Medical doctor and addictions specialist Garrett McGovern warns that most people in his profession who are anti-vaping seem to want electronic cigarettes to be “more harmful” than they are and it's almost as if “they don't want them to be safe or safer.”
Featuring:
DR. GARRETT MCGOVERN
Medical Director, Priority Medical Clinic Dublin
GP Specialising in Addiction Medicine
@AddictionsPMC
Transcription:
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Brent Stafford: Hi, I'm Brent Stafford and welcome to another edition of Reg Watch on GFN.TV. We're here in Warsaw, Poland at the Global Forum on Nicotine 2024. And we're with Dr. Garrett McGovern, who is a GP and addiction specialist and the medical director of the Priority Medical Clinic in Dublin. So, Dr. McGovern, what do you think of e-cigarettes?
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Garrett McGovern: I'm very fond of them I must say. I don't smoke myself and I don't use e-cigarettes but I'm beyond excited or I was beyond excited when this what I would call disruptive technology was able to help smokers and coming from a background of harm reduction in terms of drug use and heroin use and crack cocaine and alcohol it struck a chord with me. So it was an easy sell to be able to tell my patients that you can use a much, much less harmful form of nicotine delivery. So yeah, I'm a huge advocate.
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Brent Stafford: For how long have you been an advocate?
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Garrett McGovern: Good question. For as long as I can remember, I know electronic cigarettes are around 20-odd years. We probably didn't have them in Ireland since then, but I'm definitely doing this probably the last 12 years, maybe. Definitely.
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Brent Stafford: So somebody who's, you know, having troubles with heroin, for instance, right? They've got some pretty big problems. How much of smoking is one of them?
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Garrett McGovern: Well, it's huge. I mean, you know, if you look at the smoking prevalence among people who use heroin, it's huge. And unfortunately, one of the problems with smoking is because it doesn't come with the psychosocial sort of consequences of other drug use and alcohol. A lot of the time, people who use heroin will say, you know, one thing at a time. If you're talking about smoking cessation advice, you know, I just want to, you know, get a bit of stability in my life and smoking isn't really causing me any problems. So that's always a tough sell anyway, regardless of vaping or regardless of what method they may use to get off cigarettes. But it's changing. and more and more people now are beginning to give up smoking so the prevalence has dropped among people who would be on opiate substitution therapy there's a lot more awareness anyway and i suppose if there's one advantage we've had a lot of bad press about vaping and it's the same internationally um but the one thing that has happened is it has got a lot of coverage and i suppose and i i'm surmising here but i think a lot of people who use heroin They're an easier sell sometimes to harm reduction than sometimes the general population. They understand that using needle exchange services and using opiate substitution treatment is far better for them than using heroin and sharing needles. So actually they're actually easier to convince about vaping, which is interesting.
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Brent Stafford: So if your support for vaping is 12 years, can you point to a time in the recent past where things turned so darkly for vaping?
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Garrett McGovern: You know, Brent, I can't. That's a great question. I can't really remember. I think a lot of it would have played out on Twitter first. I was a fairly prolific user of Twitter since around 2011, and I got to see more and more good and bad stories. I got to know a lot of people that are here today who are big advocates for e-cigarettes through social media. And that's really where it started. And then obviously they became more available in Ireland. But I can't pinpoint exact. I've often thought about it. It's a good question. I can't pinpoint it exactly. But then I began to do a little bit more in the way of radio stuff and a bit of television. And we'd have debates and stuff like that, which still happens to this day. I don't think the debates have changed much. The anti side are... I'm very much against electronic cigarettes and I'm very much thinking that never the twain shall meet. There aren't a huge amount of doctors in Ireland who one way or the other are talking about this, which is probably a surprise to you given the role tobacco-related harm has in illness and death and shortening lives. But a lot of doctors don't talk about this. The whole vaping thing, in a way, has become a bit of a hot potato for some doctors. It's strange. It's probably more controversial than even harm reduction with drugs now. Harm reduction with drugs is kind of accepted, but this as a mode or method of harm reduction just isn't as accepted by the medical profession. I don't know why.
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Brent Stafford: Yeah, I was going to ask, why is that?
