ASH Briefing to MPs Prior to Lord Callanan's Motion

7/26/2019 ASH Briefing to MPs Prior to Lord Callanan's Motion

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Briefing Note

Tobacco and Related Products Regulations (TRPR)

Key points

1. ASH !ancer Researc" #K t"e Royal !ollege of P"ysicians and t"e Royal Society

of Public Healt" strongly urge you to support t"e Tobacco and Related Products

Regulations (TRPR) $"ic" are essential to successful i%ple%entation of

standardised pac&aging of tobacco products.

'. The Tobacco and Related Product Regulations 20161

transposed into UK law most of theprovisions of the revised EU Tobacco Products irective!2"ew regulations would be

needed before tobacco companies could be re#uired to put$

%arger health warnings on cigarette pac&s covering 6'( of the front and bac& of

pac&s

Picture warnings on the front of all cigarette pac&s

)ll pac&s to carr* information about where to get help to #uit

+n addition the TRPR also includes other important measures designed to reduce

smo&ing upta&e in *oung people and support #uitting including$

Prohibition of flavours from 2016 including menthol from 2020 ,there is some

evidence that menthol in cigarettes ma&es it easier for children to tr* smo&ing and tobecome addicted regular smo&ers-

Enhanced reporting obligations on the tobacco industr* including sales data and

mar&et research on the impact of ingredients and emissions particularl* on *oung

people

"otification of novel tobacco products si. months in advance of mar&eting!

/! The organisations endorsing this briefing support the TRPR regulations on electronic

cigarettes as we believe the* are appropriate and provide proportionate regulation!

owever the* will need to be monitored to ensure there are no unintended

conse#uences!

! +n repl*ing to an* debate on the TRPR the 3overnment should be as&ed to commit to$

Ensure that enforcement of the TRPR will be appropriatel* light touch

4onitor the impact of the TRPR as set out in paragraph 15 below and support

for appropriate revision of the TP as a result of the re#uired review

upport top mo&ing ervices so that the* continue to be funded and will

encourage use of electronic cigarettes and other clean nicotine products to

support #uit attempts

1Tobacco and Related Products Regulations 2016

2Revised EU Tobacco Products irective 20017/87E9

1
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/440989/SI_tobacco_products_acc.pdfhttp://ec.europa.eu/health/tobacco/docs/dir200137ec_tobaccoproducts_en.pdfhttp://ec.europa.eu/health/tobacco/docs/dir200137ec_tobaccoproducts_en.pdfhttps://www.gov.uk/government/uploads/system/uploads/attachment_data/file/440989/SI_tobacco_products_acc.pdf


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) public information campaign on the benefits of alternative nicotine products

including electronic cigarettes as a &e* part of continuing mass media

campaigns to drive down smo&ing prevalence

Refrain from ta.ing electronic cigarettes as a tobacco product ,i!e! adding e.cise

ta.- but instead as a normal consumer product ,attracting 20( :)T-

Ensure electronic cigarettes licensed as medicines b* the 4R) will attract a '(rate of :)T when sold over the counter ,as for other medicinall* licenced nicotine

products-!

Supporting nfor%ation

#se of lectronic !igarettes in *reat Britain+

,. There are an estimated 2!5 million adults in 3reat ;ritain currentl* using electronic

cigarettes an increase from 800000 in 2012! ,These figures are based on term use is #uite common about 6'( of e.>smo&ers still usingelectronic cigarettes have been doing so for more than a *ear! The main reasons

smo&ers cite for using e>cigarettes are to help them #uit smo&ing to save mone*

compared with smo&ing and to prevent relapse bac& to smo&ing!

8! The real harm caused b* smo&ing tobacco is not from nicotine which although

potentiall* addictive has not been shown to cause smo&ing>related diseases but from

inhaling tobacco smo&e which contains carbon mono.ide and ?tar@ a mi.ture of to.ic

chemicals more than 60 of which have been shown to cause cancer!These substances

are either not present in e>cigarette vapour or are at much lower levels!

