Nudge Unit Favours E-cigarette Approach to Stopping Smoking

The UK Government’s Cabinet Office’s Behavioural Insight Team, also known as the Nudge Unit, wants to persuade smokers, who are disinclined to give up the habit, to manage their nicotine addiction in a different way. Is it also telling them that e-cigarettes are safer?

The Cabinet Office’s Behavioural Insight Team recently published its first annual report. The unit aims to persuade or ‘nudge’ people into better, safer, more beneficial modes of
behaviour without recourse to legislation. The approach has the virtue of cutting out the difficult part – getting bills passed in Parliament – and appealing directly to consumers and regulatory bodies using argument and persuasion. The nudge unit claims to have implemented a series of measures which will save thousands of lives and £100 million over the course of the next parliament.

Quit or die is not working

As regards smoking, the Nudge Unit believes the current approach to smoking, which it characterises as ‘quit or die’, is not working. It therefore suggests the alternative approach of managing nicotine addiction as a means of helping entrenched smokers indifferent to pack warnings by which it means substituting a nicotine delivery product like the e-cigarette for the combustible tobacco cigarette.

Smoking is not the Nudge Unit’s only target: The unit is suggesting people opt out rather than opting in to donating organs when filling out online driving licence applications. The annual report also says the government is to change tax forms to tell people how many people in their area have paid their taxes ahead of them as a result of another Nudge Unit initiative.

Substitute similar behaviour or extinguish entrenched habit?

The Nudge Unit is not actually saying that e-cigarettes are the answer, it is however saying that new products that deliver nicotine without the toxins in tobacco smoke should be explored and encouraged. According to the Nudge Unit annual report: ‘It will be important to get the regulatory framework for these products right, to encourage new products. A canon of behaviour change is that it is much easier to substitute a similar behaviour than to extinguish an entrenched habit (an example was the rapid switch from leaded to unleaded fuel). If alternative and safe nicotine products can be developed which are attractive enough to substitute people away from traditional cigarettes, they could have the potential to save 10,000s of lives a year.’

No more harmful than caffeine in coffee

According to reports, experts have advised the UK government that the nicotine contained in some new, smoke-free cigarettes is no more harmful than caffeine in coffee. An unnamed ‘Cabinet Office source’ is quoted in a national newspaper as saying: ‘A lot of countries are moving to ban this stuff; we think that’s a mistake.’

Tobaccoless, non-combustible products have been in the news recently because of the launch by BAT of a business called Nicoventures (see article ‘BAT Creates Nicoventures to Develop Nicotine Products Without Tobacco’) to develop new non-tobacco cigarette-mimicking devices which are not e-cigarettes but which deliver the smoker the kind of nicotine dosage that a cigarette delivers and just as fast, which NRT (nicotine replacement therapy) products, according to Nicoventures, do not.

E- cigarettes are a non-tobacco, non-combustible product which looks like a cigarette and which delivers nicotine in a vapour via liquid nicotine refills and a battery-driven vaporising apparatus. None of these devices, which are growing in popularity in the US, Germany and the UK, are produced and marketed by the major tobacco companies despite the interest in new nicotime delivery technology demonstrated by BAT in Nicoventures and the acquisition of a patent for a nicotine aerosol technology by PMI. (see article ‘PMI Buys Nicotine Aerosol Patent’).

Confused regulatory situation

This reluctance of the major companies to get into e-cigarettes – BAT stated that nicotine delivery technologies being examined by Nicoventures are not e-cigarettes, though have not rule out similar devices – is thought to be because of the regulatory situation applying to NRT products. NRT products deliver nicotine via gums, patches and sprays to help people give up smoking. NRT products are sold in pharmacies and as such are controlled as pharmaceutical drugs, which means, paradoxically, a far more rigorous testing regime than that applied to cigarettes. How e-cigarettes are to be regulated in the UK has not been clearly specified to date. However, in the US, the FDA, which regulates drugs and tobacco products, has stated that e-cigarettes are to be regulated as tobacco products.

The situation is confused. When a manufacturer makes a health claim for a product it is then regulated and tested as a drug. NRT product manufacturers make health claims, e-cigarette manufacturers do not. The Nudge Unit appears to be seeking to use its influence to nudge a regulatory framework into existence which will enable e-cigarettes to be regarded as ‘safe’ but will not regulate them as rigorously as drugs thus allowing them to be sold alongside cigarettes. This is a tall order.

According to reports, the Medicine and Healthcare Products Regulatory Agency (MHRA) is looking into approving e-cigarettes for use and, should it approve them, then it is likely that the government will agitate for the products to appear in supermarkets and c-stores in direct competition with conventional cigarettes. This would be a major step forward for e-cigarettes though whether or not these products could actually be regarded by consumers as direct competitors to a major established FMCG market like cigarettes as a result of Nudge Unit encouragement begs many questions. As an NRT producer stated recently ‘we are not trying to replace one addiction with another’. However the Nudge Unit has gone closer to explicitly stating that e-cigarettes are a safer alternative to cigarettes than any government body has ever gone.