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Garrett McGovern: I don't know but I do know this that there are some very prominent medics who are very specialized in their field usually particularly in the respiratory field so people who are you know experts on the lung who are vehemently anti-vaping and of course there's a few things have happened in recent years particularly the whole youth vaping phenomenon which I think is, in my opinion, overblown and probably the nuance of it hasn't really been analysed in the right way, but it's been used now as a weapon to kind of arm the anti-vaping people that these are horrible products and that I find that distressing but I don't understand how doctors who deal with smoking related illnesses every single day of the week one way or the other are so against a as I say a disruptive technology that can actually move people away from smoking I don't get it and unfortunately there are many doctors who believe that vaping and smoking the harms are comparable which is which is you know just not the case but yet that's the way it plays out and and worse still it plays out like that in a consultation room when a patient comes in and says I might think about giving up smoking my patients have told me that I went to my respiratory specialist or heart specialist and he or she said if you're gonna consider using electronic cigarettes keep smoking Yeah, yeah. I had a patient many years ago who sadly passed away. Not because of her respiratory problems, although they were severe. She had a lung removed because she was getting pneumonia. She had a bad lung. And she used to go to the respiratory specialist for follow-up appointments but could not crack a smoking habit. And she came to me one morning late in the morning. She'd been to her specialist earlier that morning. I was obviously very interested to know how that went. And he said, well, he did talk to me about smoking. I really need to crack the habit and I haven't managed to do so. And I said, did you mention electronic cigarettes to him as a possibility? And he said, yeah. He told me very, very pointedly and very decisively, do not use electronic cigarettes. You're no better off than smoking. And I was apoplectic. I mean, I didn't show it to the patient, but I was angry when I heard that because that window of opportunity, which is very narrow anyway with this lady, was shut because she tried NRT, she tried oral medication to try and help her. None of them worked, and I thought, this is probably the last chance.
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Brent Stafford: If you give an addict, and I know as being one, an opportunity to disregard an option, the addict's going to take that.
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Garrett McGovern: You'll take it, yeah. That's exactly, I had the conversation earlier this morning, is that that probably in some ways was, I have absolutely no proof of this, probably convenient for her.
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Brent Stafford: Sure.
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Garrett McGovern: Because now she said, well, I've tried everything else, and there's no point in trying that, because that would be no better off for me. Yeah. And that's the narrative, unfortunately, that's getting out there. There's a huge, big push now. I mean, you know yourself to get rid of things like disposables. The big threat is flavour bans. We've seen what's happened in Australia with a so-called prescription model. It's prohibition, essentially. You put barriers in the way of smokers trying to quit, they're going to smoke.
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Brent Stafford: Well, the prescription model absolutely is prohibition. I mean, in the US, those who could get a prescription for alcohol were able to keep drinking.
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Garrett McGovern: Yeah, absolutely. And I think with the figures, I'm talking to Alex Wodek, he was saying, and Colin Mendelsohn, reckon that there's less than 10%, maybe about 8% of people accessing that way of getting them. The rest is the black market and all that that entails, the dangers within it and breaking the law. And they're doubling down on this policy. It's almost like, I think somebody said, the emperor has no clothes, the emperor has no skin. I mean, it's as if they've gone far into this disastrous policy that they're just sticking by it. They don't want to admit they're wrong. But they are wrong. And we know they're wrong. And the data and the research is telling us that this is a bad idea. Because what's it doing? well it's stigmatizing people criminalizing people and creating a barrier to something that they were able to pretty easily get before this came in and for what in the end of the day apparently to prevent in inverted commas a newer generation of uh to prevent a newer generation of nicotine addicts apparently to quote the phrase which is again how overblown the whole youth thing is um this idea that if we do this, young people will protect young people. Young people, vaping is happening, of course it is, but it's more of a, if you look at the data, a kind of a rite of passage. Nobody's quite sure what the harms are, but I mean, with anything, if it's a fad, the harms are going to be much less than they would be if you get dependent. But very, very few young kids are getting dependent. So they've actually brought this policy in that is actually impeding your target audience, which is 98, 99% at least, I would say, of the people who are using these devices. to so-called protect young people well we don't know they're going to protect young people because maybe the young people now will find their way onto the black market and we've now i mean this idea that if you ban flavors i mean this is not quite what they've done in australia the idea is that young people won't won't go near tobacco-flavoured only electronic cigarettes. It never stopped them going near tobacco-flavoured real cigarettes. So they don't think these things through. It's an emotional, moral hysteria that dictates drug policy. And politicians buy into it because it's probably, they feel, a vote winner. But of course, the thing that really distresses me about that is that there's no culpability here. So when they get a bad policy wrong, they don't seem to have to pay for that. There's no culpability. There's no responsibility. It's almost like, well, yeah, we brought that in, but it's disastrous. More people are smoking. But we're not taking any responsibility for that. So it's very, very distressing, I have to say. It really is.
