Martin Dockrell presentation from E-Cigarette Summit 2014

1. Vaping in public places: Towards an evidence based policy Martin Dockrell Tobacco Lead – Alcohol, Drugs & Tobacco Division

2. Starting a conversation
ASH & CIEH offer “5 Questions”
1.What are the issues you are trying to deal with?
2.What do you think you need to control?
3.Do you have concerns about the harms from NCPs?
4.Will prohibition support smokefree compliance?
5.Do you want to improve people’s health?
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Vaping in public places: Towards an evidence based policy

3. Towards “five answers”
1.Distinguishing vaping from smoking
2.Evidence on risk to bystanders
3.“Renormalisation” / “denormalisation”
4.Supporting smokers to stop
5.Effect on smokefree compliance
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Vaping in public places: Towards an evidence based policy

4. Should we treat vaping like smoking?
1.Some nicotine vapourisers look like cigarettes, but many are clearly distinguishable
2.Any harm from vaping is on a different scale to harms from smoking
3.Images of vaping in advertising can be hard to distinguish from smoking
4.Confusion between vaping and smoking should be minimised
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Vaping in public places: Towards an evidence based policy

5. Should we treat vaping like smoking?
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Vaping in public places: Towards an evidence based policy
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Relative harms of nicotine products Nutt et al 2014

6. Should we treat vaping like smoking?
1.Some nicotine vapourisers look like cigarettes, but many are clearly distinguishable
2.Any harm from vaping is on a different scale to harms from smoking
3.Images of vaping in advertising can be hard to distinguish from smoking
4.Confusion between vaping and smoking should be minimised
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Vaping in public places: Towards an evidence based policy

7. What about protecting bystanders?
•Some, including asthmatics, may be highly sensitive
•“Laboratory work suggests that electronic cigarette use in enclosed space exposes others to nicotine at levels about one tenth generated by a cigarette, but little else” Britton, 2014
•“Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.” Burstyn, 2014
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Vaping in public places: Towards an evidence based policy

8. What about protecting children?
•Currently, regular e-cigarette use among children in the UK remains rare and is largely among those who have already started to smoke
•Young people confusing vaping with smoking may have the effect of normalising smoking
•Would displacing vaping from adult indoor spaces have the unintended effect of increasing young people’s exposure?
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Vaping in public places: Towards an evidence based policy

9. What about supporting quitters?
•In the UK approximately one in three vapers are ex- smokers, approximately the same proportion are attempting to quit
•Nicotine vapourisers are among the most popular quitting aids in the UK and their effectiveness may be comparable to NRT
•If we permit vaping only where we permit smoking, what will be the impact on quitters?
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Vaping in public places: Towards an evidence based policy

10. Do bans help smokefree enforcement?
•Enforcement action requires good evidence
•Does poor compliance arise from confusion between smoking and vaping?
•If bans are not justified by harm to health, do they undermine the integrity of smokefree legislation?
•Can clear signage reduce public confusion?
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Vaping in public places: Towards an evidence based policy

11. Building a consensus – next steps?
•It isn’t easy
•We need to continue to talk and to listen with respect
•We need to stick to the evidence
•Our discussions will feed into PHE’s report to Ministers in spring 2015
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Vaping in public places: Towards an evidence based policy