The impact on lung cells of heat-not-burn (HNB) tobacco products may be no less harmful than that of conventional cigarettes, according to the authors of a small comparative study published by Thorax.
HNB products contain nicotine and tobacco but have been marketed by the tobacco industry as a less harmful alternative to conventional cigarettes on the grounds that they don’t produce specific harmful chemicals that are released when tobacco burns.
Smoking heightens the risk of coronary heart disease, stroke, peripheral artery disease, and abdominal aortic aneurysm, because it has a role in all stages of artery hardening and blockage. And it causes emphysema and pulmonary hypertension, because it contributes to the damage of blood vessels in the lungs.
Specifically, it contributes to endothelial dysfunction–whereby the lining of small and large blood vessels becomes abnormal, causing arteries to constrict instead of dilating, or blood vessels to become more inflamed; oxidative stress—an excess of harmful cellular by-products; platelet activation–creation of ‘sticky’ blood; and plaque development that can block arteries.
The researchers wanted to find out if these effects could also be observed in people who used HNB products.
So they compared endothelial dysfunction, oxidative stress and platelet activation in 20 non-smokers (average age 28), 20 long term conventional cigarette smokers (average age 27), and 20 long-term users of HNB products (average age 33).
The conventional smokers had been puffing away for an average of 3.5 years, getting through 13 sticks a day; the HNB users had been getting through around 11 products every day for an average of 5 years.
The findings showed that compared with not smoking, long term use of HNB products was associated with reduced endothelial function and increased oxidative stress and platelet activation.
And there were no significant differences between conventional cigarette smokers and users of HNB products.
This is an observational study, so it can’t establish cause. And the researchers acknowledge several limitations to their findings.
These include the small numbers of study participants involved, the lack of random allocation to each group, and the inability to confirm that a participant wasn’t a dual user of both conventional cigarettes and HNB products.
If confirmed by other large studies, these findings could provide evidence to strongly discourage non-smokers to start using [HNB products].
Nevertheless, they conclude: “If confirmed by other large studies, these findings could provide evidence to strongly discourage non-smokers to start using [HNB products] and to encourage [conventional cigarette] smokers to quit smoking.”In a second linked study, a team of researchers assessed whether the use of HNB products helped Japanese workers to give up tobacco for good.
They offered a smoking cessation program to 158 users of conventional cigarettes (94) alone and/or HNB products (64) between November 2018 and April 2019.
The workplace program included prescription varenicrine or nicotine replacement therapy (NRT), counselling, and information about stopping smoking.
The quit rate was logged in August 2019, when 45 (29 percent) of the workers had successfully stopped using all tobacco products.
Those who availed themselves of pharmacological support were more likely to quit than those who didn’t (67 percent vs 11 percent) as were those who received counseling (69 percent vs 21 percent).
Analysis of the results showed that people who used varenicrine or NRT were three times more likely to stop smoking tobacco than those who didn’t.
But those who either used HNB products alone or in addition to conventional cigarettes (dual users) were 23 percent less likely than exclusive cigarette smokers to give up tobacco altogether, after accounting for age, tobacco dependence, previous quit attempts and use of pharmacological support.
This too is an observational study, and the researchers acknowledge that their study was small and restricted to healthy men in just one workplace. Smoking status was also self-reported and assessed at a single time point, and successful quitters weren’t asked how long they had stopped using tobacco.
But they point out that those who used HNB products in their study did so because they thought they were less harmful than conventional cigarettes.
“It is possible that the rhetorical phrases by tobacco industries attract and make consumers misunderstand that changing from cigarettes to [HNB products] can provide a healthier environment for themselves and their surroundings,” they suggest.
“Although [HNB products] are misunderstood to be less harmful, they expose users and bystanders to toxicants, and the evidence does not show that [they] will reduce tobacco-related diseases,” they add.
“Given that [HNB products] undermine cessation among smokers without providing health benefits, [they] should not be recommended for any purpose,” they conclude.
In a linked editorial, covering both research papers, Professor Irina Petrache of National Jewish Health, Denver, Colorado, and Esther de Boer of University of Colorado, agree.
“[Both] reports provide impetus to conduct larger randomized validating studies and to assess the impact of [HNB products] on additional health parameters. Their work enriches the mounting evidence that [HNB products] are not safer than [conventional cigarettes], suggesting that any tobacco use should be strongly discouraged,” they write.