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Brent Stafford: We will not let another generation of young people become addicted to nicotine.
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Garrett McGovern: Yeah.
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Brent Stafford: And do those same people say that about heroin?
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Garrett McGovern: Well, you see, I don't know, but the bottom line is it sounds like it's a headline. It's a strapline. and it's a strapline that seems to be working you know this idea of well the schools are full of people vaping in toilets and the ruination of our uh of our young kids and nobody's actually asked what a young person taking nicotine means in the sense that Everybody seems to think, the public anyway, the uninformed public, think that nicotine is very harmful. And I don't think it is very harmful. It's probably no more harmful than caffeine. I'm talking about it as a standalone drug. Pretty much all the harms of combustible tobacco is due to combustible tobacco, not nicotine. So you could argue another an uncomfortable truth here is maybe we're delaying the group that would otherwise smoke from smoking if they're vaping. They're the ones who use it every day or nearly every day, which I think if you look at the S-PAD study, which is a European study for between the age of 12 and 17, it's only about 5%, but 4.6%, I think.
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Brent Stafford: Well, and those studies are all about 30-day use. I mean, it's a useless matter.
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Garrett McGovern: Yeah, but the 4.6% actually specifically is about how many are using it daily or every day.
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Brent Stafford: Oh, okay.
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Garrett McGovern: So the 95% are, you know, one puff in the month. Yeah, you tick the box, you're in. And then varying degrees in between.
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Brent Stafford: So it's 4% of the total that they say... Absolutely.
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Garrett McGovern: 4% would be dependent. But we don't know what even that means. I mean... If people were rational about research and they said, well, could the 4%, it's a hard message to get across, could the 4% be protected from tobacco smoking? I'd say that's a bloody good thing, not a bad thing. But you're not allowed to say these things. It's almost like the sacred cow. There's certain sacred cows where you can't go there. You can't in any way look. as if you're saying anything positive about a young person taking drugs. And yet, young people do take a wide range of drugs. They'll do things... We were all young at one stage, and yet they end up doing things that parents don't want them to do. But the parents were equally guilty of doing a lot of the things that the children were doing. And we seem to think that... if we, you know, tell our youth that these things are dangerous, then in some way they won't do them. You know, it's good evidence to show that the more you say something is dangerous, the more likely they are probably to try it. So I think it's a wider issue of young people drinking and young people taking drugs is we tend to be very, we tend to find it very objectionable as adults that they're doing this. but yet all the data will tell us they are doing it. And it's a bit of a hard sell to give kids harm reduction advice about drugs when really it's a Nancy Reagan just say no approach. The just say no doesn't work.
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Brent Stafford: Well, they don't even say, just say no to hard drugs. I mean, in Canada, I'm in British Columbia, they legalized, you know, possession and use of hard drugs. And I mean, so no public health person would stand up ever and advise young people not to go on to heroin. They don't say that.
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Garrett McGovern: No, they don't.
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Brent Stafford: But they will go on the air and beat the heck out of vaping.
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Garrett McGovern: Yeah, they will. They seem to, on one hand, say we don't know the long-term effects of vaping, and then when it comes to the youth, we know that their life will come to rack and ruin from nicotine addiction. They need to make up their mind. If we don't know the long-term effects of vaping, we're 22, 23 years in, possibly longer into the vaping experiment, let's say, and I think it's going rather well in terms of not unearthing very much major harms and certainly much safer than smoking. I don't think it'd be much different for youths. And many of the young people we're talking about aren't the cusp of adulthood anyway. This idea that we've decided what the harm is in someone below the age of 18, but in people who are above 18 we don't know the harms is bullshit, basically. That's just not the case. If we don't know the harms, we don't know the harms. Just say we don't know the harms. Nicotine in the developing brain is nonsense.
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Brent Stafford: Well, that used to be, Johnny, don't smoke, it'll stunt your growth.
