Weekly suggested reading in Tobacco Harm Reduction – 1 June 2011

Must Reads

PMI acquires rights to innovative nicotine inhaler
Philip Morris International joins BAT on the list of major tobacco companies who are openly developing nicotine delivery systems that use extracted nicotine (as opposed to using bits of tobacco leaf).
Associated Press
One researcher/pundit declares that this tech will be the game changer for THR products.

As an aside, it is kind of funny that the tobacco control “researchers”, in their refusal to use normal people’s preferred terminology, adopted ENDS (electronic nicotine delivery systems) to avoid just saying “e-cigarettes”. It was always clear this categorization was clueless, since it is apparent that non-electronic nicotine inhalers will likely soon compete with e-cigarettes, so the useful new category will be for all non-combustion nicotine inhalers. Consumers will probably call them nicotine inhalers or something; any bets about whether those who oppose them go for NINCOMs?

Sign the petition to end the war on drugs
Avaaz has started a petition to end the war on drugs, to be presented to the UN in June.

Amusing Enough Not to Miss

World No Tobacco Day press release, translated
In honor of the fifth anniversary of TobaccoHarmReduction.org (launched to counter what was, even then, the anti-harm-reduction focus of the WHO’s tobacco policies), we translate this year’s official WHO press release, which focuses on the FCTC and employs the standard faith-based science tactic of assuming your position is right and then measuring what you are saying against that standard.

(Note that World No Tobacco Day has resulted in a plethora of news articles reporting on countries proposing anti-tobacco bills in line with the FCTC recommendations which we are not posting here.)

Test your FCTC “knowledge”
But first, a warning: most of the answers to this quiz are made up. Really, this is what the WHO spends their time churning out? How embarrassing for them.
The Freedom-2-Choose blog summarizes the experience for those of you who cannot stand to muddle through it yourselves.

Other THR

FDA signals war on comparative risk claims about tobacco
Some online retailers were warned “they had been illegally marketing tobacco products by using misleading claims that their products carried a reduced risk of tobacco-related disease.” It was not clear if any of these claims were accurate claims about THR products, but it is clear that FDA was actively calling attention to its action as a warning to others and a political signal about its intentions to be rigid about THR claims.

But thanks to lawsuit, FDA will release and stop ceasing e-cigarette imports

Sweden pushing to end ban on snus sales withing EU
Perhaps trade liberalization will prevail where public health has failed. Trade Minister pushes for end to ban based on rules about free movement of goods within EU.

Finland anti-snus-import law fails to halt THR
Despite tightening the law, imports of snus into Finland have not dropped — good news for Finland’s tobacco users and public health. The government cannot enforce its laws, so “recommends that citizens get in touch with their local police force if they become aware of online arrangements for illegal snus trafficking.” If anyone actually does that, Finland might be a scarier place to live than Bhutan. http://www.yle.fi/uutiset/news/2011/05/illegal_snus_trade_flourishing_online_2632353.html

More on why South Carolina snus study appears designed to fail We alluded to this last week, and suggested that the science may be polluted by studies that are ostensibly about THR but are really designed to “show” that THR does not work, or to support only one particular company’s products. Here is a more detailed analysis of that fear as well as why the new study appears destined — and apparently designed — to fail to show the value of THR.

Review study of Norway data suggests snus being used to quit cigarettes The study by Lund, Scheffels, and McNeill found that snus use was more prevalent among former smokers than current in seven previous studies. Caution is required, because this measure is biased in favor of implying that snus leads to quitting, but the results tend to support the claim. The authors commit the common error of suggesting that a randomized trial would be a more appropriate way to measure this, though it would obviously be impossible to do correctly (there are better ways to measure it with observational studies, though). They also confuse selection bias with confounding, do not seem to realize the main sources of bias that are inevitably present, cite a junk study as the source of knowledge about the low risk of snus, and imply that the choice to use snus should be treated as if it were a medical intervention. They also understate the huge THR value of young people adopting snus use instead of ever smoking. Still, the result is decent news for THR. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021722/

Debunking new Karolinska Institute anti-snus study
The authors claimed that snus use causes obesity. What they actually produced was a great lesson in how epidemiology can be twisted to produce misleading claims.
http://ep-ology.blogspot.com/2011/05/unhealthful-news-143-men-gain-weight-as.html http://ep-ology.blogspot.com/2011/05/unhealthful-news-144-new-karolinska.html

Snus in Sweden: not just for smoking cessation
This may sound like stating the obvious, but those in tobacco control (and some researchers mentioned above) need to have it explicitly said to them: Snus also lowers smoking initiation. http://rodutobaccotruth.blogspot.com/2011/06/true-impact-of-snus-in-sweden-smoking.html

At some point, not all publicity is good (e-cigarettes and Hollywood)
Even apart from the personal reputations of paid e-cigarette spokespeople Lindsey Lohan and Charlie Sheen, this approach to promoting e-cigarettes might help some companies but seems likely to eventually do more harm than good for THR. Candid “look what I am using” appearances probably help; making it a Hollywood “thing” has the potential to make it about as populist as PETA or NRDC.

