I Sverige gäller undantagstillstånd och här får snus säljas, trots totalförbudet för snusförsäljning som gäller i övriga EU. Sverige har en ovanligt låg andel rökare och mindre förekomst av tobaksrelaterade skador, men ungefär lika stor andel tobaksanvändare som övriga medlemsländer - anledningen finner vi i det svenska snuset. Norge, som ligger utanför EU, har ett liknande undantag inom EEA-området. Medan vi i Sverige använt snus på en stabil nivå över lång tid, har bruket i Norge ökat - särskilt sedan rökförbudets införande 2004.
Ett av de vanligare argumenten för att upprätthålla förbudet mot snus är att snus, om det skulle tillåtas säljas även i övriga medlemsstater, skulle användas av ickerökare och därigenom bli en så kallad inkörsport till konventionell tobaksrökning. Karl Erik Lund m.fl. har i en studie undersökt snusvanor i vårt grannland och resultaten visar att majoriteten av snusarna är före detta eller nuvarande rökare. De som använder både snus och cigaretter röker färre cigaretter än de som enbart röker (23.9 st färre per vecka).
Gruppen som använder snus och som aldrig har rökt behöver undersökas närmare. Det är i nuläget svårt att uttala sig om hur stor andel som hade börjat röka om de inte använt snus, och hur många som inte hade använt tobak över huvud taget om snus inte var tillgängligt. Lund m.fl. uttalar en avsikt att i framtida forskning närmare undersöka just denna grupp av snusare.
Den relativa risken hos snus jämfört med tobaksrökning är låg - snus är uppskattningsvis 96 % mindre skadligt än tobaksrökning. Varje rökare som övergår till snus påverkar folkhälsan positivt och den samhälleliga kostnaden för tobaksrökningens skadeverkningar på människors liv och hälsa är enorm.
Risken för att icke-rökare som aldrig rökt skulle börja med snus måste vägas mot de risker som fortsatt tobaksrökning medför för individ såväl som samhälle. Genom att öppna upp för snus som skademinimerande produkt på EU-marknaden kan åtskilliga liv räddas.
NNA Sweden undrar hur nikotinfrihet kan vara viktigare än överlevnad och kräver förändring på EU-nivå.
NNA Sweden har kontaktat Konsumentverket för att få förtydligande information om vilka regler som gäller för konsumenter som recenserar produkter online, fristående från onlinebutiker - exempelvis på Youtube och i bloggar.
Bland konsumenter av elektroniska cigaretter förekommer en hel del youtube-recensioner och liknande. Då Konsumentverket nu riktat kritik mot recensioner på företagares hemsidor, har flera oroade konsumenter med egna kanaler hört av sig till oss på NNA Sweden för att fråga vad som gäller för dem. Min bedömning är att det här först måste göras en bedömning av om det rör sig om kommersiella meddelanden, och att den bedömningen bör göras med vägledning i den liknande praxis som går att finna i ärenden rörande kända bloggare.
Dessa konsumenter vill sprida information om elektroniska cigaretter huvudsakligen av personliga skäl - det finns en stark kultur kring användning av elektroniska cigaretter och många användare upplever en så stark förbättring i sin livsstil att de blir nästintill religiöst frälsta, med allt vad det innebär. Jag ser ett stort behov av att de nås av korrekt information om hur de behöver förhålla sig till näringsidkarna inom branschen för att inte själva anses göra reklam för produkterna. Jag är restriktiv i mina bedömningar och avråder dessa konsumenter från att acceptera någon form av gratisprodukter, oberoende av om de företag som skänker dem gör det med ett uttryckligt önskemål om recensioner eller ej. Förutsatt att inga former av ersättning utgår, inklusive gratisprodukter och rabatter, borde konsumenterna vara fria att uttala sig om produkterna på plattformer som är separata från näringsidkares försäljningsställen.
Angående recensioner så är det ju avgörande om det finns ett kommersiellt syfte så att det alls är fråga om marknadsföring. Att en privatperson förutsättningslöst, utan någon som helst koppling till näringsidkaren, hyllar en produkt är ju inte marknadsföring. Däremot är det en annan sak om densamme gör det och får någon form av ersättning för detta (behöver inte vara pengar). Som du själv skriver finns bra information om detta i vår vägledning på temat, Konsumentverkets vägledning om marknadsföring i bloggar och andra sociala medier.
Ni som recenserar produkter online får inte ta emot någon form av ersättning av bolag. Det inkluderar självklart rent ekonomisk ersättning men även gratisprodukter, rabatter och alla andra typer av ersättningar som kan tänkas utgå. Samma regler gäller oberoende av om det ställs några krav på er gällande hur ni uttalar er. NNA Swedens råd till konsumenter som recenserar produkter online är att tacka nej till bolag som erbjuder er gratisprodukter, rabatter eller dylikt.
Konsumentverket har i dagarna aktualiserat ett stort antal ärenden rörande marknadsföring av elektroniska cigaretter och påfyllningsbehållare. NNA Sweden går just nu igenom samtliga ärenden och återkommer med en utförlig rapport.
Tills vidare uppmanar vi på NNA Sweden samtliga näringsidkare som sysslar med försäljning av elektroniska cigaretter och påfyllningsbehållare att genast upphöra med all marknadsföring online - inklusive Facebook, Instagram, Youtube, Twitter och - i viss mån - även egna hemsidor där försäljningen bedrivs.
Kortfattat har Konsumentverket bedömt praktiskt taget varje form av information om elektroniska cigaretter, utöver ren information om produkternas pris, funktioner och tekniska specifikationer, som otillbörlig marknadsföring.