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Garrett McGovern: Yeah, it's along the same lines, but it's sort of, it's got out there. And the evidence that it affects the developing brain, I mean, I've made this comment an awful lot in regard to this nicotine in the developing brain. Nicotine in the developing brain as a strapline arrived, when vaping arrived, or when vaping was a few years in, I never heard of it with smoking. I heard a nicotine addiction, fine, across the board, and as you say, you heard it'll stunt your growth and it'll take years off your life and do all those things, but that's smoking. But I never heard nicotine in the developing brain until vaping came in. And in a way, I take the positives out of this in terms of the message. You know, if that's the best they can come up with, some trumped up thing about nicotine in the developing brain, they're not talking, for instance, about lung cancer in young kids. They're not talking about heart disease in young kids. They're talking about nicotine in the developing brain. It's kind of really what really is going on there if you scratch beneath the surface is they can't really come up with any harms. So they've, you know, put this one forward. And it is an emotive one. You know, because parents will think, oh God, my God, my child, their brain, they're going to, is that brain damage? And that is, that's very powerful in terms of turning the parent against vaping. Because if you think about it, they're using the kids and the parent, they're using the kids and the parent's fear to really, there's a bigger story here. And that is, what they want to do is, they're using that as a means to turn parents away from vaping in general. as if it's this horrible thing. And they don't seem to need any proof for it. The burden of proof seems to all be with us, the pro-advocates. We've got to constantly firefight these stories, but they're able to throw out this junk science study and it gets retweeted to beat the ban by people who should know better, people in my profession, and it seems to be fair game. But you put out a good story about, you know, a headline saying, my 40-a-day cigarette habit was cured by vaping. My lung health is really, really good. My doctor's really happy with me. My cholesterol's dropping. I'm beginning to do things that are more productive anyway. I'm changing my lifestyle. It doesn't make the headlines. And that's such a powerful story, but, you know, my lungs exploded and you get a picture in the paper of a child in bed, which may not even be anything to do with anything, is the one that sells the newsprint.
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Brent Stafford: With all the privacy rules and everything else that's gone crazy over the last 10 years, you can't really take a picture of somebody inside a hospital and post that out on Twitter and it makes it into the newspaper. That's got to be cleared by parents and facilities and so forth.
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Garrett McGovern: Absolutely.
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Brent Stafford: So you had the Evali hoax, I like to call it. And literally, I've got like in my file, 80 different pictures of young people with the tubes coming out and so forth. There is no way that that is not somehow been cleared by hospitals and legal and all that kind of stuff.
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Garrett McGovern: Absolutely.
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Brent Stafford: And you know, COVID happened and there's not a single picture of a single person in a hospital.
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Garrett McGovern: No. No. And that tells you really how dishonest this whole debate is, that they're willing to do that. They're willing to pretty much produce any sort of a picture that creates an emotive response in the public. And the Evali thing was disgusting because it had nothing to do with regulated e-cigarettes. It really had nothing to do with e-cigarettes in general. But apparently, you know, because it was such a sexy story, that when people who are anti-vaping are interviewed and they're asked a question by an interviewer who probably is not scrutinizing the questions, maybe as close as they should, and the question is, but are there any harms to these products? And they will say, yes, a number of years ago, there was an outbreak of e-cigarette vaping related lung injury. And of course the damage is done. Now a good interview would say, well, with all due respect, that was vitamin E acetate. um with bootleg vaping equipment that had nothing to do with what we're talking about here about vaping now if somebody said that to a person who made that claim they would be umming annoying and i've done a lot of radio interviews you get kind of used to this i i kind of go into a radio interview with someone who's anti-vaping and in my mind i i have what i want to get out of that so i want them first thing i want to to get out