Author Archives: CMNissen

It’s Official: No More DuMaurier Snus in Alberta

There have been more than a few moments in the last little while where I’ve been nearly inconsolable in my disappointment in the actions of my Canadian government.  One of those moments was when Health Canada peremptorily banned the e-cigarette.  Another was when my friend told me that he had tried to buy duMaurier snus (the only Canadian brand of pouched moist snuff available in my hometown of Edmonton, Alberta) at a major convenience store and was told they were no longer stocking it (Carl wrote about this here).  And yesterday, I learned from two different major convenience store chains in Alberta that not only were they not stocking it anymore, but duMaurier snus had been discontinued.  I could find no official announcement by the manufacturer, and I frankly found it surprising that they decided to discontinue it altogether; could the product really be losing that much money on an ongoing basis (beyond the initial costs, which I realize were great, but they are sunk now) that it was worth completely abandoning?  Especially in light of how Camel snus is taking off in the States, it was a surprise to me.

But then again, maybe it shouldn’t be that surprising.  As Carl has already written about in the above linked posting, a big part of the reason for why duMaurier snus was doomed inAlbertais because of the local anti-THR forces who ramped up their anti-smokeless campaign (which occurred after Carl set up shop at the University of Alberta where he and Paul started TobaccoHarmReduction.org).  Carl has described how the local government and NGO anti-tobacco people basically redirected all of their efforts from being anti-smoking to being anti-smokeless-tobacco after he started educating people there about THR.  The first of two fatal blows to duMaurier snus was the ban on all point-of-sale information (so smokers had no way of learning there was something else they might buy).  The second was an increase in taxes on smokeless tobacco that made duMaurier snus – formerly a relative bargain that might encourage smokers to switch – basically as unaffordable as cigarettes (at about $11 per pack). Restrictions on marketing (which were essentially anti-free speech laws) came into play, and it became impossible for Imperial TobaccoCanada (who introduced the snus) to communicate with their customers anything about the relative risks of their new tobacco product.

It is worth reiterating here Carl’s point about why the anti-tobacco activists were motivated to do these things: because if people found out about the low-risk THR products, they would quite logically start to use them more, and this would undermine the activists’ goal of universal abstinence from all nicotine (regardless of how low its health costs might be). Low-risk nicotine use would undermine the justification for their enormous salaries. In other words, the existence of duMaurier snus (and our group) in Edmonton threatened the existence of the anti-tobacco activists.

Unfortunately, those activists had about 100 times the resources we did, and with Imperial Tobacco basically muzzled, there was very little we could do to counteract the mass media campaign they waged against our group and duMaurier snus.  So it is not very surprising to find that it has, now, officially been killed in Alberta.  I guess congratulations are in order to the Alberta government and anti-tobacco activists, in their victory over public health, and in protecting the cigarette market from competition.

My disappointment yesterday was pretty great.  I generally buy snus online (since the taxes on the local snus successfully drove me away from that product – again, congratulations Alberta government), but occasionally I do use the local product when I run out of my shipped-in snus.  I have convinced many of my friends and family who smoke to use that snus, and I suddenly felt like because some rich activists in an ivory tower somewhere, with goals of purifying people’s behavior rather than improving their lives or health, decided to thwart our desire for better public health, we now have to accommodate them.  Our real life choices have changed for the worst because of them.

Now, there was briefly an unchecked thought that popped up from my subconscious that considered buying a pack of cigarettes instead, but it was vetoed before it took much form, because – as I’ve previously written – I simply don’t enjoy smoking.  However, the story is quite different for at least one of my friends – a former smoker – who has already switched back to smoking whenever he can’t find snus.  I wonder how many others this will have affected in that way as well.

[A note to readers: There are still many smokeless tobacco products available behind the counter at convenience stores, but these products tend to not have the mass appeal that Swedish-style snus seems to have.  They have not been marketed as THR products in Canada, nor do they seem to have made any inroads in that area.  It is important to note, however, that – being smokeless – it is still almost as good as quitting smoking entirely to switch to these products.]

-Catherine M. Nissen

Censorship in Tobacco Control

In a recent post on Tobacco Truth, Dr. Brad Rodu relays his experience with trying to post a comment on an overtly anti-tobacco harm reduction Huffington Post blog.  The original post he was commenting on is filled with misleading information – well, outright lies – on smokeless tobacco.

