Dr Sandesh Gulhane is on a mission to banish smoking from Scotland for good.
But with that day a long way off, what can a GP-turned-politician do to change people’s habits and modernise laws?
When not working as an MSP in Holyrood, he is a former surgeon who knows only too well the devastating impact cigarettes can have.
Dr Gulhane had to amputate limbs and unclog arteries, and thinks the level of national addiction is “outrageous”.
He accepts it’s unlikely Scotland will be heading towards a ban any time soon – but would like to see that day come around.
Until then, he wants a lot more attention on how vaping and e-cigarettes can help wean people off – while warning against simply pushing people onto another relatively unknown problem.
They are the worst things that are freely available for people to purchase – it is absolutely awful.
– Dr Sandesh Gulhane MSP
The Conservative has been meeting e-cigarette manufactures and wants to explore better information on packaging, including nicotine levels.
He noted the stubbornly high rate of smoking in Scotland, put at 17% of people.
“I definitely want it to be used as a means to quit, I don’t want people to go from nothing to e-cigarettes,” he said.
Reflecting on his previous job, he added: “I used to be an orthopaedic surgeon and I did jobs amputating limbs because they were smokers.
“I also did a vascular job to bypass clogged arteries that were all blocked up directly as a result of smoking.
“There is nothing smoking doesn’t do.
“It can make you go blind, and it can give you heart attacks and strokes.”
Public Health Scotland says smoking is the “most important preventable cause of ill-health and premature death”, with around 10,000 smoking-related deaths every year.
Each year smoking is responsible for around 33,500 hospital admissions and those who die from smoking in their middle ages lose on average 22 years of life.
It is also a major risk factor for stroke, a range of cancers, heart disease, vascular disease and a number of respiratory conditions.
Cigarettes versus vaping
In 2020, statistics from the Scottish Government found 6% of people in Scotland were using e-cigarettes.
Dr Gulhane has been meeting manufacturers to find out what role they could play in helping people to quit, and find out more about nicotine levels in e-cigarettes.
Currently Grampian, Tayside, Fife and Highland health boards all have less successful quit attempts than the Scottish average.
Dr Gulhane said: “What I do want to do is encourage people to stop smoking.
“I am not a huge fan of e-cigarettes and people should stop smoking completely, but I appreciate that e-cigarettes can be a very good way to get people to stop smoking.”
He suggested pharmacists can encourage people onto e-cigarettes.
But said he knows people who made the switch after being told it is “just water vapour”.
The legal age for smoking and vaping in the UK is 18.
How much is too much?
Dr Gulhane says he lack of information on e-cigarette packaging is leading to some people taking in much more nicotine than they perhaps think they are.
“A constituent of mine bought disposable e-cigarettes for remarkably cheap – three for £12,” he said.
“Afterwards he discovered the amount of nicotine he vaped was the maximum amount allowed, so there was a massive hit of nicotine he was not expecting.
“I want to try and find a way to make it clear what the strength of the nicotine in e-cigarettes is.”
Dr Gulhane suggests having the amount of nicotine displayed on packaging, or potentially introducing a colour-coded scheme, would help people choose e-cigarettes based on how many cigarettes they used to smoke.
Is a full smoking ban in Scotland possible?
Ultimately Dr Gulhane would like to see cigarettes off the shelves in Scotland completely.
Although this may seem like an impossibility, Dr Gulhane says that is how many people felt about the indoor smoking ban which was introduced in 2006.
He said: “When I was at medical school the indoor smoking ban came in.
“Before you would wake up in the morning and your clothes would reek of cigarettes which was so unpleasant.”
I don’t think a ban will happen overnight, it will be many years in the future
– Dr Sandesh Gulhane MSP
“When the smoking ban came in it was amazing, even though there was a lot of opposition to it.
“But just because something is a certain way now doesn’t mean it has to be going forward.
“I don’t think a ban will happen overnight, it will be many years in the future.
“The ideal scenario is people not doing it at all, and getting rid of it so people don’t want to smoke.
“I am a realist – yes, I want everyone to stop completely but I would much rather, given the choice, have people smoking e-cigarettes rather than cigarettes.
“E-cigarettes can’t be worse than cigarettes.”
‘No one is saying vaping is risk-free’
John Dunne, director general of the UK Vaping Industry Association, says people are not exposed to harmful chemicals while vaping because it does not burn any tobacco leaves.
He claims “nicotine is no more harmful than caffeine” and says e-cigarettes could be up to 95% less harmful than cigarettes.
He said: “No one is saying vaping is risk-free.
“What we and an increasing number of health experts are saying however is that vaping is vastly less harmful than smoking.
“The fact that leading health organisations now routinely promote the use of vaping as a highly effective way to quit cigarettes and actively encourage it to get smokers to quit is as strong an indication that you will get that it does a lot more good than harm.”
He adds he would like to meet with Dr Gulhane to talk through the association’s harm reduction commitments.
This comes after the UK Government announced e-cigarettes could soon be prescribed on the NHS in England.
Those wanting to stop smoking can get help with smoking cessation through NHS Inform.
Tayside quitters drag region to top of Scottish stop smoking table