New Four Country E-cigarette Survey Published

I’ll get back to the Bad Apple post but this is worth publicizing (noticed it on Michael Siegel’s Rest of the Story).

The citation is Adkison SE, et al. Electronic Nicotine Delivery Systems: International Tobacco Control Four-Country Survey. Am J Prev Med. March, 2013 (article here).

If you go to the article and take a look at Table 1 (awareness and use of e-cigarettes among smokers) you will see how smokers are faring in countries where e-cigarettes are essentially banned (Canada and Australia). While the awareness of e-cigarettes was substantially lower in Canada, the real difference comes in how many smokers actually tried them (roughly half compared to America). The real killer (and it is unfortunate that that does really describe the end result) is that the percentage of Canadians who tried vaping and then became users is about the same as the percentage of Americans.

In other words, it is equally attractive and effective for users in both countries but in Canada the current restrictions (not surprisingly) lessen the number of how many smokers know about e-cigarettes and thus how many try them and how many will switch from smoking. Thus current policy serves to maintain higher national smoking numbers than would naturally occur.

And by naturally I mean if e-cigarettes were as available as cigarettes.

There is a lot more meat to chew over in the article and I do encourage everyone to read it over. The one sour note I find on a cursory first scan through is the final line of the conclusion: “If credible evidence can be provided that ENDS reduces the number of cigarette smokers and does not attract use among nonsmokers, then the net public health effect is likely to be positive”.

Its been quite clear for some time that the level of risk associated with vaping is so much lower than that with smoking that if everyone vaped rather than anyone smoke the net public health effect would be overwhelmingly positive.

Bad apple studies – pt 1

I was thinking about the persistence of that FDA assay despite the rounds of criticism from all the right quarters. Just about every article or health web site arguing against vaping will cite this one study and often no others. This became quite evident to me when I was writing about a possible ban on e-cigarettes in the Gulf states (curiously enough two years ago to the day).

Not only did I think it odd that it was that one study that kept getting referenced (as though none other existed) but that an American study would be used half way across the world as authoritative in a culture that not only has its own resources but that often as not decries American influence. And reversing the situation, can you imagine the American Lung Association using an e-cigarette study out of Qatar as the sole citation on a post?

However, as odd as this situation is, it is tobacco harm reduction history repeating itself.

In 1981 the New England Journal of Medicine published Deborah Winn et al’s Snuff dipping and oral cancer among women in the southern United States. I won’t retread old ground about the shortcomings of this article – see Brad Rodu’s excellent summary – however let’s just say that the paper makes better reading as anthropology than health risks. The authors managed to run down a group of white women who had used an antiquated version of powdered dry snuff for most of the hours of the day for over fifty years. In comparison to non-users, this group was determined to have about 50 times the risk of developing oral cancer. The figure mentioned in this deeply flawed study ended up being used to represent the typical risk to the average user using products that had little in common with the product in that study.

It used to be that every site warning off smokers who were thinking of switching to smokeless tobacco would cite this figure. Looking again for the first time in a couple of years I see that little has changed (see Web MD or Illinois Department of Public Health). Their overall message much like the one that attends bad vaping articles is that smokeless tobacco is as or possibly even more harmful than smoking.

Just as with the FDA case, there were plenty of other studies out there. In fact the situation was much more pronounced. As well as other American studies there existed a body of strong research from Sweden where more people were using snus than smoking and where the shift resulted in a decline in smoking related disease rates. You think that would have clinched the deal but rather than this one bizarre outlier being consigned to ignominy there seemed to be no effect at all on the messages that public health resources were giving out.

(In addition to other studies, it is this same Swedish data that allows us to be pretty sure that e-cigarettes are so very much safer than smoking).

Paralleling the situation with e-cigarettes you would typically also read that the authors felt there were no studies demonstrating that these alternatives were any safer than smoking.

So what you have are the bad apples, the early studies that don’t seem to be replicated or supported by any other studies, which go against everything that follows, and yet remain the official sources. Even more upsetting (and detrimental to public health), these official messages ended up becoming common knowledge – basic truths everyone “knows”.

The other thing to note is that both the Winn and FDA reports were obviously flawed in themselves. You did not require other information to know that these lacked credibility. And yet these bad apples stuck.

