Shifting sands.

FIrst, a few "reported facts". 

1: according to HMG figures, every successful quit that Stop Smoking Services can claim credit for costs us, the taxpayers of the U.K., £74,000. That is seventy four thousand pounds. 

2: There is absolutely NO evidence of ecigs being a gatweway from non-smoking to cigarette smoking status in anyone of any age. None. 

So, here we go. 

I just listened to Professor Robert J West taking part in BBC Radio's "Inside Health" You can listen too at http://www.bbc.co.uk/programmes/b070dq8h and, indeed, it might be an idea to do that before or while you read the rest of this.

My first reaction is that there was some mighty confusion between the e-Voke - the licensed NRT version of an ecig that BAT has produced, and which neither of the studio guests seemed very comfortable with, primarily because it is officially a "drug" produced by evil of all evils, gasp, a tobacco company. Dragon Slaying at its finest. Robert finds it "troubling". I find Chantix troubling - yet both it and the e-Voke are licensed medicines, therefore, safe, effective and of good quality. Apparently, though, it matters who makes said safe, effective and good quality drug. 

Further into the piece, we get the ugly head of the Gateway Effect rearing itself. Let's get this straight, shall we? 

For any gateway to become an issue, a problem, or indeed to present itself into the evidence, the following will have to be true: 

1: The addictive potential of ecigs must either match or exceed that of smoked tobacco or even snus. All of the available evidence says that is not the case - nicotine taken in isolation presents none of the addictive potential of smoked tobacco. None. 

2: Assuming 1: above is true (it isn't), then non-smokers must use an ecig to become addicted to nicotine, and then, somehow, find that smoked tobacco is more pleasant and a better way to maintain their addiction. Again, for the vast majority of people, that's not the case. Who, for instance, would choose to go the lit tobacco route having become "addicted" to, say, a delightfully fragrant blend of apple pie and vanilla cream sauce?  If you answered "nobody", you're probably very close to the truth.

3: The alternative scenario is that all of these non-smokers become addicted to nicotine via ecigs (not gonna happen, see 1: above)  and then HMG decides to outlaw ecigs altogether, or severely restrict their availability such that they're very difficult to get hold of, making lit tobacco the easier and more available option. Some of the mythical addicted vapers will; choose to quit altogether, some will lapse to smoking. Again, not a particularly likely scenario, unless government makes it so, but do keep 1: above in mind. They're not going to become addicted!

Dr. Mark Porter, the interlocutor on the show, has expressed a level of surprise at what Robert West had to say. I share his surprise.

In answer to a tweet expressing disappointment and what Robert was perceived to have said

In answer to a tweet expressing disappointment and what Robert was perceived to have said

So, the piece was about using licensed NRT-style ecigs for smoking cessation. Not, apparently, about recreational use. Cessation. Nic abstinence. Not harm reduction. Apparently. 

The goalposts have been moved yet again, it seems.  That £74,000 per quit needs to be protected.