of that is i want them to admit And I'm going to make them admit, without them knowing I'm doing it, that e-cigarettes are far safer than smoking. Now, that's a job done for me. And I'm usually doing these things on the phone. I'm actually high-fiving the air when I get that one. And then if I'm lucky enough, this is very devious, to get a researcher who's pretty pro-vaping before we get on the air, I'm able to feed them the questions for the other side. And this sounds devious, but in the end, wait, these are the questions that should be asked. That's right. And I've been lucky enough to be able, that exact point about a valley in a radio interview I did, where someone said, well, with all due respect, that wasn't regulated electronic cigarettes. That had to do with cannabis oil and THC and vitamin E acetate. And they were umming and ahhing. And, of course, I'm high-fiving the air again because I've got a win on two counts. Because I'm mindful that... The person I'm trying to appeal to when I do those interviews on the radio is particularly the person who is the contemplator in giving up smoking. And they're kind of wondering, should I try these things? Because, God, there's a guy getting on here saying my lungs could explode. And then it's another guy coming on here who's completely and utterly rubbished the idea my lungs will explode. And the guy who is anti-vaping has just said that vaping is much less... harmful than cigarettes and usually what they'll do is they'll follow it up really quickly they'll try and say that really quietly and they'll say yes it's much less harmful but that doesn't mean they're harmless and then of course i know how to follow up and i go well what endeavor or what medication or what intervention is harmless there's no endeavor that's harmless they come with harms but this is about relative harm and there's significantly less harm with vaping than there is with smoking so why don't we we encourage everyone to switch and let all the research continue to come in, but we can at least do that. We can encourage people to switch, safe in the knowledge that they're not smoking anymore. I always say that to my patients, whatever the harms that ever come out of electronic cigarettes, and they're evaluated, like Public Health England, I think it's called the Health, safety authority or some other acronym now, reviews these things every year. See anything new has come up in terms of harms and nothing has been unearthed. So why wait? I always say, The other side, the anti-vaping group, will say we just don't know. Well, why don't we turn away from the thing we do know, the harms we do know, cigarette smoking too, that we just don't know? Because if it's we just don't know after 20 years, I think you've picked the safe horse there, the much safer horse than you would be to continue smoking. Don't continue to smoke and then wonder whether vaping is better when you can actually jump onto vaping and get away. And we know from... And these don't get published, but there's many, many people. You'll sometimes see it on X or what used to be Twitter or on social media in general, where people will put up their own radiographs that they've been to a really good doctor who gets it. And they'll say, listen, your lung health, your peak flows and your lungs are different. Your COPD or emphysema has halted. It hasn't progressed. and keep doing what you're doing. And that's, you know, huge evidence that these products help people in terms of the already probably significant smoking-related harm. I mean, it's never too late to give up cigarette smoking because people think, oh, well, the damage is already done. No, the damage will continue to be done. And if you've ever known anybody, and we all have, Brent, who suffers from really severe smoking emphysema or COPD, it's like breathing through a straw. It's horrendous. And if you can get some lung function preserved by the time you give up smoking, it's always worth it. And it's just that that lady was a great example of that. The patient I talked about, you know, the door, probably the last door was shut. She never gave up cigarette smoking until the day she died.
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Brent Stafford: You know, we just don't know is the thing that should stop every single off-label prescription. But yet that is something that is many ways how we find out, you know, the value of drugs. And then of course, not to bring up COVID, but I'm going to, of course, those vaccines, we don't know. No, there is not 20 years of knowledge behind those vaccines. And I guarantee you that the people that are most animated by anti-vaping rhetoric, are also the ones that were likely to be most pro-COVID vaccine. And, you know, we're staring right now at like Ozempic, right? Ozempic, this weight loss drug in that whole class of drugs, which everybody has taken. They're brand new, like in terms of this use. Nobody knows what the harms are of those, but, you know, everybody's wanting to jump on that bandwagon.