The Canadian Vaping Association (CVA) has launched vapersvoice.ca, a national initiative that provides adult vapers a platform to share their story on how vaping helped them quit smoking. The aim of the initiative, sponsored by Flavourart Distro, is to remind Canadians and regulators that punitive vape regulation has real consequences for adult smokers that have chosen vaping to reduce their harm.
Credit: Tumisu
The website will enable adult vapers to upload short videos detailing, where they live, how long they smoked, how long they have been smoke-free, the flavor and nicotine concentration they used, and what they would do if flavors were to be banned. Canadian’s need to hear from adult vapers, not the industry. The CVA encourages all adult vapers to share their story, according to a press release.
“Globally, the conversation around vaping has lost sight of the millions of lives that can be saved through vaping. Vaping has presented an unparalleled harm reduction opportunity and flavors are the key to adult adoption and success quitting smoking,” the release states. “Vapersvoice.ca will highlight the importance of flavored products and the positive impact vaping has had on the lives of millions of adult smokers.
E-cigarettes that deliver a cigarette-like amount of nicotine are associated with reduced smoking and reduced exposure to a major cancer-causing chemical in tobacco even with concurrent smoking, according to a new study led by researchers at Penn State College of Medicine and Virginia Commonwealth University (VCU).
“We found that e-cigarettes that delivered a similar amount of nicotine as traditional, combustible cigarettes, helped reduce smoking and exposure to a harmful carcinogen,” said Jonathan Foulds, a researcher at Penn State Cancer Institute and professor of public health sciences and psychiatry and behavioral health. “This study shows that when smokers interested in reduction are provided with an e-cigarette with cigarette-like nicotine delivery, they are more likely to achieve significant decreases in tobacco-related toxicants, such as lower exhaled carbon monoxide levels.”
The researchers conducted a randomized controlled trial of 520 participants who smoked more than nine cigarettes a day, were not currently using an e-cigarette device and were interested in reducing smoking but not quitting.
We found that e-cigarettes that delivered a similar amount of nicotine as traditional, combustible cigarettes, helped reduce smoking and exposure to a harmful carcinogen.
According to Foulds, the findings represent an important addition to the scientific literature because they suggest that when e-cigarettes deliver nicotine effectively, smokers have greater success in reducing their smoking and tobacco-related toxicant exposure. Caroline Cobb, associate professor of psychology at VCU and lead author, said the study is important for two reasons.
“First, many e-cigarettes have poor nicotine-delivery profiles, and our results suggest that those products may be less effective in helping smokers change their behavior and associated toxicant exposure,” Cobb said.
“Second, previous randomized controlled trials examining if e-cigarettes help smokers change their smoking behavior and toxicant exposure have used e-cigarettes with low or unknown nicotine delivery profiles,” Cobb said. “Our study highlights the importance of characterizing the e-cigarette nicotine delivery profile before conducting a randomized controlled trial. This work also has other important strengths over previous studies including the sample size, length of intervention, multiple toxicant exposure measures and control conditions.”
The study contributes to the ongoing question of what role e-cigarettes play in changing smoking behavior, and the findings support limited safety concerns for the use of the specific e-cigarette and liquid combinations over the short term, even in the context of concurrent cigarette smoking. However, Cobb added, very little is known about the effects of e-cigarettes over the course of years, as opposed to the study’s 24-week period.
Eighty-eight percent of Malaysian vapers successfully quit smoking cigarettes due to their vape products, reports the New Straits Times, citing a survey commissioned by the Malaysian Vape Industry Advocacy (MVIA).
Conducted by the Green Zebras market research firm, the survey also reported that 79 percent who are dual users (vapor products and cigarettes) have reduced the number of cigarettes they smoke since they began vaping.
MVIA president Rizani Zakaria noted that the survey’s results clearly show that vaping can be an effective tool to help smokers quit cigarette smoking and is a much less harmful alternative.
“There is a real need for the Malaysian government to recognize the benefits of vaping, especially the potential that it has to help smokers to quit cigarette smoking by switching to a less harmful product,” he said.
There is a real need for the Malaysian government to recognize the benefits of vaping.
