Wednesday 19 June 2024

ASH ORG UK :- Policy Leaders or Followers re Safer Nicotine Products 2012-2024 ?

 This blog is my attempt to make some sense out of ASH actions/inaction over the the previous decade or so,regarding safer nicotine products. This could go back even further in time,but I will leave it to the period 2012- 2024 and deliberately confine my commentary to e-cigarettes/Vaping. 

ASH is a government funded campaigning charity who has a primary aim of reducing Smoking rates to at most 5%, which would be considered as 'Smokefree'. However, a government sponsored campaigning organisation that campaigns that same government has been described as a 'sock-puppet' from some quarters.

Run up to TPD (2013) 

UK Health Secretary Jeremy Hunt who was very anti e-cigs circulated a letter to all UK MEP prior to EU Parliamentary debate and vote, regarding making ecigs a medicinal product with a minimal nicotine strength of 4mg/ml. Fortunately consumers were very active across the EU in contacting their MEP to get the Commission proposals somewhat watered down. This quote comes via Clive Bates''Looking back to the last TPD, we should recall that the Commission, the Council, the scrutinising committee in the European Parliament (ENVI), and nearly all tobacco control NGOs all agreed on medicalising vapes in June 2013''.

 - this was also outwardly the position of ASH at that time .

Which came 1st, was ASH guiding or following? 

Nudge Unit circa 2013-14 

This unit took a far more pragmatic approach to e-cigs and managed to persuade the UK PM David Cameron of the virtues of advancing safer nicotine products as an alternative for folks who smoked. Jeremy Hunt the self-same Health Secretary also adopted this pragmatic approach culminating in the Public Health England Report of 2015, further supplemented by the Royal College of Physicians report of 2016 . All credible Public Health bodies in the UK welcomed both reports. ASH were outwardly supportive of this new found approach.

The UK medicines regulator MHRA who previously were quite dogmatic in what they would allow, introduced a registration and yellow card scheme that in effect licensed existing registered products even if not approved as medicines. To date, this has worked well, unlike it's US counterpart the FDA that has left virtually all Vaping products either in limbo or simply unapproved or worse. 

Which came 1st, was ASH guiding or following? 

2015-2022 

Various Ministers of Health throughout this period and the supportive, pragmatic position adopted post 2015 was maintained if not particularly reinforced. Of note the Health Dept spokespersons attended various COP meetings of the WHO #FCTC and never once outwardly voiced opinions or objections to draconian proposals or communiques issued by this opaque organisation. ASH attended as observers 

What part did ASH play throughout this period? 

It must be noted here though that ASH does produce invaluable information that has been v. useful for all users of that information, whether from government running through to interested private citizens, sometimes the assessment/analysis could be lacking balance but overall is generally very good .

2022- present 

A marked shift from both Ministers and ASH, ostensibly due to a large uptake by youth, this has been exacerbated by a number of factors, eg Covid, boredom of youth unable to attend school or college due to Covid, cheap disposables, poor to non-existent enforcement, start of a grey market with illicits .....an endless list . This has meant that 'Something must be done' approach has replaced the previous pragmatic one. This is a genuine issue, but one that has been stoked up in the media, maybe with malicious outside intent from anti-THR groups .  

The UK Government introduced the Smoking and Vaping Bill in the Spring of 2014 following pitiful scrutiny from various hand-picked committee members and a clearly biased Minister of Public Health(Andrea Leadsom) who has made a series of illogical non-factual comments towards Vaping in general. The Vaping part of the bill was designed to limit marketing and appearance, restricted flavours, along with a disposable ban, throughout the period a Treasury 'consultation' (from the Chancellor Jeremy Hunt...yes,him again!) was in place to get the opinions from everyone regarding punitive increases in vape fluid graduated from low to high nicotine content . 

Interestingly, D.Arnott was involved as a co-author of this research paper  , which recommends no differential taxation, interesting quotes are in this Guardian article . Paper here 

This above research collaboration featuring an ASH presence is far from unique 

So the government was/is proposing quite a drastic change overall, this is reinforced with support from all of the other traditional political parties, with Labour Party Shadow Health Minister(Wes Streeting) saying that the Australian Prescription model was under investigation (made a few months ago, prior to the recent terrible incidents of firebombing and deaths that have resulted from the gravely flawed policy,hopefully this madcap prescription model gets ditched asap)

I was given this quote regarding ASH 

'Internally they want to see consumer vaping banned by 2026, and prescribed vapes with plain packaging, minimal flavour'' I won't attribute this to anyone

Hopefully this is spurious nonsense, but even if a genuine quote, I would hope and expect that this ASH 'wish' is rapidly ditched, the unintended consequences would be catastrophic and wouldn't be simple to reverse the nonsense once set in motion.

But are ASH once again leading or following what the current (past tense) or future expected Labour Govt Health Ministers thoughts and proposals?

Recent published research(referred to above) from respected UK researchers seemingly challenges the Vaping aspects of the bill especially the disposable ban, along with the differential strength nicotine e-liquid taxation.

Internal and external pronouncements seemingly don't always tally, this is one area where the accusation of mixed ASH messaging comes from.

This blog was not intended to be an anti-ASH diatribe, simply a collection of thoughts of where and what their true position is on this contentious issue. There have been some glorious highlights eg where ASH CEO Deborah Arnott and Martin McKee were involved in a C4. TV interview, this again was an outward manifestation .......'What do they really think behind the scenes though? or is it a case of action speaks louder than words, how many times do we see media reports or demonstrably false information plastered across social platforms where there is little or no response forthcoming from ASH. I can understand that they cannot counter all mis or disinformation, but for it to be so sparse to non-existent isn't helpful.

Will anything be any different with the upcoming change of CEO from D.Arnott to Hazel Cheeseman?

Does ASH lead(advise) or follow Govt policy .........this of course is totally unknown to outsiders, known only to the participants.

From a consumer point of view it would be greatly appreciated if a consistent long-term tone was advanced towards THR, I can count at least 4 distinct changes in approach since 2007 , this report featuring Prof John Britton et al and received ASH support .


 


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