Oireachtas Joint and Select Committees

Tuesday, 1 March 2022

Joint Oireachtas Committee on Health

General Scheme of the Public Health (Tobacco and Nicotine Inhaling Products) Bill: Discussion (Resumed)

Mr. John Dunne:

I thank the Chair and members of the Oireachtas Joint Health Committee for inviting vaping retailer and member of Vape Business Ireland, VBI, Eoin O’Boyle and me, spokesperson for VBI, to appear before them today on behalf of the association. I will be sharing the time allocated to VBI with Mr. O'Boyle. First, we would like to acknowledge and commend the members of the committee on the work undertaken on this important legislation at the pre-legislative scrutiny stage. We very much welcome the opportunity to represent the interests of the 200,000 people around the country who use vaping products and the 300 plus retailers and newsagents, who each day are responsible for guiding, supporting and advising adult smokers in their communities on this less harmful alternative to help achieve a tobacco-free Ireland.

In 2013, the Department of Health set an ambitious goal of a tobacco-free Ireland by 2025, aiming to achieve a smoking prevalence rate of 5% or lower. Despite the efforts of many, the HSE acknowledged in its report of 2018, The State of Tobacco Control in Ireland, that this goal will not be achieved until 2052. As members know, the Department of Health’s Healthy Ireland survey of 2021 found that the smoking rate has actually increased for the first time in many years, and with a current smoking rate of 18%, we are nowhere near reaching the goal.

Clearly, to get us back on the path towards achieving this goal, we need a new approach, and vaping should be a central component within that. Vaping has a vital place in this equation. Indeed, the Healthy Ireland survey of 2019 showed that compared to nicotine replacement therapy, NRT, almost four times as many successful quit attempts were attributed to vaping. While 10% of those who successfully quit used NRT, 38% used vaping.

In our written submission to this committee, Vape Business Ireland provided samples of the expert-led evidence which shows that vaping is significantly less risky than smoking. The most important of those was the Public Health England evidence review of 2015, which was carried out by experts from King's College London and Queen Mary University of London, showed that vaping products are around 95% less harmful than smoking. Public Health England has consistently maintained this position in its annual evidence updates, and its findings have been backed by key health experts and groups, including the Royal College of Physicians and leading anti-tobacco NGOs such as Action on Smoking and Health, ASH, and Cancer Research UK to name but a few.

Driven by our responsible approach to vape usage and tobacco harm reduction, Vape Business Ireland particularly welcomes what we view as the most critical part of the Bill, that being the proposed ban on the sale of vaping products to persons under the age of 18 years. This is something we have urged the Government to introduce since 2015, to protect young people and to create a controlled environment where vaping products are available for adult Irish smokers looking to switch to a less harmful alternative. In fact, we have stringent rules in place for membership of the association and we also have a code of conduct that is fully focused on prohibiting the sale of vape products to under-18s. Mr. O'Boyle will elaborate on this shortly as someone who has first-hand experience of applying for membership and the standards VBI has set for the retail sector.

It should be noted that we use the exact same technology as supermarkets to prevent the underage sale of alcohol, despite no official under-18s ban in place in the State. We take our self-imposed obligations seriously and do not want young people using these products, which is why we urge the committee to make this law as soon as possible. It should also be recognised that the licensing system in the Bill will be hugely beneficial in creating a database of responsible licensed sellers and we support appropriate sanctions for those who do not meet its requirements.

On youth access research in Ireland, the most recent study which perhaps has not yet been raised with the committee is the WHO-supported Health Behaviour in School-Aged Children, HBSC, report released in 2021. It showed that smoking among school-aged children had plummeted from 22.6% in 1998 to just 5.3% in 2018.

Furthermore, the Department of Health Healthy Ireland Survey 2021 showed that less than 1% of "never smokers" use vaping. This is a survey of 7,500 people aged 15 years or above. In a recent response to a parliamentary question, the Minister for Health confirmed this, saying the number of vapers remains low and "primarily consists of current and former smokers". While the evidence does not point to a huge vaping problem in Ireland, we need to urgently ban underage sales while ensuring adult smokers have an alternative that works.

The fact is that the data indicate that youth uptake of vaping remains low. Although any youth uptake of these and other products is of concern, the Healthy Ireland Survey 2021 found that regular use among young people remains in line with the national average of 4%. It also showed that virtually no "never smokers" currently vape. This is not a gateway into smoking; it is the most effective tool for helping smokers to quit for good.

Part of a responsible approach to regulation and business practice alike is that it is proportionate and strikes a balance between different but sometimes compatible interests that are focused on achieving similar objectives. For this reason, VBI opposes an overly limiting ban on flavourings in vaping products. It is important we recognise that flavours in NRT and vaping products play a vital role in helping adult smokers to quit. We fully agree with the views expressed by Department of Health officials who appeared before the committee in November 2021 and who said we have to "strike that balance" when it comes to flavours. VBI argues that we must get the balance right for the 200,000 people who depend on vaping products to prevent them from lapsing back into smoking and the 700,000 smokers who might be considering vaping as a tool to help them move away from smoking. Those who have quit smoking do not always want to taste tobacco flavours. Adults like flavours, and flavourings make up things adults consume such as caffeine drinks, alcohol, foods, etc. That is why NRT products also have flavourings.

This brings us back to the beginning of my remarks. We are here to face the reality of the specifics of Irish smokers and the Irish vaping market. The facts are clear: vapers in Ireland are overwhelmingly current and ex-smokers, and the majority of them began vaping in order to quit and to stay off smoking. Furthermore, backing up the Department of Health's Healthy Ireland survey year on year, the Health Research Board's 2019-20 Irish National Drug and Alcohol Survey found that more than 95% of Ireland's vapers are former or current smokers. Clearly, vaping is being used by those for whom it is intended, namely smokers who want to quit and ex-smokers who never want to go back. Vaping works, and that is why it is vital we support adult smokers in making the switch while also taking the necessary steps to ensure that young people never access a product that is not intended for them.