“As it stands, the vape products are still unregulated, and we believe it is time for the government to look into introducing regulations on the products and adopt policies that would encourage smokers to switch to vaping that is less harmful.”
In a report released today March 31, the U.K. All-Party Parliamentary Group (APPG) on Vaping has called upon the government to make the most of Brexit by challenging the World Health Organization’s (WHO) opposition to vaping at the upcoming Framework Convention on Tobacco Control (FCTC) Conference of Parties (COP).
The call follows a four-month Inquiry into the FCTC by the APPG which investigated the FCTC’s history, governance and approach to evidence-based decision-making. It was prompted by the WHO encouraging and applauding bans on vaping.
At a time when the U.K. government has set an ambitious target to make England smoke-free by 2030, and Public Health England has asserted vaping is at least 95 percent less harmful than smoking, the members of the House of Commons and the House of Lords wanted to ensure the WHO doesn’t turn its back on the lives of the 1 billion people around the world who still smoke, including the 7 million in the U.K.
The parliamentarians—which included Viscount Matt Ridley, a vocal advocate for reduced harm alternatives—have called on the government to consider “dramatically scaling back our funding” if they don’t see a change in the approach from the WHO with the FCTC better reflecting the U.K.’s national interests.
The main recommendations from the report include:
Ensuring the WHO returns to the founding principle of the Treaty which includes harm reduction.
Restricting any decision to ban vaping and other reduced risk alternatives to smoking.
Sending experts and consumers to sit alongside the Department of Health & Social Care officials at the multilateral event.
Establishing a Working Group to look at the science and evidence for new and emerging products.
Ensuring openness and transparency instead of secretive decision making.
If the WHO continue to pursue an agenda-driven approach to ban less harmful alternatives to smoking, then the U.K. should consider dramatically scaling back our funding.
The inquiry heard evidence from Clive Bates, former director of anti-smoking group ASH, as well Professor Lynne Dawkins from the London South Bank University and consumer groups the New Nicotine Alliance and We Vape, among others.
They called for the delegation of departmental health officials, diplomats and activists usually sent to these events to be strengthened with experts who have real world experience, and even former smokers who can attest to the benefits of vaping and other reduced risk products. It was strongly felt that the voice of the consumer has been missing in these debates so far, and by defending the strong story the U.K has to tell at home, the government would be putting the marker down for “Global Britain” abroad.
Now that the U.K. has left the EU, the U.K. delegation is no longer bound to a common European position on tobacco and nicotine policy. The COP9 meeting would be one of the first opportunities for the U.K. to take a stand at a UN forum.
We call on the government to defend the U.K. approach, challenge the WHO to stub out their ban on vaping, and help return the FCTC to its founding pillar of harm reduction.
The MPs called for coalitions to be built with like-minded countries that have embraced tobacco harm reduction and have their own good stories to tell. At previous COP meetings, member states have often been afraid to speak up, but the inquiry encouraged the U.K. government to stand firm in defending its strong domestic position, even if the WHO continues with its prohibitionist approach.
“There is no doubt that the WHO has developed a negative stance in relation to vaping over recent years,” said Mark Pawsey, member of parliament for rugby and chair of the APPG for Vaping. “We wanted to evaluate whether it remained fit for purpose in an evolved landscape where new technology has enabled new harm reduction strategies.
“One of the founding pillars of the treaty the U.K. signed up to nearly 20 years ago was that of harm reduction. If the WHO are opposed to adhering to this and continue to pursue an agenda-driven approach to ban less harmful alternatives to smoking, then the U.K. should consider dramatically scaling back our funding.
“At the FCTC COP9 the U.K. has a unique opportunity to champion its progressive, successful and evidence-based, domestic policies on the global stage. We are a world leader in tobacco harm reduction, and we call on the government to defend the U.K. approach, challenge the WHO to stub out their ban on vaping, and help return the FCTC to its founding pillar of harm reduction.”
The APPG has written to Jo Churchill MP, the Public Health Minister at the Department of Health & Social Care with its findings and has requested a meeting to discuss its recommendations.
This is the first of two inquiries the APPG for Vaping is undertaking this year. Its second—looking at how the U.K. can diverge from EU rules to further the U.K.’s chances of reaching the smoke-free 2030 goal—is set to launch imminently.