Part 2 will explore possible reasons why these zombie studies would not die.

More on this tomorrow….

Credit where credit is due: Some positive e-cigarette coverage

In the wake of the recent uproar regarding the Daily Mail’s “E-cigarette’s can cause more harm than smoking” (see Clive Bates for the before and after pictures of the webpage – deleted after a formal Press Complain was lodged) and the Marie Claire’s “Fears e-cigarettes could be more harmful than smoking” not to mention the iterations in Pakistan and India and who knows where else and not to forget the descent into madness at the Philippine Star, it’s pleasing to report that not all the news is nonsense.

In early January we had the Lionel Shriver article in the Guardian and just today in the National Post we have Jesse Kline’s “E-cigarettes are not your father’s smokes.” A couple of days ago we had Jacob Sullum at reason.com with “How E-Cigarette Alarmists Endanger Smokers’ Lives, or Why Eli Lake Should Not Switch Back to Marlboros.” And back in January at the Globe and Mail Lucy Kellaway wrote “Why e-cigarettes should be allowed in the office.”

When this blog began, e-cigarettes were hardly known and the most prominent safer nicotine alternative was smokeless tobacco, it was rare to ever find any positive coverage in the media. Though e-cigarettes do get a fair share of bad press they almost get as much good. Of course the bad articles seem to get all the traction.

Two ways in which vaping will clear more than just the air

(I would like to thank Char from VapeMate for bringing the podcast to my attention.)

I’ve just finished listening to a CBC podcast: The rise of E-cigarettes: Helping to quit or encouraging to smoke? It was oh so fairly moderated and presented opinions from various Edmontonians, a smoker turned vaper, an owner of a non-nicotine e-cigarette company and a London Drugs pharmacist, as well as an non-smokers rights activist from Ottawa. The interview with the pharmacist from the local stringer was the only place where the media side seemed to be a wee bit rabid about the affair.

Other than the ex-smoker there seemed to be a strong agreement that nicotine is the devil’s tool, that we need big randomized control studies before we let people near the nicotine e-cigs, and that the only goal worth pursuing was ridding the world of nicotine with only the faintest nod in the direction of improving public health. In fact one of the greatest howlers was when Melodie Tillson of the Non-smokers’ Rights Association described herself as part of the health community. This from someone who is fighting tooth and nail to keep e-cigarettes out of the hands of smokers. (By the way, superlative examples of those big trials exist showing how ineffective nicotine replacement therapies are, not to mention how dangerous Champix is, and given the ringing endorsement of these as “proven cessation therapies” I hate to think what kind of evidence would be needed to get e-cigarettes approved.)

But I diverge.

This reminded me of something I have been thinking about for some time and that is once you remove any substantial health risk from using nicotine (as in vaping or using smokeless tobacco) it will cease to matter whether or not you use nicotine. It would be like the old days where whether someone was a smoker or not did not imply anything about their character and it certainly was not a sufficient reason for barring them from employment.

And once whether you use nicotine or not ceases to matter, then quitting becomes moot.

So back to that article subheading: helping to quit or encouraging to smoke? It doesn’t matter. (Of course if they mean many vapers for reasons that only make sense to tobacco control advocates would drop their relatively safe habit for one with proven health risks, which stunk up their clothing and breath, caused them to hack, and which would make them (at least in Canada) stand outside alone in the cold just to get their nicotine. Isn’t that a little like discouraging people from using seatbelts because using them would make it more likely that they would want to drive without them?

But before I use up the typical online reading patience let me present point two.

Once we have finally driven home the point that nicotine and the health effects associated with inhaling burnt matter are two different things then research on nicotine itself can move forward.

Its no secret that whenever a substance or a plant has negative connotations it is difficult to get funding unless you are exploring the negative potentials. We can then do the same studies we do with caffeine or alcohol. We’ve already gotten hints that nicotine might be useful in the treatment of Alzheimer’s, Parkinson’s and ulcerative colitis. For all we know nicotine users might be better off in the long run than abstainers.

Once we finally get it that nicotine is a safe enough drug which a lot of people seem to get a lot of benefit from and that burning tobacco is one of the worst ways to go about getting it and once public health gets it as well, that the focus should be on health and not about whether someone is holding a tube to their mouth inhaling and then blowing something out, once we all get that then we can dismiss it as yet another interesting thing that a lot of people like to do and then we can move on to more important issues.

