E-cigarettes in the UK
-- the UK situation examined in detail - Part 1
How many e-cigarette owners are there ?
The UK electronic cigarette industry at Q1 2011 was probably worth about £5m a year, so substantial numbers of units, refills and accessories are being sold. There are several firms who have declared annual earnings of over £1m in the UK, so business is robust.
This figure excludes sales to the US, which are normally attributed to the US arm of a business, and sales to Europe. Therefore, the number of current e-cigarette owners in the UK at Q1 2011 was thought to be at least 200,000 as this is a plausible minimum (one 2010 survey suggests about 300,000 [3]). It may well be higher but the numbers are confused a little by EU sales. As an example, one UK vendor with a US arm claims gross turnover for 2011 will be £12m. If we assume that US sales are likely to be up to ten times UK sales, and that EU sales will equal UK sales (which is not necessarily the case), UK sales for this vendor alone will be at least £1m. Vendors of this size have approximately 15 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 is thought to be worth up to $100 million a year, suggesting that there are at least 2 million electronic cigarette owners there - perhaps 3 million or more.
In the UK, electronic cigarettes first became known in early 2006 (and in 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 figure of around 500% per year, as any figure less than that would not account for the current user base.
At Q1 2012, it is reasonable to assume that this early period of phenomenal growth has now levelled off, and current UK growth is probably somewhere around 50% per year, with growth gradually slowing to between 25% to 50% annually by 2014:
2006 - a small number of e-cigarette owners
2007 - 1,000 owners
2008 - 5,000
2009 - 25,000
2010 - 125,000
2011 - 250,000 - 300,000
2012 - ?? [400,000 - 500,000 expected by Q4]
2013 - over 0.6m expected
It seems that we will reach the million-owner user base within a few years. To put that in perspective, assuming that there are around 13.65m smokers in the UK (about 21% [1] of the population of ~65m), this would be about 7.5% of smokers converting within around 8 years of the product becoming available.
This growth equates to an average of around 1% per year conversion of smokers - something like ten times the efficiency of the NHS, who reduce the number of smokers by around 0.1% per year, at a cost of about £180m - £200m per year.
As seen, at Q1 2011 a viable figure for the minimum number of e-cigarette users in the UK was 200,000, given that the UK market is over £5m per year at that time. 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.
A very large user base is inevitable, because Snus in Sweden now accounts for almost double the number of tobacco users than smoke: 20% Snusers vs 12% smokers. And in addition to this, e-cigarettes are proving far more popular than Snus - it took Snus over a hundred years to reach this point, but ecigs will capture 25% of the smoking market before too long.
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: a million users plus will not be told by a corrupt government or EU agency 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?
Age groups
The largest 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.
Legal status
Since electronic cigarettes are not currently classed as a tobacco product in the UK, and are not a medicine, they fall into the general products group under Customs & Excise and Trading Standards procedures. This means they are regulated at local level by Trading Standards. Therefore, e-cigarette products are regulated by the Trading Standards organisation.
There are no import controls and no special taxes, but local authority ('council') staff inspect and analyse products and materials. This applies to both high street retailers and web-based vendors with a UK office.
Some say that electronic cigarettes fall through a gap in product legislation in most countries currently as they are neither a drug nor possibly a foodstuff. This school of thought feels that e-cigarettes are of a type comparable to tobacco or alcohol, but perhaps not necessarily of that class.
Another viewpoint is that an e-cigarette is basically the same as a coffee percolator: a device to supply a pleasant consumer product that has a substantial and demonstrable pharmacological effect. Obviously, such things already exist in the general product range and are not considered drugs or medicines or extra-taxable products. A coffee percolator is a device that delivers a drug with a significant pharmacological effect, and so is a cocktail shaker. This being the definition of a pharmacological device for licensable drugs preferred by the medical licensing agencies, it appears on the surface that their definition is fundamentally flawed and would not stand up to legal challenge. Since e-cigarettes are a consumer product, sold as an alternative to tobacco, pharmaceutical licensing seems clearly ineligible and would be difficult or impossible to enforce at law.
The only concrete statement that can be made is that electronic cigarettes, whether used with or without nicotine, are not a medicine - as this would imply that tobacco and alcoholic drinks, or coffee percolators and cocktail shakers, are also medicines. E-cigarettes are not used to treat or cure any disease or addiction since they are simply a better alternative chosen by consumers who switch to an alternative product. 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.
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.
In the UK e-cigarettes are competently regulated by the local Trading Standards authorities, although the competence shown by local authority staff is in direct contrast to the substantial incompetence shown by their national management at LACORS*. This is demonstrably so poorly run that it appears to be the single most deserving government agency for a long-overdue shake-up, something not impossible in the current efficiency-seeking climate. And this is a powerful statement to make in light of the strong whiff of corruption surrounding one or two other government agencies.
* LACORS was dismantled in 2011 [4].
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 take a larger and larger chunk out of NRT sales (nicotine patches, gum and drugs) - because if smoking is virtually harmless, there is simply no need to quit. People enjoy smoking and if they have an even more enjoyable, safer alternative, there is little reason to buy expensive (and sometimes dangerous [2]) quit-smoking medicines. Because the quit-smoking pharmaceutical trade is so lucrative, the trade 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 at least ten times the NRT trade - and as smokers convert to e-cigarettes, and therefore the sickness and death rate starts to drop, pharma's drug income will be hit terribly hard.
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 40%, 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.
Health aspects
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 medical schools, 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'. Some interesting quotes can be found here:
http://www.world-vaping-day.com/quotes.html
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 cancer death rate in Sweden is 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.
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.
continued in Part 2 - also see menu link >>
_________________________________________
Notes
[1] The figure is variously estimated at 21% to 25%.
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 real figures, since (a) the result depends on what questions you ask, and (b) there is now a guilt factor since smokers have been denormalised, and it is inevitable that some smokers will report as non-smokers.
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 21%. 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%.
[2] 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. 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 number of deaths and the very high scale of harm caused. 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 episode 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 unfortunate history of Chantix proves otherwise.
E-cigarettes are thousands of times safer than Chantix, and orders of magnitude more successful.
[3] 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 banning tobacco in all forms, as against reducing the death rate from smoking. The only method that has ever been proven to work in significantly reducing the death rate is the Swedish Solution: allow free purchase of tobacco harm reduction products such as Snus (or e-cigarettes). Sweden reduced their smoking-related death rate by nearly 40% using this solution - free and unrestricted sale of Snus. The NHS stop smoking service reduces the smoking death rate by about 0.1% per year, and is thus proven worthless and a huge waste of money at £180m plus per year. Snus is banned in the UK due to an EU-wide ban that Sweden has an exemption for.
[4] 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, passed the error through several management levels without it being checked or questioned, then launched a hysterical public attack on e-cigarettes including statements that inferred 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. Incompetent, lying government agencies are about as useful as those subject to 'regulatory capture'. Unfortunately we also have those.