Weekly suggested reading in Tobacco Harm Reduction – 24 August 2011

Must Reads (For American Readers)

US Senate bill would drastically increase tax on smokeless tobacco
For our American readers, we urge you to contact your senators to inform them about the harm this would cause. For more information and analysis, please see CASAA’s page about this, which also includes links for contacting your senators.

Other THR

Survey results shows low knowledge of low risk from smokeless tobacco and other nicotine ex-smoke
A new analysis of a survey from four anglophone countries confirmed that only a small minority understand that smoke-free nicotine products are low risk. (The exact numbers are, as with any study like this, rather meaningless because they are so sensitive to question phrasing and such.) Sadly, the results showed no time trend toward understanding, but the data ended in 2008 so perhaps there has been some progress since then. The results showed that respondents who answered one question correctly (e.g., saying that smokeless tobacco is lower risk than smoking) were barely more likely to answer the related questions correctly (e.g., saying that NRT is lower risk than smoking); this is interesting because seems to argue against the hypothesis that anti-ST propaganda spills over into ignorance about NRT. Rather, it seems that people’s beliefs are a muddle, suggesting that anti-smoking campaigns have managed to dis-educate people about many of the specifics. However, misinformation about ST was worst in the US, where it is far more popular in the other survey countries, which tends to implicate the anti-ST propaganda.
If you read the paper, we suggest skipping the introduction, which contains some of the usual utter nonsense about the topic (in most cases, skipping the introduction when reading research papers about tobacco is a pretty good strategy, particularly if you want to save time and avoid the urge to delete it before getting to the real content); the rest of it is fairly interesting and seems solid.

Latvia proposes to tax and otherwise treat e-cigarettes like cigarettes
We heard that the finance ministry is proposing this, but cannot find a report to confirm it. It seems credible and is potentially very important, since it would represent a non-anti-THR stance by a national government. (It is not quite pro-THR if the taxes would be the same as for cigarettes.) Unfortunately, Latvia has a recent history of being pushed around by international institutions, so it seems fairly likely that anti-nicotine extremists at the WHO will stop this from happening.

Linn County, Iowa votes down proposal to ban dissolvable tobacco
The article starts off with the usual “think of the children” claims, but ends with some heartening quotes from those who voted to get rid of the bill (including one indicating that underage use of tobacco is a “parenting issue”).

British Heart Foundation declares that smoke-free nicotine is not a major heart attack risk
We knew that, of course, but it is nice to see the endorsement. Before anyone gets too excited about this organization supporting THR, however, note that this came in a discussion of a new biological measure of nicotine that correlates with heart disease risk and read: ‘”People using nicotine replacement therapy should not be alarmed by this study,” said Ellen Mason of the British Heart Foundation, “as it is the other chemicals inhaled when smoking, such as carbon monoxide that cause the risk of heart disease, not nicotine.”’ Still, it is a great example of how it is impossible to say lots of true things about nicotine and tobacco and not implicitly argue in favor of THR.
(h/t to Julie Woessner for finding this gem buried in the article)

Nice response to Australian e-cigarette policy statement from consumer advocacy group
A point-by-point rebuttal by Australian Tobacco Alternatives Consumer Association.

Stier calls for Europeans to learn from the FDA scientific review process re low-risk tobacco products
We cannot say that we agree with his positive view of the FDA process, but he makes some good points, particularly that any semi-open formal process is probably better than no formal process.

Swedish anti-snus group claims that snus increases the risk of heart failure
Since these authors from Karolinska Institute are notorious for producing anti-snus junk science using unethical methodology (and then, in their efforts to cover up what they have done, refusing, in violation of Swedish law, to disclose further information), their claims should not be taken seriously until reviewed in detail by someone else. Caveat emptor if you want to try to interpret the results without the help of someone skilled in forensic epidemiology.