Vi vill uppmärksamma på att detta inkluderar extrapriser av alla slag, inklusive fri frakt vid köp över en viss summa.
Vi råder näringsidkare att följa Konsumentverkets direktiv i nuläget, även i den mån de kan uppfattats som orimligt begränsande, då avvikelser från verkets direktiv riskerar att medföra allvarligare begränsningar av den redan kraftigt begränsade marknadsföringen av elektroniska cigaretter och påfyllningsbehållare. Vi löper risk att få en marknad belagd med fullständigt exponeringsförbud i det fall att branschens aktörer inte hörsammar Konsumentverkets krav.
Med hänsyn till konsumenternas behov av tillgång till saklig information om produkterna ber vi, å konsumenternas vägnar, samtliga aktörer att vidta yttersta försiktighet. Vi konsumenter vill inte se en marknad där vår tillgång till information mer eller mindre klipps av fullständigt. Genom att agera snabbt och med ett stort mått av försiktighet, kan aktiva inom branschen visa sina goda avsikter och därigenom minska risken för ytterligare begränsningar.
Det är oss konsumenter ni vill nå och varje aktör som efter Konsumentverkets uttalanden fortgår med otillbörlig marknadsföring, riskerar vår framtida tillgång till information.
NNA Sweden stödjer inte den oerhört strikta väg Konsumentverket väljer att gå i denna fråga. Vi uppmanar branschens aktörer att möta Konsumentverket med information om behovet av information, på ett sakligt sätt och med respekt för svensk processrätt.
Ifrågasätt Konsumentverket genom yttranden till dessa - inte genom att fortsätta med den marknadsföring som verket i nuläget bedömer som otillbörlig.
Fråga: Lyder nikotinhaltiga basvätskor under E-cigarett-lagen?
Basvätskor med nikotin har, fram tills Finandepartementet kom med sitt skatteförslag, varit en gråzon. I detta skatteförslag framgår tydligt att Lag (2017:425) om elektroniska cigaretter och påfyllningsbehållare inte täcker nikotinhaltiga basvätskor. Dessa är att betrakta som en delkomponent snarare än en färdig produkt. Detta var vår ursprungliga tolkning av både EU-direktivet och det svenska lagförslaget kring e-cigaretter, men fram tills skatteförslaget kom uppmanade vi likväl till försiktighet i detta område. På s. 28 i "Beskattning av elektroniska cigaretter och vissa andra nikotinhaltiga produkter" (Fi2017/04328/S2) framgår:
"Ett tänkbart argument för att skatten bör omfatta även nikotinfria vätskor är att det annars kan finnas risk att användare köper nikotinfria vätskor och sedan själva blandar ut dessa med rent nikotin för att undvika skatten. Nikotin är vid klassificering enligt förordning (EG) nr 1272/200812 klassificerat som akut toxiskt kategori 2. Ämnet anses därför vara en särskilt farlig kemisk produkt enligt 4 kap. 1 § Kemikalieinspektionens föreskrifter (KIFS 2008:2) om kemiska produkter och biotekniska organismer. Det krävs enligt förordningen (2008:245) om kemiska produkter och biotekniska organismer tillstånd för att hantera eller yrkesmässigt överlåta sådana produkter. Det är även reglerat vem sådana produkter får överlåtas till. Det är således inte tillåtet att sälja rent nikotin till konsumenter. På marknaden finns dock företag som säljer s.k. nikotinbaser som består av nikotin som är utblandat med andra vätskor i en sådan omfattning att det inte längre anses vara akut toxiskt. Det finns inget hinder mot att beskatta även sådana vätskor."
Denna ordalydelse (fetmarkerad) ska tolkas som att sådan försäljning är tillåten och att vätskorna inte lyder under E-cigarett-lagen. I E-cigarettlagens andra paragraf, andra punkten framgår definitionen av påfyllningsbehållare, vilken är: "behållare som innehåller vätska som innehåller nikotin och som kan användas för att fylla på en elektronisk cigarett." Denna ordalydelse, i dess juridiska betydelse, innebär att enbart den färdiga vätskan - ej dess delkomponenter - lyder under lagens regleringar. Basvätskor med låg nikotinhalt - sådana som har en nikotinhalt på 3-20 mg - är att anse som smakfria vätskor som lyder under lagen. Basvätskor med högre nikotinhalt än så lyder inte under lagen - förutsatt att de säljs som just delkomponenter till en färdig produkt, snarare än att marknadsföras som en produkt som är färdig att användas utan vidare anpassningar.
Då detta område varit diffust och svårförståeligt för många, särskilt DIY-tillverkare, har NNA Sweden noggrant undersökt existerande praxis från nationell rätt, som berör liknande fall gällande alkohol och tobak. Det finns en del rättsfall inom det skatterättsliga området som behandlar frågan om när tobaksskatt blir tillämplig på tobaksprodukter. Från dessa rättsfall framgår att en viss nivå av anpassning av delkomponenterna krävs för att de inte ska anses som beskattningsbara tobaksprodukter. De rättsliga bedömningarna har varit att tillsättandet av enbart vatten inte är en tillräcklig anpassning för att produkterna ska anses som delkomponenter, medan tillsättandet av smakämnen, värmebehandling och dylika åtgärder har ansetts tillräckliga för att de olika ingredienserna ska anses vara delkomponenter. En delkomponent är inte en slutlig produkt och det är enbart de slutliga produkterna av e-juice som lyder under E-cigarett-lagen.
I och med att dessa produkter ej regleras genom E-cigarett-lagen är det otillåtet att märka produkterna i enlighet med lagens krav på hälsovarning på ytterförpackningen. I det fall att återförsäljare märker nikotinbaserna med de EU-standardiserade hälsovarningarna är produkterna att anse som påfyllningsbehållare enligt lagens betydelse, och då är lagen i sin helhet tillämpbar på dessa vätskor.
