Public health matters….But!

This week Public Health England published their guidance on the “Use of e-cigarettes in public places and workplaces” A useful addition to the literature on vaping or another example of government interference in people’s lives? Go have a read of it;

Use of e-cigarettes in public places and workplaces Advice to inform evidence-based policy making

OK at first glance it seems quite good and then I read it again and I thought ‘this is brilliant, exactly what we needed’ However as the day wore on I started to feel a bit uneasy and I couldn’t put my finger on exactly what caused this unease. That got me thinking! (roll credits).

The guidance is boiled down to five points for quick scanning, obviously business are busy people who can’t be wasting their time reading long involved arguments which is why this policy guide is needed in the first place. For them, it’s far easier to just include e-cigs in all smoking bans.

1. Make clear the distinction between vaping and smoking

Well duh!, The fact that you need to state this is because, you, public health, spent the last 4 years confusing the two. OK now you have seen the light, that’s good.

2. Ensure policies are informed by the evidence on health risks to bystanders

The thing is, there is no evidence of health risk to users let alone bystanders. There is, however, a lot of junk science being peddled by the media and most of it coming from factions in public health.

3. Identify and manage risks of uptake by children and young people

So far there’s none so no need for any additional policies then! Still, I suppose some mention is necessary or the ‘think of the children’ brigade will be after you.

5. Support compliance with smokefree law and policies

Support compliance? Smokefree laws are enforced by the law, the only way to support compliance is to ban smoking and report transgressions. Are you suggesting smokers be encouraged to vape in places they can’t smoke? I’m all for that. I get the feeling that’s not what is intended here. Yep, that uneasy feeling is starting.

When e-cigs first came on the market they looked like cigarettes, they were marketed as cigarette replacements and they really didn’t work well as such. They did show potential and users started adjusting them. Within a few years the products on the market looked nothing like cigarettes, were being used to replace smoking rather than cigarettes (there is a difference!) and ‘e-cigs’ began to ‘work’. Vaping started to replace smoking permanently for millions of people.

So here we are, vapers see e-cigs as a new thing, they see themselves as former smokers, they don’t feel they deserve any of the stigma or restrictions smoking suffers. This set of guidelines goes a long way towards that but within limits. Limits based not on vaping but on smoking and the stigmatisation of smoking. Isn’t it only a matter of time before those limits are tightened until we get to a point where vaping is the new smoking and  restricted to designated areas? In fact this is built in to the guidelines, “Managers should indicate accurately where vaping is permitted or prohibited,“, ” Where a designated outdoor smoking area has been provided in a public place or workplace, vapers should be allowed to vape elsewhere“, “Approaches might include allowing vaping in a designated adults-only indoor area” and most telling of all ” Where a decision is taken to allow vaping in an enclosed place, policies could consider some simple etiquette guidelines for vapers, such as minimising the production of visible vapour“. The assumption being prohibition as the default and if not followed then vapour should be minimised.

Don’t get me wrong these guidelines are not just welcome but enthusiastically welcomed, without them, we are stuck with ad hoc bans. Instead, we will have some order from the chaos and bans will be justified on etiquette grounds and customer consideration and children’s needs. But I doubt these guidelines will prevent further bans or lead to the repeal of current ones. No, I don’t count Nottingham University Hospitals NHS Trust allowing vaping outdoors while banning outdoor smoking. That’s just the smoking ban from a few years ago.

There is a distinct lack of enthusiasm from public health about vaping, it’s had to be dragged kicking and screaming to the harm reduction table and it took overwhelming evidence to convince them vaping is a viable option for harm reduction. There’s an air of “let’s help the poor addicts, they are a lost cause, let’s allow these dinosaurs die in peace” in their approach. Which might miss the one great advantage vaping offers (apart from the whole not dying from lung cancer) it’s a better experience than smoking, it should be celebrated as such. That way it can not only help current smokers but future smokers. Unless you are assuming that there will be no smokers at some point in the future, you have to consider them as well.

Public health matters but so does the public’s right to enjoy habits you disapprove of!

 

 

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