Eastern Co. is studying electronic cigarettes as an alternative to traditional combustible products, reports Egypt Today.
In a statement to the Egyptian Exchange (EGX), Eastern Co. said it consulting with manufacturers of electronic cigarettes in preparation for putting them on the market after obtaining the necessary licenses.
The move is in line with the company’s strategy to expand and diversify its products.
Earlier in March, Eastern Co. announced that it is studying several new investment projects that will enhance its position in the field of smoking and tobacco alternatives.
Eastern Co. operates within the food, beverage and tobacco sectors. It was established in July 1920 and currently holds a monopoly in the domestic tobacco market.
Egypt has invited tobacco companies to bid for a license to manufacture cigarettes in the country, a move that could reduce Eastern Co.’s dominance of the local market.
An international consumer group released a position paper today that claims blanket bans on vaping and heated tobacco products (HTPs) are a detriment to low- and middle-income countries (LMICs). The International Network of Nicotine Consumer Organisations (INNCO), a global advocate for sensible tobacco harm reduction (THR) says bans on electronic nicotine delivery systems (ENDS) are an overly simple solution that make the problems that come with combustible cigarette use far worse.
“The hundreds of millions of people who smoke in these countries should have the ability to make decisions about safer nicotine products, particularly when their own health is on the line,” said Samrat Chowdhery, president of INNCO’s governing board. “Overly simplistic policy solutions, such as proposed bans on all ENDS and THR products by the Bloomberg Philanthropies-funded The Union, are being offered as a blunt and impractical tool for a situation that requires pragmatism and nuance, making meaningful and sustainable change more difficult.”
Samrat Chowdhery
The report, “10 Reasons Why Blanket Bans of E-Cigarettes and HTPs in low- and middle-income Countries (LMICs) Are Not Fit for Purpose,” sends a strong warning to organizations and governments that limiting options to reduce harm will only increase the number of people smoking tobacco, inevitably leading to illicit markets and increases in crime. The paper lists the Top 10 reasons the bans don’t work as the following:
Bans are an overly simplistic solution to a complex issue and will not work.
Prioritizing the banning of reduced harm alternatives over cigarettes is illogical.
Reduction and substitution are valid goals for smokers in LMICs.
People who smoke have the right to choose to reduce their own risk of harm.
Reduced harm alternatives can significantly contribute to the aims of global tobacco control.
Lack of research in LMICs is not a valid reason to ban reduced harm alternatives.
The prohibitionist approach in LMICs is outdated, unrealistic and condescending.
Bans will lead to illicit markets with increases in crime and no tax revenue.
Banning reduced harm alternatives leads people back to smoking and greater harm.
• Blanket bans in LMICs are a form of “philanthropic colonialism.”
INNCO estimates that that there are scores of LMICs in jeopardy of increasing the number of people who smoke cigarettes in their countries unless pragmatic approaches to tobacco harm control are adopted, including the availability of a wide selection of safer nicotine products. Leveraging the paper’s findings, INNCO states that it will work with its global membership to inform policy makers in developing nations to help achieve risk-relative regulations and access to safer THR products, according to a press release.
“Africa is home to some of the highest-ranked smoker countries on the planet,” said Joseph Magero, chairman of Campaign for Safer Alternatives, a pan-African non-governmental member organization dedicated to achieving 100 percent smoke-free environments in Africa. “While improving overall public health has made great strides in these regions, efforts to directly address smoking cessation and harm reduction strategies have lagged due to limited or no access to safer, non-combustion nicotine products. By denying smokers access to much safer alternatives while leaving cigarettes on the market, policymakers would leave only two options on the table – quit or die.”
Several other THR groups also agree with the paper’s position. Nancy Loucas of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates, a grassroots alliance of THR advocacy organizations, said a blanket ban in LMICs is a form of philanthropic colonialism, suggesting that these countries and their citizens cannot be trusted with any level of self-determination. “Inhabitants are treated as second-class citizens, which is offensive,” she said. “There is no benefit in limiting choice of safer nicotine products, but only the potential for increasing harm.”
Francisco Ordóñez of the Asociación por la Reducción de daños del Tabaquismo Iberoamérica, a network of consumer organizations in Latin America, says that very few low- and middle-income countries have adopted even the most basic prevention measures suggested by the World Health Organization (WHO).