Prohibitionist group issues notice that US Army smoking restrictions extend to smokeless tobacco
Presumably they are right (referring to only their factual claim regarding the regulation — not most of their propaganda, given that the article claims that ST is as harmful as cigarettes). Fortunately we suspect that this will have little effect on encouraging smoking instead of ST use, though no doubt the activists will do everything they can to discourage use of low-risk products.

Denmark has more smoking than Sweden or Norway? Shocking!
This article suggests that the Danish press are unaware of the fact that their Scandinavian neighbors have seen much greater reductions in smoking than Denmark because of the substitution of snus. Or perhaps they just do not want to support proven success, free choice and greater welfare when they can instead call for aggressive restrictions? Maybe Oliver Twist (smokeless tobacco from Denmark, with a licorice flavor that only a Dane could love, and that has managed to fly under the radar of the snus police) can save the day.

Related Topics

A compelling short commentary on addiction
The author notes that addiction needs to be defined in terms of a behavior pattern, a useful message for those who think it can be defined biochemically, let alone those who consider it to be mere consumption of a particular substance. More important, she argues that a critical component of addiction is pleasure flowing too easily from a simple act without investment, which argues against calling thoughtful nicotine use (which THR usually is, and smoking sometimes is) “addiction”.

Czech government openly declares that smokers contribute a huge net benefit for government coffers
This is true across rich countries and is common knowledge to experts, but is hidden from the public to justify further increasing the burdens on smokers, and is seldom acknowledged by government. The analysis by the health ministry shows that smokers pay ten times as much in taxes as their estimated extra medical costs. This apparently does not even consider their foregone consumption (reduction in pension payments and such).

In an epic reversal of cause and effect, BMJ blames industry for human desires
Discussing the upcoming UN summit on establishing a nanny superstate (they call it a summit on noncommunicable diseases, but you have to read between the lines with these people), an editorial in the medical journal suggested that if efforts to curtail the consumption of nicotine, alcohol, and yummy foods fail it will be because of industry interference. In keeping with typical disconnect between the medical and international ruling classes and the other seven billion of us, there was complete obliviousness to the fact that the industries exist because human beings like the things they are supplying. It just does not occur to those people that nannyism is resisted because people do not want its results. Here is the link if you want to read it, but we suggest not:

Russian advocate predicts cigarette tax increase could impoverish people
Anti-smoking activists are usually oblivious to the damage that their policies do. Tax increases are the only policy intervention that has been proven to be effective, other than the most effective two: general education and THR. But unlike the other two, they do a lot of damage. They just cut into the entertainment budget of even lower-SES Westerners, but in poor countries (which Russia increasingly is) they can interfere with nutrition and schooling. Of course the extremists are just going to say “well then, people should just quit”, which is a dressed up way of saying “the children of anyone who will not obey us deserve to get inadequate nutrition”.

Tobacco taxes also create nasty crime problems
An interesting human-interest article about how tobacco smuggling is making Canada’s southern border start to look like the US’s.

If the cannot have taxes, the Russians will just strong-arm their neighbors
For example, pushing the Uzbek airline to limit transport of the local smokeless tobacco, nos, a burden on migrant workers and perhaps a way of discouraging THR (though we have no idea about the risk profile of nos) and encouraging the purchase of cigarettes in Russia.

Guardian repeat’s WHO nonsense that hookah smoking session is equivalent to smoking 200 cigarettes
This patently dishonest claim is based on the volume of air inhaled through the hookah compared to how much is inhaled through a cigarette. So, by WHO methodology, just breathing for an hour is equivalent to smoking about 300 cigarettes — pretty typical of the scientific quality we have come to expect from WHO. At least The Guardian did report, albeit buried, some useful information from Kamal Chaouachi.
For a bit more analysis of the story, see Snowdon:

Australian tribunal denies FOI request about plain packaging policy documents
They could at least have required disclosure of all of the government’s evidence that supports the claim that the policy would be beneficial — after all, disclosing an empty folder is not a burden. Last week we reported that Mexico and Indonesia said they would wait to see Australia’s evidence before doing anything like that, and it appears they will be waiting quite a while. The tribunal claim was that it is not in the public interest to release the information about how the government decided to impose this burden on the people; Australia apparently has an odd definition of public interest.

