Ready for regulation – An interview with Derek Yach

More and more commentators are looking at ways to inform the global debate on e cigarettes. Derek Yach, Executive Director, The Vitality Institute, shares his thoughts with us. This interview was originally posted on in 2013

Derek Yach has focused his career on advancing global health. He is Senior Vice President (SVP) of the Vitality Group, part of Discovery Holdings Ltd, where he leads the Vitality Institute for Health Promotion. Prior to that he was SVP Global Health and Agriculture Policy at PepsiCo where he supported portfolio transformation and led engagement with major international groups and new African initiatives at the nexus of agriculture and nutrition.

He has headed global health at the Rockefeller Foundation, has been a Professor of Global Health at Yale University, and is a former Executive Director for Noncommunicable Diseases and Mental Health of the World Health Organization (WHO). Is regulation going to develop or damage the global vaping industry?

Derek Yach: At this stage regulation could go either way. If hardnosed evidence based regulations aimed to reduce the harm caused by tobacco dominate, the industry will thrive. If draconian regulations are implemented before we have adequate evidence, the industry could be harmed. What real life evidence is there that vaping is an effective alternative?

Derek Yach: Terminology matters. First we need to be clear that the very term smoking needs to be split into two components: exposure to tar (which kills) and exposure to nicotine (which addicts). ‘Vaping’ includes non-combustible, non-pharmaceutical nicotine devices devoid of tar. For these technologies, the evidence is accumulating that provided users replace tobacco products, the harmful impacts of tobacco will decline. What rights should vapers demand (ingredients listings etc)?

Derek Yach: First, an assurance that they are not harmful to users and exposed non-users. Basic safety needs to assured. Second, nicotine dosing needs to be predictable and accurate. In a word, vapers must demand quality norms. Where is the industry for e cigarettes growing fastest?

Derek Yach: US and many European countries. Interestingly it appears that demand crosses social class and age divides. I have an impression that many smokers are actively seeking a means to reduce the harm caused by tobacco and see e-cigs and related products as the way forward. What one step would ease the transition into a wider global vaping community?

Derek Yach: The US Surgeon General would issue a statement in January 2014 on the 50th Anniversary of the first SG report on Smoking that approved new non-combustibles will reduce the considerable harm caused by tobacco. Is vaping a healthy alternative, a profit making alternative for companies, or both?

Derek Yach: Once my points under your question number three are in place, vaping would meet health and profit objectives. Can vaping ever be truly healthy?

Derek Yach: The technology has the potential to reduce the risk of tar to zero. And in a world where almost seven million die from tobacco today (440,000 in the US alone), this is a huge win. What may be left is a very low health risk associated with nicotine. Are bans on vaping in public places in any way reasonable or effective?

Derek Yach: Bans for smoking have been very effective. This issue is not one of effectiveness but of desirability. If vapers do not emit harmful side stream smoke, the justification for such bans in my view falls away. What is the motivation behind the mistruths and the attacks on e cigarettes, and is there a conspiracy against the electronic cigarette. Do a lot of the government issues towards vaping have to do with fear of the unknown?

Derek Yach: The new non-combustible products have not been subject to much research leading to some legitimate questions related to their impact on kids entry into the market (and then on to tobacco); on safety and dosing; on dual use impacts and more. I am confident that as research is done we will see that fears are not justified. As this becomes clear, many core assumptions and policies linked to tobacco control start crumbling. NRTs and pharma solutions to quitting will probably be shown to be less effective in reducing demand, threatening their interests; smoke free policies as mentioned above will require review; the importance of tobacco excise tax to governments will erode leaving a gap in revenues; and tobacco farmers livelihoods may be threatened. Each of these issues generates understandable fear and concern by those whose interests are threatened.

These include leaders in tobacco control whose careers have been built on an assumption that total cessation is the only legitimate way to reduce the harm caused by tobacco. More debate, better evidence and a central focus on harm reduction should drive us to find solutions to some of the concerns raised. Where do you see electronic cigarettes going in the future?

Derek Yach: E-cigarettes and related non-combustibles could be the most important disruptive technology we require to reduce the massive harm caused by tobacco. Provided issues raised above are addressed, I see a bright future for the new technologies with wins for health and business.

Thanks for the interview Mr. Yach.

We will be happy to hear your thoughts

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