Once known as the most progressive country on vaping and tobacco harm reduction, the UK is now poised to join the ranks of nations that demonize, restrict, ban, and tax, potentially lifesaving nicotine vaping products. Why is the UK turning its back on tobacco harm reduction?
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Brent Stafford: Hi, I'm Brent Stafford and welcome to another edition of RegWatch on GFN.tv. Once known as the most progressive country on vaping and tobacco harm reduction, the UK is now poised to join the ranks of nations that demonize, restrict, ban and tax potentially life-saving nicotine vaping products. Why is the UK turning its back on tobacco harm reduction? Joining us today to help answer that question is Mark Oates, a fellow at the Adam Smith Institute and prominent UK advocate for vaping and tobacco harm reduction. Oates is the founder and director of We Vape, an organization established to unite vapers across the UK and amplify their voices in public debates concerning vaping. Mark, thanks for coming on the show.
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Mark Oates: Thank you very much for having me.
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Brent Stafford: Mark, tell us a bit about your background and how you came to Vape Advocacy.
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Mark Oates: So the story starts when I was in China over a decade ago working and I was smoking some 50 pence a pack cigarettes and I flew home when I finished my work via Sweden and I bought some Swedish snus really by accident. I thought it was chewing tobacco and I tried it when I worked in America and I wanted to tried again just for fun, but out came these pouches of tobacco, and I thought these were absolutely brilliant. I then read up into the subject, and it turned out they were vastly safer than smoking, and the reason why Sweden has the lowest smoke-related illnesses amongst men in Europe. And I was able to sort of quit smoking, although because it was illegal to sell it in the UK and still is, I was the government, the British government was implicit, complicit, sorry, in keeping me smoking because I couldn't get hold of the product. So I'd go back to smoking whenever I couldn't get hold of it. And it was only when I brought vaping into the equation and I went, you snooze sometimes and use vaping. That's when I fully managed to quit smoking. But I felt it was entirely unjust that this product was illegal. And it was bad policy because it has led to many more people smoking than otherwise would if we'd had access to this product. And I'm very fearful that the same thing could happen with vaping.
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Brent Stafford: Now, in a way, isn't it, we know that snus and safer nicotine products are tobacco harm reduction, but sometimes are they not like government harm reduction, you know, preventing some harm from government that's banning products?
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Mark Oates: Yeah, I mean, governments seem obsessed with banning things. And I think, you know, my background and interest in politics really began both in terms of harm reduction, but also in terms of policy reform for drugs policy. And there's an obsession with government banning things. and without necessarily understanding that when you ban things you may be removing the legal supply of a product but it does nothing to have any impact on the demand for that product and you are therefore leaving the product to be supplied by the black market now you've got some experience working in british parliament um how has that impacted your advocacy So it gave me the freedom to really research huge numbers of topics. And I was part of my work. I was campaigning on a huge number of different issues. And I really enjoyed it. You know, I was editing from health to transport. Often I was in a situation where I was advocating on behalf of individual constituents for my boss who had suffered because of the state. And the state is a huge apparatus and someone needs to stand up for them. And often that's the role of the MP and their team. And there's been some very sad cases I worked on involving things that I wouldn't even want to talk to you about, but tragic. And you are the people that are willing to stand up to the government and say there's been a fault here by the state.
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Brent Stafford: So Mark, as you know well, the UK has historically been a global leader in endorsing vaping as a harm reduction tool for smokers. Famously, Public Health England estimated that e-cigarettes are approximately 95% less harmful than smoking. It's a stance that significantly influenced public health policies in your country and bolstered vaping advocacy around the world. But today, Public Health England doesn't even exist, and the UK seems to be turning its back on vaping. Is this appraisal accurate, and if so, why?
