Hazel Cheeseman Director of Policy

Action on Smoking and Health

Ian Gray, CFCIEH, MBE

Chief Policy Officer, Chartered Institute of Environmental Health

Permitting or prohibiting vaping –

ingredients for developing a policy

Ian Gray

Principal Policy Office

Chartered Institute of Environmental Health

Hazel Cheeseman

Director of Policy

Action on Smoking and Health

The project

• Support small number of councils through policy development process

• Learn from their experiences to share ideas about a good process with others

• To date worked with seven councils, three now have formal policies, rest in development

• Next year we’ll publish conclusions

• This presentation is based on lesson’s we’ve learnt working with these councils and others around the UK.

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Why do organisations find this difficult issue to address?

• Complexities

• Confusion

• Conflicting beliefs

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Complexities: There are no easy answers

“Are they safe to use?”

“Will they lead to more children smoking?”

“Will they undermine smokefree legislation?”

“Will banning them have a negative effect on people trying to quit?”

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“They’re safer than smoking”

“There’s no evidence of this yet…”

“They haven’t yet, we don’t think they will…”

“We don’t know, it’s possible…”

Complexities: competing ‘rights’

Number of different and conflicting rights • Non-smokers and non-vapers to clean air • Smokers to have alternatives available to

them • Vapers to use a product which does not

harm others • Non-smokers right to ‘smoke’ breaks • Those trying to quit to use product of

choice • Those trying to quit not to have to stand

with smokers • Those trying to quit who don’t want to see

products that look like a cigarette • Etc etc

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Complexities: a balance of responsibilities

Number of different and conflicting responsibilities

• Promote public health

• Duty of care to staff

• Duty of care to clients and public

• Support smokers to quit or reduce harm

• Protect corporate image

• Minimise workplace conflict

• Maximise the choice of vulnerable service users

• Locus Parentis

• Etc etc

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Confusion: failure to distinguish between smoke and vapour

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0%

5%

10%

15%

20%

25%

30%

35%

40%

A LOT MOREharmful

MOREharmful

JUST ASharmful

LESS harmful A LOT LESSharmful

Completelyharmless

Don’t know

Do you think electronic cigarettes are more, less or as harmful as

regular cigarettes?

Confusion: poor knowledge of nicotine

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0%

5%

10%

15%

20%

25%

None or verysmall

Some butwell underhalf the risk

Around halfthe risk

Much morethan half the

risk

Nearly allthe risk

Don’t know

According to what you know or believe, what portion of the health

risks of smoking comes from nicotine in cigarettes?

Conflicting beliefs: addiction

“harm reduction will leave people addicted to nicotine forever..” “Its wrong not to support people on low incomes to overcome their addictions…”

“Smokers don’t need nicotine, they should just go cold turkey…”

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“I’ve got a right to my addiction if it doesn’t bother anyone else” “What’s the difference between your coffee addiction and my electronic cigarette addiction?” “People are more likely to quit and stay quit with support and access to nicotine”

Conflicting beliefs: tobacco industry

“If the tobacco industry is involved then it must be for the wrong reasons – we must have nothing to do with this agenda”

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“Our policies on nicotine containing products should be developed in the interests of the public’s health regardless of who develops or markets them.”

Why do organisations find this difficult issue to address?

• Complexities – people (and corporate policies) struggle to manage complexity

• Confusion – without a shared understanding of some basic evidence development of good policy is a challenge

• Conflicting beliefs – slow and difficult to find consensus on questions of belief

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The spectrum of permissiveness

Complete

prohibition Qualified use

Complete

freedom

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Ingredients needed for policy development

1. Identify key principles and policy objectives • Vaping and smoking are not the same • NICE guidance directs us to reduce harm from

tobacco use • Policies should aim to maximise public health gain

2. The right stakeholders engaged

3. The best evidence considered

4. Using appropriate language

5. Review fit with existing policies and strategies

6. Clear process for implementation and review

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