June 2, 2021 - 7:00am
Smoking is very bad for you.
No, seriously. Smoking is astonishingly bad for you. Something like 15% of all deaths worldwide are attributable to tobacco smoking: about 8 million deaths a year, out of about 55 million. In India alone, it probably contributes to about 800,000 deaths a year, if my calculations (9% of all deaths in India; about seven people die per 1,000 in India per year; 1.3 billion people in India) are correct.
I mention India in particular because the WHO has just given Dr Harsh Vardhan, an official in India’s Ministry of Health and Family Welfare, an award for “special recognition for tobacco control”. “His leadership was instrumental in the 2019 national legislation to ban E-cigarettes & heated tobacco products,” tweeted the WHO secretary-general, Dr Tedros Ghebreyesus. “Thank you, Minister!”
Now. According to a literature review by the widely respected Cochrane Collaboration, e-cigarettes are very effective at helping people quit: about 10 out of every 100 people who use e-cigarettes to try to quit smoking are successful, compared to about six out of every 100 who use nicotine patches, and about four who go cold turkey.
Of course, if you quit smoking for vaping, but vaping is just as bad for you, then you’re out of the frying pan and into the fire. But it’s not. Cochrane’s review didn’t find “any clear evidence of harm”, albeit only in the first two years of use; Public Health England say that e-cigarettes are 95% less harmful than smoking, and a PHE review of the evidence suggests they are 0.5% as likely to cause cancer.
Cancer Research UK says: “The evidence so far indicates e-cigarettes are less harmful than tobacco smoking and can be an effective quitting tool.” The anti-smoking charity ASH uses the 95% less harmful stat and agrees that they are effective in helping people quit. It also points out that there is no evidence of harm from passive e-cigarette smoking or of vaping being a gateway to actual smoking (“gateway” theories are usually rubbish anyway). All of them say that the long-term effects are unknown, but since the long-term effects of actual smoking are known, and are extraordinarily bad, it’s a very safe bet that, if there are long-term effects, they’re nowhere near as bad as those of smoking.
A recent attempt in the BMJ to model what would happen if all smoking was replaced by vaping found that it would save between 1.6 million and 6.6 million lives over 10 years in the US alone.
It’s worth noting that public communication of the risk of vaping has been absolutely terrible. Two surveys (1, 2) have found that, while people used to think, correctly, that vaping was much less dangerous than smoking, they now often think it is just as bad. The PHE evidence review says that it is important to “communicate the large difference in relative risk unambiguously so that more smokers are encouraged to make the switch from smoking to vaping”, but that has conspicuously failed to happen.
Why is that? Because (among other things) the World bloody Health Organisation keeps telling us that vaping is bad! Astonishingly, in a Q&A last year, the WHO said that it wasn’t clear that vaping was safer than smoking (one tobacco addiction researcher, understandably, called that Q&A “malign” and “blatant misinformation”). On Monday they were telling people not to switch. In February last year they said: “Both tobacco products and e-cigarettes pose risks to health and the safest approach is not to consume either.”
I don’t know what happened to make the WHO so implacably opposed to vaping. No one sensible thinks that vaping is without risk, but it pretty obviously is many, many times safer than smoking, and clearly effective at helping people quit. They are making the perfect the enemy of the good, like those dimwitted American campaigns trying to stop STDs and teen pregnancy via abstinence.
(And I haven’t even mentioned the fact that some people enjoy vaping; so there is some small amount of risk which they would consider acceptable, just as I accept a small risk from drinking alcohol or eating unhealthy foods. We shouldn’t pretend it’s all downside.)
The WHO does important work. It hasn’t been perfect during Covid by any means, but it hasn’t been conspicuously worse than a lot of other institutions. But it is weirdly, awfully, terribly bad on vaping, and it is not hyperbole to say that this weird awful terrible badness could kill thousands or even millions of people. Giving people tobacco-control awards for banning vaping is like giving people a Nobel Peace Prize for banning diplomacy.
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Subscribe“I don’t know what happened to make the WHO so implacably opposed to vaping.”
Lobbying, bribery, corruption spring to mind.
But lobbying by whom, and to what end? Could tobacco companies be paying off the WHO to protect their markets, particularly in developing countries?
Quite likely – countries with tobacco growing industries, perhaps even the high tax benefit from cigarettes in other countries.
Most UN organisations are rife with this sort of thing.
I would think so and not just in developing countries. It would seem obvious that tobacco companies would wish to discredit vaping, especially if it encourages people to quit smoking entirely.
There’s no reason the tobacco companies can’t dominate the vaping industry as well. They have the raw materials!
Of course, but it’s a diminishing market since it’s a halfway house to stopping rather than a long-term addiction like gaspers.
The only people who actually want to vape are those who already smoke cigarettes and want to stop.
No-one in their right minds would vape if they weren’t smokers in the first place.
The tobacco companies tried bubblegum flavoured vape – clearly aimed at young people who probably haven’t smoked cigarettes – but I think those are banned now.
Vaping clearly represents a major threat to them, hence the lobbying and bribery.
The Chinese are heavy smokers, just sayin.
India is a great country but its politics and governance are more than usually awful. Arbitrary and evidence-free government decisions are commonplace, as with this ludicrous ban on e-cigarettes.
The Indian government owns 28% of ITC, its main manufacturer of cigarettes, bidis and other tobacco products. Shares in stocks in that corporation are soaring.