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Mark Oates: I think it is largely accurate. We were very lucky. There were some fantastic independent researchers in the UK who pointed out how much safer these products could be. And the government in 2010 listened. In fact, the story behind that, a guy called Matt Ridley, who was a former peer in the House of Lords, writes in his book, Innovation, a great book, by the way, very, very interesting, of people interested in this subject and in technology and innovation. Actually, a guy called Rory Sutherland that some of your viewers may have seen. He appears in TikTok and YouTube a lot. He's a marketer. And he'd quit smoking through vaping. And he actually had a beer with someone who was in charge of the... a nudge policy, nudge team, and their job is to nudge the public into doing things that would be advantageous for the country. And this guy told the guy who's head of the nudge team all about how vaping had helped him, and that may have been the thing. The meeting, the conversation that swayed it from the government allowing the product to grow as a consumer product and do the amazing good it has done. Because at the time, there were a lot of calls from people to make the product a prescription-only product. And we know how awful that is and how it would have kept more people smoking had they done that. In terms of the turning the back, they are looking like they're going to be imposing some really bad policies. And that could lead to a number of things. One thing would be vapors that are currently vapors going back to smoking because they're going to hinder the ability for people to get hold of these products. And then the other one is preventing people that currently smoke from making a switch in future. And also the people that are choosing a nicotine product, they may be more likely to choose a product that will kill them.
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Brent Stafford: So let me ask you, Mark, and this, I think, is the burning question, at least for those on our side that have heard so much about this in our own countries. Is there an epidemic of teen vaping in the U.K.? ?
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Mark Oates: I think there's an epidemic of moral panic within the media about teen vaping. If you look at the numbers, back when I was at school, we had a similar number of people smoking cigarettes as we now have trying out vaping. And for some reason back then, no one really cared about it. It didn't make the newspapers. But now it's always in the newspapers, even though this product is vastly safer than smoking. Now, I should be clear, I'm not advocating or encouraging under 18s to consume this product. It's an adult product. But what I am saying is that it seems... crazy that it's hitting the headlines so much when it wasn't when i was at school when uh plenty of people were consuming combustible cigarettes which will kill you are they calling it an epidemic in the uk they are calling an epidemic yeah um i think it's it's come it's hit later than it did in america um but it's it's been called an epidemic and for some reason there's something psychological about it uh Before, if parents found cigarettes in their child's bedroom, it was the fault of the child. But now it seems to be the fault of others. Little Timmy would have never smoked. And it's these evil others that have led to him vaping. But I know that's not how I'm going to act with my child. I'm certainly going to recognise they've got their own choices and I don't think I'll be blaming outsiders for what they choose to do. But it goes as far as a journalist wrote an article because a parent found a vape in the child's bedroom. And I think a lot of this has been driven by clickbait. There's a lot of attempts to get headlines And it's really bad for public health because the headline will be vaping is now as dangerous as smoking. And you read into the article and it refers to a study which shows that when someone vapes, their heart rate goes up to the same level as it does when you smoke. well, I'm sorry, but that in itself is not evidence of harm. Heart rates rise for all sorts of things, drinking a coffee, consuming nicotine, which obviously both vaping and smoking is, going for a run. So it's abysmal and it's a real shame because people read the headlines and they form an opinion based on the headlines. They might not necessarily read the whole article. And that's pushing people to stay smoking. It's pushing people to take up smoking. And it's pushing the public to, look down on their friends and family who are making the switch. I've heard stories of vapors saying, you know, when I tried to quit, my friends and family were saying, oh, you shouldn't do that. And we need people to support people quitting smoking. And when the public is so misinformed, when smokers are so misinformed, what hope do we have of helping people improve their health through switching and quitting?
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Brent Stafford: Let's take a quick look at some of the actual numbers for teen use in the UK. This was put out by Action on Smoking and Health earlier this year amongst 11 to 17-year-olds. Current use of vapes and cigarettes, and you can see the number there, it starts in 2021, is really where it actually dipped. It had been growing a little bit in a couple of percentages here or there. But from 2020 to 2021, there was a massive dip. And then from there in 2021, it just shot up. I mean, this is for real. We also take a look at the 20 again here at the 11 to 17 year old. And you can see the over time, this is the mix of youth vaping. And you can see that same trend across the whole board being starting in 2021. So my question for you, Mark, is why did this turn so late? It was 2018 was the main hit in the US and Canada. By 2029, it had already started softening. And then in the last four years, vaping in the US, vaping and smoking amongst youth have just cratered. How is this happening in the UK now in 2023, 2024?
