Rebecca Taylor was a Member of the European Parliament for the UK Liberal Democrats in 2013, when the EU agreed its current rules on vaping. Peter Beckett, our co-founder, was one of the lobbyists in favour of vaping during the process of agreeing those rules. Eleven years later, they sat down virtually to talk about what happened back then, and what we can learn from it.
So you were kind of an accidental MEP back in 2013 when this story takes place, how did that happen?
I had been the third placed candidate on the Liberal Democrat list for Yorkshire and the Humber in the 2009 European elections. I'm originally from Todmorden in West Yorkshire. As expected, only the first person on our list got elected, which reflected the vote share the LibDems usually got. That person was Diana Wallace, who had been LibDem MEP for the region since 1999.
Then a couple of years later, Diana suddenly and unexpectedly resigned after an unsuccessful attempt to become President of the European Parliament. As per the electoral rules for closed list PR elections, Diana would then normally have been replaced by the second placed candidate on the list. However, for various reasons, the second placed candidate declined, so it then fell to me.
Having been the third candidate on a list where only the first candidate was elected two years previously, I was obviously not expecting to become an MEP at that moment. I was three months into a new job I was really enjoying. My boss from that time says I still hold the record for the most original reason to resign he ever heard!
But in your career to that point – and since – had you always taken an interest in public health issues?
I was working in Brussels in the late 90s and early 2000s for a couple of pharmaceutical trade associations, the European Community Pharmacy body PGEU, and the PR agency Fleishman Hillard where I mostly had health sector clients. So very much on the public health side of health policy. Although I have to say, tobacco harm reduction and smoking cessation were not really big topics in my career at that point. Smoking cessation was a service community pharmacists in many European countries offered, along with other services like diabetes and hypertension management, but I didn’t really work on it. Then in 2009 I went back to the UK and first worked on health service reform in the NHS, before moving to the International Longevity Centre UK, a think-tank, and then joining the Health team at Hanover Communications in November 2011. I also started a part-time Master's degree in public health. Then in the space of a few weeks in early 2012 I suddenly became an MEP.
So it was natural for me to want to focus on health when I got into Parliament, and I managed to swap Committees with another Lib Dem MEP so I could get on the ENVI Committee. And that’s how I ended up working on the TPD.
What was your first impression of vaping? How did you become aware that there was a policy issue that needed addressing here?
I got contacted a lot by constituents across Yorkshire and the Humber after the Commission published its proposal. This was a series of unconnected individuals who had managed to quit smoking by switching to vaping and were worried about what the directive might do to the product that had finally helped them quit. Not knowing much at all about vaping/e-cigarettes, I realised I needed to inform myself, so had one of my researchers pull together reading from a variety of sources with different views. My instinct early on was, I don't think medicines regulation – which the Commission had initially proposed – is the right way to go. It felt like the Commission had done a quick copy-paste from existing pharmaceutical legislation in order to have something to put in the TPD. So it was from that moment that I ended up becoming a kind of advocate for tobacco harm reduction.
I know some people think the Commission’s proposal was a big pharma conspiracy. But from what I saw, it was not on the pharmaceutical industry's radar, at least not from the ethical (prescription medicines) side of the business. Not at that point.
You're wrong about that. Just before getting involved myself I was interviewed by Johnson & Johnson for a role with their public affairs team. And my focus would have been the Tobacco Directive, and they were very, very keen on making vapes medicines.
No one I knew was working on it, but I didn’t work with those on the consumer health side. Most of the pharma industry people I dealt with were focusing on key therapy areas like oncology, cardiovascular disease, etc., and they did not address tobacco control.
I think it still was a bit lazy of the Commission to use pharmaceutical legislation because nicotine replacement therapy like gum and patches and vaping are really not the same thing. They don't work in the same way. And if you just sat down and thought about it for a couple of hours, you would understand how different they are. NRT products come in a unit dose from e.g. a patch with 21 mg of nicotine, with no way for the consumer to adapt them. Non-disposable e-cigarettes comprise a reusable device that the consumer can modify to suit their preferences, along with separate nicotine-containing liquid available in different strengths and flavours. People who switched from smoking to vaping also liked vaping, and online vaping communities sprung up; never heard of that for NRT products.