“Policymakers should embrace harm reduction as a valid goal, particularly in LMICs where access to cessation programs is extremely limited,” said Ordóñez. “Replacing combustible tobacco with alternative nicotine products can significantly reduce the risk of harm by at least 95 percent. It works in industrialized nations and can do the same in LMICs.”
A new film being launched by a Yorkshire cancer charity wants to turn around the growing mistrust surrounding vaping and e-cigarettes. The group says that the misinformation is inhibiting efforts to save lives.
The 30-minute documentary “Vaping Demystified” was commissioned by Yorkshire Cancer Research (YCR) and launched on No Smoking Day (March 10). The film features interviews with several tobacco harm reduction experts in the hopes of fixing the falsehoods surrounding vapor products.
The film confronts the impact of negative media coverage when the general public give their opinions on e-cigs. Many think that it is as bad as or worse than smoking, which is completely false, according to numerous studies. The film makes clear that many people are not aware of the ground-breaking scientific studies involving vaping.
Martin Dockrell, tobacco control lead for Public Health England (PHE), for example, discusses a PHE study that found vaping to 95 percent safer than smoking combustible cigarettes, according to a story in the Yorkshire Post. “We have been following the evidence about vaping as it has been evolving, and what has become increasingly clear is that vaping is far less harmful than smoking and perhaps twice as effective as licensed medicines at helping smokers to quit,” he said in the film.
The film details additional studies that show an increasing mistrust of vaping, with the proportion of those who think it is less harmful than cigarettes falling from 45 percent in 2014 to 34 percent in 2019. In 2019, the e-cigarette or vaping product use-associated lung injury (EVALI) cases hit the headlines globally. EVALI was found to have been caused by black market THC vapes that contained vitamin E acetate, and had nothing to do with e-cigarettes like many media reports had claimed.
Stuart Griffiths, director of research at YCR, said by the time the true cause had been found, the media cycle had moved on. “We didn’t see any of these vaping injuries that the US saw,” he said. “It got a lot of coverage – but the end of the story never really came out, that it was a consumer product that had been tampered with.”
The Altria Group Inc. asked the U.S. Food and Drug Administration (FDA) for its help in convincing Americans that nicotine isn’t linked to cancer. In a letter to the regulatory agency, the maker of IQOS and Juul products asked for the FDA to assist in combatting misperceptions about nicotine as part of a proposed $100 million advertising campaign to reduce the harm caused by tobacco.
According to a letter seen by Bloomberg, Altria states that nearly three-fourths of U.S. adults incorrectly believe nicotine causes cancer, citing government research. Clearing up the drug’s health risks will be key to the agency reducing smoking combustible cigarettes because it will help convince cigarette users to switch to noncombustible options for nicotine, the company said.
While there are at least 60 well-established carcinogens in cigarette smoke, it’s been known for years that nicotine isn’t the direct cause of many of smoking’s ills. The drug has even been touted as a way to ease tension and sharpen the mind. But nicotine is the ingredient that addicts people to tobacco products, and it has risks, according to the National Institute on Drug Abuse, a government agency.
The FDA “should commit resources and expertise to correct the deeply entrenched public misperceptions regarding the health risks of nicotine,” Paige Magness, Altria’s senior vice president of regulatory affairs, said in the letter dated Feb. 25. Such a campaign would help the agency by getting more smokers to use noncombustible offerings that “may present lower health risk,” according to the letter.
The FDA declined to comment, according to Bloomberg.
If society wants a smoke-free world, it cannot allow promising products to die of neglect.
By George Gay
Browsing the internet recently, I came across a report claiming that 22 countries with, according to my calculation, a total population of about 2.6 billion, or 34 percent, of the worldwide population, had banned the use of vaping products. I cannot vouch for the accuracy of those figures, but I guess they would be at least as accurate as the widely accepted estimates of worldwide, annual tobacco-related deaths.
At the same time, many people are living in countries where certain forms of vaping products are banned (Japan, for example, with a population of about 126 million) or where the appeal of vaping products has been deliberately and sometimes severely narrowed by, for instance, restricting flavors (the U.S., 328 million) or limiting nicotine levels (countries of the EU, 448 million post-Brexit).