Canadian Lung Association says reducing health risk not as important as quitting nicotine

In a recent press release “celebrating” Canada’s National Non-smoking Week, the Canadian Lung Association warned people “Don’t be fooled by e-cigarettes!”
Given that this is a one stop shop of misinformation of all sorts I am a bit surprised that they didn’t go the whole hog and use all caps in addition to the exclamation point at the end.

It seems they are worried that people who are thinking of quitting cigarettes will turn to “gimmicky” e-cigarettes rather than pharmaceutical products. They do not even mention one other method that has been proven to be more successful than NRTs – quitting cold turkey. I suspect that there is quite the funding disparity associated with the two routes of quitting smoking.

The CLA is forgetting their mandate to “improve and promote lung health”. While there is a little wobble on how safe vaping is, nobody who has looked at the literature (and that means reading more than just the one ludicrous 2009 FDA study) thinks that vaping is anywhere near as dangerous as smoking. The point here is that even if it were only 10% safer than smoking, any organization which purports to care about the health of smokers would advocate it as a preferable alternative.

But here the message is quite obvious in that the CLA says that if you are not going to quit nicotine then don’t even consider switching to using nicotine in a way that eliminates almost all the health risks.

In other words, if you were thinking of trying e-cigarettes, the CLA would prefer you keep smoking tobacco. This in turn means that they think that the two have similar risks.

The only evidence of e-cigarette associated harm they proffer is the discredited FDA study from 2009. (See here for a recent article on the ever proliferating nonsense about diethylene glycol as a concern in e-cigarettes; ). Since even if that contamination were common the harm in vaping would still be a far cry from smoking, the CLA resorts to the ever popular “think of the children” fear.

Leaving aside the inconsistency in that this was all about quitting smoking (and how many kids are doing that), e-cigarette distributors have in general been quite scrupulous about not only quality control but also who they sell to. Every survey done about e-cigarette users has found that just about every vaper is an ex-smoker with multiple quit attempts and the median age seems to be around 30 (see here for two examples – one, two).

E-cigarettes do come in flavoured varieties and many users find that a plus (yes, those people who are 30 years old). News flash to all the tobacco control types out there who use the flavour argument – it is not that flavoured products appeal to kids, flavoured products appeal to human beings.

And as far as the new user problem – it’s not. If something is as low risk as vaping, it really makes little difference whether they ever quit or not. And if someone started vaping why would they ever decide to replace it with something that not only had proven health risks but was also much less pleasant.

Finally, news flash number two to the same folks – kids do not smoke because they think it is safe. They steal and try cigarettes precisely because they are dangerous. I know I did and just about anyone I’ve ever talked to about it. If we thought it was safe what would have been the point?

Though going after this horribly uninformed press release has been amusing it ends up leaving a very bad taste in the mouth. Should we not be able to trust these publicly funded organizations to provide us with evidence based guidelines to better health rather than political posturing that undermines public health? Should we not be more angry that they are deliberately misleading people who really are looking for and need healthier alternatives to their presently risky behaviours?

Addendum: This just in regarding youth using e-cigarettes. Michael Siegel reports today on a study looking at youth attitudes toward e-cigarettes which failed to find a single non-smoking youth who had even tried an e-cigarette.

Sunoco minimart on Lancaster Ave, a leader in reducing smoking

Price of the new Americanized version of General snus: about $1.60 for a “trial pack” of 10.  Pennsylvania excise tax on low-risk alternatives to smoking:  just what it should be — zero — thanks to the tireless work of Bill Godshall; there is just the regular sales tax.  Coupon in each package: $1.00 off of your next purchase.

Net cost of using General instead of smoking:  <7 cents/pouch, or a quarter the cost of a cheap cigarette.

No, I don’t really have a deep point, other than the local Sunoco C-store near my house is apparently doing more to help reduce smoking than a the “Quit Smoking Now!” hypnosis place up the road — or than the local quitline and other official efforts.

Of course, I am kidding.  The real credit for that goes to Swedish Match.

Maybe my point was to try to make the anti-harm-reduction people’s heads explode, upon learning how attractive the option of THR is here, and to give them something new to post at their silly little “Tobacco Tactics” page.

