In one press release on December 22, the Swiss association, Helvetic Vape, proposes a plea for the end of the public health scandal concerning vaping.
How have we come to believe that vaping products are tobacco products and what must be done to break the scandalous impasse imposed by the national executive?l?
To understand, it is necessary to expose the perverse game which the executive has been engaged in these last years about vaping. In 2009, shortly after the appearance of vaping products in our country, the Federal Office of Public Health (FOPH) unilaterally decides to ban the sale of products containing nicotine and limit their importation for personal use through a simple administrative letter. This is good, Article 37 of the new ordinance on foodstuffs and everyday objects (ODAlOUs), which has just been updated by this same administration in collaboration with the Office of Food Safety and Veterinary Affairs (OSAV) stipulates, by the greatest of coincidences and to protect the pharmaceutical industry, that it is forbidden to add substances giving them pharmacological properties to the usual objects coming into contact with the mucous membranes. Perfect, the FOPH will use that to give a semblance of legality to its ban, taken officially on the pretext that the risks related to vaping are not yet known. More prosaically to protect the pharmaceutical industry from the appearance of competitors to nicotine replacement drugs. An insignificant little problem arises anyway after the hasty elaboration of the ODAlOUs, the tobacco products are subject to article 37 of the ordinance. The lack of reflection of the administration and its eagerness to please the pharmaceutical industry therefore leads to making all tobacco products illegal. But fortunately nobody, not even the fight against tobacco, will use this article to immediately ban the sale of tobacco products. It is therefore a small bug without unfortunate consequences for the administration ...
It should be noted that doubts about the risks of vaping were understandable at the time. There were few scientific studies, although a careful review of these studies already showed the low risk potential of vaping (the 2009 FDA study did show nitrosamine levels in vaping liquids but at a similar to those found in pharmaceutical nicotine inhalers). However, the hasty and unthinking decision of the FOPH focuses on nicotine, implying that it is responsible for the uncertainty of vaping at that time. However, the uncertainty concerned the inhalation of propylene glycol, glycerol, food flavorings and possible traces of contaminants, ie the composition of nicotine-free products, which are duly authorized by the FOPH without any age limit. purchase. The FOPH's ban was therefore not intended to protect public health but only served to protect a status quo: the tobacco industry makes people sick, the pharmaceutical industry treats them and all the world is making a lot of money, everything is fine. The ban on the sale of nicotine-containing vaping products also provided a sneaky insight into the misconception that these products are more dangerous than over-the-counter tobacco products, and that they require strict regulation.
The fact that the sale of vaping products containing nicotine is "prohibited" by a simple administrative letter rather than by a real administrative decision then prevents any legal action. It was not until 2015 that the ploy of the FOPH's pseudo-administrative ban was denounced and the open sale of liquids containing nicotine began. The FOPH is meeting with the FSVO to reflect on the measures to be taken in the face of the dispute. No question of authorizing nicotine vaping products, the bill on tobacco products (LPTab) of the head of the department, who artificially tries to assimilate vaping products, is on its way and must be presented to Parliament soon. As vaping products are subject to the Foodstuffs and Utility Articles Act (LDAl), it is the FSVO that is competent to make and sticks to a decision.
We then witness, in the space of 24 hours, a tour de force of the Federal Department of the Interior (DFI). The FSVO issues an administrative decision which states, without any scientific basis, that nicotine vaping products are dangerous and must be banned. Meanwhile, Mr Berset quietly presents his LPTab project to Parliament and the media, insisting that vaping products containing nicotine must be legalized to reduce the risks. The manipulation is obvious, the vaping was used by Mr Berset to convey his LPTab project. Mr Berset, apart from any public health consideration, preferred to continue to limit access to a risk and damage reduction tool to serve his political projects. In doing so, it has drowned the necessary debate on risk and harm reduction in the shapeless, polarized and obsolete mass of sterile discussions on “tobacco”.
Vaping products are not tobacco products. The late LPTab project used a Kafkaesque twist to try to assimilate them. It's a pure view of the mind from the executive. A view that goes against the will of Parliament, which expressed itself in 2011 when it decided to exclude vaping products from tobacco taxation. If the vaping products were tobacco products, they could not escape the imposition on tobacco. The rejection this year of the LPTab assimilation project confirms once again that Parliament does not consider vaping products to be tobacco products. So why the executive, relayed by media that do not analyze the situation, continues to want to believe that the rejection of the LPTab project will further delay the legalization of nicotine vaping products in a new tobacco bill?