5! 9urrent evidence supports the conclusion that electronic cigarettes are as helpful asother clean nicotine products in helping smo&ers to cut down or to #uit altogether!'

topping smo&ing is difficult and most individual #uit attempts fail! The best chance of

3ee Use of electronic cigarettes in 3reat ;ritain$ ) Aact heet 4a* 2016 and Use of electronic cigarettes among

children$ ) Aact heet )ugust 201'

44onographs on the evaluation of carcinogenic ris&s to humans! :ol 5/$ Tobacco smo&e and involuntar* smo&ing! %*on

+nternational )genc* for Research on 9ancer ,+)R9- 200

5Aor e.ample the recent ;;9 oriBon programme CE>cigarettes$ miracle or menaceD trac&ed a group of smo&ers attempting

to #uit some with no nicotine replacement product some with electronic cigarettes and some with licensed nicotine

replacement therap* ,"RT- products! ;oth electronic cigarettes and "RT improved #uit rates but neither was measurabl* more

successful than the other!

2
http://www.ash.org.uk/files/documents/ASH_891.pdfhttp://www.ash.org.uk/files/documents/ASH_959.pdfhttp://www.ash.org.uk/files/documents/ASH_959.pdfhttp://www.bbc.co.uk/programmes/b07c6ll4http://www.ash.org.uk/files/documents/ASH_891.pdfhttp://www.ash.org.uk/files/documents/ASH_959.pdfhttp://www.ash.org.uk/files/documents/ASH_959.pdfhttp://www.bbc.co.uk/programmes/b07c6ll4


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success for most smo&ers is to receive pharmacological and behavioural support

through the top mo&ing ervices which can increase success in #uitting up to four

times above #uitting cold tur&e*!6

F! Therefore the regulator* framewor& for electronic cigarettes should aim to$

upport their use b* smo&ers see&ing to #uit iscourage their use b* people who have never smo&ed particularl* *oung

people and children

Provide appropriate regulation of nicotine products including a route to approval

as medicinal products which would allow them to be advertised as providing

specific health benefits and to be made available on prescription to support #uit

attempts!

This position is widel* shared among medical and public health organisations including

the Ro*al 9ollege of Ph*sicians 8 the Ro*al ociet* for Public ealth 5 9ancer

Research UK Fand Public ealth England! 10The EU Tobacco Products irective is

consistent with the regulator* obGectives above and the provisions on electroniccigarettes are in an* event subGect to review ,see point 16-!

Safety and Perceptions of Ris&

1. urve*s for ) show that for smo&ers who have never tried vaping the most common

reason cited is concern that the* are not safe enough! 4isperceptions about the relative

ris& of vaping and smo&ing are growing not declining! +n 4arch 2016 onl* 1'( of adults

thought electronic cigarettes were a lot less harmful than smo&ing regular cigarettes

down from 21( in 201/! The proportion of adults thin&ing electronic cigarettes were

e#uall* or more harmful than cigarettes had risen from 8( in 201/ to 2'( in 2016!

11. The provisions of the TP should help reassure smo&ers particularl* if combined witheffective publicl* funded mass media campaigns on the dangers of smo&ing and the

help available ,including electronic cigarettes- to smo&ers see&ing to #uit!

!riticis%s of t"e TP/ and TRPR11

1'. The irective and Regulations set a li%it to t"e nicotine contentof e>li#uid of 20mg7ml!

The li%it for t"e li0uid content of tan&s and cartridges in electronic cigarettes has

6ee for e.ample the9ochrane Reviewof nicotine replacement therap* ,"ovember 2012- which concluded that$ All of the

commercially available forms of NRT (gum, transdermal patch, nasal spray, inhaler and sublingual tablets/lozenges) can help

people ho ma!e a "uit attempt to increase their chances of successfully stopping smo!ing# NRTs increase the rate of "uitting

by $% to &%', regardless of setting rovision of more intense levels of support, although beneficial in facilitating the

li!elihood of "uitting, is not essential to the success of NRT#*

7ee "icotine without smo&e$ Tobacco arm Reduction! R9P)pril 2016

8topping smo&ing b* using other sources of nicotine$RP )ugust 201'