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Mark Oates: A large part of the reason is bad regulation, and that's the PMTA. Actually, what's happened in America has caused the vaping youth use to increase. So you have the disposables arrive in America because of the pod ban, and then the Chinese manufacturers look for new markets, so they enter the UK. And what disposable vapes did was they put lots of different flavors and easy to use products into convenience shops. Whereas before to get all the flavors, you had to go to a specialist vape shop. And these specialist vape shops were, this was the only thing they did. And they were largely very good at checking people's ages and they wouldn't sell to under 18s. Some of the convenience shops, they didn't really care so much about the selling to under 18s. And so you had a product which is easy to use. Open systems are much more complex and they're harder for people to get hands on. And you have them in convenience shops and prices, you know, five pounds are quite cheap and easy. The only thing we should mention here, the really important thing, is that at the same time as this happening, we have had a huge reduction in the number of cigarettes sold in the UK. It's almost halved. So whilst the debate has been, yes, young people have got hold of this product because of shop sellers not doing their job, what we've actually seen is a large number of people quitting smoking or reducing their smoking rates. What I've been calling for is for the government to introduce a licensing scheme. I personally went round with a hidden camera and bought illegal vapes in the UK, of which illegal vapes make up the majority of the disposable market. They're freely available. I went to the Prime Minister's constituency, I bought illegal vapes. I went to the Secretary of State for Health's constituency, I bought illegal vapes. The Minister of Health, I bought illegal vapes. And unless they have a licensing scheme that brings more money into the people that enforce the laws, then all these bans and taxes aren't really going to shift the dial because people are going to be pushed to the black market. The licensing scheme I suggested would bring in 50 million pounds to trading standards, which is our government agency that enforces the rules. So that's how you can tackle the problem. We want bigger fines. I surveyed my members. I've surveyed the public. They want to see bigger fines for people breaking the law. They're not happy with it either. And some shop sold to an under 18 year old and got a fine of something like $30. Now that is not going to prevent someone breaking the law, especially when the profit margins are so high for these products.
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Brent Stafford: So the government, and actually I should say governments because it's plural in this case, have brought in the tobacco and vapes bill, which has led their signature effort here as a disposables ban, which begins in June of 2025. So it's coming up. six, seven months here. Tell us about the conservatives and labor government. Was there any change between them? And what is the disposables ban going to mean specifically?
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Mark Oates: So first things first, both governments effectively have the same policy. There's not much change. Rishi Sunak met Michael Bloomberg in the summer of 2023. And then at the party conference of summer 2023, he announced he was going to ban disposables. Was there some kind of link there? I'll leave it up to your viewers to discern that. The reasons they want to do it are the youth use, but also the environmental aspect. And I know a lot of vapers and myself are equally frustrated with the environmental aspect of disposables. I would say the answer to that is to impose a deposit return scheme where, say, you have a pound on each disposable and then you have to bring it back and it can be recycled, which they can be recycled now. And that would mean we would still have this product for people that want to buy something conveniently to use nicotine. And what I saw with disposables is the people I knew that would tend to just smoke when they're out for a drink or out partying, disposables managed to get them off the cigarettes. And if those disposables are not available, they're not going to bother with any other system. They don't see themselves as a... long-term or a regular user, and they're likely to just go for something that's more convenient, a pack of cigarettes. So yeah, the disposable ban, 2025, June, the big issue with that is that they've banned the legal sale, but the illegal sale looks like it will still continue.
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Brent Stafford: Yeah, and that's the question. I mean, for one, is it practical to assume that the market could be cleared of disposables? Is there enough enforcement? You know, is it even possible? Or is it just going to mean an explosion of the black market?
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Mark Oates: I think it's going to lead to an explosion of that market. The only question is, the government have said in their tobacco and vapes bill, they have given themselves the power in this bill to a later stage introduce a licensing scheme. So that is a positive. How that looks, we don't know yet. But unless they do that, if they don't do that, then it's going to have very little effect. And in fact, it could be more problematic because currently there are people who are legal companies that are selling these products that are involved in the recycling of the products. Once it goes to that market, no one's going to care about recycling.
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Brent Stafford: So it's pretty clear then, I think, that one of the ways this turns out is that there's still millions of disposable vapors available on the market.
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Mark Oates: Absolutely. I mean, you look at Australia right now, where there's huge numbers. I know that in Australia, apparently, if you're buying a container load of disposable vapes from China, you can pay something like 3% of the total cost of that shipment. And the company selling it will insure you against border force catching that product. And we know in Australia, the rates of vaping are similar. So legal or illegal, you seem to have similar rates of consumption.
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Brent Stafford: Now, Mark, there is some evidence actually out there showing that the disposables ban could indeed push people back to smoking. The impact assessment statement from the Department of Environment, Food and Rural Affairs, which is DEFRA, says that a disposables ban could push as much as 29% of current vapors back to smoking. That's massive.
