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It's most telling that the two writing this piece are from the US. British medical opinion, and previous Guardian pieces, seem to boil down to it's good as it's

It's most telling that the two writing this piece are from the US. British medical opinion, and previous Guardian pieces, seem to boil down to it's good as it's not tobacco and that vaping is far more successful at getting people to quit whilst dramatically less harmful. The "common knowledge" around vaping is dramatically different on each side of the Atlantic

seanmcdirmid 8y ago
The British have skin in the game via the NHS. In the USA, adverse health affects due to smoking are masked via higher insurance premiums while states reap sin taxes; in the UK reduced smoking is a public cost savings measure. It makes sense that the views would differ due to different self interests.
- NeedMoreTea 8y ago
  Good point, hadn't looked at it quite like that. Does the surgeon general still put out scary warnings? It's fair to say vaping has had huge and surprising impact on smoking in the UK, it's now become really rare to see a smoker. It's now an occasional surprise when you catch a whiff of tobacco in the street. It helped that cigarettes have been progressively taxed to nearly unaffordable (not sure, but I think a pack of 20 is now comfortably over £10). At the same time tobacco has been hidden in ugly packaging and no visibility is allowed in stores.
  - madaxe_again 8y ago
    Yeah, a 20 pack is now well over a tenner. It’s great. I do not smoke at all in the uk now, where I currently predominantly live, as the cost is just nuts. £4000 a year or so if you’re on a pack a day, which is where most active smokers sit. I now vape, spend about £200 a year on it. I will confess that I do still smoke if I find myself in a country where vaping is illegal and the cigarettes are 50p a pack, as I am still a nicotine addict, but I would much rather vape. Cigarettes make my lungs hurt. Vaping doesn’t. So, unless it turns out that vaping is somehow worse than smoking, this is a resounding public health policy success. My behaviour and the scarcity of smoking you note underscores this.
  - seanmcdirmid 8y ago
    In Australia, a pack is around $25! Taxation helps, but states are loathe to tax so much that they actually decrease demand more, they are addicted to the extra revenue and don’t want to see that go down. But society still loses out in the long run, whereas in the UK and Australia, the costs of smoking are all socialized, so sin revenue isn’t as appealing.
- Stevvo 8y ago
  That's innacurate. The US government spends more on healthcare per person than the UK; so the public cost saving would be higher in US, despite the lack of universal healthcare.
  - seanmcdirmid 8y ago
    I don’t think that is true either, as 50% of healthcare spending in the USA is private. Actually, you could be right, but I would want to see some evidence before I was convinced.
daddylonglegs 8y ago
Having lots of people take up e-cigarettes is not a bad thing if they are moving away from smoking tobacco. On the other hand, if lots of teenagers take up e-cigarettes (with nicotine) then that is a public health disaster; and will cost millions of lives. So there could be an actual difference in health effects in different countries, which would be a reasonable basis for the difference in perception. Note that the UK has active public health campaigns to quit smoking [0] and tougher laws on advertising than some parts of the world [1]. Having said that, an awful lot of UK teenagers have smoked e-cigarettes[2], so perhaps we're just complacent. [0] https://www.nhs.uk/smokefree/help-and-advice/e-cigarettes https://www.nhs.uk/smokefree/help-and-advice/e-cigarettes [1] https://www.asa.org.uk/advice-online/electronic-cigarettes.html https://www.asa.org.uk/advice-online/electronic-cigarettes.h... http://www.bbc.co.uk/newsbeat/article/38978119/santa-claus-vaping-advert-banned-for-appealing-to-kids http://www.bbc.co.uk/newsbeat/article/38978119/santa-claus-v... [2] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/datasets/ecigaretteuseingreatbritain https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... 2017: 16 to 24 year olds: 32% had experimented, 17% had previously smoked e-cigs, 5% were current users. Edit: I forgot to add that there are different limits on nicotine content.
- qes 8y ago
  > if lots of teenagers take up e-cigarettes (with nicotine) then that.. will cost millions of lives That's quite a claim. Based on what? Can you point to any deaths reasonably believed to be caused by nicotine consumption from vaping?
  - daddylonglegs 8y ago
    There will be two main mechanisms: The first is the direct effects of nicotine (and possibly the vaping mechanism). The figure being bandied about on this thread is that vaping is probably 5% as directly dangerous as tobacco. The second is that teenagers and young people who vape (with nicotine) will get addicted to nicotine and are more likely to smoke tobacco. Smoking currently kills more than five million people a year[1], 5% of that would be more than 250,000 deaths a year and so a million deaths every four years. If vaping is taken up by young people on the scale that smoking tobacco is then millions of premature deaths is a conservative estimate, given what we know now. [1] https://ourworldindata.org/smoking https://ourworldindata.org/smoking edit: typo

seanmcdirmid 8y ago

The British have skin in the game via the NHS. In the USA, adverse health affects due to smoking are masked via higher insurance premiums while states reap sin taxes; in the UK reduced smoking is a public cost savings measure. It makes sense that the views would differ due to different self interests.