See my post. $$$$$$$$$$
Yes smokers pay a lot of tax. They must continue to get ill or even die to pay for the NHS.
Well, sure, this is kind of true, but only in the sense that every public health institution has been incompetent on COVID well past the point where they made things worse rather than better. The WHO has been absolutely mind-bendingly terrible on COVID and the only thing that “saves” it is the fact that most other large public health bodies reflexively follow it, so it drags them all down to its level.
Its stance on vaping is exactly what you’d expect to see from the WHO given its track record. This isn’t some weird aberration, the WHO is always like this. Misinformation pours out of it on a near daily basis. COVID is the textbook example, especially anything China-related, but it’s not just that. This is an organization that mounted an investigation of the lab leak theory which it had to renounce days later when people pointed out they hadn’t actually investigated anything. It claimed there was no clear evidence COVID was transmitted person to person, even though human-infecting CoVs always are. It stated outright to a BBC journalist that the there was little evidence masks worked but the messaging had changed due to political lobbying. Their last great outing on the world stage resulted in an article in Der Spiegel titled “Reconstruction of a mass hysteria: the Swine Flu panic of 2009”. Their chief at the time gave a speech in which she argued swine flu should be exploited to fight for “changes in the functioning of the global economy,” and to “distribute wealth on the basis of” values “like community, solidarity, equity and social justice” – and that was before they got an actual former communist as their chief!
The WHO is a disaster zone and should be scrapped. It took an entirely manageable medical problem and turned it into a global catastrophe due to its complete takeover by a hard left ideology that has learned it can manipulate people through an artificial fear of death.
(Oh, good article by the way, very important topic and I wasn’t aware of how big the difference is! 🙂 )
I couldn’t agree with you more about the WHO. . It has become over-politicised and the people running it, down to goodness-only-knows what level, are too compromised for it to just do a bout of navel-gazing and miraculously emerge ‘reformed’. The whole thing should be scrapped.
Quite apart from anything else, a global health bureaucracy, oddly enough, behaves like any other global bureaucracy does. Since its turf in this case is health, the more global health problems there are, the bigger the empire it builds.
If they’re coming for vaping (I’m a vaper), what about alcohol? Surely more harmful than vaping?
Don’t give them ideas.
What about vaping alcohol flavour-rum & bacardi that sort of thing?. The drinks industry would not like that
It hasn’t been perfect during Covid by any means, but it hasn’t been conspicuously worse than a lot of other institutions. First, is this a serious statement? And second, what kind of defense is it to say “others were worse.” WHO is the tip of the spear globally. It’s the same place that did its best to pretend China was not the source of the virus. It parroted the Chinese claim that there was no evidence of transmission of the virus between humans. That it’s off base on vaping does more to demonstrate consistency than leadership, and the wrong sort of consistency at that.
If freedom of the individual is so important, why do we have to waste time and money persuading people that they shouldn’t smoke?
Imagine that all UnHerd contributors were smokers and governments around the world were trying to stop us from smoking. Outrage and more outrage!
We can still have laws to protect people who choose not to smoke from the dangers of passive smoking.
Exactly! Enclosed spaces like bars and restaurants should be able to define their own policies – advertise “Smokers’ Bar!” if they want – as long as no one is forced to work there and the policies are gradually implemented to allow those who took their jobs with the understanding they would be working in a smoke-free environment can change jobs.
It’s the HCN, CO, PNAs etc that are dangerous in smoke, not the nicotine. So vaping should be strongly promoted as a smoking alternative if the WHO wanted to actually, you know, promote health.
The bureaucratic mind.
The WHO has shown itself to be easily captured by Chinese interests. Has Big Tobacco also bought its acquiescence?
I think it is the Puritan strain which runs through much of the public health establisment that accounts for much of the hostility toward vaping. They get high on their prohibitionism and can’t stand that a fun smoking substitute might be available.
My take as a pot smoker (not a tobacco smoker) is that there is something about vaping that is unconsciously associated with weed smoking. And that this visual association is enough to implicate the device. Between that and the tobacco industry it doesnt have a chance.
Here’s why.. https://www.who.int/news/item/17-08-2016-michael-r-bloomberg-becomes-who-global-ambassador-for-noncommunicable-diseases
Sure the WTO is seriously flawed, but it’s hardly high brow to point this out.
Hmm. Not a very balanced article. I’m a Canadian doc. The national committee I was on a few years ago, as part of its public health mandate, looked into the question of: is vaping an on-ramp to or an off-ramp from cigarette smoking? The answer is BOTH. Over time most places where vaping is common (mostly amongst youth) have seen cigarette smoking rates rise, indicating it is more of an on-ramp than off-ramp. (a huge number of new cigarette smokers started with vaping and moved up)
As with every question of societal policy, the scientific stats and research on vaping cannot answer the question of whether we should ban it. That is a question of civil liberties, and how much control we think the government should have over individual lives. People are free to do many risky things. Should they be allowed to vape as well?
I hate vaping as much as smoking. A friend vaped in my flat, telling me it was not as bad as passive smoking exposure. Even though he vaped by an open window, I started coughing which lasted all evening and well into the next day!
So it is not better than real cigarettes.
Vapers and smokers are banned from my home.
Don’t you just hate auto-correct. Instead of vape, it’s ‘corrected it to taped or raped!! Dumb robot!
On my IPAD I can turn off auto-correct.