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Simon Chapman: Why is Big Tobacco investing in e-cigarettes?

20 Mar, 14 | by BMJ

simon_chapmanDiscussion about e-cigarettes on social media, the blogosphere, and vaping chatrooms is dominated by impassioned accounts from former, now vaping, smokers wanting to encourage smokers to do what they have done.  The early data on e-cigarettes show them to be as good as, or marginally better than nicotine replacement therapy in helping smokers to stop. Which is sad to say that so far, they are about as unsuccessful as NRT for the great majority who use them. Hopefully, better and stronger data will emerge about newer innovations, but until then, their smoking cessation breakthrough status remains hype.

Every smoker who quits via vaping counts on one side of the public health ledger as a success. But as shown in my last blog, the 80% of vapers who only reduce smoking cannot be so counted. Cigarette sales were down 6.2% in France in 2013, while e-cig sales were heralded by vaping advocates as “skyrocketing.” Some of this would have been from quitting, but more would have been from clinically insignificant reduction among continuing smokers. Prospective studies need to examine whether vaping uptake serves to hold a significant number of smokers in smoking, who would otherwise quit, not just immediately, but soon enough to substantially reduce their risk of premature death and serious disease. Such an effect would need to be balanced against the quitting volume achieved in any calculation of net population benefit.

And that’s before we come to questions of the ambitions of e-cigarette manufacturers in all this. All tobacco transnationals now have launched or acquired e-cigarettes lines. As they have done this, none has made statements about their goals of actively working to decrease cigarette sales. And tellingly, none has desisted from aggressively opposing effective tobacco control policy.

Only the most naïve or captured advocates for vaping could fail to acknowledge that the tobacco industry wants people who vape to smoke and vape, not vape instead of smoking. To the credit of some such advocates, nascent policy proposals to accelerate the decline of smoking and calls for governments to set dates for combustible tobacco to be “phased out”  have been made. But to date, no government has even gestured serious intent about this beyond sloganeering.

Big Tobacco has already started buying out e-cigarette minnows, and shutting out competition via patent law actions. Here it is following its global playbook in buying up almost all national tobacco companies. Many e-cigarette start-ups would be salivating at the prospect of getting rich quick, but what will be the public health focus of this entirely predictable momentum?

Big Tobacco must think all its Christmases have come at once. E-cigarettes may allow it to profit from nicotine addiction around the clock: in places when you can’t smoke, you should be able to vape, it argues. Restrained from using flavours in cigarettes in some nations, e-cigs offer a cornucopia of kiddie-friendly flavours familiar at pre-schoolers’ birthday parties. With tobacco advertising banned, e-cigarettes have opened the door to all the old themes and allowed the fully market researched semiotics of smoking to be reborn. Those arguing that there will not be any major collateral benefits in this for tobacco companies via smoking are indubitably myopic.

In an inglorious triumph for the logic of capitalism, e-cigarettes also promise hope of respectability to tobacco companies. The same tobacco company staff who scheme to attack effective tobacco control, and bust open low income, high illiteracy markets with cigarette promotions, suddenly have opportunities to present themselves in wolf-in-sheep’s clothing pantomime mode as the solution to the “terrible” health problems that arise because of their work.

Disturbingly, some experienced tobacco control people are now aggressively advocating for the importance of e-cigarettes to be freely advertised to promote wider uptake. For decades the tobacco industry maintained the public farce that they had no interest in children smoking and that their advertising was crafted to attract only smokers, with some magic barrier preventing from attracting the attention of non-smokers and especially children. Privately, they of course understood completely that “The base of our business is the high school student.” (See this powerpoint collection of industry insights into the teenage market)

Yet today, like ventriloquists’ dummies, some e-cigarette advocates blindly insist that the Niagara of advertising like this will have zero impact on non-smoking teenagers and is not “intended” to catch their interest.  Big Tobacco cannot believe its luck that it has these people on tap to make the arguments for them.

Early signs are here. In December 2013, the Utah Health Department, in a state with the lowest tobacco use in the country, reported statewide data showing that ever-use of e-cigarettes had doubled in high school kids since 2011, with current use tripling. Seven per cent of grade 10 students were current users. Nearly one third of these reported that they had never smoked cigarettes.

Nations with advanced tobacco control programmes have achieved all time lows with youth smoking. In Australia today only 2.5% of 12-17 year olds smoke daily (p24). None that age has ever seen a domestic tobacco advertisement. This reduction is slowly starving the tobacco industry as fewer people than ever start smoking. But in the name of accommodating the pleas of what are frequently exaggerated claims about the size of the smoking population who “cannot” quit, some policy approaches to e-cigarettes place these amazingly important gains at risk.

London addiction specialist Robert West thinks any nation banning e-cigarettes is “nuts.” But there are many sensible things that be done without banning them, as several nations (eg Singapore) have done.

Smokers desperate to quit tobacco, and unhappy with or uninterested in NRT and prescription cessation products, should be able to access e-cigarettes at pharmacies, perhaps with a permit or prescription. Nearly every nation has such a system of controlled access to drugs with abuse or dependency potential. Only two nations, the USA and New Zealand, allow direct to consumer advertising of prescribed or restricted drugs. No one but those with commercial interests and extremist advocates argue that it is a sensible idea to attract children into addiction.

Scheduling e-cigarettes would allow them to be overseen for quality and safety, carefully monitored through research, and their availability relaxed or tightened on the basis of evidence or benefits or harms. Nicotine is a rapidly and strongly addictive drug, that many find extremely difficult to quit. Every imaginable mistake was made with the way tobacco was sold and marketed. If we are not to repeat those mistakes with a product that so far has an unimpressive record in doing what its advocates claim for it, which threatens to renormalize the smoking performance and hold many smokers longer in their addiction, early caution is critical.

