Is parody dead when writing about tobacco harm reduction?

During the Bush administration, satirist Jon Stewart discovered the frustration of trying to parody the U.S. government when just reciting their actual claims and policies already sounded like parody.  In the spirit of “irony is dead” (a reference to Kissinger winning the Nobel Peace Prize), perhaps we should give up on doing parody, not just because it seems to confuse people, but because it is redundant.

An article in the University of Alabama at Birmingham (UAB) house organ magazine has really raised the bar for parody about tobacco harm reduction ( Granted, probably only a hundred people would have read it if we did not write about it, but it is just too rich to ignore, and many of these comments generalize well to higher-profile articles.  Also,  UAB, during the Rodu era, was once the center of THR work in North America, so the source is not quite as obscure as it might seem.

On to some of the gems, which couldn’t be more perfect if we’d designed them ourselves.  First up, we are introduced to Cherie, an electronic cigarette user who states that she isn’t ready to quit smoking completely, but is looking for a less hazardous substitute for smoking while she prepares to quit.  She has found that e-cigarettes have adequately filled that role, and we are further informed that e-cigarettes deliver nicotine without tar, chemicals, and the cancer-causing smoke that comes with tobacco cigarettes.  So far it all sounds pretty good.  But thankfully, William Bailey, a UAB pulmonologist, is there to set us straight:  “This is less dangerous than smoking cigarettes… It’s clearly less of a toxic substance, but that doesn’t make it a good thing.”  Huh?  And why aren’t e-cigarettes a good thing, if they are less dangerous than smoking cigarettes?  Well, in a nutshell, smokers should be using other cessation devices that are not as fun.  As Bailey’s puts it: “The whole point of all these other cessation devices is that they’re not attractive. They’re not made to be a lot of fun.” [bolding mine]

So if I can get this straight, other nicotine products are better because they are less pleasurable, and e-cigs are not good because they are less dangerous.  Not only should we be concerned about the quality of the UAB pulmonology department, but perhaps we should be a bit worried about Alabama’s grade school English classes, since “better”, “less”, and “good” are not actually very difficult words to master.

Since it is widely accepted that using nicotine products is bad not so much because some are deadly, but because they are a spiritual failing, and only by suffering can you be properly cleansed of your ill considered descent into sin.  Your heart attack risk drops back to close to baseline around three years after quitting, but your moral turpitude remains until you have suffered severely.

Fun and pleasure is sinful; suffering is cleansing.  This point is driven home further with another point later on in the article: “Many people are able to quit on their own, even if they failed miserably in the past. The average successful quitter has failed five or six times in the past. So don’t give up.”  Boy, that does sound like fun, like Sisyphus, failing miserably over and over again.  If only there was some sort of satisfying substitute that was low-risk for the majority of smokers who prefer their lives to stay enjoyable…

We also have what appears to be a plug for nicotine throughout, except for the use of quotations to indicate that the positive effects of nicotine are really just “positive”; or in other words, in the figment of the smoker’s imagination.  When describing nicotine, Bailey says it “does almost whatever you want it to do,” and that it can  calm when stressed, and stimulate when tired.   They go on to say that “The primary effects of nicotine, including its mood-altering powers and a tendency to sharpen mental focus and curb appetite, are most attractive at first,” and “just a handful of brushes with the drug can permanently reshape neural wiring, leaving a lifelong craving for more.”  Well, they’ve certainly made the case for why no one wants to quit using nicotine.  So, e-cigarettes as a substitute for smoking aren’t acceptable because smokers just need to quit nicotine entirely, meaning they’ll miss the cognitive benefits, the appetite suppression, the calming and stimulating effects, AND they’ll have a lifelong craving for it.  But that is the price of spiritual cleanliness!

The warning tone of the entire article is based around the purely speculative claim that e-cigarette users are more likely to go back to smoking than are NRT users, despite the subject of the article being an e-cigarette user who has done the opposite.  Bailey explains the reasoning behind this, as with nicotine replacement therapy “you have broken that hand-to-mouth oral gratification habit… With the e-cigarettes, you’re actually encouraging it. I just don’t think people are going to be quitting as easily.”  Apparently, the very reason why e-cigarettes are appealing to smokers is the very reason why they’ll end up smoking again.  The backwards reasoning required to think that a health-conscious e-cigarette user would switch back to smoking cigarettes because the hand-to-mouth action is the same is mind-boggling.

Of course, there is a much more valid reason for why e-cigarette users would switch back to smoking cigarettes, and that would be an active campaign of disinformation with respect to them, waged by the government and health authorities, and their subsequent banning.

-CMNissen (with input from CVPhillips)

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  • Elaine Keller  On September 12, 2010 at 10:20 pm

    The legal battle is not about “whether they should be regulated.” The battle is about which law provides FDA with the authority to regulate the products. FDA claims that the products are drug-delivery combination products that should be regulated under the Food, Drug and Costmetics Act. The vendors maintain that the purpose of their product is to serve as an alternative to smoking conventional cigarettes. The lower court found that the products are recreational tobacco products and that FDA has all the power required to ensure product safety by regulating the products under the Tobacco Act. FDA has appealed the lower court decision.

    If FDA wins, the losers are the smokers who might have switched to this much less harmful product, and the former smokers who rely on using e-cigarettes in order to remain smoking abstinent. If the vendors win, fewer people will die prematurely of smoking-related illness.

  • cmnissen  On September 13, 2010 at 10:38 am

    Thanks for the clarification Elaine. That was another misleading part of the article.

  • rothenbj  On September 13, 2010 at 1:18 pm

    Thanks for the blog rebuttal. I was so fumed by how badly it was written and by the analysis performed by Bailey but, since there was no way to comment, I just wrote it off.

    I started with E cigs over a year ago. I immediately got down from 2 to 3 packs down to a half dozen daily. No original intention, just the way it worked. I stayed that way for about six months, but couldn’t stop smoking and wanted to at that point. Then I found Swedish snus and smoking was gone forever. Seven months later now and not one puff or a real desire to.

    Back on point to the article. I still use my E cig, but the interesting part is when. Generally in social settings where I may have a desire for that hand to mouth activity, I pull out my very low nicotine E cig and it never inspires me to pick up the real thing. Go figure.

    • cmnissen  On September 13, 2010 at 3:03 pm

      One thing that stands out when reading people’s commentary on how they switched from smoking to e-cigs is the ease with which it happened (many people not even intending to quit). Obviously the behavioral similarities in common with smoking play a huge part, but here that similarity is trotted out as a disadvantage. Sometimes the logic encountered in tobacco control makes you feel you’re in the Twilight Zone…

      Interesting comment about the snus. If indeed the hand-to-mouth action was the issue, why not endorse snus? But I suppose, it still delivers a satisfying dose of nicotine (and is therefore, still too much fun).

  • Elaine Keller  On September 13, 2010 at 2:52 pm

    I just listened to a webcast interview with Yolanda Villa and Ron Ward of CASAA. Both are attorneys. Yolanda clarified one legal point. The decision made by Judge Leon was whether to grant the injunction sought by the plaintiffs against FDA product seizures. In deciding this, he had to take into consideration which way the actual case decison might go when it finally is heard. It was his opinion document, rather than the decision, that stated the products should be regulated as tobacco products under the Tobacco Act. This is not a final finding.

    On September 23 the Appeals Court will hear Oral Auguments from the attorneys from both sides regarding FDA’s appeal of the injunction issued by the lower court. The actual court case, which is months, if not years, away from being conducted, will provide the final decision on whether e-cigarettes are a drug-delivery product or a tobacco product. Sorry if that sounds clear as mud, but the legal situation is a tad complex.

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