Weekly suggested reading in Tobacco Harm Reduction – 6 October 2011

“Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma — which is living with the results of other people’s thinking. Don’t let the noise of others’ opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.”
Steve Jobs

(see also: http://www.theonion.com/articles/last-american-who-knew-what-the-fuck-he-was-doing,26268/ — not so relevant to our project here, but too good not to cite, and arguably it relates to the FDA cite and a few others below)

Must Reads

New Book by Chris Snowdon
The Art of Suppression: Pleasure, Panic and Prohibition since 1800 covers the history of prohibition, similar ground to his Velvet Glove, Iron First.
We will admit that we have not had a chance to read it yet, but anything on this topic by Snowdon is a must read, regardless of the details. Absent out review, here is someone else’s:

Amusing Enough Not to Miss

Their motto: “That didn’t work, let’s do it again.”
Snowdon makes this amusing observation about the prohibitionist factions (the post is related to THR in spirit only, being primarily about anti-alcohol laws in Scotland), but he points out that the observation about the motto certainly applies to anti-tobacco. Hmm, if only there was something that was proven to work — oh, wait, the motto probably extends to “that works, so we had better shut it down”.

FDA “infographic” on their anti-tobacco effort so far
This is not intended to be funny, of course, but you cannot help but laugh at their “historic advances” that represent nothing but sound and fury, including “reducing youth access” (because until FDA showed up, no one thought to make rules that prohibited kids from buying cigarettes, right?). The best is their closer: “Unprecedented knowledge about tobacco products. FDA knows that more than 4,500 tobacco products exist, where they are made, and, for the first time, the ingredients have been revealed to the FDA.” Yeah, that’ll result in beneficial outcomes any day now. Note to Congress: If you put the FTC in charge of tobacco, they will look at advertising; if you put Homeland Security in charge, they will look at smuggling; if you put FDA in charge, they will look at manufacturing. (Also note the last clever caveat in that quote: it is not that the ingredients were not previously revealed, just not to them.) As for THR, there is, of course, no mention. What would they say, after all — “Our efforts to prevent harm reduction have been successful.”?

Other THR

From the “we already knew that, but perhaps others will catch on” department: HPV, rather than, say, smokeless tobacco, has been the trending cause of oral cancer for decades
A recent study provides further evidence to support what the attentive have known for almost a decade, showing the extent to which HPV seems to be causing oral cancer.

Stier-Conley commentary, The War on E-Cigarettes
Emphasizes the malfeasance by US governments in their advocacy efforts (there is no other word for it).

RJR subsidiary working on anti-depressant that uses nicotinic receptors
“Most new depression drugs today work by increasing the chemicals serotonin, or serotonin and norepinephrine, in the brain. TC-5214 targets a different set of receptors, known as neuronal nicotinic receptors.” “It seems clear that nicotine, which activates the same receptors, can have antidepressant effects and boost cognition, Heinemann said. It is thought that many smokers and schizophrenics use cigarettes to ‘self-medicate.’” The relevance to THR speaks for itself, we think. (Thanks to Bill Godshall for finding this.)

Swedish Match study published
We commented on this before, but it is now in final form. The study looks at a snus-based smoking cessation intervention and finds it effective. Unfortunately, this approach is a perfect example of “lamp-post” research, precisely measuring something we do not really want to know (what happens when you try to get a naive population to try snus in very artificial situations) rather than a decent measure of what we do want to know (will people adopt THR when they learn about it in realistic circumstances). But we understand why companies are motivated to pursue such studies, to respond to the anti-tobacco extremists who pretend to believe (or maybe they are really that stupid) that randomized trials are more informative about THR than the overwhelming more relevant observational evidence we have.

Interview with Phillips re e-cigarettes

Interview with Rodu re e-cigarettes (audio)

Ron Borland commentary supporting e-cigarettes
Abstract is at: http://www.bmj.com/content/343/bmj.d6269.extract
The full text is behind a paywall (great way to get the word out, isn’t it), except that information wants to be free:

CASAA call to action against Boston’s proposed restrictions on e-cigarettes

University of East London running online survey on e-cigarettes.
We do not know about the methodology, politics, etc., but here is a link for taking the survey:

Related Topics

FDA-NIH research collaboration announced
It will be a huge longitudinal study of tobacco users to assess effects of new regulations. Since the effects of new regulations — unless there is a miraculous promotion of THR — will inevitably be trivial, watch for hyping of trivial results and aggressive data-dredging and biased reporting to try to hide that fact.

