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E-cigarettes in the UK
How many e-cigarette owners are there ?
At this time the UK electronic cigarette industry was probably worth over £10m a year, so substantial numbers of units, refills and accessories are being sold. There were several firms who declared annual earnings of over £1m in the UK, so business was robust.
This figure excludes sales to the US, which are normally attributed to the US arm of a business, and sales to Europe. The number of e-cigarette owners in the UK in early 2011 was thought to be at least 200,000 as this is a plausible minimum (one 2010 survey suggests about 300,000 ). As an example, one UK vendor with substantial EU and US sales claims gross turnover for 2011 was £12m. Vendors of this size have approximately 40 UK-based staff.
In the US, it is generally accepted that numbers in most cases can be multiplied by a factor of between 5 and 20 when compared with the UK, an average figure being 10. The US trade at that time was thought to be worth about $150 million a year, suggesting that there were somewhere between 1 and 2 million electronic cigarette owners there.
Electronic cigarettes were first sold in the UK in 2005, and by 2006 there were several hundred owners. E-cigarettes were introduced to the US in late 2006.
By 2007 it is thought there were about 1,000 UK owners, and by 2008 strong growth was starting to be seen. Usage seems to have grown at an averaged-out figure of around 500% per year to 2011, as any figure less than that would not account for the current user base.
By Q1 2012, it is reasonable to assume that this early period of phenomenal growth had levelled off, and current UK growth is probably somewhere around 50% per year, with growth gradually slowing to around 40% annually by 2014:
2006 - a small number of e-cigarette owners
2007 - 1,000 owners
2008 - 10,000
2009 - 50,000
2010 - 150,000
2011 - 300,000
2012 - Q4: 600,000
2013 - 1m expected by Q4
It seems that we will reach the million-owner user base within a few years, possibly by the end of 2013 and certainly by 2014.
To put that in perspective, let's take two cases: a smoking prevalence of 20% and 17% (we have no real idea of the number of smokers in the UK, different sources quote different figures).
1. If the population is 68m (but government figures are normally too low), and if 20% smoke (this figure is always too low in any case as it omits social smokers), there are 13.6m smokers (although for a multitude of reasons, government figures will always be too low for this figure). If 1 million switch to ecigs, this would equate to 7.5% of 'inhalable nicotine consumers'.
Another way of expressing the same thing is that if there are 14.6m smokers and 1m switch to ecigs, then 7% have changed to an alternative.
2. If 17% smoke, there are 11.56m smokers. If 1m have switched then this is 8.5% of current 'smokers'.
If there were 12.56m smokers and 1m switch to ecigs, then 8% will have switched - within around 8 years of the product becoming available.
This growth in the uptake of e-cigarettes equates to an average of around 1% per year conversion of smokers - something like 1,000 times the efficiency of the NHS, who reduce the number of smokers by around 0.001% per year, at a cost of about £200m per year. So THR (Tobacco Harm Reduction) is rather more efficient than the State process: it costs zero and is 1,000 times more effective. Generally, this would be seen as a good thing in any other area; however, smoking creates such vast incomes for so many parties that THR has been widely condemned in a massive propaganda war designed to create an environment in which it can be prevented by legislation. Our calculations indicate that smoking generates about £25bn in the UK for those who benefit; open permission for THR would conceivably reduce that income by 50% or more. This explains why we don't embrace this solution with open arms - the pain created will be so intense, for so many people with the power to stop this process, that in practice it may be impossible to proceed down this road without intervention.
As seen, at Q1 2011 a viable figure for the minimum number of e-cigarette users in the UK was 200,000. Up to this point numbers have increased by an averaged-out figure of 500% per year, as has been demonstrated. It is reasonable to assume this growth will gradually slow down since such phenomenal gains are unrealistic in the long term. What has probably happened is that initially, in the years 2006 to 2010, growth was very much higher; and now it is slowing to about 50% per year or similar.
However, it seems inevitable that market penetration will reach 25% at some stage, and therefore a valid question is: when, exactly? It seems likely that the 25% mark will be reached by 2025 - and perhaps even by 2020.
How big will ecigs get?