 

[As anyone coming across this probably knows, this blog is mostly on hold, waiting to see if we want to start using it again.  In the meantime, if you have not discovered our new Anti-THR lie of the day blog, you would probably like that.]

We should really be doing this more often…

Over at ep-ology is a posting of some new research re the candy-tobacco issue. It’s called Demonstrating that children believe that deadly tobacco products are harmless candy, an experimental study.

Excerpt:

There has recently been an explosion of organized concern about the risk of accidental poisoning of children who mistake dissolvable smokeless tobacco products for candy. It is already known that that young children may be at risk of ingesting small objects that come within their grasp. However, since tobacco is completely unlike any other consumer product, previous research on other products cannot be considered informative. The nicotine lozenge variants of dissolvable tobacco products have already been implicated in a significant number of toxicant exposure events, which suggests that there is risk that one of the tobacco company products might someday poison someone also.

Several previous studies demonstrate that there is a view that the public health community should encourage worry about the poisoning risk:

An anti-tobacco QUANGO of the Virginia state government calling itself “Virginia Foundation for Healthy Youth” issued a press release [1] reporting that when teens were presented with dissolvable tobacco products without any context, they often thought they were mints or candies. While it might be considered a minor limitation of the study that the methods and actual results of the study were never reported or that the research was designed and conducted by high school students without any apparent supervision by scientists, the subsequent wide coverage in the popular press confirms that it was credible, important, high-quality research.

We’ve been writing off and on about this for years (see Like candy to children and Iowa more worried about candy than cigarettes but take the time and check this latest one out. At least a couple of laughs guaranteed.

Worth reading: Carl Phillips testimony at the FDA tobacco center meeting

reprinted from Epology

My testimony at today’s FDA tobacco center meeting

Today I departed from my usual practice of fiercely avoiding any “science by committee” setting or engaging with government overlord-types, and gave some testimony at the Center for Tobacco Products TPSAC meeting. Greg Conley and Bill Godshall talked me into make the trip as an advisor to the tobacco harm reduction advocacy group CASAA. It was worth it — there were several great presentations by harm reduction advocates in the “citizen comments” that our public mastersservants grudgingly allow because they have to. Greg recruited several people who had quit smoking by switching to low-risk products, and there were great THR presentations also by Greg, Bill, Elaine Keller, Jeff Stier, Gil Ross, and others. I was pretty pleased with mine too, given that I wrote it while sitting through the talks earlier in the day (something to do during the tedious and pointless presentations by the well-paid consultants and others who were invited to speak by the hosts).

To appreciate my talk, I need to offer some background (which kind of spoils the freshness, I know, so if you are familiar with all this, you might want to skip right to the text of my talk).

Background for those who know nothing about CTP etc.: The US FDA was fairly recently given authority over tobacco products. The unit that formed is dominated by dedicated anti-tobacco extremists who are opposed to harm reduction, and its external scientific advisory group (TPSAC) is stacked with extremists and junk scientists, and contains no harm reduction experts even though most of their role is to evaluate harm reduction products. There is a serious threat that FDA will substantially restrict, one way or another, low-risk alternatives to cigarettes. They are particularly notorious for playing the chemophobia game, obsessing (or pretending to obsess) about detectable chemicals in products, implying that these have health effects even though the evidence about actually effects suggests otherwise. No doubt they are annoyed about having to deal with public comments, because (in a complete perversion of the term) they consider the stakeholders to be the busybody activist groups and not include the actual primary stakeholders, the product users. Public comments also are a challenge to their preferred way of dealing with information they do not like, which is to declare it to not exist and claim we do not really have any information (they still do that, of course, but they probably momentarily feel worried that someone is going to realize they are bullshitting). Indeed, the defining characteristic of this whole process seems to be to pretend that evidence about THR does not exist, because it is not exactly the “right” form of evidence, or is not collected by the “right” people, or whatever. That is the same old game used by the anti-harm-reduction extremists for a decade, but now it is official government policy.