See also:

Competing interests: I have read and understood the BMJ Group policy on declaration of interests and have no relevant interests to declare.

Simon Chapman AO PhD FASSA is professor of public health at the University of Sydney and for 17 years was deputy editor and editor of the BMJ’s Tobacco Control.

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  • Tom Gleeson

    A lot of good points in this piece but a lot of supposition and false equivalence as well.

    Tobacco company’s may eventually switch completely to producing ecigs but like you I doubt their in any hurry to do so. Their best bet is to continue selling cigarettes while they slowly build brands around ecigs. The problem is that most regulation proposed plays right into the tobacco model of business. How to avoid this is the question.

    Your proposal to have them as prescription only would not achieve this unless you could prevent tobacco companies from producing ecigs by order. In fact medical ecigs would be only produced by tobacco companies because they are the only players in the business who could afford the cost of achieving medical certification.

    The idea that advertising ecigs is equal to advertising cigarettes is patent nonsense as is concluding that ‘ever use’ is equal to daily use. Free advertising might lead to the result you fear but as no one is proposing anything other than targeted advertising this is a red herring. As to scheduling ecigs because every nation has a system of controlled access to drugs with abuse or dependency potential.. do I even have to mention that cigarettes will not be included in this scheduling any more than the other drugs with abuse or dependency potential, alcohol and caffeine.

    We should schedule based on the risk of the particular drug not it’s abuse or dependency risk which may be nothing more than the dependency that caffeine has.
    So to justify scheduling nicotine containing products (with the exception of tobacco cigarettes) would need definite proof of actual harm. Mere habit won’t cut it as that’s a personal choice that has no health consequence for the user or anyone else.
    All that’s required for ecigs to be what they are claimed to be is sensible regulation, targeted advertising, age restriction and product standards.
    Failing to achieve this will result in exactly what we fear most, the continued prevalence of smoking as the nicotine delivery method and a glacial pace of reduction to about 15%. At which point the black market will deliver the goods as it has done with all other scheduled drugs

  • Darla McGahan

    First tobacco companies own 5 brands, other companies own over 250 different brands and that is just in the Cig look alike market. What about the hundreds and hundreds of non look alike PV or mods? You may think tobacco companies have it in the bag but they don’t. They are way behind the 8 ball on this one.

    E-cigs were made by smokers for other smokers to get away from smoking. they have been on the market for 10 years. Big tobacco only came on the market last year. 14 million people world wide use e-cigs.

    We all know here in the US e-cigarettes can not be put under pharma or treated like a drug. A judge ordered that. So they are to be deemed a tobacco product by the FDA. They in reality are an alternative to smoking. and for many a source to get off smoking. Its the side effect of vaping that you do quit smoking. In a small survey done over 86% of people using e-cigarettes had quit smoking totally.

    Advertising is targeted to the smoker and I don’t see how you could see anything different than that. I guess you see what you want to see.

  • Roger Hall

    It’s highly ironic that Mr Chapman and other Tobacco Control “experts” are all too keen to demonise e-cigs because the big tobacco companies have finally entered the marketplace, when the EU has recently agreed legislation that will enable tobacco companies to effectively “control” through unnecessary and rushed legislation the future of e-cigs. Tobacco companies were late to the e-cig market, (possibly because they thought that they would get classified as pharmaceutical products in which case e-cigs seemingly wouldn’t be a problem for Mr. Chapman) and have now entered through acquisition for the simple reason that e-cigs are taking business away from conventional tobacco cigarettes as recent tobacco cigarette sales both in the US and the EU can demonstrate.

    Surely what really matters isn’t who actually owns e-cig companies, but the often forgotten fact that e-cigs are universally scientifically proven to be 99% safer than tobacco cigarettes, so their uptake should be promoted for the simple reason that they will save millions of lives. They shouldn’t be demonised because a few tobacco companies now own and produce them and if Mr Chapman is really serious about eliminating the harm from tobacco cigarettes, than he should promote the independent e-cigs products and companies who have absolutely nothing whatsoever to do with tobacco and actually are preferred by experienced vapers who have managed to totally quit all tobacco cigarette use. There are hundreds and thousands of e-cig companies that have no involvement with tobacco, so why does he focus on these when surely promoting healthy competition in the e-cig marketplace stands more chance of eradicating tobacco’s control of recreational nicotine.

    Is Mr Chapman totally against any safe recreational nicotine that save lives or just the tobacco companies that supply safer recreational nicotine? I’m fairly certain that he has no issues with Pharmaceutical companies supplying safe recreational nicotine as is the case with the smokers who have got addicted to regulated nicotine gum, so it appears that the smoker, their health and the consumer’s recreational nicotine choice simply don’t matter.

  • e juice

    Lot’s of tabacco company’s are switching towards e cig,e-juice.off course they are in hurry to do so .because they do not want to sell more and more units ,but they also want to fulfill there social responsibility

  • http://www.ecigworld.com.au/ eCigWorld

    E-cigarettes have the potential to be a disruptive and profitable industry. Electronic cigarettes, promoted as a healthier alternative to tobacco, are getting powerful new backers with an unhealthy reputation: big tobacco companies.

    Big Tobacco is fully aware of the threat that e-cigarettes pose to their traditional business and have concluded that the only way to beat them is to join them. Anyone looking to invest in the future of e-cigarettes need look no further than these enormous conglomerates as they benefit from the distribution channels, market understanding, and capital to take advantage of this potentially game-changing consumer shift away from traditional cigarettes.

    eCigWorld.com.au

  • Inna

    Why wouldn’t they invest? It’s a fast growing industry with tons of profit potential and the market is not yet saturated. Great article!

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