Rodu indicates he posted a comment rebutting the claims in the blog only to have it disappear shortly after.  While misleading claims on smokeless tobacco (ST) are commonplace, and censorship by those in tobacco control is unsurprising, this experience was made more interesting in that it now stands as a published (and easily accessed) record of censorship by the tobacco control folks.  Of course, the obviously great thing about new media is that it makes it incredibly easy to keep and publish a record of things like this, even if the original content gets deleted. (Too bad there is no PDF of the original posting with the comment intact – mental note to our readers that PDF’ing your comment on a post is a useful thing to do, if you find yourself in a situation where you believe your comment may get deleted.)

In light of these observations, we thought it might be useful to make a collection of similar experiences.  Specifically, we are interested in any examples that are either first-person reports or references to where someone has reported their experience (like Rodu’s).  In the interest of bounding this, we are looking for cases where statements that support THR (including statements explaining the low risks of smokeless tobacco or e-cigarettes, or just correcting attacks on them) were censored.  We know that there are many examples of censorship involving related topics (smokers’ rights, second-hand smoke) but we need to define the bounds somewhere.

Feel free to post them in the comments section of this post, or send them to us directly.  Also, if you have a large Facebook, Twitter, etc. following who might have examples and you want to help our collection, please post a message.  Suggested text (twitter length):

Have/know story of pro- Tobacco Harm Reduction comment being censored by journal/blog/newspaper/etc? THR.o is collecting http://bit.ly/jmOM4S

What’s so wrong with being “second best”, anyways?

As discussed in a recent post on this blog, tobacco control advocates tend to think dichotomously when it comes to tobacco use: they lump behaviour into either abstention or use (with abstention being good, and use being bad).  Most people I talk to (and it seems, even many tobacco harm reduction advocates) seem to consider THR as a second best option to abstinence (creating three categories: smoking, THR, and abstention).  The general consensus seems to be that if you can’t quit smoking, then using a low-risk form of nicotine is acceptable.  If, however, you’re capable of quitting entirely, then abstention should be your only goal.

This categorization makes sense when you consider the political positions that people are in.  If your goal is eliminating the use of nicotine rather than improving public health (as it is with most anti-tobacco groups), then THR isn’t even second best… it’s no better than smoking.  Which is, indeed, the message being sent out by anti-tobacco zealots (with the dichotomies of abstention vs use).  For the THR advocates – who actually factor health into the equation rather than the all-or-nothing goal of nicotine abstinence – it’s a little trickier.  My own opinion on this tendency to place THR in the second best category is that it’s probably the result of trying to be as politically correct as possible in a politically incorrect field.  THR is the “fine, if you absolutely must use nicotine, then at least do it in this safer form” category.  Most of the people who I’ve talked to and who are aware of THR also think that it is the second best option.  The majority of smokers I know who have managed to switch would still like to quit nicotine entirely at some point (although for the years I’ve known them they have not been successful, and some feel a sense of failure about this fact).

From our view, however, THR can be the best option for many people. We’ve discussed the welfare perspective a few times on this blog and elsewhere (like here, here, here, and here), the idea being that abstinence is not necessarily the best idea if you consider a person’s quality of life.  Forcing someone to quit a relatively innocuous drug that provides them with cognitive benefits seems particularly unnecessary; if people benefit from nicotine and have the option to switch to a safer delivery mechanism (and find it satisfying), then using low-risk nicotine products is no longer the second best option, but the best option (this goes even for some people who don’t smoke at all).  In fact, for some, nicotine is such a boon to their quality of life that to go without it would inhibit their ability to function on a day-to-day basis, making the adoption of THR a clear win for them.

(In fact, we can argue that adopting THR is probably the best immediate option for any current smoker, period, since the health benefit of switching to a low-risk product right away is actually better than repeatedly trying to quit and failing over a few months.)

Viewing things in black-and-white reflects a tendency in our society to view things as either winning-or-losing.  Second best is not exactly what most people strive for in a competition; if THR is considered second place to abstention, it seems to infer that since you’ve only merely switched to a low-risk product instead of quit entirely, you’ve lost the race (in particular, the purity race).  And if you think that first place is simply not achievable (abstinence being first place in the mind of tobacco control), or you end up trying to achieve abstinence several times and fail miserably in the process (even though you’ve been told time and again by anti-smoking groups that abstinence is possible for everyone), it’s going to feel pretty damn discouraging (and may end up resulting in learned helplessness).