Bits of background on this meeting: Today’s meeting was dedicated to dissolvable tobacco products, smokeless tobacco mixed with confectionary which dissolve in the mouth. These face particularly great existential threat from the regulators, probably because they compete with the almost identical products from the pharma companies who many of the extremists carry water for. The citizen comments period allowed for only 16 of us, and only for 3 minutes each — “government for/by the people” in action! It was quite clear from various comments and questions from the floor that many members of the committee did not understand key points about THR, despite supposed expertise and a year on the committee, and even more clear that they had never talked to any actual product users. (They appeared genuinely astonished to hear one of the presenters say that he has kept using an e-cigarette, even though he is sure he could quit, because he likes it.)

In yesterday’s session, the committee had been offered a lesson in the Swedish experience, about how smokeless tobacco use had caused the world’s best reduction in smoking and had been shown to have trivial health risks. They then tried to make up every possible reason about why that is not a good reason to encourage (i.e., allow) the marketing of new smokeless products in the US — because that is just not the same thing, so we really have no idea whether something similar could happen. Oh, and there was a trumped-up obsession with how children might get poisoned by these products (never mind that it had never happened, or the question of why they should be worse than existing pharma products that are almost exactly the same but much easier to unpackage, or other medicines) and resulting tangents about safe packaging.

Anyway, since (a) I figured several of the other presenters were already covering any basic information that I could communicate in 3 minutes, (b) Bill submitted 200 pages of written testimony (which they clearly did not read), and (c) the members of the Center and committee have had months to learn things, and if they did not already know them it was not because they had not heard them. In short, they either already knew what I could tell them as a THR expert, or the reason they did not know is that they were intentionally ignoring the information. So, I decided to go a different direction with my testimony. Here it is (in full — 3 minutes is a very short time):
I speak today as an educator with an interest in the nature of science and its role in the functioning of our society, and from that perspective would like to say, “won’t someone please think of the children?”
If an impressionable young mind stumbled across how science is often portrayed in this corner of our nation’s government, he would be at risk of never becoming scientifically literate, let alone to wanting to be a scientist.
First, science is supposed to be an honest truth-seeking process that attempts to figure out the best possible answer to a question, often via methods that require innovative thinking. Our impressionable young mind, however, might come away:
-believing that science consists of just a few narrowly-defined recipes, rather than taking in all the information we have in myriad forms, available from many forums, and thoughtfully making the best use of it;
-believing that health science focuses on looking only under streetlamps and obsessing about easy but not directly informative work like chemistry, rather than trying to do the more difficult work to translate this and other information into what we really want to know about health effects;
-from today’s session, he might believe that science involves such methods as manipulating children into giving the answers you want, speculation-laden anecdotes, limiting reviews of the evidence to exclude any evidence that you wish did not exist, and counting unsupported assertions by authors as evidence;
-and he would be taught that science it is not about identifying how we maximize our knowledge, but that it is involves declaring that we just do not know anything, when in fact we know quite a lot.
Our impressionable young mind is not going to think very highly of science, and he might reasonably conclude that the best way to get involved America’s version of science is to go to law school. And, yes, that means that misguided ways of looking at science may be a gateway to more dangerous behaviors.
Second, this poor child would get the impression that a hypothetical cardiovascular condition or cancer 40 years from now will be just as harmful as a near-term case in a current smoker, a case that was caused because smokers are discouraged from switching to low-risk alternatives. Do we really want to tell that child that we expect so little of him, that his generation’s health science will be so lousy that the 40-year-out cancer will be no more treatable that it would be today?
Finally, at the very least, I would urge this committee and Center to make sure that any such anti-scientific writing is kept in child-proof packaging, rather that being left laying around on the internet where anyone could stumble across it and damage their developing minds.
In case you are wondering, still more background re that third bullett (explaining the joke does not make it funny, but it can clarify): The “manipulating children” refers to the the Indiana Health Department who presented there and are the darling of the anti-tobacco extremist nutcase faction; their infamous “study” consisted of assembling some children, mixing dissolvable tobacco products (which the children had never seen or heard of before) in with some candies, and asking the children what they thought they were looking at. Obviously, they “discovered” that the kids thought the dissolvables were candies like the other items they were presented with. This is what passes for evidence for these people. I suspect it would be possible to convince the kids that the dissolvables were cats if you worked at it.