It is time to put an end to political manipulation that goes against public health. The vaping products are governed by the LDAl. They are not excluded from its scope by the new LDAl because they are not tobacco products. Therefore, there is no reason not to regulate them immediately in this context. And that the executive does not come to say that it is impossible. Nothing in the LDAl, old or new version, prevents it. The ridiculous paragraph, the misleading interpretation of which has been used for years to artificially delay the placing on the market of products allowing nicotine users to reduce the risks and damage to their health, is found in a simple order written by the administration and approved by the executive, not in the law passed by Parliament. What's more, in an order being reviewed by the executive who took care to transcribe the old 37 article in the new 61 article to perpetuate the illusion of an inability to quickly regulate nicotine vaping products to promote the LPTab project using vaping as a carrot.
The scandal of DFI's treatment of vaping in recent years must be denounced. While, thanks to nicotine vaping, already more than 6 millions of Europeans have stopped smoking and more than 9 million have significantly reduced their consumption of tobacco, Switzerland is lagging behind because of an administrative ban on sales without scientific or legal basis. The number of vapers in our country is ridiculously low compared to countries where vaping products containing nicotine are allowed for sale. Any policy or measure aimed at restricting nicotine users' access to a harm and harm reduction solution without good reason is contrary to public health. There is an urgent need, 9'500 people die prematurely every year in our country because of an obsolete, dangerous and freely available form of nicotine consumption: smoked tobacco. This is 95 times more than drug-related deaths, 31 times more than deaths on the road and 8 times more than alcohol-related deaths. What are we waiting for?
Vaping is not a threat but an opportunity. It is part of a dual logic: on the one hand, the informed and voluntary choice of individuals taking charge of their health by reducing their risky behavior based on unbiased information rather than on paternalistic injunctions, on the other hand the emergence of new enterprising, dynamic and innovative competitors in the face of the old traditional players in the nicotine market, namely the tobacco industry and the pharmaceutical industry. These two associated factors upset the old paradigms and create a favorable framework for a new pragmatic policy based on opportunities rather than fears. Vaping products are not tobacco products or pharmaceuticals. They have nothing to do with either legislation specific to these two particular sectors.
The current state of scientific knowledge on vaping is summarized in two English reports from world-renowned health authorities, particularly for their pioneering work on smoking in the 1950s.
- Public Health England (PHE), E-cigarettes: an evidence update (August 2015)
- Royal College of Physicians, Nicotine without smoke - Tobacco harm reduction (April 2016)
These two respectable institutions estimate at less than 5% the relative long-term risk of vaping compared to smoked tobacco based on the products currently available on the market, without heavy regulation and without specific standards (this market is rapidly evolving, the products tomorrow will be even less risky).
« ... the health hazard from long-term inhalation of aerosol vaping products available today should not exceed 5% of the harm caused by smoked tobacco. Royal College of Physicians Nicotine without smoke - Tobacco harm reduction
They conclude that there is a need to encourage and promote the conversion of smokers to vaping through an environment that encourages and facilitates access to vaping products. They are supported in their approach by many players in the fight against tobacco: Action on Smoking and Health, Association of Directors of Public Health, British Lung Foundation, Cancer Research UK, Faculty of Public Health, Fresh North East, Public Health Action (PHA), Royal College of General Practitioners, Royal Society for Public Health, Tobacco Free Futures, UK Center for Tobacco and Alcohol Studies and UK Health Forum. The documentation and analysis work carried out by PHE and RCP to reach their conclusions has no equivalent published in Switzerland. These reports open an effective way of fighting to reduce smoking by no longer opposing nicotine users in an infantilizing relationship but by working with them to take charge of their health through risk and harm reduction tools. . Apart from tobacco, nicotine alone, a fortiori without combustion, is not very addictive. It presents a risk profile for the health of the user similar to that of caffeine. In the United States, the Schroeder Institute for tobacco research and policy studies and the Truth Initiative "Inspiring tobacco-free lives", two entities very committed to the fight against tobacco, have just published a report calling for rethinking nicotine and its effects :
- Pr. Raymond Niaura, Re-thinking nicotine and its effects (December 2016).
This cautious report mentions in particular that " a considerable body of evidence indicates that relatively little of the harm caused by smoking is due to nicotine, which, with some exceptions, is acceptable at dose levels that are within the range usually consumed by consumers tobacco and nicotine substitute drugs in self-service. A major strategy for potentially reducing harm to the public is to allow Alternative Nicotine Delivery Systems (ANDS), which replace smoking, thus allowing smokers to obtain nicotine without exposing them to nicotine. Fatal combustion products And stresses in his conclusions that " there is a continuum of damage among combustible and non-combustible products containing nicotine. A good public health policy must recognize this continuum and harness this knowledge to move people who continue to smoke as quickly as possible to less harmful nicotine-producing products."