If, however, the THR option of “second best” is promoted as more of a desirable option (and in fact the best option for many people) rather than just a sad second place to abstinence, we may have more people warming up to the idea.  Since THR doesn’t ask people to make the huge adjustment that abstinence demands (because so many low-risk nicotine products are indeed still satisfying), it’s much easier to adopt.  And because using low-risk products is roughly the same as abstention from a health perspective, then whoever has the biggest number wins.

So why not put smokers in a win-win situation with a quit or switch message?  Either one gets you to a healthier place.

CMNissen

Coming out of the closet as the feared “new user” of low-risk nicotine products

In the spirit of our previous posting, examining the welfare-based case for tobacco harm reduction, I thought I would offer my own experience with it as an example of what I consider to be a success for the welfare perspective.  (For those interested, we have also expanded on the welfarist case for THR here and here, and are just finishing up a more complete analysis that will be out in a few months.)

The cornerstone of the welfare approach is that nicotine is enjoyable and therapeutic and that people want these benefits.  It is thus reasonable to include among those benefitting from THR not just smokers who can switch to low-risk products that still confer many of the benefits, but also people who do not currently use nicotine but who would benefit from it.  The tobacco control crowd calls these the “new users”, and they fear the creation of them because it undermines their abstinence-only viewpoint on nicotine and tobacco, both because it means one less person is abstinent, and because it makes it difficult for them to pretend that most people agree with them.

One of the oft-repeated pseudo-arguments against the promotion of low-risk alternative nicotine products is that people who are interested in nicotine (that is, benefit from it in some way) but that have chosen not to smoke because of its detrimental health effects will start to use these low-risk products upon learning that they are, indeed, low-risk. These new users are not a problem, however, based on the views of most people – including most ethicists and policy analysts – that favor humanitarian concerns over the elimination of drug use for its own sake.  Every such new user represents a win from the welfare perspective, since the provision of accurate information regarding the relative risks of products has allowed a person to make a rational choice to start consuming (and enjoying) something they otherwise would not have.  In other words, it has provided a welfare improvement for someone who makes the rational judgment that the benefits exceed the costs.  I am one such person.

When I first started with the THR.o team I had only occasionally smoked cigarettes.  I had tried smoking when I first came of legal age to buy them because it was a bit of a thrill to do so, and I tried several times over the years to inhale properly, but never did get the hang of it (much to the amusement of observing friends).  Although the nicotine rush was a bit nice, I could never get used to the harshness of the smoke, and quite frankly I just didn’t enjoy it enough to incur the health risk associated with regular smoking.  So, smoking was not for me.  (Although, I am happy to inform the U.S. Surgeon General that I’m still alive despite those brief encounters with tobacco smoke!)

Years later, however, I joined the THR.o team and entered the wide world of smokeless nicotine products.  Once I found out that I could in fact use nicotine at almost no health cost (and without the smoke inhalation that I never could get used to), I quite rationally started to use them.  I’ve become a daily snus user, and I look forward to trying out new kinds and different nicotine levels.  I enjoy using it, and find it helps me concentrate when working and is a pleasant addition to a coffee break.  On some days I use more than others, but I sometimes go days without it.  I’m sure others in the tobacco control community would characterize my attachment to it as “addiction”, but if that’s the case, many other activities in my life fit that description as well (my compulsive watching of a few seasons of 30 Rock comes to mind).

Talk of new users actually gaining something in terms of welfare is pretty much sacrilege in the tobacco control world.  The fact that my experience represents a failure to tobacco prohibitionists (masquerading under the false name of public health advocates) strikes me as their problem, not mine (or the world’s).   I am, after all, an adult who is perfectly capable of making decisions regarding my own health.   The knowledge that authority figures have been lying and misleading to people in the name of abstinence-only not only angers me because it limited my choices for many years, but because it has endangered the lives of people I know and love, who continue to smoke.