Finansdepartementet har föreslagit en punktbeskattning av e-vätska på 2 kr/ml vätska. NNA Sweden anser att departementets konsekvensanalys uppvisar såpass stora brister att någon sådan punktbeskattning inte kan accepteras. Vi har självklart svarat på remissen och fokuserar, som alltid, på konsumenternas intressen före allt annat.
Här kan du ta del av NNA Swedens svar i sin helhet!
NNA Sweden is today proud to thank brother and sister organisations around the world for support. There was a massive turnout from individual organisations in protesting against Sweden failing in its international responsibilities. These responsibilites include providing unbiased, comprehensive and non-misleading information on snus as a harm reduction product and effective societal vector toward lower smoking and better health. The WHO has set goal of less than 5% smoking for a country to be considered smoke-free.
In terms of daily smoking, Sweden is the first country globally to achieve this elusive and difficult to reach goal.
NNA Sweden will follow up on these protests in the coming days but as a teaser present you with one of these letters of protest from our esteemed vaping friends in Denmark:
Tankesmedjan Tobaksfaktas agerande riskerar att misstänkliggöra regeringens ANDT-politik och Tobacco Endgame som koncept. NNA Sweden önskar att dessa organisationer granskas närmare och uppmanas att följa sina självutnämnda principer om fri informationsspridning. (Läs mer nedan)
At the age of 85 many smokers would probably shrug their shoulders when told that stopping smoking would be a benefit to them. Many smokers who reach that age have been smoking, in one form or another, for decades and feel it is too late to stop.
As a smoker of 69 years, one man, after being diagnosed with borderline chronic obstructive pulmonary disease in 2010 decided to at least try to minimise the number of cigarettes he smoked. Over the course of two years, Terry Walker reduced his cigarette smoking from 10 per day to just 2.
The headline statistics from the annual ASH survey on vaping appear great at first glance. Vapers now number 2.9 million in the UK and for the first time ex smokers outnumber current smokers. Is this news really all it's cracked up to be though?
The NNA legal case is the first time that a ‘right to health’ argument has been used to challenge a bad tobacco control law. We hope that this example might be a springboard for challenges in other countries.
NNA’s case to the European Court of Justice is based on EU law and the EU Charter of Fundamental Rights (CFR) . Our argument is that the ban on snus is disproportionate, and that it is contrary to the human right to health. Given the evidence that snus is substantially safer than smoking cigarettes, and that it protects against smoking, it is both unethical and contrary to EU law to deny access to this product.
NNA supports the idea of ‘tobacco harm reduction’ as it is often formulated, in offering smokers and would-be smokers a low risk alternative to smoking. It is as an approach that is preferable to an abstinence only strategy, which is in effect a ‘quit or die’ approach.
NNA also supports the idea that many people like using nicotine and thus – especially if lower risk forms of nicotine are available - there must be major limitations on the ability of the state to interfere with that choice. Tobacco harm reduction recognises that many people find the use of nicotine pleasurable. This is reflected in our arguments that the ban on snus is contrary to the principles of autonomy and choice that flow from Articles 1 and 7 of the Charter of Fundamental Rights of the European Union (CFR).
Rights to health
Our thinking is as follows.
European states are obliged to further the health of their citizens. The preamble to the European Social Charter  states that: ’Everyone has the right to benefit from any measures enabling him to enjoy the highest possible standard of health attainable’ and Article 11 requires Parties to take measures to prevent disease and to encourage individual responsibility in matters of health.
Moreover, all EU law must take into account ‘health protection’. Facilitating a high level of health protection is required under Title XIV of the Treaty of Lisbon that ‘A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities’. A high level of health protection is relevant to all EU legislation including the Tobacco Products Directive. We have argued in our submission to the High Court and the European Court of Justice that health protection includes not only protection from health threats but also includes enabling people to make choices that help them avoid ill-health.
We thus base our argument on an interpretation of Article 35 of the CFR that a high level of health protection must allow access to snus.
A similar argument may be made on the basis of other international treaty obligations.
The relevant obligation is Article 12 of the International Covenant on Economic, Social and Cultural Rights , which has been ratified by 165 countries including all EU states. Article 12 recognizes: ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’ and that States Parties must take steps regarding ‘the prevention, treatment and control of epidemic, endemic, occupational and other diseases.’ This has been interpreted by the UN Special Rapporteur on the Right to Health to include access to harm reduction resources for people who use drugs . We similarly argue that Article 12 includes access to tobacco harm reduction resources, ie safer nicotine products.
Tobacco harm reduction is consistent with obligations in the international treaty on tobacco control. All European Union states are signatories to the Framework Convention on Tobacco Control (FCTC), the international health treaty that aims to reduce the use of tobacco . The preamble to the FCTC notes obligations (as mentioned above) under the Article 12 of the International Covenant on Economic, Social and Cultural Rights. Moreover Article 1d of the FCTC specifically refers to harm reduction as one of the defining strategies of tobacco control, which is: ‘a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke’.
As mentioned above the European Social Charter requires states to encourage individual responsibility in matters of health. This view links to a basic principle of public health, which is one of creating the conditions in which people can lead healthier lives. In particular, as stated in the constitution of the World Health Organisation , that: ‘Informed opinion and active co-operation on the part of the public are of the utmost importance in the improvement of the health of the people.’  Empowering individuals and communities to take control of their health is a fundamental principle of public health, as set out in the Ottawa Charter on Health Promotion .