A very large user base is inevitable. We can look at the situation in Sweden, where there is a useful comparison: the local oral tobacco product known as Snus has reduced smoking there by about 45%, and for men by 55%, as only about 8% of Swedish men now smoke - a phenomenally low number for an EU country. At Q4 2012, Snus accounts for almost double the number of tobacco users than those who smoke: 21% Snusers vs 11% smokers.
In comparison, e-cigarettes are proving far more popular with smokers than Snus, where both products are freely available. It took Snus many decades to reach this point, but ecigs will capture 25% of the smoking market in the near future. Since, outside Sweden, e-cigarettes are more acceptable to consumers than Snus, and if Snus reduced smoking by 45%, then it is an under-estimate to conclude that ecigs will reduce smoking prevalence by 50% in many countries; 60% is probably more realistic, and could apply to the UK.
This will occur with or without legal status for e-cigarette sales in the UK or indeed the EU. If for some reason electronic cigarettes or their nicotine-containing refills were no longer freely/legally able to be sold in the UK, the largest black market ever seen here will be created: two million users plus will not be told by a corrupt government or EU agency, bought by the pharmaceutical industry, that they must shorten their lives by returning to smoking. And it will be a black market that eventually becomes supported by most of the population. The question will be widely asked: why does the government force smokers to keep smoking and die? Who exactly is paying for this legislation and why?
The largest user groups are the 30 to 40 and 40 to 50 agegroups. There are more over 50 than under 30. This indicates that users tend to be older smokers who seek a lower risk alternative.
The UK is the only country in the world, as far as we are aware, in which e-cigarettes are comprehensively and efrfectively regulated. They are regulated by law (about fifteen consumer protection, electrical, toxicity, certification, packaging and labelling laws apply) and actively controlled in practice by an executive arm of government right down to local level (by the Trading Standards authorities).
Since electronic cigarettes are not classed as a tobacco product in the UK, and are not a medicine, they fall into the general sales products (GSP) Customs & Excise classification, and also for Trading Standards procedures. They must conform with around 15 separate Acts that control the sale of products, and are therefore regulated by the Department of Business (BIS) through the executive arm of the Trading Standards organisation. Trading Standards used to be controlled by LACORS, but this was dismantled in 2011 .
The BIS policy can be seen in this parliamentary answer:
Dept of Business e-cigarette regulatory policy
The range of laws that e-cigarettes sold in the UK must comply with can be seen at the ECITA trade association's website (see Section 3 of PDF):
Statutes governing e-cigarette sales
There are no import controls and no special taxes, but local authority ('council') TS staff take away, inspect, test and analyse products and materials. This applies to both high street retailers and web-based vendors with a UK office. Due to the current 'noise' surrounding e-cigarettes, we believe that TS enforcement is a little more robust than may be the case with other products.
In practice it means that e-cigarettes are well-regulated and contain no toxins or contaminants at significant levels. This is the definition of a safe consumer product.
Since e-cigarettes do not contain any tobacco, they are not a tobacco product (the nicotine, if used, could come from any vegetable source or be synthesised - tobacco is simply the cheapest source). As they are a consumer product, they cannot be classified as a medicine or a medicinal device; this is because a medicine is defined by any one or more of these factors:
1. 'Delivery of a drug with a significant pharmacological effect.'
Although this would not apply if zero-nicotine refills are used, even for with-nicotine use this is an illogical definition that cannot be enforced in isolation since it would apply to many other consumer products. Coffee, tea (which usually contains nicotine), wine, whisky, cigarettes, and cigars are not pharmaceuticals, but would need to be re-classified as such if this definition can be applied to a consumer product such as an alternative smoking product. In addition, coffee percolators, cocktail shakers, cigarette holders, tobacco pipes and teapots would need to be re-classified as devices that deliver active drugs. Even tea is involved as it shows measurable effects, perhaps not surprising as most tea contains nicotine. And in that case we would also need to include aubergines or any dish used to present an aubergine, since they have a relatively high nicotine content compared to the nicotine content of other vegetables. Nicotine is a natural and normal part of the diet, so classifying its use as medicinal is rather problematic.
2. 'Sold as or generally accepted as a device or drug to treat or cure a disease.'