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Garrett McGovern: Yeah, the vapour, that's a great one. I've talked about that even just today. We were talking about the whole, the rush to, I think within a year, we had a number of different very well-known companies, Peyton and the COVID vaccine. And you see what was waiting, and this is the interesting thing, there are huge, In a way, there are huge parallels, but there's a gaping unparallel in the fact that this was rushed out after a year. But the reason they did it was because the public had convinced us that COVID was going to kill everybody. So they said, listen, I don't care what this vaccine does and what the bloody thing turns out to be. You're going to die or you're going to give it to a vulnerable person and stuff like that. So everybody went, oh, yeah, let's get in and let's get the vaccine. And I personally had no problem with the vaccine. I'm not anti-vax. But you don't have to be anti-vax. It's quite okay to be vaccine skeptic, which is a different thing altogether. Like anti-vax people are anti-vax probably across the board. But I mean, there are people who are going, hold on a sec, 12 months, you've been trying to... you know, do randomised control trials and this thing. Are you sure? I mean, what happens if something's unearthed? But I didn't. I figured that, look, I'll go with it. And yet that's a gaping hole in that argument when people talk about 20-odd years of experiences around harms. They sort of go, you know, oh yeah, well, the vaping is, the COVID's okay. And I know why they say that. The COVID vaccine's okay because It's our vaccine. It's sort of... It's okay because we say it's okay. But if we don't like vaping, then, you know, I don't care if it's 20 years. It's another point, by the way, about the 20 years, because I often hear, you know, this... it's oft quoted thing of, you know, it's the same playbook as the tobacco industry. They said after 30 years that these weren't harmful. That is actually untrue. It was fairly quickly after cigarettes kind of came, filtered cigarettes came on the scene that they knew these things were actually causing harm. So it's kind of a lie that we had to wait 30 years to know that tobacco caused harm. And we know from That guy, I think it was Dahl who did the studies. He was a physician and he did the 10-year sequential thing. So they were doing those studies already. So that's a bit of a lie. But even if it were true that, oh, we waited 30 years, we're somewhere 22, 23 years in on this one. Like, you know, are they really that specific? Have we got to wait? Will you finally be convinced in seven years' time we hit the big 30-year landmark and compare the two and you realise that there aren't lots of people dropping off like flies? Is that going to convince you? Do we have to wait 50 years? How long do we have to wait? They don't have an answer to that. But yet they'll throw that out. And again, the message inside a contemplator, a person who's contemplating quitting is, ooh, that sounds like smoking to me, smoking 2.0. So I'm not gonna try it.
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Brent Stafford: How much is this about the tobacco control industrial complex?
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Garrett McGovern: Yeah. Well, I mean, I'm doing a talk tomorrow about the precautionary principle. And, you know, I've talked to a few people in the lead up to me doing that talk and they made some excellent points, which I probably didn't think of myself. And they said that, you know, when you think about it, I mean, vaping has... the great potential to sort of end a lot of jobs in tobacco control because, you know, the game is up. If this thing turns out to be what it looks like it's turning out to be, then tobacco control, who hate vaping by and large, don't have a function anymore. So there's a lot of jobs, a lot of money at stake here. And that's a very nasty side of this.
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Brent Stafford: Billions and billions.
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Garrett McGovern: A hell of a lot. And it is strange that tobacco control have become more nefarious than the tobacco industry. I never thought I'd say that, but it's true. The tobacco industry, actually, are a bit like the alcohol industry. I don't know anybody who works in the tobacco industry who's going to go around claiming cigarettes are good for you and stuff like that. But they have a very important role, the tobacco industry, and that is that they produce regulated products. What are we going to do, put that on the black market? No. So, you know, and I've heard some horrible stories because there's people at the conference, say, who either work in BAT or, you know, have worked for the tobacco industry. And the way they're treated whenever they go to conferences is they're treated like pariah. We can't listen to you because you have to stay outside the door when we're talking here, that type of thing. You know, but tobacco controller, I think far worse. Because they're actually... And I don't know if they have the awareness, the self-awareness to know this, but what their actions are doing actually is actually keeping people smoking.
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Brent Stafford: Well, they are perpetrating the very same things they accused the tobacco industry of 30, 40 years ago. They are the new merchants of doubt.
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Garrett McGovern: Yeah, absolutely. And they don't have the same level of scrutiny. Everybody who thinks tobacco control must be really good. Now the game is up from our point of view because we know what they're at. And it could be tobacco control or IP if this continues. But they're doing everything in their capacity, Brent, to halt the disruptive technology. So disposables. and flavours are where they're concentrating their efforts. And they seem, I hate to say unstoppable, I don't want to get pessimistic about this, but they seem to be really going for this large.
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Brent Stafford: They are, and it's growing in terms of their pushback. Let me ask you, when it comes to the Global Forum on Nicotine, why do you think an event like this is important?