Tobacco harm reduction is consistent with the broad public health aim of enabling people to take action to reduce risks to their health. They cannot do that unless they have access to the resources that help them do this. That is why a ban on snus is inconsistent with helping people to lead healthier lives. Snus has to be legalised because snus saves lives.
Chair, New Nicotine Alliance
 Charter of Fundamental Rights of the European Union (2000/C 364/01)
 European Social Charter https://www.coe.int/en/web/conventions/full-list/-/conventions/rms/090000168007cf93
 Open Letter by the Special Rapporteur on the right of everyone to the highest attainable standard of mental and physical health, Dainius Pūras, in the context of the preparations for the UN General Assembly Special Session on the Drug Problem (UNGASS), which will take place in New York in April 2016. http://www.ohchr.org/Documents/Issues/Health/SRLetterUNGASS7Dec2015.pdf
 Framework Convention on Tobacco Control http://www.who.int/fctc/text_download/en/
 Constitution of the World Health Organisation http://www.who.int/governance/eb/who_constitution_en.pdf
 Ottawa Charter on Health Promotion. World Health Organization 1986. http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
More from the NNA on snus:
NNA contends that snus fulfils the criteria for a tobacco harm reduction product and hence should be available in the UK. The legal ban on snus denies smokers of the choice of a much safer nicotine product than cigarettes.
The introduction of snus into the United Kingdom would form part of a coherent strategy of tobacco harm reduction that help people avoid smoking. The current scientific evidence, and the fact that Sweden, where snus is used, now has the lowest lung cancer and tobacco-related mortality in Europe, indicates that snus is a suitable and appropriate product for individuals who are seeking to avoid smoking and other combustible tobacco products.
The rapid rise in the popularity of electronic cigarettes, a grass roots consumer driven phenomenon, shows that many smokers want to avoid smoking-related harms. There is the potential to reduce smoking when acceptable products are available to consumers; such uptake being at no cost to public funds.
The NNA submits that the ban on snus is disproportionate given the low risk of snus compared with other nicotine products. It is an unsuitable means by which to achieve the aim of public health protection because it removes from consumers the option to use a safer nicotine product.
NNA also contends that the ban on snus infringes the human right to health. The availability of snus is an aspect of personal health and personal autonomy by which consumers can avoid the health hazards of smoking. The ban on tobacco for oral use limits smokers’ choice of safer alternatives, by excluding a product that is significantly less harmful to health than cigarettes. The NNA therefore submits that the ban on snus engages issues under European law, in particular those articles in the Charter of Fundamental Rights of the European Union (CFR) that protect autonomy and choice - Articles 1 (human dignity), Article 7 (respect for private and family life) and Article 35 (health care).
Article 1 of the CFR is an overall obligation to respect human rights, and protects ‘human dignity’. The issue of dignity is linked to personal autonomy: a principle by which individuals make choices on the conduct of their life, which presupposes a range of choices.
Respect for private and family life
Article 7 on ‘respect for private and family life’ is a broad-ranging right that is often closely connected with other rights including autonomy such as freedom of religion, freedom of expression, freedom of association and the right to respect for property. Article 7 has been held to apply to issues of quality of life, self- determination, a right to establish relationships, self-identity, choices in relation to medical treatments to prolong life, and decisions on parenthood by insemination techniques.
The EU Charter of Fundamental Rights stipulates in Article 35 that a high level of human health protection shall be ensured in the definition and implementation of all the Union's policies and activities. NNA argues that the EU legislators based the law on a limited understanding of ‘health protection’ in violation of Article 35. By banning tobacco for oral use, the EU prevents access to a product that significantly reduces harm to consumers as compared to cigarettes. The EU legislators, we believe, took a narrow definition of ‘health protection’ to mean protection from products, whereas it should have taken a broader public health definition to include making it possible for people to take action to avoid ill-health through the choices they make.
More from the NNA on snus:
European Court of Justice sends legal arguments out for comment
More progress with our case against the ban on snus: the European Court of Justice has now sent the legal arguments out for comment.
In January the High Court in London ruled that Swedish Match and NNA could take their challenge against the UK and EU ban on snus to the European Court of Justice, in Luxembourg.
The documents setting out the legal arguments were agreed between Swedish Match, the UK Department of Health (as defendant) and NNA, approved by the High Court and sent to the European Court of Justice. You can view them here.
This first stage is in itself a major success: there are few referrals to the ECJ, and even fewer involving an NGO such as NNA.
The ECJ has now requested comments on the legal issues (see below).
The Swedish Match legal challenge against the ban on snus
Swedish Match – the main manufacturer of Swedish snus – brought the challenge in the UK High Court. Their legal argument is that the law discriminates against snus compared with cigarettes and with lower risk nicotine products, that the ban is disproportionate, is against the EU principle of subsidiarity in removing national regulatory discretion, breaches the duty to give reasons for the ban, and is an unjustified restriction on the free movement of goods.
The NNA legal challenge against the ban on snus
NNA is acting as a third party in the public interest – in legal terms it is an independent ‘intervenor’.
NNA argues that the ban on snus is (a) disproportionate in that it is incommensurate given the low risk of snus compared other products on the market, and (b) contravenes the right under EU law to a high level of health protection.
Significantly, for the first time in a challenge against UK (and EU) tobacco legislation, NNA argues that the ban infringes human rights. NNA argues that the ban contravenes the EU Charter of the Fundamental Rights with respect to Art 1 on ‘human dignity’, Art 7 on ‘respect for private and family life’, and Art 35 on ‘health care’.
Art 35 stipulates that a high level of human health protection shall be ensured in the EU policies and activities. NNA argues that the snus ban is wrong as it prevents smokers from having access to a safer product and is an unsuitable means for achieving a high level of health protection. We consider that the EU legislators misinterpret health protection as meaning only protection from risks from products, whereas it should have considered a product such as snus in helping people to protect themselves from risks through the choices they can make to avoid smoking.