This would be a valid legal argument if e-cigarettes were designed as or sold as a way to stop smoking, since smoking may by convoluted methods be defined as an addiction and therefore a disease, which can be treated or cured.
E-cigarettes were invented for the purpose of replacing smoking, as a clean nicotine delivery system that replicated smoking in every way except the delivery of smoke. A water-based mist replaces the smoke. The whole point of electronic cigarettes is that they are a permanent replacement for tobacco cigarettes, to be used instead of tobacco. Neither the inventor of e-cigarettes, the manufacturers of e-cigarettes, nor the users of e-cigarettes intend to quit. The whole point of an e-cigarette is that it can be used for the purpose of continuation of a habit that is dangerous unless modified. Just as Snus consumption is not cessation, it is harm reduction, so e-cigarette use is not cessation.
It is quite true that an occasional rogue trader may market e-cigarettes as a quitting aid, but steps need to be taken to remove rogue internet marketers and there is plenty of legislation available for that purpose. Such persons are not members of the trade association, are not approved by the consumer association, are not registered with any community forum or other resource, and are generally recognised by everyone as outlaws who need to be shut down.
3. 'The product is presently unregulated and there is a likelihood of harm being caused'.
The UK is probably the only country where e-cigarettes are comprehensively and effectively regulated, so any such statement is an outright lie and can be proved so in court. In addition there is abundant proof that no contaminants are present at toxic levels.
If something like 'dosage' is envisaged, for a general consumer product, then we would have to accept regulated dosages for coffee and wine as well. This seems highly unlikely.
Consumer products with uncontrolled 'dosages' are the norm. Very few people check the nicotine content of a cigarette before they smoke it, or the alcohol content of wine before they drink it, or the caffeine quantity in coffee before they consume it. In fact it is impossible to do this in some cases. Masses of people are not being harmed by 'uncontrolled dosages' of caffeine even though there is no possible way to check it: the consumer can easily judge the result, as this aspect of the result is precisely what is aimed for and carefully monitored. The consumer self-titrates for the desired result, in medical speak. E-cigarettes are no different: the effect is obvious when the amount consumed is too small or toogreat, and significant effects of excess consumption are easily avoided.
In addition, if there is clear potential for harm, then after millions of user-years of product usage worldwide, the effects should be obvious: many deaths and even more examples of serious harm caused. It is no surprise to learn that the FDA and the MHRA looked very hard indeed and could not find a single instance of morbity, let alone mortality. Compare this with the licensed drug Chantix, a psychotropic drug for smoking cessation introduced at about the same time as e-cigarettes, which in the same timescale has left a swathe of hundreds of deaths (272 are admitted by the FDA but this may be an underestimate), thousands of psychotic events, and hundreds of thousands of 'cardiac events', and is regarded by some as the most dangerous prescription drug and known as 'the death pill'. It is, of course, highly profitable.
Perhaps it is just a coincidence that Pfizer, makers of Chantix, are responsible for funding medics who according to Prof Carl Phillips publish lies and propaganda about Tobacco Harm Reduction products such as e-cigarettes; and are, legally speaking, the second-largest criminal fraudsters in the world (Pfizer were the world leaders in fraud but the top spot was recently taken by GSK, another pharma corporation convicted of fraud and criminal corruption on a massive scale).
Enforcing a pharmaceutical classification
It would be impossible to enforce legal classification of e-cigarettes as a pharmaceutical product in a UK court, and the same holds true for any valid legal system. This is why such actions have been overturned in every country where such a restriction has been imposed by government: in the USA, Holland and Germany, actions overturned at lower court level have been taken to higher or supreme court level on appeal by governments and the removal of the unjust restrictions has been upheld.
Clearly, if a consumer switches to oral tobacco in order to avoid lung cancer then they are not using a medicine - it is simply a consumer purchase decision. The same holds true for e-cigarettes.
All such choices are consumer-driven or they simply don't work - in fact the term Harm Reduction itself is a definition of consumer purchasing choices. When Harm Reduction is medically managed, it is properly referred to as Harm Management.