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Mark Oates: It's huge. And it's deeply worrying that a government would look at that and be OK with the potential of 29% of people switching back to smoking. I mean, two thirds of smokers die. So the government is happy to see people die when there were many other ways we could solve this issue. But they just frustratingly wouldn't listen to the people that actually perhaps know what they're talking about.
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Brent Stafford: Mark, when the disposables ban goes into effect, will there be any restrictions on the sale of combustible cigarettes?
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Mark Oates: So not in June 2025, there won't be any restrictions. Later down the line, if the tobacco and baseball goes through, they're introducing a generational ban. So children that reach 18, I think it's in 2027, they won't legally be allowed to purchase cigarettes. And I put emphasis on the legally because they'll still obviously be able to purchase them from the black market. And again, it's frustrating talking about it because people's response is, well, they won't be able to buy cigarettes. It's like, they will. A large number of people buy cigarettes currently under the age of 18. So we know the rules don't work around then and they won't work later. It'll be even worse. I mean, imagine the profits that people at university will be able to make selling to students who can't buy cigarettes. You know, you'll have someone in the year above or in the same year as you who's maybe taking a year out. So they're one year older. They'll be able to buy them. You won't. There'll be profits galore for the black market. And I feel sorry for the shopkeepers who are going to have to somehow track this changing age. frustratingly, they're going to create a black market there for people based on age at a time when we're actually cigarette smoking is ending for the young people because they're choosing to vape instead. So there's a real risk that we could end up putting people back to smoking because it's illegal and maybe more attractive.
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Brent Stafford: Mark, the tobacco and vapes bill will also introduce restrictions on vape advertising and sponsorship, as well as restricting flavours, displays and the packaging of e-cigarettes to reduce their appeal to children and young people. That's a lot. It feels like anti-vaping forces have won and the government is dropping the hammer.
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Mark Oates: Yeah, what it's going to do is it's going to give the impression to the public that vaping and smoking are one and the same. And that's dangerous because people who are smoking will think, well, they're the same, so I'll just continue smoking and continue dying. You know, ironically, the advertising, the sponsorship thing, in particular on a global level, this could be a real killer because if a major sports team like Man United happened to have a nicotine pouch brand on their top, you know we could reduce massively the 1.1 billion people smoking globally because this product is not really known about but nicotine pouches in terms of price point are very similar to cigarettes so they're affordable for lower middle income countries whereas vape products are much more expensive so if you really cared about trying to reduce the 1.1 billion smokers and therefore the 8 million people dying a year from smoking then that ban is terrible. What we want is to quickly, as quick as possible, inform the world that they can end smoking deaths if they get their public to transition to nicotine pouches. An amazing product. Sweden is about to become smoke-free. It's a fantastic story and it's being ignored by policymakers.
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Brent Stafford: Well, Mark, I've saved the worst for last. The government is also implementing an excise duty on nicotine vaping products. How big is the tax and what's going to be the impact?
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Mark Oates: So the tax is enormous. I mean, you're taking a product that's £10 now up to about £36. So nearly, you know, three, 400% rise. And it's really upsetting because I speak to vapors. There was a lady at the Vapor Expo a few weeks ago, and she was so pleased that she'd managed to quit smoking through vaping. And one of the things she pointed out alongside the health improvements was the fact she only spends £25 a month. on vaping products. That's going to almost quadruple. So over the course of a year, the government is going to take £900 out of that lady's pocket, out of her family's pocket. And this is really going to drive people into poverty. We know the smoking rate and the vaping rate are higher in those that are the least well off. So really, this is a tax that will create poverty and also drive people to smoking. The tax they're adding on to cigarettes because they're doing this is something like £2.20 per 100 cigarettes. But this tax on vaping is £2.20 per 10 millilitres. It's not really comparable. They don't understand the difference between vaping and smoking. Vaping is less efficient at getting the nicotine into your system, so you tend to vape more liquid. But the fact is that you don't harm yourself.
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Brent Stafford: Now, everything you're saying here is entirely familiar to those of us in the US and Canada. We just never thought that this kind of misinformation and media hysteria could ever happen in the UK, the home of tobacco harm reduction.