See here for more details of NNA’s legal case and the documents filed in the High Court.
Progress with the case
The High Court agreed on Jan 26th 2017 that there was a case for a review of the legislation. NNA’s request to be joined to the case was allowed by the High Court.
Because the UK law – the Tobacco and Related Products Regulations 2016 – is based on the EU Tobacco Products Directive 2014, the case was referred by the High Court to the European Court of Justice.
The ECJ has initiated the first steps in the legal review (case C151/17).
The ECJ has now sent out the case for comment to EU member states, the European Commission, Parliament and Council, and EFTA states. All these parties are able to make a submission to the ECJ commenting on the legal issues that we have raised: their comments have to be received by ECJ by 7th July.
When comments have been received back they will be reviewed by the court. It is likely that the actual case will be heard in Luxembourg at the end of the year or the beginning of next year.
Implications of the case
For more details of the argument that the ban on snus infringes the right to health see here
Watch this space!
Preliminary reference letter
High Court letter with ECJ stamp
More from the NNA on snus:
NNA calls on UK parties to repeal arbitrary restrictions on e-cigarettes and snus
We have written to the major UK political parties to urge them to include this in their election manifestos:
“We will help Britain’s 9 million smokers switch to healthier alternatives by removing unnecessary restrictions on e-cigarette advertising, tank and refill sizes, strength of liquids, and by ending the ban on snus as soon as we have left the EU. “
However, a lot more pressure is needed. The parties need to know that vapers are voters who are unhappy with the TPD.
This is what we sent to the parties (along with the manifesto wording, above):
Brexit removes the excuse for political parties to avoid reforming the worst elements of current anti-smoking policies many of which come into force on Saturday 20 May.
Particular anger among the 2.8 million UK e-cigarette users has been caused by the EU's arbitrary restrictions on their devices which have no benefit but which make them less convenient to use. These include maximum tank and refill sizes and a much reduced limit on the maximum concentration of nicotine in e-liquid consumers can purchase. Disproportionate restrictions on e-cigarette advertising were introduced in May 2016.
Also of deep concern is the ban on the Swedish smoking substitute snus. As the New Scientist reported in March this product is the key to Sweden’s huge lead in the EU in reducing smoking. The Spectator wrote that “if we want to benefit from Brexit the first thing that we should do is make snus legal”.
E-cigarettes and snus help prevent smoking and smoking-related disease at no cost to the exchequer.
The UK election offers a golden opportunity to encourage legislative change. Don’t waste this chance.
NNA will be at Vape Jam next weekend and we would love to see you there. You can find us at stand G58, along with INNCO and ViP. Dave Dorn (NNA) and Judy Gibson (INNCO) will be giving presentations so look out for those too.
The Vape Jam organisers, Amir Saeed and Maria Borissova, are, for the second year running, donating all the proceeds of the raffle to NNA. We will be selling the raffle tickets from our stand. We hope this will help to spread the word to a much wider audience, as well as raise much needed funds for the NNA. We are very thankful to Amir and Maria for their generosity.
We’ll be collecting NNA Supporter sign ups so please encourage anyone who hasn’t already signed up to come along and do so. The more supporters we have the louder our voice.
We are selling these silicone NNA branded 18650 battery sleeves / condoms from the stand: attractive, useful and consistent with the harm reduction theme! We have battery safety leaflets to hand out too; many thanks to e-cigarette direct for supplying those.
And these bags, perfect for carting about all the freebies you’ve picked up over the day:
And we'll be wearing these beautiful polo shirts, very kindly ordered and paid for by vapers.org.uk:
So, if you go to Vape Jam please do stop by for a chat and a sit down (no need to buy a raffle ticket, etc!). We’d really welcome an opportunity to discuss the issues we are all facing - that’s actually the whole point of us being there.
NNA has come a very long way in two short years and we have thoroughly earned our reputation as a “go to” organisation on tobacco harm reduction. Now we need your help to achieve even more. We have never asked for money before but we need to now.
We take every opportunity to represent the interests of those who seek safer methods of nicotine use. This includes working with the media, making submissions to governments here and abroad, responding to consultations, challenging rules that make life harder for consumers, speaking at events and working with scientists and regulators. All this costs money and we depend entirely on voluntary contributions. We would like to thank everyone who has given to us in the past, your support has enabled us to achieve remarkable things.
Our Trustees and Associates have worked really hard to get NNA this far and, until now, all of NNA’s work has been done by volunteers. We have recently appointed a part-time administrator to ease some of the pressure on our Trustees and to enable our charity to grow.
Every week there are new challenges: yet more questionable science, threats of creeping prohibition and individuals and organisations that want to sow doubts and fears. We need resources to counter these.
Guest blog from Rhydian Mann, NNA Associate and Welsh Campaign Manager at Vapers in Power
For all of you out there who know what my day job, is this piece won’t surprise you at all. For those who followed the development of the Tobacco Products Directive (TPD) 2014 into the UK’s transposed version, the Tobacco and Related Products Regulations (TRPR) 2016, this piece will be even less of a surprise.
For everyone else, well, this could be both an education and a shock!