Although most people I know are aware of my habit, I still get the occasional raised-eyebrow when I whip out a tin of snus and start using it.   I just say to them, why quibble over something that is about as risky as drinking coffee?  I usually find at the bottom of their disapproval is that pesky idea that humans just are not supposed to enjoy drugs for the heck of it, if you have the choice of being abstinent.  In the words of the estimable Dossie Easton and Janet W. Hardy (who wrote The Ethical Slut): “our culture places a very high value on self-denial, which is fine when there is hard work to be done.  But all too often, those who unapologetically satisfy their desire for pleasure in their utterly free time are seen as immature, disgusting, and even sinful.”   Even though they were speaking particularly to sex-negativity, that thought can be extrapolated to so many more things, substance use included.  So there we have it; and out of the closet I come with respect to my unabashed enjoyment of low-risk nicotine products.

-CMNissen

Taking advantage of scientific illiteracy when it suits them

Speaking of pet peeves (see Carl’s recent ep-ology blog posting), one of mine is the frequent implication in news articles that a certain chemical is dangerous because it is used either in dangerous settings, has dangerous applications, or is an ingredient in another chemical that is hazardous to health.  This is a common tactic used by journalists, lobbyist groups, and even governments when trying to incite public fear about something.

Of course, simply associating something with a dangerous or hazardous material does not mean that the chemical itself is hazardous.  The rule of thumb is that the dose makes the poison, and so by that understanding, everything can be toxic at some level; it’s really only the amount of something that matters.  People are primed nowadays to fear chemicals, and anything that sounds foreign or unnatural (known as chemophobia).  However, everything we touch, see, and smell is made up of chemicals, and anything reduced to its chemical name can sound sinister when presented in the right context and to people who are unfamiliar with chemistry.  Probably the best example of this is the famous dihydrogen monoxide hoax, where students ran a mock petition to get rid of water by using its chemical name and indicating all the terrible things it is associated with (for example, that it can cause drownings, floods, and is used as an industrial solvent and coolant).  Also check out the American Council on Science and Health’s turkey dinner ingredient list (in the spirit of the turkey-eating season being upon us) for more sinister-sounding, but perfectly-fine-to-ingest chemicals.

Unfortunately, journalists and lobbyist groups use this ignorance to their advantage when they want to demonize something.  By stating that something is associated with a hazardous chemical, they imply that it, too, is hazardous.  (Perhaps we can call this “science by implication”.)  This not only takes advantage of chemophobia to create fear, but perpetuates ignorance and scientific illiteracy with respect to our environment.  Readers of this blog will be all too familiar with this tactic, in the example of propylene glycol. Any article that wants to portray e-cigarettes as negative manages to neatly fit in a statement about propylene glycol being an ingredient in antifreeze.  Of course, just because propylene glycol (or any other chemical) may have anti-freezing properties does not make it dangerous, and considering how ubiquitous propylene glycol is, fears regarding it are mostly unfounded.  It is safely used in theatrical fog and asthma inhalers and many other products (like lotions and toothpaste), and has received a GRAS (Generally Recognized as Safe) rating from the FDA.

Another example that people may not be as familiar with is the old claim that there is urine in cigarettes.  This is perpetuated by the “Truth” campaign, which has a game called the “urea collector”, where you get to mop up cat pee with a virtual sponge.  (No, I did not type that with a straight face.).  Urea – also called carbamide – is used in many different products, including toothpaste and chewing gum, and it is an important chemical used in the metabolic processes in animals.  It is indeed excreted in urine, but the way “Truth” implies it, you’d think that tobacco companies had purposefully extracted urea from the urine of animals (cats, in this case), and added it to cigarettes.  In reality, it is just used to lower the pH of cigarettes, but all this is not sensationalist enough for the “Truth” campaigners.  (Note that the belief that tobacco companies add in the dangerous chemicals found in cigarette smoke is what causes many people to move to herbal and roll-your-own cigarettes, mistakenly believing that inhaling smoke from these is somehow safer.)

Dr. Josh Bloom of the American Council on Science and Health recently put it quite well when talking about perchlorate, and how news articles insist on referring to it as an ingredient in rocket fuel and explosives: “What perchlorate is used to manufacture is irrelevant… Such a descriptor is completely misleading and is only referenced to horrify the reader.”  Indeed.  And imagine if the opposite occurred?  No group will ever start promoting the safety of cyanide due only to its  presence in lima beans, spinach, and soy.