NeedMoreTea 8y ago
Good point, hadn't looked at it quite like that. Does the surgeon general still put out scary warnings? It's fair to say vaping has had huge and surprising impact on smoking in the UK, it's now become really rare to see a smoker. It's now an occasional surprise when you catch a whiff of tobacco in the street. It helped that cigarettes have been progressively taxed to nearly unaffordable (not sure, but I think a pack of 20 is now comfortably over £10). At the same time tobacco has been hidden in ugly packaging and no visibility is allowed in stores.
- madaxe_again 8y ago
  Yeah, a 20 pack is now well over a tenner. It’s great. I do not smoke at all in the uk now, where I currently predominantly live, as the cost is just nuts. £4000 a year or so if you’re on a pack a day, which is where most active smokers sit. I now vape, spend about £200 a year on it. I will confess that I do still smoke if I find myself in a country where vaping is illegal and the cigarettes are 50p a pack, as I am still a nicotine addict, but I would much rather vape. Cigarettes make my lungs hurt. Vaping doesn’t. So, unless it turns out that vaping is somehow worse than smoking, this is a resounding public health policy success. My behaviour and the scarcity of smoking you note underscores this.
- seanmcdirmid 8y ago
  In Australia, a pack is around $25! Taxation helps, but states are loathe to tax so much that they actually decrease demand more, they are addicted to the extra revenue and don’t want to see that go down. But society still loses out in the long run, whereas in the UK and Australia, the costs of smoking are all socialized, so sin revenue isn’t as appealing.
Stevvo 8y ago
That's innacurate. The US government spends more on healthcare per person than the UK; so the public cost saving would be higher in US, despite the lack of universal healthcare.
- seanmcdirmid 8y ago
  I don’t think that is true either, as 50% of healthcare spending in the USA is private. Actually, you could be right, but I would want to see some evidence before I was convinced.

daddylonglegs 8y ago

Having lots of people take up e-cigarettes is not a bad thing if they are moving away from smoking tobacco. On the other hand, if lots of teenagers take up e-cigarettes (with nicotine) then that is a public health disaster; and will cost millions of lives. So there could be an actual difference in health effects in different countries, which would be a reasonable basis for the difference in perception. Note that the UK has active public health campaigns to quit smoking [0] and tougher laws on advertising than some parts of the world [1]. Having said that, an awful lot of UK teenagers have smoked e-cigarettes[2], so perhaps we're just complacent. [0] https://www.nhs.uk/smokefree/help-and-advice/e-cigarettes https://www.nhs.uk/smokefree/help-and-advice/e-cigarettes [1] https://www.asa.org.uk/advice-online/electronic-cigarettes.html https://www.asa.org.uk/advice-online/electronic-cigarettes.h... http://www.bbc.co.uk/newsbeat/article/38978119/santa-claus-vaping-advert-banned-for-appealing-to-kids http://www.bbc.co.uk/newsbeat/article/38978119/santa-claus-v... [2] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/datasets/ecigaretteuseingreatbritain https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... 2017: 16 to 24 year olds: 32% had experimented, 17% had previously smoked e-cigs, 5% were current users. Edit: I forgot to add that there are different limits on nicotine content.

qes 8y ago
> if lots of teenagers take up e-cigarettes (with nicotine) then that.. will cost millions of lives That's quite a claim. Based on what? Can you point to any deaths reasonably believed to be caused by nicotine consumption from vaping?
- daddylonglegs 8y ago
  There will be two main mechanisms: The first is the direct effects of nicotine (and possibly the vaping mechanism). The figure being bandied about on this thread is that vaping is probably 5% as directly dangerous as tobacco. The second is that teenagers and young people who vape (with nicotine) will get addicted to nicotine and are more likely to smoke tobacco. Smoking currently kills more than five million people a year[1], 5% of that would be more than 250,000 deaths a year and so a million deaths every four years. If vaping is taken up by young people on the scale that smoking tobacco is then millions of premature deaths is a conservative estimate, given what we know now. [1] https://ourworldindata.org/smoking https://ourworldindata.org/smoking edit: typo