Today, as part of my job, I met with two local Trading Standards Officers( aka TSO’s) in Swansea to discuss some of the“finer” points of TRPR compliance. Sorry, I can’t divulge the actual outcome because I could get fired BUT here are some of the knowledge bombs that came out of it:
1 Local Trading Standards have had no training in TRPR enforcement.
Yes, you read that right. I bluntly asked one of the TSOs if they have had any training or guidance on what to look for regarding compliant and non-compliant packaging for e-liquids. One of the senior TSOs said they have not received anything from the Chartered Trading Standards Institute, the body which provides training for TSOs across the country in any consumer product or consumer service provided to the public. I even rang the CTSI, earlier in the week, to see if they have any enforcement guidance and the best they could do was to pass my inquiry onto someone that specialises in “TOBACCO CONTROL”
This is a very scary thought indeed! This indicates that local TSO’s, when visiting an e-liquid manufacturer or a vape shop, are relying on the text of the TRPR itself and their own interpretation of it. Are the MHRA (the so called “competent authority”) and the Department of Health saying “just get on with it” to local council Trading Standards departments?
3 Interpretation = Confused.com
It’s been hard for manufacturers and retailers to get their heads around what the TRPR actually means. TSOs are probably going to have the same issue. As there is no guidance for enforcers, it is very likely that they will use the “Labelling”/”Product Presentation” requirements from Sections 37 and 38 of the TRPR as a checklist along with their interpretation.
I sense that term “harmonised enforcement” is a very comical thought. To put it bluntly, each local council TSO can have a different understanding of any line of the TRPR and hence enforce it differently. Here is an example of what I mean:
“(2) The unit packet and any container pack of the electronic cigarette or refill container may not include any element or feature falling within paragraph (3).
(3) An element or feature falls within this paragraph if it—
(d) resembles a food or a cosmetic product; or…”
This line has already seen some enforcement in some areas of the UK, resulting in some products being seized. You might remember this photo being passed around social media last month:
Now this is where manufacturers have become confused. Does this mean that a bottle or box can’t look like something you’d find in a supermarket cereal aisle or like a bottle of your favourite perfume? More than likely! OR Does it mean that you can’t have a graphic of an apple to show that your e-liquid is apple flavoured? Who knows!
Actually this line crosses over with an existing piece of legislation known as The Food Imitations (Safety) Regulations 1989. This basically says that no product should look like (amongst other things) foodstuffs because it would be “likely to cause persons, in particular, children to confuse them with food.” So based on that line, having an apple, a marshmallow, a donut on your product packaging should not result in that product being seized by TSO’s. Yet the photo above suggests otherwise...
This a perfect example of where interpretation between different local TS can cause massive issues. Take my employer who supplies across the country: Swansea TS could give our packaging a thumbs up but a TSO in York, or anywhere else for that matter, could give the products a thumbs down. So how can this situation be avoided?
4 Let your Local Trading Standards handle it
Provided that you’ve followed the guidance from your own local TSOs on packaging, (mainly because the MHRA guidance is a smidge contradictory with the TRPR itself) continue to work with them. There is an agreement between a manufacturer or retailer and the local Trading Standards department under what is known as “Primary Authority”. This has a statutory basis and if your own trading standards gives a thumbs up but another doesn’t then the discussion on the possible non-compliance is held between the two different local Trading Standards departments. Another bonus is that, depending on the Trading Standards, you might have a dedicated TSO that will deal with your company. This is not a free service but I am sure that it will offer some solace amongst all the other stresses.
I hope for the sake of vapers in the UK that manufacturers AND retailers strike up a conversation with TSO’s and continue to talk to each other. I am sure that all vapers would love to see their favourite brands and flavours in shops. I am also sure that vaping businesses want to see their brands flourish as much as possible in what has now become some sort of level playing field. The only way that EVERYONE can be made happy is to work together to get through this.
Finally, remember that Trading Standards Officers are not just “spoil sports” or “clouds of doom” who remove non-compliant or dangerous items from sale but they can also be your “right hand man” or “right hand woman” for advice.
New Nicotine Alliance Sweden (NNA Sweden) is a brand new Swedish Tobacco Harm Reduction promoting civil society, started early in 2017. NNA Sweden is an affiliate of NNA UK and NNA AU, as well as a member organisation of the global network of consumer advocacy organisations for safer nicotine products, INNCO.org.
The public launch of NNA Sweden took place at the Swedish premiere of A Billion Lives on February 7th. The premiere sported Aaron Biebert, snus advocacy crowds, vaping advocacy crowds, politicians, health economists and decision makers from the Swedish tobacco control landscape. The initial board of trustees for NNA Sweden are Atakan Erik Befrits from policy research, Ms Jennie Gejel a veteran vaping expert and Mr Patrick Pihl who is a 25 year veteran of snus advocacy and covers snus science in Sweden.
NNA Sweden aims to give a valuable contribution to both Swedish tobacco control policy work and to the important international work being done to safeguard rights to harm reduction products and policy.
Please feel free to contact us at any time to discuss cooperative efforts, access to Swedish data and experience or just to say hello.
Jennie, Patrick and Atakan
One of the outstanding weaknesses in some recent research into e-cigarette use is the obvious lack of knowledge that some researchers and commentators have about the workings of vaping devices. indeed, whether by accident or design, some massive 'bloopers' have been made and those have had serious repercussions. How many smokers have disregarded alternative advice and have continued to smoke?
It is difficult for people who are in the front line: people who vape, to express their thoughts and counter the 'wittering's' of some experts. It is difficult for shopkeepers, hairdressers and used car salesmen to have their voices heard above the 'babble' of health professionals, politicians and media presenters all proclaiming loudly, this, that and the other.
Yet... Who are the experts when it comes to vaping? More importantly, are they really experts? Let us take a quick tour and have a look at what some 'experts' have said about vaping.
Let me start with what is to my mind, one of the 'daftest' ones. E-cigarettes may cause tuberculosis. That is correct, e-cigarettes may cause tuberculosis.
