I write this piece as a hardened tobacco-smoker of eighteen years who has, in the past, smoked anything up to forty to Camels’ per day. Initially rejecting e-cigs as a bit of frippery, my then partner convinced me to buy one following the death of her friend’s son. Since then, bar for the occasional drunken-accident, I have clung tightly to my ‘photon-tank’. Significantly, this has nothing to do with any commitment to quitting. Rather, it is because I, like many, have quickly come to prefer the rich flavour vapour to that of smoke. What’s more, a simple headcount at Cardiff Central would suggest that I am now in the majority.
Public health drives are rarely modelled by physicians. Rather they have become the property of canny advertising consultants. Whilst seeking to preserve the façade of scientific efficacy, they seek to shock and ‘suggest’ through an established set of referents. Often, the statistical probability of developing an unpleasant and ultimately fatal disease is bound to the suspicion of foul odours, bad-skin and impotence.
Overall, attempts to engineer aversion have proved broadly successful. Having grown up in the late eighties, when courtesy determined that one should only smoke on the top-floor of a double-decker bus, I have witnessed a gradual but radical shift in perception. What was once an everyday event has now become widely perceived as an act of aggression.
This is precisely why we need to draw a distinction between ‘public health’ and social-conditioning. Whereas the one lends its self to rational debate, the other operates on a mute, subliminal level. In way of anecdotal evidence, I point to a friend who recently remarked “why should I be made to inhale somebody else’s breath”? The stakes are high – the 50 or so senior health professionals whose letter featured in last weeks nationals estimated that e-ciggs might potentially save tens of millions of lives world wide. Is it not good sense to think that at least some of this might benefit Wales?
Granted; besides the welcome suspension of nicotine, gelatine and preservative, it would of course be desirable to have some certainty as to what it is I am actually inhaling. However, many of the current proposals far exceed normal quality control. For instance, the suggestion that access should be restricted to pharmacies is not only mean but frankly ludicrous. Clearly an attempt to ‘medicalise by association’, the likely affect of not being able to purchase out-of-hour ‘e-juice’ will be to drive addicts like me to the nearest off licence to wretch upon a packet of ten B&H. From this perspective, policy-makers might as well recommend that contraception be returned to the chemist’s top-shelf (lest young people be tempted into unprotected sex).
Similarly, the notion that an e-cig will ‘normalise’ or ‘glamorise’ tobacco consumption can be easily refuted through the following simple experiment. Next time you are at the bar, offer a Lambert full-strength to a friend or stranger who has for the past three months been happily enjoying vanilla & amaretto. It would be wise to step-away as the effect can easily be compared to inviting a polished taster to knock back a can of special brew!
As any law undergraduate will attest, rights, far from being inviolable, coexist amidst a jumbled range of often contradictory categories. Consequently, my right to free expression is qualified by your right to life, a transaction governed by the principle of ‘proportionality’.
However, what is proportionate can only be properly considered in the wider context of comparative harms. The fact that some Welsh Health Trusts are now prepared to countenance the suspension of treatment pending the completion of a ‘quitters-course’ possibly suggests some of what is at stake. Moreover, given the demographics (smoking is a class issue!), and peculiar strains on the Welsh Health Budget, far from attempting to prohibit or control these machines, it is difficult to see why policy makers are not insisting that charger-points be installed in public places?
So let’s lighten up! Some of us have now acquired visible breath, a predicament not uncommon in Scandinavia. Similarly, the notion that mere exhalation carries a personal or secondary risk does not bode well for joggers, laughers or anybody else who happens to be engaged to strenuous public activity.
On a parting note, if Welsh Government are serious about tackling the major killers of our age, perhaps they would like to spend some time focusing on work-related stress? Speaking as a trade union organiser and ex-tobacco smoker who acquired the addiction as a part consequence of ‘performance-management’, bringing dignity to Welsh workplaces would possibly do more to save lives than restricting access to an innovation that has permitted me to at least mitigate one of the worlds most compelling and deadly addictions.
Doctor – “do no harm”!