Ten reasons to dislike the UK Tobacco and Vapes Bill
The anti-smoking measures are useless, the population at greatest risk has been ignored, and the anti-vaping measures will do more harm than good.
Ten reasons to dislike the UK Tobacco and Vapes Bill
Solves a problem already solved. The headline measure - the Tobacco Free Generation - is worthless as a public health measure. It solves a problem that is already solved by other, less coercive means; the migration of smoking to safer non-combustible nicotine products, notably among young people who will gradually age into the population. Technology is ahead of prohibitive age restrictions in ending the cigarette era. Even people who take up smoking as teenagers today will have plenty of options to switch to safer products well before the long-term damage from smoking begins to accumulate from age 40 onwards. I expect hardly anyone born after 2008 to die from smoking-related disease because the options to avoid it will be pervasive.
Ignores the critical population at risk. The Tobacco-Free Generation measure targets the wrong population for public health purposes. The key public health challenge in the UK and elsewhere is the stock of people who have already smoked for many years, have an entrenched habit, and who are ageing into a lifetime of smoking (mid-30s and older). This group is at rising and imminent risk of serious disease, debilitation and death. The measure does not apply to them, as they were all born well before 2009. The failure to focus on the needs of the primary at-risk population (adults who continue to smoke) is why the Bill cannot be seen as a credible public health measure. Instead, it tries to fiddle with youth risk behaviours.
Imposes anti-vaping measures that harm the at-risk population. At the same time as doing nothing for the population at greatest risk (older adults who smoke), the legislation takes aim at vapes and other smoke-free nicotine products, which could work well to address adult smoking if all those involved were aligned with a modern harm reduction approach (as England was prior to 2023). The hostility to this approach is not only manifest in this Bill but also in a range of policies that form a broad hostile approach to harm reduction. The government is introducing high vaping taxes and has banned disposable vapes (previously the most popular form of vape) with casual disregard for the consequences to adult smokers. It will ban vape advertising (a gift to the incumbent cigarette trade) and is consulting on bans on vaping in public places, roughly equivalent to the bans on smoking. In the Bill, there is a range of powers to advance more hostile and restrictive policies on vapes, which on current form, we must assume they will use in a way that is damaging for public health.
Driven by a moral panic about poorly understood youth vaping. The hype around the Tobacco Free generation has served as cover for the hostile anti-vaping agenda, driven by moral panic about youth vaping, which is itself based on misunderstandings about youth nicotine use and risk behaviours more generally. Many of those taking up vaping would otherwise have become smokers, and so for them, there is a significant benefit - even if it is uncomfortable to acknowledge harm reduction through this mechanism. The government has been encouraged in this youth vaping folly by misguided activists and too many academics telling ministers what they want to hear. (see UK Tobacco and Vapes Bill: Why so many are wrong to support it). I’ll go further, we probably need MORE youth vaping in the UK to match the success of the U.S. in driving smoking out of the youth population.
Drives adverse risk perceptions. The hostile measures towards vaping and a harm reduction approach create an implicit risk communication. If the government wants all these bans, restrictions, and taxes, it must think vapes are pretty bad for health - an understandable reaction. Not only do the measures themselves implicitly contribute to excessively negative risk perceptions, but the effort needed to justify them also inevitably requires ministers, officials, and activists to take a relentlessly negative stance. Risk perceptions are already grossly misaligned with reality: 53% of people who smoke believe vaping is as harmful or more harmful than smoking (see ASH(UK) survey), so this will likely make things even worse.
Uses fanciful justifications to exaggerate the impact. The idea that age restrictions that eventually cover the whole population will somehow end smoking is ridiculous. We have an age limit of 18 today, but quite high levels of smoking in 16-17-year-olds (about 10% - Smoking Toolkit). We know young people use social sourcing for underage access, yet the TFG is a retail restriction. The government has justified the measure using absurd, unrealistic assumptions, claiming:
(i) the near-total effectiveness of an age restriction, virtually eliminating smoking uptake among those born after 2008;
(ii) the persistence of unchanged smoking initiation if the measure is not introduced (in reality, smoking has been declining, and young people are far more likely to take up vaping or pouches);
(iii) the long-term continuation of smoking without subsequent switching.
Even with these absurd assumptions, no health value is evident until 2045. See detailed analysis here: Why is anyone supporting the UK Tobacco and Vapes Bill?)Drives illicit trade. We already have a substantial illicit market in tobacco in the UK (the size contested - see Chris Snowdon), and this will facilitate access to smoking products for anyone who wants them (while exposing them to other illicit products and services). Like all illicit trade, it will not bother with age controls and will incorporate young people into the criminal supply chain. Luckily, the protected generation will also have access to vapes, and if necessary, a growing illicit market in vapes that will thwart the government’s counterproductive anti-vaping agenda. But creating a giant illegal market of the type formed in Australia and the United States is hardly the optimum policy approach. The creeping age restriction will steadily increase the customer base for the illict market.
Gratuitous scope-creep. The headline measure is often called the “smoke-free generation”. But this is a misrepresentation because the birthdate-based retail ban is not limited to smoking products. Because it is performative and not substantive, the Tobacco Free Generation, with no justification or reasoning, also covers heated tobacco and smokeless tobacco, and any other tobacco products. Yet these may be important alternatives for some in the future. I attribute this to a kind of tidiness reflex among the cheerleaders of the legislation, who are more interested in being anti-tobacco than in being pro-health. No one considered unbanning snus (strong proof of concept for public health), instead deciding to double-ban it by including it in the Tobacco Free Generation measure.
Infantilising adults. There are two basic forms of opposition to a measure like this: (1) Does it work? (2) Is it right? Much of my criticism is of the former, utilitarian form. But there is also a strong argument on principle. To achieve nothing of value, the government has made a substantial assault on adult autonomy with broader implications for the relationship between the citizen and the state. Many have misunderstood the Tobacco Free Generation as a youth prevention measure. But it is an exclusively adult measure, having a material effect only after the current age limit of 18 is exceeded in 2027 by the first of the tobacco-free generation. This age could have been raised to 21, which would have been exceeded by the TFG restrictions in 2030. My guess is that TFG will be repealed and replaced by T-21 as soon as we have a government interested in public health and rational policy-making.
For more on this aspect, see Conor Friedersdorf in The Atlantic: The U.K. Smoking Ban Is Illiberal: Distaste for cigarettes is no reason to cede bedrock liberties to the state, and Jacob Grier at MS Now: The U.K. banned tobacco products for anyone born after 2008. Here’s what could go wrongNo convincing public health case. Once we dispense with the rhetoric about saving the children and ending smoking, it seems no one can provide a convincing public health theory of change for this legislation. How do we think it will save lives? Why does anyone think the illusory benefits of the anti-smoking measures will outweigh the pro-smoking effects of the anti-vaping measures? I just can’t see it. If you are reading this and disagree, please write back with how you expect it to work for public health. My own view is that the anti-smoking measures are useless, the primary at-risk population has been ignored, and the anti-vaping measures will do more harm than good, though probably mitigated by illicit trade, which brings harms of its own.
So, that’s a net negative for public health. Well done, everyone!
More analytical material from my blog:
Slow hand clap to UK. Fist bump to Clive.
It’s appalling. And quite tragic to see how a once world leading country with such success is randomly knee-jerking. The uk should be shouting from the tops of trees about the work done up to 2023 in reducing smoking and youth smoking.