The “anecdotes” point refers to someone who presented statistics about thousands of tobacco poisonings which were meant to imply that dissolvable products were dangerous, but in fact showed the poisonings were from other products. Perhaps realizing how worthless her data was, she threw in a single story about a mild poisoning that might have possibly maybe been the result of dissolvables that someone had unpackaged and left around, maybe. The “unsupported assertions” referred to a really stupid report presented by someone from RTI (for which they probably got paid a fortune of our government’s money) reviewing some of the studies on the topic; the report highlighted whatever random conclusions the authors asserted, regardless of the fact that most were unrelated to the evidence reported in the study. In other words, they did work at the level of a bad MPH student (which I suspect is exactly what most of the researchers were). The “limiting reviews” referred to that RTI report, in which they every-so-conveniently had reasons to not include all papers not written by opponents of harm reduction, as well as similar behavior in all the other reviews of the day.

Unlike some of the other presenters, I did not get any questions from the committee. What could they say? The one question/comment I thought might come was something like “do you think this committee is some kind of joke”. I was prepared with an answer — “well, if you really cannot understand the seriousness of what I was communicating, then, I guess the answer is yes”. Alas, no one asked the question.

But I still wonder how many of them even began to understand what I was saying. I know that many of my THR-expert colleagues got it, but I kind of doubt a sufficient level of intellect is common among the officials and committee members. Long-standing science committees are generally populated by political hacks and former scientists who cannot or do not want to think hard any more. I was told that the top FDA guys looked like they were amused at least part of it (but whether that is a good sign or just a smug “yes, you caught us, but who cares — we are still the ones in power” is not clear). I noticed that at least one committee member, Jonathan Samet, perhaps was also getting it, but he knows my style from crossing paths over the years and, though I am pretty sure he does not like me, he gets it. He a clever guy, albeit someone who has risen to seemingly dominate institutionalized American epidemiology, due to position and connections, not scientific skill, and then perverted it with politics, further damaging and already shaky field. (No mystery why he might not like me, huh?)

Anyway, I am pretty sure they missed my final bit of satire. Before the citizen comments, the chair read this ridiculously long statement about how we are encouraged to start by disclosing our conflicts of interest, who paid for us to be there, etc. This is in keeping with the “look for any excuse to dismiss what someone has to say” mentality. It is ironic, since that committee is notorious for being stacked with people with enormous conflicts of interest. Anyway, I was not about to waste time from three minutes with that, but since I spoke a bit faster than I expected, I had 15 seconds left at the end. So I added,
Oh, and no one has ever paid me for my work doing history and philosophy of science like this.
And CASAA paid the two-figure cost of me coming here.
I am guessing that they had no idea that I was ridiculing their conflict of interest obsession.

The meeting was painful, but it is good to be reminded sometimes: I generally know with how little wisdom the world is governed, but sometimes it is useful to remind myself of some of the details. It was just so absurd. The committee would ask presenters questions the presenter could not answer but which (a) everyone on the committee should have already known and (b) someone in the audience was clearly the top expert on. But we peons in the audience were not asked to solve the conundrum, because science-by-committee does not allow for stepping outside the box (or in this case, beyond the plastic chain with “no one past this point” signs that separated the audience — I am not kidding). Several of the answers were in Bill’s submission, but they could not be bothered with looking at that. My favorite was when the committee was asking about some details of what one company had reported and the speaker was not sure; representatives of that company who undoubtedly knew the answer were sitting in the room, and no doubt some or all of the committee knew that, but the people up front went around and around without being able to figure out the answer rather than actually doing the research (asking) needed.

This kind of consultation among the privileged ignorant, which never actually seeks data, passed for scientific inquiry in the Dark Ages. But dark ages never really die. They just take refuge in government and religious institutions. So try not to think too much about the children — it is just too damn depressing.

Canada’s health experts don’t mind lying to the public

Two items this week once again make me think twice about self-identifying as Canadian. I suppose I can take solace in the fact that one’s country and one’s identity is something quite different from what occurs in the corridors of power, or whenever prohibitionism rears its mishapen head.

The first item, brought to my attention via Velvet Glove, and reported in the Huffington Post, is about a spate of tainted ecstacy related deaths in Western Canada. What is crucial in the report is that the coroner, Lisa Lapointe, had pinpointed the unique look of the bad batch but did not make this information available to potential victims because “We don’t want to give the impression that these are the tablets that are risky, and other tablets are safe”.