Looking at this situation, I couldn’t help wondering whether a person with the foresight 15 years ago to have predicted the arrival on the market of products whose consumption was far less risky than was the consumption of combustible cigarettes and that could substitute for those cigarettes would have foreseen also the wide-ranging and often visceral hostility that has greeted their arrival.
I can’t help feeling that our seer would have dismissed as ridiculous the idea that these new products, vaping devices as it turned out, would be so badly served by so many governments, companies, organizations and individuals. She would surely have found it incomprehensible that smokers would be let down so badly.
Why? Well, as is still the case, 15 years ago, the combustible cigarette was the pariah consumer product and, we were told, no amount of effort was being spared in trying to do away with it. It was claimed that this was the only product that killed its consumers when used as it was designed to be used, and this claim was employed to underpin the justification for legislating for the degradation of both the product and its packaging, and the restriction of cigarette sales.
Credit: Nadine Shaabana
And it was not only the product that was seen as unacceptable. Cigarette manufacturers had cynically manipulated their products to make them “more addictive” and thereby keep consumers hooked and the profits rolling in. And consumers were little better. So, in the U.K. at least, they were attacked by officialdom as being smelly and then denormalized to the point where they and their secondhand smoke were cut off from normal society.
Given this, and given that vaping is recognized by most sensible people to be hugely less risky than is smoking, why is it that vaping has had such a rough ride? There are, of course, any number of reasons based on the vested interests and breath-taking hypocrisy of some individuals, researchers, companies, organizations and governments, for all of whom and which the continued use of tobacco represents a nice little earner.
But here I would like to speculate about another possible reason. Could the U.K. government at least have decided that the problem of tobacco smoking has been overblown? No, let me put that another way. Could it be that the government has decided that the net problem caused by smoking—that is, the smoking negatives minus the smoking positives—has been overblown, especially when compared with other problems it must confront? For instance, I guess it is becoming just too difficult to ignore the elephant in the morgue: the pollution-related deaths, many of which, I assume, overlap with tobacco-related deaths.
According to Damian Carrington, environment editor, writing in the Guardian on Jan. 26, a global review in 2019 concluded that air pollution may be damaging every organ in the human body as inhaled particles travel around it and cause inflammation. And it is instructive, I think, that a statement made late last year by the U.N. secretary general, Antonio Guterres, pointing out that air pollution is killing nine million people a year, has, unusually, not been trumped by the World Health Organization coming up with an even higher figure for tobacco-related deaths.
But I have a more specific reason for believing that the U.K. government might be letting smoking slip down its list of priorities. While it has been progressive in respect of encouraging the use of vaping as a means of getting people to quit smoking, during the Covid-19 pandemic, it has steadfastly refused to allow vape shops to open during lockdowns; that is, it has deemed them not to be essential, whereas a shop selling plugs for the basin in your bathroom apparently is essential. This indicates to me that the government doesn’t put much importance on encouraging people to quit smoking, though that is not to say it isn’t happy to dabble in such an enterprise.
OK, I hear you ask, could it be that the government does believe that encouraging people to quit smoking is important, but, right now, in the face of a deadly pandemic, such encouragement has had to take a back seat?
There are a number of reasons why I don’t think this is the case. One is that the government has found the time to deal with all manner of pet issues during the pandemic, such as its undermining of the BBC in an attempt to better control its image. Another was Brexit, which was hugely time-consuming, but its deadline our erstwhile fellow members of the EU had been willing to postpone.
However, the most telling reason in my view was the government’s announcement at the end of March 2020 that it was to axe Public Health England, an executive agency of the department of health and social care, and transfer some of its responsibilities, but not its smoking prevention and some other obligations, to a new organization, the National Institute for Health Protection.
Meanwhile, while the government seems to be taking its foot off the quit-smoking pedal, there are some for whom the very existence of the pandemic is seen as underlining the need for the government to encourage the switch from smoking to vaping. The usual suspects have been only too willing to tell smokers, without, I suspect, any solid evidence, that they are at increased risk of suffering severe symptoms if they are infected with Covid-19. And one respected public health professional has argued that the emphasis should be placed on fighting noncommunicable health problems because, in that way, we will all be leaner and fitter to fight the next pandemic. Hmm.