Canada also spending a fortune on evaluating tobacco control policies
Unlike the US case, this might actually find something, since the predominant effective intervention (basic education) is not in place everywhere, and there might be a few places that could see a tax increase without tipping into the black market. Still, I would bet that for less than 1/100th the $7.4 million budget, we could create a fake research report now that would be difficult to distinguish from the one that will eventually come form this (“…proven effective regulations were implemented in many countries…” [with no actual proof they are effective included, of course] “…much more needs to be done…blah, blah, blah…”).

Australia seeks other goverments’ backing for plain packaging WTO fight
This is a great illustration of the monomania of the anti-tobacco extremists. The WTO has serious flaws that hurt poor people, but some parts of it work as well as we might legitimately hope for, like the parts that push back against pick-and-choose protectionism. But the ANTZ are willing to impose radical and thoughtless change on it to salvage one policy that any sensible analyst realize will accomplish approximately nothing.

Health economist proposes pay-to-quit approach for poor smokers
In an op-ed, Jody Sindelar proposes that smokers who receive Medicaid (the US medical fund for poor people) be paid to quit. What is interesting about this is that it clearly recognizes smoking as a consumption choice and thus changing the cost-benefit calculus can affect it. Also very positive is her proposal that proof be in the form of CO monitoring, and thus adopting THR would count as quitting, as it should. It would be a very interesting experiment to learn how many of these smokers will quit for what price, and thus how great the net benefits of smoking are for them. Not addressed is the problem one of us (CVP) wrote about in his dissertation (and that later became called the “anti-commons” in economics, for those interested): Paying people to give up something they have a right to do, but usually do not choose to do, creates the incentive to “discover” that you want to exercise that right in order to be paid to stop. How long does a non-smoker have to smoke before she is eligible for the quit smoking payments?

Siegel argument supports claim that anti-tobacco organizations will just say anything, but they are just not so smart about what they choose to say
In two recent posts, Michael Siegel predicts that the current lawsuit against proposed US cigarette labels hinges on the whether they constitute forced anti-tobacco advertising and not just fair warning, and that the brief filed by ANTZ groups in support of the government benefits the plaintiffs by arguing just that.

An interesting take on the corner anti-tobacco has put itself in
We missed this interesting column about the rise of activist smokers from Frank Davis during our thin coverage in September. The post (and its interesting comments) picks up on the paranoia of anti-tobacco researchers who justify their suspicious (to be charitable) research practices based on claims of threats. Davis argues that grassroots smoker activism is growing, which might contrast with our observations that the much smaller number of e-cigarettes users have created a more effective sense of identity and social movement.

New American Legacy Foundation report calls for torturing mental health sufferers
The report is about how “tobacco use”, their misleading way of saying “smoking”, is common among those with diagnosable mental illness, which is common knowledge among experts on either tobacco or mental illness. They cleverly avoid pointing out that the reason for this is that nicotine is such a great drug for treating many psychological conditions and demand efforts to make them stop (without, of course, substituting low-risk nicotine). It would certainly be worth looking for cases where use may do more harm than good in this population, but we are never going to get an honest analysis of that from those with a huge obvious conflict of interest (i.e., they are dedicated to the elimination of tobacco). Speaking of COI, it is really interesting in their press release about this, Legacy aggressively acts to hide their huge COI, describing themselves as “dedicated to helping Americans live longer, healthier lives” without saying their real mission is to eliminate tobacco use.

Glantz engages in passive aggressive threats to movie industry
Our catching up on the great writing of Chris Snowdon continues with:
This follows Snowdon putting him in historical perspective in a post that ends, “How strange it is that we have 20/20 vision when it comes to identifying cranks and puritans in earlier times but are so blind to them in the present day.”

New marketing survey about tobacco use, including “dual use”
Some interesting information for those who follow the market — likely better than the “public health” surveys. We notice with amusement that multiple product use is strongly correlated with watching football and NASCAR. Someone needs to tell Glantz — we would just love to see him sending letters to the NFL and NASCAR threatening them.

Louisiana hospital bans “thirdhand smoke”
Perhaps not as destructive as trying to set the precedent for ignoring the WTO, but more troublesome about what it says about the ivory tower of allopathic medicine, a move is afoot to engage in employment discrimination against anyone who has been near smoking. How long until smokers are no longer allowed to visit dying relatives or attend the birth of their baby (we hope that at least the latter prohibition will apply only to the fathers).

**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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