation aid conducted by the International Journal of Environmental Research and Public Health concluded that even after one year 40.8% of smokers who had used vaping to quit had eradicated tobacco from their lives completely and a further 15.5% had dropped their cigarette intake by over 80%. A further 10% had reduced their smoking habit by 50%.

The scientists conducting the survey concluded that “smokers purchasing e-cigarettes from vape shops with professional advice and support can achieve high success rates”.

In 2016 the Journal for the Society on the Study of Addiction also backed the findings of The International Journal. Furthermore, it concluded that relying on the expert advice from a specialist supplier of vaping products was more likely to result in success, owing to the ability to purchase the correct equipment, obtain the correct strength of nicotine within the e-liquid and psychologically feel part of the Vaping community.

The Psychological Aspects to Vaping Success

As shown by many studies, NRT’s such as patches, gums and sprays enjoy initial success as smoking cessation devices, however, their success is minimal when studied long term (over a 12-month period). This is because whilst they may satisfy a nicotine dependence they do not solve the psychological elements involved in stopping smoking. These include the habitual traits of smokers having developed a hand to mouth habit; smokers looking for the stress relief feeling of smoking and the exhalation of a ‘smoke’ is a substantial mental barrier if using the stated NRT methods.

Dr Lynne Dawkins, Senior Psychology Lecturer at the University of East London comments: “The hand-to-mouth action of smoking through associative learning mechanisms can become a deeply entrenched habit. The habitual act of reaching for a cigarette, coupled with reduced impulse control during a quit attempt, may constitute a strong relapse factor. Any smoking cessation aids which more closely resemble a cigarette could help more smokers to quit.”

Vaping is successful in combating all of these psychological aspects and is therefore proven to be much more successful over a long term period.

Many smokers fail to quit or relapse after smoking due to being in unavoidable social situations with other smokers. Vaping is again successful in this situation as the smoker has something to turn to and not feel ‘left out’ with friends in smoking areas.

Vaping/e-Cigarette Safety Should Be Unanimously Supported

HIQA has a very real opportunity to make a substantial difference to tobacco addiction in Ireland with its Smoking Cessation report by fully supporting the use of vaping devices. It is now abundantly clear that vaping is completely safe and that the level of toxicity of e-cigarette vapour is absolutely minimal.

The most recent study published in Regulatory Toxicology and Pharmacology showed what exactly is in e-cigarette vapour compared to the contents of cigarette smoke.

Scientists concluded that the toxins in e-cigarette vapour were quite similar to the normal toxins found in regular room air.

Instead of deadly toxins, the e-cigarette vapour only contained propylene glycol, water, and small traces of flavoring and nicotine additives. In order to register any degree of toxicity, the scientists had to use 99 puffs of an e-cigarette to get even the tiniest measurement of 0.18 milligrams of HPHC’s. To put that in perspective, a single puff of a Marlboro Gold cigarette measured 30.6 milligrams. In a puff-to-puff comparison, the cigarettes had 2000 times more toxins than the e-cigarettes.

This study makes it clear that vaping is a far better alternative for smokers. They are now scientifically proven to have harm reduction properties and there is no way that lawmakers can argue that public vaping is harmful after looking at these findings.

Dr Michael Mosley, very publicly tested vaping in his programme Trust Me I’m a Doctor for the BBC and discovered very similar conclusions to the Regulatory Toxicology and Pharmacology tests.

Professor Linda Bauld (Professor of Health Policy at the University of Stirling, Deputy Director of the UK Centre for Tobacco and Alcohol Studies and holds the CRUK/BUPA Chair in Behavioural Research for Cancer Prevention at Cancer Research UK), alongside the Royal College of Physicians and the Royal College of General Practitioners, believes that it is important to promote the use of e-cigarettes, along with other non-tobacco nicotine products to smokers looking to stop.


Linda BauldShe believes that scare stories perpetuated in the media regarding vaping are based on poor science and ulterior agendas of the tobacco industry and various Big Pharma companies who have a vested interest in seeing these vaping products over-regulated into obscurity. 

These industries have enormous power and influence with regulatory bodies and as investigative journalist Greg White says on NewsTarget.com “As is typical in politics, the driving force behind regulating e-cigarettes has everything to do with money and nothing to do with legitimate concerns over public health”.

