The insidious re-normalisation of smoking

    31 July 2014

    The NHS has long since been smoke free, banning smoking on-site for patients and staff alike back when I was a nursing student. Of course this is ignored pretty much universally by patients and visitors, and every time you enter a major hospital it is usually through a cloud of tobacco smoke whilst the poor nurses must change out of their uniform and leave the hospital site in their rest break. It was with great surprise then, whilst sipping my morning coffee recently and trying to recover from the hacking smokers cough acquired entering the building, that I noticed a patient nearby sat merrily smoking away.

    I was incredulous. Outraged. I stared open mouthed, and, being British, said absolutely nothing. Fortunately, I realised before I could release an almighty tut that she wasn’t smoking at all. She was doing something entirely different; she was ‘vaping’. Being a longish-term ex-smoker this phenomenon had largely passed me by until now. Vaping & e-Cigarettes offer a cigarette-like experience of inhaling nicotine without tobacco smoke and all the known disease-causing tobacco constituents. It is considered by some as a harm reduction strategy for tobacco, but did not meet the National Institute for Health and Care Excellence (NICE) guidance on tobacco harm reduction; with very clear statements on the lack of evidence of long-term safety, lack of reliable evidence of short-term safety, and concerns over toxic constituents. The Medicines and Healthcare products Regulatory Agency (MHRA) will soon be regulating licensed products that may serve to improve their availability, acceptability and popularity. This will also allow them to be marketed as a smoking cessation aid.

    Debate continues over whether this is an entry or exit drug to smoking, and it may yet have a place in the arsenal of medications for helping smokers quit. But, being tobacco-free, they are not subject to the same controls and legislation. This makes me very sceptical indeed. As I have begun to pay attention, I cannot help but notice that the branding is typical of the ‘golden age’ of cigarette smoking, and I wonder how long it will be until we have slogans such as ‘happiness is a vaporiser called (insert brand name here — might I suggest Majestic as an excellent potential brand name)’. The flavours available are vast. With options such as fruit, chocolate, absinthe and ‘cinnamagic’, they seem designed to appeal specifically to our young. It is easy to see why. Big tobacco is in decline in the western world, and both old tobacco companies and e-cigarette start-ups are hungry for profit.

    The years of denial of tobacco’s dangers should remind us quite how little concern can be shown for public health by companies and cartels that want to sell you totally unnecessary and addictive products. There is a stealth, re-normalisation of smoking underway and an insidious attempt to grow a new market by targeting the young and naive. So, my advice is to treat any individuals or organisations who claim that these products are harm-free as you would a regular cannabis user who cites research about the health benefits of THC while ignoring all the really bad associations with the drug, like psychosis, paranoia, depression, and even cancer. Give them a nod, a smile and a big fat dose of scepticism, or ‘sceptimagic’ maybe?