While we might not be certain that the other ones are safe, we do know that the ones she found were poisonous, and in the interests of a political and not a health-related aim, she left the public at the same level of risk as before. Her job, as I understand it, is to find out what is causing harm and then taking the steps to reduce the likelihood of it recurring.

What is also remarkable about this is that the most prominent Canadian reports on this ceased to mention that the unique design had been uncovered and that that information was being deliberately withheld from the public.

How provincial are we getting when we need another country’s news agency to report on the most information in a domestic story, and the locally relevant life and death ramifications.

As far as I know, this dereliction of duty has not imperiled Lapointe’s appointment; how do you suppose we would treat a transport commissioner who did not label dangerous roads because that might give the false impression that all the other roads were safe?

The second story did get good local coverage but reported verbatim misinformation (lies to be perfectly accurate about it) from physicians who claimed to be concerned about public health. The story was a bit of a press release/ activism trying to raise support for the banning of shisha (flavoured tobacco used in hookahs).

The “good” doctors don’t seem to have much of a problem with unflavoured tobaccos but just tart up the product a bit and suddenly it is more dangerous.

They start with the old loophole complaint in that tobacco companies responded to the banning of flavoured small cigars by making them bigger and thus not subject to the regulation. What they seem to ignore is the ban was motivated by the belief that kids liked small cigars (which is why they did not target regular cigars in the first place). So if the company, which is well aware that there were plenty of adults who liked small flavoured cigars, sought to deliver a second-best choice to their stranded adult customers, how is that a loophole?
But I digress.

The passage I found such exception to was

Physicians for a Smoke-Free Canada wants all flavoured tobacco products banned, including shisha, because of their appeal to young people. Shisha, flavoured chewing tobacco and other flavoured products are sold with no warning labels, or with small ones, leading the public to believe they are not as dangerous as cigarettes, the group said.

“If Health Canada required these products to carry large health warnings like those on cigarettes, kids would be more likely to understand how harmful these products are,” Kapur said.

I find it quite strange when most of us regular folks are quite concerned about tossing around anything that could be construed as lies or ignorance, that this Dr. Atul Kapur, the leader of a national organization, has no problem parading, in full view, what is certainly one or the other. Insanity or arrogance, take your pick.

As in the case with the ecstacy, health officials are deliberately withholding information from the public which could affect their future prospects. Here they wish the authoritative line to be that cigarettes are no more dangerous than smokeless tobacco.

Of course what we really should all be clamouring for are large product descriptions saying just how much safer these products are than smoking.

General Nordic Mint snus: good news for US smokeless users (and smokers who want to quit)

This week, I chanced upon the opportunity to try this new product from Swedish Match North America and learn that it is on its way to the largest chain convenience stores in my area.

[Request to one of my readers from SM:  Could you put me in touch with your local (Philadelphia area) rep to discuss this a bit more.]

The product has been re-engineered for taste to better appeal to the American palate than do existing General products.  It seems like a very appealing product, a huge improvement (at least for this American palate) compared to the existing General mint-ish product, which just tastes like vile medicine to most of us.  There is also a version of the new product without characteristic flavoring, which is presumably a bit Americanized from the unflavored US version of General, which is perfectly good but still a bit un-American in its flavoring.  (For those interested in more and better product assessments, members of the “snus press” were invited to try these in June to generate some buzz, and several reviews appeared.)

More important, though, is the plan to broaden distribution.  Currently I know only a couple of local specialty shops that sell General, while Camel Snus and others are available at every gas station and most every cigarette store.  Many of these others are perfectly good products (we, of course, do not endorse any particular Western smokeless tobacco product over any other – they are all equally good for THR).  But I have heard many people derisively say, “that’s not real snus!” about the RJR product and others, so the new widely-available General, which seems to deliver more nicotine, faster, and from a smaller pouch than Camel, characteristics which likely appeal to many consumers.

The Swedes and Swedophiles have been saying for a year or two, “that should be our market!”, and this will be a good test of whether that works out.  But whether the new product eats Camel’s lunch or RJR stays as strong as ever, the result will be better for consumers, and thus for public health.  Never doubt that a single thoughtful company, trying to better serve its customers, can improve the world.  Indeed, it is the one thing that most often does.

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