The following comment appeared in the Cape Bretton Post of 2nd January 2014. It was written by an 'expert.' (But not a medical expert)
“Now most of the e-cigarettes sold here are made in China, where there is very weak government regulation with respect to how they are made. The Canadian government does not know if Chinese workers making cigarettes wear masks. If they aren’t wearing masks, there are increased risks associated with tuberculosis.”
I spotted this at the time and wrote to the professor, pointing out that...
"This is just about one of the most ridiculous statements have ever come across. Pure, unsubstantiated scaremongering and an indication of the lack of care you have taken with your research.
There is a beautiful irony here. Some ‘idiot’ has reasoned that if there is tuberculosis in China, there must be a risk involved. You have decided to parrot this. And here is the irony! You see, the main ingredient in e juice is propylene glycol. Propylene glycol is a disinfectant. And, do you know what? It is used extensively in the war against… yes… come on now… Think! That’s it… Tuberculosis!"
Yes, I know, just because propylene glycol is a constituent in e-liquid does not mean it would prevent infection via vaping - but there again, there are, as far as I am aware, no cases of tuberculosis having been caused through vaping.
Anyway, I am not an expert. Oh! And you may have noticed that my propensity for using emotive terminology has not changed between my writing back then and now - I offer no apology even though scientists avoid doing this... or do they?
An emotive headline but did the researcher claim this? It would appear he did. “[Level of PAHs] in e-cigarettes is at least one million times more than roadside air in Hong Kong,” said Dr Chung Shan-shan, assistant professor in the university’s biology department." The study itself turned out to be 'pure garbage,' sorry, I must stop doing that. The study itself contained one or two weaknesses. No, back to my own style: It was not worth the paper it was written on, or perhaps I should say, the papers it was written in, because I am not sure if the research was ever published except in the world press.
It is not a one off... The New England Journal of Medicine [Published by Marvel Comics? I can say this because I am not an expert and have no ambition to have anything published in publications of disrepute] The New England Journal of Medicine published a report that started a media frenzy.
However, is was soon revealed that, once again there were major flaws.
Clive Bates said the following in his article, Spreading fear and confusion with misleading formaldehyde studies.
"This experiment, published in the New England Journal of Medicine, operated the vaping device at a such a high temperature that it produced thermal breakdown products (so-called dry puff conditions), but no user would ever be able to use it this way – the vapour would be too acrid. They went on to calculate human cancer risk from these unrealistic machine measurements and presented the data in way that was bound to mislead, which it duly did and created a world-wide media storm. This was irresponsible science, careless publishing, and credulous journalism adversely changing the perceptions of the relative risks of smoking and vaping in a way that will cause harm. The paper should be retracted in its entirety".
And on and on and on. 'Experts,' media, spouting crap, anything to demonise this perceived threat - and not necessarily a threat to the vaping consumer. Lipoid Pneumonia, Tuberculosis, cancer, gateway,However, thank goodness, there are real experts out there. [Note, no inverted commas].
And now we come to the present day, yesterday in fact. Yesterday I read an article by Sofia Carlsson, Associate Professor, Institute of Environmental Medicine, Karolinska Institute, and Cecilia Magnusson, Professor, Department of Public Health Sciences, Karolinska Institute, here. [You may have to use translate]
They discuss a paper purporting to show a connection between heavy snus use and diabetes type 2. Before saying anything about this, in the above [linked] article they stress, and stress it more than once, that we should not jump to conclusions as there may be confounding factors - how very refreshing...
They also state as a fact: "Smoking is an established risk factor for diabetes, and a new problem in previous studies has been to separate snuff effects from smoking as inter use is common."
This comment started warning bells ringing. So I Googled (five minutes' worth) and the very first thing I came up with was... (page 250)
"Then there are quirky findings. In the Sweden study, researchers also looked at the risks associated with using "snus."... In this study, and in contrast to smoking cigarettes, the use of this nicotine containing product did not significantly increase the risk of diabetes."
Oh aye! But it is the next paragraph I find really interesting.
"The Hopkins' study also had an unexpected finding. Although cigarette smoking was clearly linked to type 2 diabetes, stopping smoking led to higher short term risk. highest in the first three years after cessation with a hazard ratio of 1.9.
The last finding is a head scratcher. A report from the University of Oxford, England, involved 1,919 patients followed over 6 years. Of these subjects, 1,216 were initially free of retinopathy
Hang on a second, what on earth is retinopathy? I am not an expert you see. Right, Google: 'Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye'
and 22% developed the pathology over the next 6 years. Of the 703 persons with retinopathy at the onset of the study, 29% progressed with 2 scale steps or more... Not smoking had an unfavourable effect on the development or progression of retinopathy.
A head scratcher right enough.
Sofia Carlsson, and Cecilia Magnusson, rightly emphasise that there may be many confounding factors but also state that, they, "have also, insofar as possible, taken into account other risk factors for type 2 diabetes such as overweight, physical inactivity, heredity, alcohol consumption, and education level." Did they? I do not have access to the research and even if I did, I doubt that I would understand much of it. It just seems to me to be an echo of previous, dubious e-cigarette studies. It just seems to me that not enough attention has been paid to the lifestyles of the participants... For example, is it the case that, like so many heavy smokers, heavy snus users are concentrated within specific society groupings, that they tend to be less active: that their diets are poorer; they belong to a particular ethnic group. (Some racial, ethnic groups continue smoking cigarettes at higher rates) Whatever...
It seems dubious to me that just because diabetes is higher in heavy snus users that it is the snus which is the cause? The researchers welcome any discussion - so do I.
And please take into account http://www.accessdata.fda.gov/Static/widgets/tobacco/MRTP/18%20appendix-6a-environ-snus-monograph-2013.pdf
Pay particular attention to the sections dealing with diabetes.... and you say that there has been little research. Hmmm!
