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Unintended consequences 
Counterfactual 
www.clivebates.com 
@clive_bates
Unintended consequences: Ban flavours
Indoor vaping ban
Control advertising?
Impose burdens, costs and restrictions
Diminishing and negative returns to regulation 
Net 
health 
Value to society 
Net 
harm 
Regulatory costs, 
burdens and 
...
Morgan Stanley on FDA deeming regulations 
The greater barriers to entry (slower approval process, higher 
costs, higher p...
Bureaucratic 
regulators 
Predatory 
companies 
Public health’s 
“useful idiots” 
The Unholy Trinity
Changing perceptions – for the worse 
Birth defects 
Lipoid 
pneumonia 
Third hand 
nicotine 
exposure 
Ultrafine 
particl...
Winning hearts and minds? 
Believe e-cigs safer than 
cigarettes? 
US adult smokers 
85% 
65% 
100% 
80% 
60% 
40% 
20% 
0...
Science: five orientating propositions 
• Relative risk: at least 95% less harmful than smoking, 
probably lower, may be n...
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Wells Fargo 2014 E-cig conference - Bates

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Presentation on unintended consequences of excessive e-cigarette regulation.

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Wells Fargo 2014 E-cig conference - Bates

  1. 1. Unintended consequences Counterfactual www.clivebates.com @clive_bates
  2. 2. Unintended consequences: Ban flavours
  3. 3. Indoor vaping ban
  4. 4. Control advertising?
  5. 5. Impose burdens, costs and restrictions
  6. 6. Diminishing and negative returns to regulation Net health Value to society Net harm Regulatory costs, burdens and restrictions Builds confidence Destroys viable firms and products Compromises design & consumer appeal Sweet Spot
  7. 7. Morgan Stanley on FDA deeming regulations The greater barriers to entry (slower approval process, higher costs, higher product standards), will ultimately take a toll on the number of available products and rationalize the category. This could result in the larger tobacco companies dominating the category in the future, given the burden it would place on smaller manufacturers.
  8. 8. Bureaucratic regulators Predatory companies Public health’s “useful idiots” The Unholy Trinity
  9. 9. Changing perceptions – for the worse Birth defects Lipoid pneumonia Third hand nicotine exposure Ultrafine particles Blindness Anti-freeze Poisoning Gateway
  10. 10. Winning hearts and minds? Believe e-cigs safer than cigarettes? US adult smokers 85% 65% 100% 80% 60% 40% 20% 0% 2010 2013 Tan ASL, Bigman CA. E-cigarette awareness and perceived harmfulness: prevalence and associations with smoking-cessation outcomes. Am J PrevMed 2014; 47: 141–9. Perceived e-cig risk in young British smokers Trends in electronic cigarette use in young people in Great Britain over 2013-2014 Arnott, Britton, Cheeseman, Dockrell, Eastwood, Jarvis, & McNeill ASH, CR-UK, PHE 2014
  11. 11. Science: five orientating propositions • Relative risk: at least 95% less harmful than smoking, probably lower, may be negligible risk. • Bystanders: no material health risk, possible nuisance • Adolescents: use rising with adults, vast majority of users are smokers, may be displacing smoking • Smoking cessation: combines appeal and effectiveness and improving over time – limited studies show at least as good as pharma nicotine already. • Promoting smoking: no sign of gateway effects or renormalising smoking.

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