Tacoma WA gets sensible with e-cig regulation
They backed off a proposed total ban, acknowledging there is no justification, and are now considering a public-space indoor use ban with an exception for bars and a few other places. Many e-cigarette advocates object to any indoor ban, but there might be a sensible compromise here.

Vapestock 2011
To be held in Clearwater, Florida, June 10-11.

Related Topics

IHRA-associated conference organizing corporation bankrupt
We reported last week that Harm Reduction International (formerly and better known as IHRA) cancelled their 2012 meeting. It is now reported (via email – no link) that the Conference Consortium, the corporation that existed mainly to organize conferences for IHRA and some related groups suffered major losses from this year’s Beirut conference and is being liquidated. The loss was enigmatically attributed to “the political situation in the Middle East and the response of western governments” and that they “misjudged the capacity, ability and enthusiasm of local conference partners in the organisation, planning, promotion and fund-raising for the event.” Interestingly, “The Consortium negotiated arrangements with the proposed venue for next year’s conference, in Adelaide, that would allow for the contract to be transferred to IHRA/HRI and their local partners.” This tends to support our theory that IHRA/HRI could have gone forward with their conference, but chose not to for other reasons.

Physicians for Smoke-Free Canada openly advises its supporters to lie to the public
Michael Siegel exposes how the dominant anti-tobacco QUANGO in Canada has published a guide that calls for supporters to produce disinformation about trivial exposure to ETS and the effects of smoking bans on behavior. It is not surprising that this is their playbook, but it says something about the institutionalized disregard for science and truth that they openly publish it.

India plans to make graphic “warnings” on smokeless tobacco uglier looking
India (like other poor countries who are much more cowed(!) by the WHO than are Western countries) continues its push to be more knee-jerk anti-tobacco than its neighbors, a trend which is flying under the radar in the world news. This was widely reported as introducing graphic warnings, though actually those already exist — the new graphics are the type intended to just make the package so unpleasant people want to avoid it, the equivalent of requiring that they be made to smell bad. The justification is “ Smokeless tobacco is responsible for 80 per cent of mouth cancer while 20 per cent of mouth cancers are occurring due to smoking” — and no, that is not from some backwater county health official or random activist, it is from the current Minister of Health! Do we detect a hint of trying to blame someone for one’s own poor performance?
The Statesman

Have anti-tobacco measures become the way lowly health ministries try to impress the Great Anglo-Europeans at WHO?
At the risk of sounding racist, it is really starting to feel like a competition to implement draconian or pointless FCTC measures has nothing to do with helping one’s citizens, and everything to do with impressing the rich white guys in Geneva and maybe getting asked to the prom. How else can we explain behavior that includes official government statements like “Bhutan is still ahead”…
…or India’s government considering subsidizing nicotine gum, priced at approximately 20,000 rupees for a full course (India’s annual per capita GDP is only about 55,000 rupees).

Though this theory does not explain everyone...
The European Commission reports that it is considering new rules “adapted to international tobacco control commitments” regarding a variety of FCTC-type measures. Sadly, this explicitly incudes “Regulatory solutions to address novel smokeless tobacco and nicotine products.” (Great bureaucrat-speak, isn’t that?)

Harm reduction opiod becomes drug of choice in prisons
Or so the claims goes — there might be a little of the usual exaggeration. But if the NYT story is to be believed, Suboxone (a buprenorphine cocktail) has become a favorite for smuggling in. Perhaps overlooked is that this is good news compared to other drugs that might be used.

Further corrections of Simon Chapman’s pseudo-scientific ramblings
It turns out there really are cigarette black markets in Australia. Imagine that.
Related: a nice summary of how cracking down on black markets is not only harder than Chapman thinks, but causes violence.

Anti-Chantix words and action increase in the face of cover-up of fatal events
Many suicide and other violent incident reports were “lost” due to misfiling.
In response to the worries, France removes it from reimbursable drugs list.

WHO and others taking a “reefer madness” approach to hookahs
Hookah smoking has risks that are probably of the same order of magnitude as similar-intensity cigarette smoking, though the data is so weak it is difficult to know. Tobacco control activists seem to be are making a concerted effort to portray it as much worse than cigarettes, trying to keep it from becoming popular in the West, particularly using WHO’s claim that “a hookah session as bad as smoking 100 cigarettes”, which defies credibility.
If that claim were true, the shifting back to hookahs in lands where they are native, when cigarette prices are pushed up, would be very troubling.
The Egyptian Gazette

European Harm Reduction Network meeting in France
To be held in Marseille, October 6-7, 2011

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