So how did the issue rise to prominence in your office?
As previously mentioned, simply by individuals contacting me, expressing their concerns, and asking me to help. There was no organised consumer campaign at that moment because the consumer organisations didn't yet exist. The emails I received were not identical, but they all pretty much said the same thing, which was “I smoked for a long time. I wanted to give up. I tried and failed so many times until I came across e-cigarettes, switched to vaping and quit smoking for good.” Their request was simple: “please don't take this product off me.” They were worried that the product that had, in their view, saved them from a lifetime of smoking and associated health problems would be regulated out of existence and they’d be pushed back to smoking. And that was basically the story.
There were – and still are – some people who try and claim that this was all a big astroturf campaign from the beginning. I can tell you without reservation, that it was absolutely not.
It certainly wasn’t organised consumers at all. I tried to organize them all and it was a nightmare! One thing I never understood – and in fact still don’t understand – is why a lot of public health stakeholders won’t get on board with harm reduction.
One very senior tobacco control activist I met told me they were very, very concerned about the World Health Organisation. They worried if the regulation wasn’t strict enough, that the WHO would try to ban e-cigarettes, which they desperately wanted to avoid having seen how vaping could work as a route out of smoking. So they ended up supporting medicines regulation sort of by default.
I was very disappointed that the MEP leading the process – Linda McAvan – simply refused to listen to the arguments. What were your interactions like with her?
She was talking to people in the public health community who were really convinced that medicines regulation was the way to go. You have to remember that some of the people that Linda was engaging with had experienced many years of fierce, often underhand tobacco industry lobbying, and had, for example, been burned by the whole low-tar episode. They were therefore very wary of getting screwed over again. It is also worth remembering that at least three Brussels-based public health NGOs had their offices broken into, with thieves stealing very little of value, so everyone was on edge.
At the beginning, I can understand why public health and in particular tobacco control advocates looked at vaping and thought “it looks a bit like smoking, and we're trying to get rid of smoking, this could set us back.” But as we learned more, that just became less credible.
I think there were many who genuinely believed the gateway argument: if they didn't regulate e-cigarettes really tightly, then lots of people would start vaping, which would then lead them to start smoking, and they would have enabled it. I think they really believed that. But for me it became very clear that there was only a gateway from smoking to vaping and not the other way around. When I met with the UK Medicines Agency (MHRA), the lead official even said that “the gateway is one way.”
Those of us who do this for a living are forever being tarred with the “you’re all just big tobacco” brush. Is that something you see as trying to silence the kinds of people who contacted you organically?
It never happened to me personally. I remember when PMI’s stakeholder mapping was leaked to the press, I was marked down as “hostile,” so I was quite pleased with that.
The sheer incompetence of PMI during that whole episode was quite something to behold. So much for their lobbyists being “masters of the dark arts”…
Well quite. But there was a lot of proxy lobbying for the tobacco industry, although it focused on tobacco control, not on vaping. I recall meeting a representative from an industry body, which represented companies in many sectors, the vast majority unconnected to tobacco, and their narrative and asks were 100% tobacco industry aligned. I was so disappointed as I had been hoping to hear some different perspectives.
But I do understand the struggle consumers face in getting their voices heard. In the end, effective advocacy costs money and funds can be difficult to obtain. Small patient groups can find it difficult to fund their frontline work like patient support, never mind advocacy activities. The bigger patient groups and health charities can rely on teams of professional fundraisers, but the smaller patient groups can find that the funding they can most easily obtain is unrestricted grants from the pharmaceutical industry. And if it's done properly – I've managed those kinds of programmes as a consultant – with transparent funding and clear safeguards around independence e.g. no industry input on content, then valuable work can be undertaken.
However, even with high levels of transparency and safeguards in place, those charities can still be criticised. So my question to the critics is, where else can they find the funds? Public funding is increasingly difficult to come by and you need people who are experts in making grant applications to succeed. When I worked on pharma industry-supported programmes for patient groups, they were aimed at helping the patient group engage more fully with policymakers and get their messages across, even if that wasn’t necessarily helping the pharmaceutical companies, and that's fine. I recall a pharma industry executive telling me “you know it’s not our views in the report.” That's how it should work.