VBI wishes to highlight that vaping has been strongly regulated by the second EU tobacco products directive since 2016. It is important to compare like with like and focus on the experience of vapers in the UK and the EU. Vaping is largely unregulated in the United States, so comparing the United States with the UK or the EU is not a like-for-like comparison. In the United States these products contain three times more nicotine and are unlimited in volume, and ingredients are not regulated. Drawing conclusions from studies conducted outside the European Union and seeking to apply them to the Irish scenario fails to reflect the stringent EU and Irish regulatory framework controlling the manufacture and marketing of vaping products.

Under existing regulations, health warnings that advise consumers that vaping products contain nicotine are mandatory. The regulations also provide for mandatory safety and quality requirements for vaping products and refill containers, including maximum nicotine concentrations and maximum volumes for cartridges, tanks and nicotine liquid containers. The regulations require vaping product manufacturers and importers to notify the Health Service Executive of all products they place on the Irish market. If a manufacturer, importer or distributor has reason to believe a product is not safe, it is required by law to notify the Health Service Executive.

A crucial part of helping smokers to give up smoking is advertising and awareness raising. Vaping product advertisements are subject heavily to EU regulation under the aforementioned directive.

In Ireland the Advertising Standards Authority for Ireland's code of standards for advertising and marketing communications includes strict rules on the marketing of vaping products to consumers, including those who are under the age of 18. Furthermore, no medium can be used to advertise vaping products if more than 25% of its audience is under the age of 18.

I would like to take this opportunity to outline the experience of Estonia as a case study of a country that got it wrong when it implemented a ban on vaping flavours. By limiting choice, the country adversely impacted smoking cessation rates and a black market of unregulated and unsafe products prospered. In response to this dramatic shift, Estonia has actually softened its regulations now to allow more flavours for adults looking for a less harmful alternative to smoking. Continuing to looking at this issue through an EU-wide lens, I would also like to highlight current and future developments. Just last month, the European Parliament supported a Beating Cancer report which calls for harm reduction and the explicit recognition of electronic cigarettes as a product that allows users to progressively quit smoking and that should be regulated differently from cigarettes. Separately, work on amending the EU tobacco products directive is expected to advance soon. VPI would argue that Irish legislators should not pre-empt this process but should wait for the outcome of this work before making decisions that could potentially limit the options of smokers looking for an alternative.

As the EU moves towards recognising the value of vaping products in tobacco harm reduction, we have already seen support for vaping as a less harmful alternative to smoking from major public health authorities and health bodies across the UK and worldwide. Looking at the UK, ASH UK, Cancer Research UK and the British Heart Foundation have looked at the evidence and taken a clear position identifying and advocating vaping as a harm reduction tool. Indeed, in June 2021, the National Institute for Health and Care Excellence, NICE, which advises healthcare professionals in the UK, updated its guidance to general practitioners on smoking cessation. NICE finds that combined with behavioural support, the options of either a combination of short and long-acting nicotine replacement therapy, NRT, or nicotine-containing e-cigarettes are more likely to result in people successfully stopping smoking, and recommends that general practitioners should provide patients with guidance about e-cigarettes as a smoking cessation tool.

Cochrane is held as the gold standard among academics, and its review of electronic cigarettes for smoking cessation found that nicotine-containing e-cigarettes are 70% more effective in supporting smokers to successfully quit than NRT products. This backs up the aforementioned evidence from successive Healthy Ireland reports which showed that vaping has been far more effective than NRT in helping smokers to quit. Smoking rates fall as the rate of vaping increases. One example of this is seen in the European Commission’s Eurobarometer findings which showed that Ireland’s smoking rate was 5% below the European average, while Ireland’s vaping rate was 5% above the European average. Already, vaping is making a difference in the State and with the right approach it could help far more smokers to quit.

We have a real-life example of how this can be achieved by looking at the UK. The British health authorities have parsed the evidence and they have been both ambitious and decisive on how vaping can help smokers quit. The NHS is working on proposals that could see England be the first country in the world to prescribe medicinally licensed vaping products to help reduce smoking rates. The UK Secretary of State for Health and Social Care, Mr. Sajid Javid, M.P., was recently quoted as saying that they would unveil a White Paper this spring that is to include a "vaping revolution". The continuous downward trajectory of smoking rates in the UK is in no small part testament to the pragmatic approach taken towards vaping and understanding the integral role vaping products can play in delivering on their tobacco reduction strategy. We are seeing a similarly progressive approach being adopted by other countries such as New Zealand, where vaping is a critical part of the country’s plans to dramatically decrease their smoking rates. We firmly contend that the adoption of a similar approach and treatment of vaping as a harm reduction solution would have a significant impact in helping Ireland reach its Tobacco Free Ireland objectives.

In the context of this Bill, we must not continue to ignore the growing and credible body of evidence supporting vaping as a less harmful alternative to smoking.

While it is essential that we do everything we can to prevent youth access to vaping products, we must also ensure that we find the right balance in protecting the 200,000 vapers right across Ireland from relapsing. We must also ensure that all options remain open and accessible to those adult smokers who are currently trying to move away from smoking.

I will hand over to Eoin O'Boyle, who will give the committee his front-line perspective on how businesses like his have helped adult smokers with less harmful alternatives across the country. I thank committee members for their time and I look forward to our discussion.

Comments

No comments

Log in or join to post a public comment.