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Garrett McGovern: Well, I think it's important. The one thing about the Global Forum on Nicotine that I'm really struck by is that the one thing for sure is that it's an honest forum. I've been at a number of talks today about e-cigarette products and liquids and safety and stuff like that. They're not sitting on their laurels. They're not sort of saying... these products are safe, just let's leave it at that. We're constantly scrutinising to make sure it's as safe as it possibly can be. But I think something like this is very, very important for another reason, and that is we need to redress the balance here. We often do feel like we're firefighting. If there's one criticism, and it's not a criticism of GFN in general, it's that We are guilty, all of us, and the other side as well, of working in echo chambers. And I don't think there's any conflict. And conflict is obviously very visceral at the moment in a number of countries. You're not going to sort conflict out by constantly being separated and having polarizing views. At some stage, you've got to come to the table and talk. That's the reality of this. I think if this plays out the way it's playing out, we're probably going to lose out in vaping because most of the people in my profession who are anti-vaping have the ear of the government. that's the worrying thing you don't see too many governments although the UK up to this point have adopted a very sensible approach to this and even they're beginning to change now which is a real worry because they've been sort of accused of all the UK are outliers so that's the That's the kind of phrase that countries will use when they want to discredit anything that's happening in the UK. They're outliers. But they don't get what does outliers mean? Because they're doing the right thing and the rest of you guys are doing the wrong thing. You call them outliers. Outliers sounds like they're wrong. I mean, they're not outliers. They're just following the evidence. This is much less harmful than smoking. And the youth... Epidemic is not an epidemic because you don't know the meaning of the word epidemic you look at the numbers we're talking about they're relatively small and so the UK have to this and Ireland actually Ireland and the UK actually the legislation is pretty much the same we still have disposables we still have flavors and as I said to somebody if you could just leave it at that just leave it be don't tinker with it I'd actually be happy. And I think the vaping industry would be happy and the consumers would be happy. I think we've got somewhere... Now, I don't know, I haven't seen any hard evidence of this, but I'm hearing that in Ireland, of a population of 5.5 million, that there's possibly as many as 250,000 people vaping. And the vast, vast majority of those are for smoking cessation. There'll be a few people that are using it for other reasons and there'll be a small number of children who will be trying them. That's a hell of a number. And our smoking rates are... A lot of people don't realize, Brent, that smoking is actually a really hard habit to crack. So when people go, oh, you know, vaping is not that effective at helping people. Well, it is, but all the methods really are by no means brilliant at, you know, but then again, Welcome to addiction. I treat addiction. You know, lapse and relapse happen. And all you can do is be there to try and support people and make them not give up trying to give up. So they sometimes will use clever phrases. They're not really that clever. To the untrained eye, they might be. Things like, oh, well, I looked at that research on vaping and it's no more effective vaping than varenicline or NRT. I said, well, that sounds like it's equally effective.
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Garrett McGovern: So they say that. And I have heard some interviewers say, but no more effective? Does that mean the same? And of course they go, um, and they, oh, and again, I'm high-fiving the air because they've got them on that. And I think it was, I think Colin Mendelsohn at lunchtime actually said that, you know, the problem with the, the problem with the anti-vaping group is they won't really engage we occasionally get a little bit of, you know, argy-bargy on the radio, but they won't really engage. You know, they'll get onto Twitter, and a lot of these guys on Twitter, and I'm used to this from the drug prohibition side, is they'll never engage in anything they say. You know, it's almost like a- They're sniping. Yeah, they kind of, I almost call it a sort of a, the phrase I use is, they almost use X as a brochure a forum. They put a brochure out of their views, but they'll never really get into any discussion about it. They will, of course, if somebody goes, oh, brilliant, you're doing really well, and that's such a great, oh, it's terrible, protect our kids. But I've seen them ask questions that really have just rubbished their argument, and they just don't come back. In fact, it's worse than that. They block. The likes of Simon Chapman and Capewell and and all those guys is Martin McKee most people are blocked with those guys because you come out with what I call one phrase too many of common sense and you're getting blocked and that's the way they operate so they'll work in the complete echo chamber where all these phoning people come in and go you're doing a great job you're protecting our children and stuff but uh they don't engage you know I've been thinking about this is it seems to me that people almost want electronic cigarettes to be more harmful than they are. It's almost as if they don't want them to be safe or safer. They want them to be as harmful as possible. If a story came out that someone's head blew off because they vaped, they go, Yes, that's brilliant. And that is really the dark side of this. What's going on there? Why do you want these? You want them to be more harmful than they are. You don't want them to be. You don't want to hear a story about someone who has given up 40 cigarettes a day and is now a non-smoker because they're vaping. The whole thing, and the whole research side of it now has got completely polluted. Because they're publishing studies now which end up getting retracted later about cardiovascular risk. So the whole thing is really mucky now and it's a really polarising sort of debate that is in the end of the day, who suffers from this? Who suffers? The smoker who wants to quit because they're getting such conflicting messages and being such a hard habit to crack, they're in a position where they will probably continue to smoke.