I cannot agree with these people’s reasoning, but I do maintain that this is not the time to let the opportunities offered by new generation products slip through our fingers. And in this regard, I would like to put in a word for Kind Consumer and Voke, whose fortunes I have followed on and off for a number of years. Voke, as I wrote about last year, is a product that was developed by Kind and licensed by the U.K. Medicines and Healthcare products Regulatory Agency as a medicinal product that is a safer alternative to smoking. Voke is not a vaping product but an alternative nicotine-delivery system that uses pharmaceutical-standard inhaler technology in a device that closely resembles a traditional cigarette in both the way it looks and in the way a consumer, in using the device, mimics most of the rituals of smoking.
Voke, which has no batteries and no electronics and therefore generates no heat and no chemical reactions, produces no smoke nor vapor, just an invisible, odorless aerosol, so it can be used anywhere. And its environmental credentials are good given that it is a relatively simple device made of metal, card and plastic: materials that can be recycled.
Last year, I wrote that, in theory at least, Voke should be a game-changer and that it would be interesting to follow its fortunes on the market to discover how committed smokers and vapers were to the pursuit of reduced risk.
I’m now concerned that I may never know. Voke was launched in November 2019 exclusively online, but when I visited the Voke website in January this year, this is what I was told: “Due to Covid-19 and the current financial climate, we are unable to accept any orders.” Meanwhile, a Sky news story toward the end of last year said it was understood that Kind, which had raised £140 million from investors since it was set up [in 2006], had, at the beginning of December, called in the administrators and that they had signed off on the sale of Kind’s assets to OBG Consumer Scientific, a subsidiary of Pharmaserve, a privately owned group, for £1.6 million.
Pharmaserve, which is based in Runcorn, U.K., did not respond to requests for information, so I am unaware of what fate awaits Voke. However, one source told me that Pharmaserve had been part of the Voke supply chain, providing the device’s cannisters, and this aligns with information provided by Kind, which said last year that one of two manufacturing sites it was using was at Runcorn (the other was said to be at Waterford in Ireland). If this is the case, it is quite possible that the product will be relaunched.
It would certainly be a crime if Voke were allowed to disappear without fully testing whether it can become a game-changer. There is no doubt that, because it delivers a cool aerosol rather than a warm vapor, it presents a challenge to smokers wishing to switch. But, at the same time, its nicotine delivery is efficient enough that it has to deliver only a low dose, 0.45 mg, from which, if the U.S. Food and Drug Administration is correct, it could be inferred that it creates a significantly lower risk of sustaining addiction than do cigarettes or e-cigarettes.
And Voke seems to have some as-yet untested advantages over cigarettes and electronic cigarettes when it comes to sales channels. While the product had a medicines license that allowed it to be prescribed by a doctor in the U.K., it had also an over-the-counter drug or general sales list label, so it could have been sold anywhere from pharmacies to major retailers, corner shops and garage forecourts. And there was no reason why Voke, under another name and possibly modified, could not be sold in other jurisdictions simply as a consumer product.
Many societies that claim they want to become smoke-free have thrown obstacle after obstacle into the path of vaping devices. Surely, we are not going to let Voke fail for the want of a little investment. According to the Sky story, Kind had been looking to raise only another £36 million to deliver a revised business plan, so here, perhaps, was an opportunity for a tobacco company—or even the U.K. government.
Credit: Martin Budenbender
Of course, the U.K. government is ideologically opposed to public involvement in the private sphere, but there were some good reasons why it could have justified keeping Kind and Voke going. I don’t know why Kind got to the point where it had to call in the administrators, but certainly, fate had not been kind to it. When, in 2009, Kind set out in earnest on the development of Voke, it immediately found itself in a commercial bind.
At that time, when vaping devices were still something of a novelty, it was believed that, under the then forthcoming revised EU Tobacco Products Directive, all such products sold in the EU would need to have a medicines license. But such a requirement fell by the wayside; so Voke, a device being developed at great expense within the constraints necessary to make it conform with a medicines license, was destined to compete with devices developed at less expense without such constraints. And to cap it all, Voke was launched just as the world was hit by the start of the coronavirus pandemic.
If societies believe that tobacco smoking is as harmful as it is generally made out to be, and if they are truly aiming to go smoke-free, they cannot afford to allow the army of naysayers to keep throwing vaping devices under the bus, and they certainly cannot allow a promising product to die of neglect.