We can not afford to do the opposite any longer in Switzerland. The executive can not on one hand support the National Strategy for the Prevention of Noncommunicable Diseases (MNT Strategy) and the National Addictions Strategy while continuing to play with the health of nicotine users. The 2017-2024 Measurement Plan of the MNT Strategy, which falls under the 3.4 item of the United Nations 2030 Sustainable Development Agenda, provides in its scope of action 1:
« In line with the NCD strategy, existing prevention and health promotion programs are being developed to improve the effectiveness of cancer prevention, cardiovascular disease, chronic airways diseases, diabetes and disorders. musculoskeletal. As so far, it is to prevent smoking, alcohol abuse, unbalanced diet and sedentary lifestyle in all phases of life. Individuals are supported in their efforts to reduce these risk factors, build protective factors, and develop healthy lifestyles. In this way, health skills and the responsibility of individuals are strengthened. The life-stage and the living-environment approaches are strengthened, and equal opportunities are encouraged. The experiences of health prevention and promotion programs and the results of scientific studies provide a broad base of knowledge on the effectiveness of the measures. They constituted the frame of reference when defining the measures. »
Reducing risk factors doesn't just mean “total abstinence”. Guiding, informing and facilitating the transition to very reduced risk consumption patterns is essential to support individuals who consume nicotine. If it is essential to prevent the consumption of smoked tobacco (smoking), it is because of the combustion which generates carbon monoxide, tar and fine solid particles. The combustion of plants, whatever the field, produces an extremely harmful smoke which is the cause of a large proportion of non-communicable diseases. According to the Global Burden of Disease Study 2015 (GBD 2015, The Lancet) Tobacco smoke (hence combustion) is the source of 44% of the DALYs (disability-adjusted life year) in Switzerland related to chronic respiratory diseases, 24% of cancer-related DALYs and 14,5% DALYs related to cardiovascular diseases. It is therefore above all else that combustion must be combated to drastically reduce the risk factors for noncommunicable diseases. It must be combated by properly informing the population about the risks of the different modes of nicotine consumption as well as other substances and by promoting the adoption of non-burning consumption patterns. One can, of course, fantasize about an ideal world without tobacco and without nicotine, as one dreamed of a world without drugs. Experience shows the failure of this kind of project.
Regardless of the severity of the repression of substance use, individuals continue to consume it. The principle of harm and risk reduction is a pragmatic approach that has been proven in many fields (road safety, AIDS control, drug policy, etc.), it is high time to apply it to consumption of nicotine in Switzerland as stipulated in 3.1.3 of the 2017-2024 Measurement Plan of the Addictions Strategy:
« Broadening of risk reduction: mainly applied to illegal substances so far, the approach to harm reduction - which consists of limiting the damage associated with risky behavior and setting up offers that are not accessible only to abstinent - should be extended to all forms of addiction when it seems appropriate and necessary. » .
All the elements are in place for a fast and moderate regulation of vaping products under the LDAl in order to offer safety and availability to nicotine users. All elements except the will of the executive. What new excuse could he find for continuing to do nothing despite the obvious urgency? Two appeals against the FSVO decision before the Federal Administrative Court (FAT) are still pending. The executive could use this fact to extend the ban, arguing that his hands are tied until the court reaches a decision. Waiting to be forced by a court decision to reconsider his hazardous choices, rather than finally show his sense of responsibility. It would be one more manipulation. At any time, the FSVO may withdraw its decision prohibiting the sale of nicotine-containing vaping products, thus extinguishing the procedures, rendered moot, before the TAF. If Mr Berset has a bit of panache, he should take the opportunity to be a good player. Everyone can be wrong, it's not so bad as long as you correct your mistakes.
Vaping products pose little health risk and do not require heavy regulation. On the other hand, they have many benefits for public health. The LDAl already provides the necessary framework to guarantee the safety of users. A simple and easy to understand regulation for nicotine users will guarantee a better adoption of the risk and harm reduction tool that is vaping. It must be accompanied by clear and unbiased information on the risk profiles of the different modes of nicotine consumption. Swiss public health has already suffered enormously from the scandal provoked by an executive stubbornly in an illogical and deleterious way. The time has come to correct the blame.
Source : Helvetic Vape