Commentary demands adult ratings for movies with smoking
Yes, we realize that another repeat of such silliness warrants only a yawn (as does the lack of a similar call for zero tolerance for violence, sexual exploitation, and other staples of PG-13 movies), especially given that it was published by the anti-tobacco and pro-censorship PLoS, a publisher that announced that it would not publish research about THR. The interesting bit is that Simon Chapman wrote the rebuttal, arguing that this would not be useful and was inappropriate censorship. Apparently even a stopped clock correctly interprets the evidence and recognizes an unethical proposal twice an hou… well, maybe more like twice a decade.

Psych study of emotional violence images in anti-smoking messages
This has been cited as showing that that disgusting and fear-inducing messages diminish the uptake of warning information, though it really did not show that since it suffered from the usual problem of pschy studies: the measured endpoint is only vaguely related to what the authors claim to have produced evidence about. Even though the results are pretty meaningless, the counter-propaganda value is there: It stands as a counter to the psych research that purports to show that such images do some good (but really does not, for the same reason noted above). For those interested in the actual evidence, there is no real evidence that such imagery accomplishes what it is supposed to, though no affirmative evidence that it has the opposite effect either; the evidence of lack of effect takes the form of the lack of effect where it has been tried.
James Dunworth (Ashtray Blog) also contributed his own survey on the topic, which if roughly equally informative, though few people will recognize that fact.

Facebook causes teen smoking and other drug use?
Of course not, but it is a textbook example of junk science in action, they type of junk that is the basis for tobacco and other drug policy. The sensationalist headlines resulted from a prohibitionist group’s claiming to have found that the small minority of teens who do not use internet social networking are less likely to consume various drugs, a survey conducted by “researchers” who have apparently never heard of confounding. (We wonder what portion of the “unexposed” group are imprisoned, either literally or de facto, mentally or socially low-functioning, or Amish — seriously.) Here is further analysis of how dumb the claim is:
(In response to this series of VGIF posts, one of us mused that perhaps prohibitionist groups should be classified as religious organizations. That would free them to make whatever faith-based claims they wanted, and save them the embarrassment of the junk science they use to rationalize their views. At the same time, it would allow the public to oppose the actual basis of their claims rather than their rationalizations — “you think the world would be best with prohibition; we disagree.”

**Note to readers: If you have written something you wish to see included in the weekly readings, or produce a relevant news feed that we might be missing, please call it to our attention. If you think we missed a specific THR story of note in the previous week, let us know and we can include it the following week. Finally, if you figure you are someone whose feed we are using to help us collect stories — you can probably guess who you are — and would like to be sure to get an occasional hat-tip, let us know and we would be glad to do it (and please do the same for us if we are helping you).

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  • Jonathan Bagley  On August 30, 2011 at 10:47 am

    It is to be hoped that Latvia does not end up treating ecigs like cigarettes for tax purposes. I’m sure that, in the UK, the relative cheapness of ecigs encourages people to persevere with them and find a model which mimics closely enough the nicotine delivery of cigarettes.Note: the UK price for 20 cigarettes is now around 9.70 USD. The same goes for Swedish snus. Were the UK Government to start interfering with the black?/grey? snus market, it would mean an end to a much cheaper and less harmful alternative to cigarettes. I hope they let sleeping dogs lie, but I’m not optimistic. There would, of course, be a huge mail-order contraband market in sub-standard ecigs and unregulated nicotine solution..

  • Elaine Keller  On August 30, 2011 at 3:09 pm

    The Royal College of Physician’s 2007 report states, “If nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.” Products such as dissolvable tobacco orbs, low-nitrosamine snus, and electronic cigarettes have proven to be acceptable and effective cigarette substitutes. Banning such products or discouraging smokers from switching by exaggerating the health risk of these products prevents saving those millions of lives. Is preventing a life from being saved much different from directly taking a life? The effects are the same. Dead is dead.

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