Linda Bauld has stated, “I believe that e-cigarettes have huge potential to save lives by providing an alternative to smoking. Yet this can only be realised if we address negative harm perceptions and communicate honestly with the public”.

It is the responsibility of organisations such as HIQA, the HSE, HPRA and CORU to publicly state the benefits, safety and value of vaping and e-cigarettes as a smoking cessation aid and assist in modifying public opinion to counteract the scaremongering surrounding the vaping sector.

Conclusion

With many health bodies, eminent health professionals, such as Professor Peter Hajek, Professor Robert West, Dr Michael Mosley and others, and many Anti-Smoking Institutions such as Cancer Research UK and the NHS now endorsing Vaping as a viable and the most successful method of quitting smoking and with non-partisan studies highlighting how safe Vaping is an alternative to smoking it seems contrary to common sense to over regulate such a revolutionary industry.

The industry is very much led by independent vape companies and despite their efforts the tobacco industry is having limited success in the market – this is their reason for spreading the scaremongering stories to quash the rise of vaping amongst smokers.

According to the experts vaping has the power to save millions of lives and in the process save the health industry millions of euro in treating smoking related diseases - in Ireland alone this could equate to up to two billion euro.

The fact that vaping has incorrectly fallen under the banner of the Tobacco Products Directive legislation is nullifying its potential positive effect on society.

I find it inexplicable that legislative bodies seem to be doing their best to thwart the efforts of independent vaping companies to help rid society of tobacco – paradoxically banning informative advertising and restricting to an absurd degree the size of available e-liquid bottles. These measures will only ensure smokers stay smoking.

It seems lawmakers are regulating a concept rather than anything physical – by classifying Vaping (a concept with no relationship to tobacco) under the Tobacco Directive, it would seem they are classifying nicotine and therefore should be classifying patches, gums and sprays under the same Directive. If not, then are simply allowing the tobacco industry to gain further leverage over the independent vaping sector.

I sincerely hope that HIQA will see the benefits vaping is having on society in general and smokers in particular. purplebox vapours has witnessed many clients, who were smoking in excess of 30, 40 or 50 a day successfully eradicate tobacco from their lives. History will surely judge this pivotal moment in the fight against tobacco.

Anecdotal Evidence

At purplebox vapours we devised a S.T.E.P. initiative (Switch To Electric Programme) that assisted smokers to make the life change to vaping. We talk with the customer regarding their existing habit and devise a strategy that gives them the best starter kit and the right e-liquid for them. We then monitor their progress over a period of time and help them eliminate tobacco from their lives for good. To give some examples:

Customer A smoked between 50 – 70 cigarettes per day. He had be warmed by his doctor that he may have less than a year to live if this continued. At 46 he had never played football with his children and had difficulty even climbing a set of house stairs. With the correct advice he reduced his habit over two weeks to 30-40 per day and then to between 10-20 and eventually stopped after 6 weeks. After his first game of 5-a-side with his boys he came in to share his delight.
Customer B is a woman who was smoking between 20-30 per day, this was increasing with the stress of her son getting very sick. With our assistance she has now been smoke free for a whole year despite the incredible strain of dealing with personal issues.

 

We also find that 30ml bottles of e-liquid are key to people sticking to vaping as 10ml bottles can run out quickly and become an inconvenience. 30ml is the perfect size that will last approximately 2-3 weeks and ensures people have enough liquid handy to not relapse to cigarettes if liquid runs out. The new restrictions on bottle size to just 10mls will have a very negative impact on vaping success for new starters.

Without official support the proven safety of vaping will remain hidden and whether to vape or not will remain a dilemma for many smokers. It is time for health organisations, legislative bodies and government departments to step from under the cloud of the tobacco industry and Big Pharma – save lives and save health care budgets. Vaping should not be steeped in self-consciousness and negativity but be celebrated as the revolutionary step that it is.

Witnessing the joy and sense of pride in our customers who switch to vaping and stop smoking is hugely rewarding for us both as individuals and as a business. Should representatives from HIQA wish to spend the day at purplebox vapours you are most welcome.

Steve Barrett

Managing Director

purplebox vapours

 




Steve Barrett
Steve Barrett

Author



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