But why do so many researchers publish materials that that are so far from the truth? What can it be that motivates them to go down this road? Michael Siegel, Professor in the Department of Community Health Sciences at Boston University School of Public Health gives us an insight into the world of Tobacco Control. He paints a picture of a world where individuals are indoctrinated and controlled. A world which will broke no contradiction; suffer any criticism.
He says, in an article, containing a great deal more...
"...if I conduct a study and it fails to show a significant relationship between second hand smoke and chronic disease, then all of the sudden, I have automatically become an illegitimate scientist."
"If it fails to show." Is this why so many 'studies' risk ridicule; a combination of induced blindness and fear?
"I was able to overcome my "brainwashing," but it took a lot of courage to do so, and a lot of risk to my career. I paid a heavy price for breaking out of the mould into which I had been cast. It shattered my career in tobacco control. But at least it didn't shatter me, and the person who I really am."
How many experts show this kind of courage, and the answer, surprisingly, is quite a few... these are the experts, the genuine ones, and their number is growing.
The edifice which is Tobacco Control is crumbling. Soon it will be gone.
New Nicotine Alliance would like to offer our thanks to Robert Innes for this guest blog entry. He can be reached on Twitter at @brainyfurball
The EU consultation on excise duties applied to manufactured tobacco ends on 16th February and includes proposals to tax reduced risk nicotine products. It’s vital that nicotine consumers respond to make their feelings known. If the EU permits taxation on reduced risk products the prices will go up and many people will be discouraged from switching. It’s simple and quick to respond to the consultation - it only takes around 15 minutes. Vapers in Power has done a useful guide to it, here. The Clive Bates/NNA briefing is here.
If you have already responded then please make it your goal to get three other people to respond too.
Here's a repost of NNA's "EU Tax policy - harmful to health - our briefing", in case you missed it the first time round:
The EU Commission is currently consulting on a revision to the Tobacco Excise Directive, which could see reduced risk products such as e-cigarettes being included. Our associate Clive Bates has written an in depth briefing together with NNA which details why this is a very bad idea. The full briefing can be read here. The consultation can be found here.
There is no case on principled or practical grounds to apply excise duties to vaping products and other products that offer a much safer alternative to smoking. The value to health and wellbeing associated with switching from smoking to vaping will exceed any benefits arising from revenue collection.
Just as it was with the Tobacco Products Directive, the inclusion of products which do not contain tobacco in the Tobacco Excise Directive is unhelpful and risks creating confusion in the minds of consumers.
If vapour and other reduced risk products are to be included in the directive then our view is as follows:
Our recommendations for low risk non combustible products are as follows:
We urge the European Commission, European Council and member state tax authorities to take great care in striking the balance between public health, revenue raising and administrative costs. The institutions involved should conduct thorough impact assessments, take a hard look at the risks of causing harm to health and then think again about imposing excise duties on products that are already helping millions of Europeans to improve their health and wellbeing and have the potential to help millions more.
Please do read the full briefing and have your say. Make sure your MP also understands your concerns.
On the day that NNA was in the High Court asking for permission to join the effort to overturn the ludicrous ban on snus, and Hertfordshire County Council were holding their very successful 'e-cigarette masterclass', at which delegates learned about vaping, and sensible vaping policy, Public Health Wales issued their new position on e-cigarettes. http://www.wales.nhs.uk/sitesplus/888/news/43873
It is difficult to imagine the machinations that must have gone on within PHW whilst coming to this position. Seemingly realising that a failure to admit that e-cigarettes are very much safer than smoking tobacco cigarettes is now akin to being an anti-vaxxer, they grudgingly advise that anyone who is unwilling or unable to stop smoking should switch to vaping instead. Quite why anyone would want to do so given the rest of the PHW statement is anyone's guess.
Cherry picking from the US Surgeon General report, and of course the World Health Organisation, we are told that:
There are no benefits to children or young people using e-cigarettes.
No one wants to see young people initiate nicotine use via any method, but for those who have or will take up smoking there are definite benefits.
'Confectionary-like' (sic) flavours of e-liquid should not be permitted, in order to reduce the appeal of ENDS to children and young people.
How many times do we have to point out that the majority of adults prefer candy and fruit flavours. Certainly these flavours should be marketed responsibly, but in light of the fact that there is no evidence that 'confectionary-like' flavours, or indeed any other flavours, cause young people to take up regular vaping, all that this policy would achieve is to make e-cigarettes less appealing to those adult smokers who, as PHW admits, would benefit from switching.
Until a more definitive risk assessment can be completed, voluntary restrictions on the use of ENDS in enclosed public spaces should continue.
No doubt PHW would have preferred to push for legislative bans, but given what happened last time they tried, they settle for telling Welsh businesses to do that job for them. Contrary to PHW's carefully selected 'evidence' on this issue, there is no evidence at all of a risk of harm to bystanders, or that vaping renormalises smoking.
Additional 'factoids' in the statement include:
"Use of e-cigs may reduce the likelihood of smokers quitting by displacing scientifically proven methods to help people quit."
"The use of ENDS will act as a gateway to tobacco use."
Needless to say there is no evidence to suggest that either of the above concerns are happening in the real world.
In summary, whilst PHW's assertion that for a smoker, switching to e-cigarettes will significantly reduce the risk of harm to health is welcome, this statement is completely outweighed by the very negative comments which follow. We can all guess what this information will look like:
"Public Health Wales will include information on ENDS alongside other aids to stopping smoking in all information materials and in Stop Smoking Wales support services. Information on all products will be presented to support smokers in making an informed choice about the best way to quit for them."