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Mark Oates: Yeah, I mean, I think one of the biggest frustrations is I don't think many in public health and government really understand what vaping is. It is a societal substitute and replacement for smoking combustible cigarettes in the same way that we want electric cars to replace the combustion engine vehicle. And that means that my son will probably, possibly never drive a combustion engine vehicle because it's the new mode of transport. This is how we do things. We drive electric cars now so we can save the planet. No one's going to say to my son, oh, you shouldn't be driving an electric vehicle. You never drove a combustion engine vehicle. That's not for you. That's for someone that drives a combustion engine vehicle. So we're seeing that now, you know, adults perfectly legally allowed to want to consume nicotine, and some of them will choose to use a safer product. And we shouldn't be saying, no, no, no, you must first harm yourself before you're allowed to use this product. But in the eyes of public health and a lot of the public and the media, they view this as purely a smoking cessation tool when it's not.
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Brent Stafford: Mark, I'm pretty convinced here that public health has lost the plot in the UK as elsewhere. I would share this one statistic with you. One million people in England now vape despite never having been regular smokers. And that's a seven-fold increase in just three years, which is according to research published in the Lancet Public Health Journal. So you've got a million more adults, young adults in the UK who are vaping, who never smoked. And I think that that's the big issue. It's the underlying elephant in the room is that nicotine, recreational nicotine. They don't want to see even adults choosing to take up the habit.
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Mark Oates: Yeah, absolutely. The author of that study She was very frustrated that the media were taking the wrong things from these headlines. And she actually said that What you need to understand is the impact of this established rise in vaping among young people who have never regularly smoked will depend on what these people would otherwise be doing. And that's the important point. A lot of these people would have chosen to smoke instead, but we now have a way out immediately for them. So that's a positive. And even people that may not, and we will never know, ultimately they're doing something that is probably, in terms of known risks, similar to consuming caffeine. And there's no doubt that consuming alcohol is probably more harmful, and young people are consuming that at a higher rate than they are vaping. I think this headline, a million people are now vaping that never regularly smoke, you could switch that around. You could say a million people are now using condoms that never regularly had unprotected sex. But they did sometimes have unprotected sex. And the fact is that if you're going from something that is extremely harmful to something that's very much less harmful, that is a net positive.
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Brent Stafford: Well, I know for myself that I picked up smoking at 21 in my early 20s. It was an adult decision I made and it's haunted me for the rest of my life. And I wasn't the only one. Your 20s are a time when people do pick up smoking. It's not always Johnny when you're 12. Sometimes it's decisions that are made when you're a bit older because, you know, you're at legal drinking age and drinking and nicotine go well together.
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Mark Oates: They do. I don't think many in public health really understand that humans will chase pleasure. We'll always chase pleasure. It's a part of our makeup. And just telling people not to do things doesn't work. Offering them an alternative, which is safer, is the best way of removing the harms, but allowing people the freedom to do what they naturally want to do. This kind of attempt to just stop people doing things doesn't work. We saw it in the 1980s with the HIV epidemic. There were some very immoral people that basically just told people not to do these things. And not only was it immoral, it didn't work. because of human nature. The way that we've solved that is through safer sex, condoms, but also PrEP. PrEP, for those that don't know, is a pill you can take once a day. And if you're at risk of getting HIV and you come into contact with it, you won't actually get it. So we utilize harm reduction in a lot of fields. There seems to be an inherent fear over it in regards to nicotine because of the prejudices that come from smoking that are passed on to safer nicotine products.
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Brent Stafford: So Mark, is vaping, and pardon my French, screwed in the UK, or is there hope to turn this around?
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Mark Oates: I don't think it's entirely screwed. Ultimately, the public health groups and the government understand the role it plays in smoking cessation to get people to quit smoking. They don't understand the role it plays in its substitution and replacement as its role in society. The real risk though comes from these policies that are being implemented not working. because then government nature seems to be, well, we must ban another thing. So they'll then ban pod systems, okay? Then pod systems get banned. Then the only way you have access to this product is if you use coils and you refill your product, which makes an even smaller group of society that willing to do that when you've got the easy use of a cigarette. And then maybe that doesn't work. And then they decide to ban open systems as well. And that effectively is the story of Australia, isn't it? Which is just horrifying, the sort of hole they've gone down. And you see the profit margins in Australia. Australia for tobacco and illegal vapes are higher than cocaine. So of course you're going to have people wanting to supply them. And it comes back to this age-old story of people not understanding that bans don't always work.