Winners and losers
There are bound to be winners and losers in any change in product use as radical as this situation. The winners will be the hundreds of thousands who won't die from smoking-related disease (as e-cigarettes cannot cause cancer, heart disease or arterial disease). The losers will be:
- The tobacco industry, until they themselves change and move into the e-cigarette market - and there are clear signs many tobacco corporations are planning to do this
- The pharmaceutical industry, who will lose tens of millions in NRT (quit-smoking drug) sales, and hundreds of millions in lost sales of pharmacotherapies for sick smokers (chemotherapy drugs, COPD drugs, cardiac drugs, vascular drugs).
- Government, who will lose substantial tobacco tax revenue.
The pharmaceutical industry will most likely be the biggest loser as e-cigarette sales immediately take a chunk out of NRT sales (nicotine patches, gum and drugs) - because if smoking is virtually harmless, there is simply no need to quit. This is now a $3bn global market. People enjoy smoking and if they have an even more enjoyable, safer alternative, there is little reason to buy expensive (and sometimes dangerous ) quit-smoking medicines. Because the quit-smoking pharmaceutical trade is so lucrative, pharma has put millions into trying to have e-cigarettes banned.
Then, of course, there is the fortune made in the supply of chemotherapy drugs and similar treatments for sick smokers. This drug trade is probably worth around $100bn annually - and as smokers convert to e-cigarettes, and therefore the sickness and death rate starts to drop, pharma's drug income will be hit hard. Pharma's very good friends in government are working hard to try and slow the global move to THR products down.
In Sweden, every smoker who switched to Snus was one less who got sick or died from smoking. The number of smokers was reduced by 45%, and the death rate fell by a similar amount - fairly convincing proof of the value of Harm Reduction.
As the twin drug markets of NRTs for smokers and the drugs to treat them when they become sick are seriously threatened, and the pharmaceutical industry stands to lose billions of dollars in worldwide sales, pharma is absolutely desperate to have e-cigarettes taken off the market. You will see their money placed judiciously in many areas that might have been thought of as immune to 'pressure'. Currently they are spending millions on trying to get electronic cigarettes banned, as you might expect.
There is no evidence whatsoever that e-cigarettes can be harmful, and looking at the ingredients this is highly unlikely in any case. Many senior medical professionals such as the American public health physicians' association (AAPHP), the American Council for Science and Health (ACSH), professors in charge of university public health departments, doctors recognised as experts in tobacco control, and other international experts in public health have clearly and repeatedly stated that e-cigs need to be promoted as an important and viable harm reduction strategy for smokers, just as other smokeless tobacco products should be.
Some professors of medicine are on record as describing people who are funded by the pharmaceutical industry to promote anti-ecigarette propaganda as 'crooks and liars'. There are many interesting quotes here:
There are dozens of research papers and opinion papers published by senior medical figures as above that support the use of e-cigarettes. There is no case of a senior medical figure publishing research that shows evidence that the use of e-cigarettes entails any significant risk.
Since the experts estimate that e-cigarettes are at least 100 times safer than tobacco cigarettes, and cannot possibly cause lung cancer, then smoking death rates will fall as more convert from tobacco to e-cigarettes, just as is the case in Sweden where many smokers replaced tobacco with Snus, causing a dramatic fall in the cancer death rate. The male lung cancer and oral cancer rates in Sweden are the lowest in Europe as a direct result of the use of Snus, an oral tobacco with a special manufacturing process that removes carcinogens. The AAPHP have stated that if smokeless tobacco products including e-cigarettes were to be promoted and widely used, the least reduction in the death rate that could be expected would be 50%, increasing to over 90% dependent on uptake.
It should be carefully noted that if a medical professional states in public that, "We don't know much about e-cigarettes", or "We don't know what's in them", or "We don't know if they are safe or not", such statements should be seen as paid-for misinformation, given the weight of medical research and opinion outlined above. Pharma-funded crooks and liars abound, so be careful of their propaganda.
You can see that there is a direct contradiction between what the medical experts are saying and the propaganda funded by the pharma industry to try and discredit electronic cigarettes.
One implication that might be drawn from this is that a percentage of people speaking out against e-cigarettes or trying to ban them must be funded in some way by the pharmaceutical industry. Currently it is estimated that eight out of ten voices raised against e-cigarettes are funded in some way by the pharmaceutical industry; one is an independent tobacco control worker who wishes to ban all tobacco for idealogical reasons unrelated to health; and one is a State or national councilman whose job is likely to disappear as the huge tobacco tax revenues shrink due to smokers converting away from cigarettes.