9=ur polic* on harm reduction and electronic cigarettes$ 9ancer Research UK website

10E>cigarettes$ an evidence update$Public ealth England )ugust 201'

11The impact of the EU Tobacco Products irective on e>cigarette regulation in the UK$) ;riefing )pril 2016

3
http://www.cochrane.org/CD000146/TOBACCO_can-nicotine-replacement-therapy-nrt-help-people-quit-smokinghttp://www.cochrane.org/CD000146/TOBACCO_can-nicotine-replacement-therapy-nrt-help-people-quit-smokinghttp://www.cochrane.org/CD000146/TOBACCO_can-nicotine-replacement-therapy-nrt-help-people-quit-smokinghttps://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0https://www.rsph.org.uk/filemanager/root/site_assets/our_work/position_statements/rsph_smoking_positional_final.pdfhttps://www.rsph.org.uk/filemanager/root/site_assets/our_work/position_statements/rsph_smoking_positional_final.pdfhttps://www.rsph.org.uk/filemanager/root/site_assets/our_work/position_statements/rsph_smoking_positional_final.pdfhttp://www.cancerresearchuk.org/about-us/we-develop-policy/our-policy-on-tobacco-control-and-cancer/our-policy-on-harm-reduction-andhttp://www.cancerresearchuk.org/about-us/we-develop-policy/our-policy-on-tobacco-control-and-cancer/our-policy-on-harm-reduction-andhttps://www.gov.uk/government/publications/e-cigarettes-an-evidence-updatehttps://www.gov.uk/government/publications/e-cigarettes-an-evidence-updatehttps://www.gov.uk/government/publications/e-cigarettes-an-evidence-updatehttp://ash.org.uk/files/documents/ASH_1011.pdfhttp://ash.org.uk/files/documents/ASH_1011.pdfhttp://www.cochrane.org/CD000146/TOBACCO_can-nicotine-replacement-therapy-nrt-help-people-quit-smokinghttps://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0https://www.rsph.org.uk/filemanager/root/site_assets/our_work/position_statements/rsph_smoking_positional_final.pdfhttp://www.cancerresearchuk.org/about-us/we-develop-policy/our-policy-on-tobacco-control-and-cancer/our-policy-on-harm-reduction-andhttps://www.gov.uk/government/publications/e-cigarettes-an-evidence-updatehttp://ash.org.uk/files/documents/ASH_1011.pdf


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been set at 2ml and the siBe of refill containers at 10ml! +t has been argued that these

limit are too low and could discourage use of electronic cigarettes!

1+. owever the ) surve* found that onl* F( of vapers report using e>li#uid containing

1Fmg7ml or more of nicotine and onl* 11( use more than ml of li#uid a da*! Therefore

onl* a small number of users will need to refill their device more than twice a da*! Theminorit* of vapers using higher strengths and higher volumes of e>li#uid will continue to

be able to bu* these products until 20th 4a* 2018 leaving time for the mar&et to evolve

further to meet their needs!

1! )lthough the TRPR restricts adertising of electronic cigarettes awareness of electronic

cigarettes grew rapidl* before heav* advertising of the products too& place! cigarettes!

134R)!E>cigarettes$ regulations for consumer products!

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https://www.gov.uk/government/publications/proposals-for-uk-law-on-the-advertising-of-e-cigaretteshttps://www.gov.uk/guidance/e-cigarettes-regulations-for-consumer-productshttps://www.gov.uk/guidance/e-cigarettes-regulations-for-consumer-productshttps://www.gov.uk/guidance/e-cigarettes-regulations-for-consumer-productshttps://www.gov.uk/government/publications/proposals-for-uk-law-on-the-advertising-of-e-cigaretteshttps://www.gov.uk/guidance/e-cigarettes-regulations-for-consumer-products

Documents

ASH Briefing to MPs Prior to Lord Callanan's Motion