 The figure is variously estimated at 19% to 24% (Q4 2012).
The figure is impossible to determine because different UK government departments give different results, the same being true for EU statistics.
In any case, there may be a fundamental difference between the official figures and the actual figure, since:
- The result depends on what questions you ask - for example are we just talking about daily smokers here?
- If social smokers are included, you can probably add 25% to the figure.
- There is now a guilt factor since smokers have been denormalised, and it is inevitable that some smokers will report as non-smokers.
- Who knows if the 10%+ of UK smokers who now buy from the black market are included?
As an example, if you define a smoker as someone who reports themselves as one, and who smokes daily, the figure (at Q3 2011) may be as low as 20%. If however you include anyone who smoked a cigarette within the last 30 days, the figure jumps to nearly 30%. This aligns better with EU stats that say smoking prevalence for EU countries averages 30%.
 The quit-smoking psychotropic drug Chantix / Champix (varenicline) is directly implicated in hundreds of suicides and one case of the murder of a patient's entire family. The FDA acknowledge 272 suicides as being caused by Chantix, which some say means the real total is at least four times this figure.
It is known to be responsible for thousands of psychotic events including violent episodes such as assaults and suicide attempts, and in addition there are now multiple clinical research trials that show it causes a 'cardiac event' (or heart attack) for 1 in 30 patients (and is thought to have caused 62,500 heart attacks just in the USA in 2010). It is reported to be the most dangerous drug currently available on prescription, and has also been described as the the most dangerous pointless drug available (since there are far better alternatives). There have been numerous calls for it to be withdrawn, due to the swathe of death in its wake. However, it remains available and there is a school of thought that attributes this to the fact it is highly profitable.
Chantix has been available for almost exactly the same time as e-cigarettes have been in the UK and US. While Chantix is known to have caused harm on a wide scale, and is responsible for a large number of deaths, e-cigarettes do not have a single report of mortality or morbidity in the same timescale. Both the FDA and the MHRA looked very hard indeed to find one instance and failed. We can also see that the timescale of availability for e-cigarettes is not too short to reveal potential for harm and death, as the appalling history of Chantix proves otherwise.
E-cigarettes are thousands of times safer than Chantix, and are likely to prove orders of magnitude more effective in preventing smokers' deaths.
 ASH UK carried out a survey in 2010 that reported there were over 300,000 e-cigarette users at that time. We have no reason to doubt their figures since their aims do not coincide with ours*. In the end we decided a more conservative figure could be used and therefore difficult to challenge: 200,000.
* In general, tobacco control organisations seem mainly interested in trying to ban tobacco in all forms (which doesn't work), as against reducing the death rate from smoking (which works very well). The only method that has ever been proven to work in significantly reducing the death rate is the Swedish solution: allow free purchase of THR (Tobacco Harm Reduction) products such as Snus (or e-cigarettes). Sweden reduced their smoking prevalence by 45% by allowing free and unrestricted access to Snus; the disease and death rate have fallen through the floor. The NHS stop smoking service reduces the smoking death rate by about 0.001% per year, and is thus proven worthless and a huge waste of money at about £200m plus per year. Snus is banned in the UK due to an EU-wide ban that Sweden has an exemption for.
 Trading Standards was managed at national level by LACORS. This agency demonstrated such outstanding incompetence it was abolished in 2011.
For example LACORS performed tests on an e-cigarette product, incorrectly analysed the ingredients with a factor-10 error, over-calculating the nicotine content by ten times, passed the error through several management levels without it being checked or questioned, then launched a hysterical public attack on e-cigarettes that included statements inferring such things as 'poisoning the children'. Press releases and website articles repeated a catalogue of entirely erroneous statements, which seemed to have some sort of idealogical or religious agenda.
Fortunately, LACORS was disbanded and abolished before any further damage could be done. If this had occurred recently then a civil case for substantial damages would have been likely. Utterly incompetent, lying government agencies are about as useful as those subject to 'regulatory capture'. Unfortunately we also have those as well.