(For more information on chemicals and cancer, see: http://www.ncpa.org/pub/st214: “Misconceptions About Environmental Pollution, Pesticides and the Causes of Cancer.”)

 

-CMNissen

Tobacco control does the easy thing, not the right thing

I recently read an article on how humans will tend to do the wrong thing, as long as it’s the easy thing.  The article reports on some research done regarding moral decisions (like whether or not to cheat on a test or help another person out), and researcher Rimma Tepper states that “People are more likely to cheat and make immoral decisions when their transgressions don’t involve an explicit action. If they can lie by omission, cheat without doing much legwork, or bypass a person’s request for help without expressly denying them, they are much more likely to do so.”  For instance, the article describes the results of an experiment where people were presented with the option to check off “Yes” or “No” in response to whether or not they would be willing to assist a learning disabled person, while others had to actively click a link to volunteer to help.  They found that it was easier for people to simply not click the link and avoid volunteering than it was for them to check off the “No” box and explicitly deny their help.   (This idea is quite similar to the organ donor question presented in a TED talk by Dan Ariely awhile back.)

That people tend to be lazy about their moral decisions may not seem all that revolutionary to some, but it is interesting, especially when thinking of this on a larger scale.  In terms of tobacco control, the easy thing to do is to go along with the status quo; smoking bans, graphical warnings, and opposition to low-risk nicotine products are all the rage right now, and it’s far easier to just go along with them all and agree than it is to point out the junk science and try to correct the massive amount of disinformation out there.  The FDA, WHO, and almost all other anti-tobacco groups have fallen in step with this, and the farther they go with their draconian anti-tobacco regulations, the harder it is to go back.  For instance, now that misleading and inaccurate textual warnings on smokeless tobacco have been rolled out, it makes it very difficult for an agency like the FDA to correct them, since it would require them to admit they made a mistake.  They have also expressly indicated their opposition to e-cigarettes, and to suddenly turn back on that decision and admit their error would make headlines all over the world.  For governments and other groups to correct this kind of disinformation would take a great deal of explaining, as well as a lot of policy reform, red-faces, and possible firings.  So, the FDA will continue to do the wrong thing when it comes to tobacco, because it’s the easy thing.

It’s a similar story for researchers in the field of tobacco.  If you decide to take a negative stance on all tobacco products, accurate or not, you will suddenly have access to tons of funding and easy acceptance into journals (no matter how rife with junk science your study may be).   On the other hand, saying truthful things about the relative risks of different tobacco products can get you exiled from conferences, journals, and tobacco control circles.

There is a comedian (I can’t remember the name) who once indicated that politicians who changed their minds about things were seen as wishy-washy, and were looked down on by the public as people who, since they were wrong about one thing, could be wrong about another.  Of course, changing one’s mind is usually a sign of intelligence, not weakness, since nobody is right about everything all the time.  And from me in particular, you won’t hear any “I told you so’s” if policy gets changed to favour tobacco harm reduction products…  I’ll just be thrilled that the right thing is finally being done.

 

-CMNissen

The CMAJ, IDRC, and Barbara McDougall

Recently we came across an article published in the Canadian Medical Association Journal (CMAJ), commenting on the Chair of the Board of the International Development Research Centre (IDRC), Barbara McDougall, and her role as a tobacco industry executive for Imperial Tobacco.  (This is somewhat old news as this article was published in July, but we did not comment on it then, and thought it worth a blog posting.)   Despite McDougall’s resignation from Imperial Tobacco after her role there became widely publicized, these CMAJ authors still call for her resignation from the IDRC, claiming that her resignation from Imperial Tobacco does not sufficiently remove the conflict of interest.  They state that “Given [McDougall’s] role on the Board of Imperial Tobacco, one can only conclude that tobacco control will no longer be a priority for IDRC and the Government of Canada.”  Apparently CMAJ thinks that a single person is capable of subverting a large organization and an entire country’s tobacco reduction plans.

While conflicts of interest of course should be acknowledged, McDougall’s role at Imperial Tobacco was no secret; she had been there since 2004 (three years prior to her joining IDRC), and biographies found through a Google search have her role at Imperial Tobacco listed.  Not knowing the intimate details of the situation I can’t comment on whether or not she was appropriately transparent at the time of her appointment, but in the response from the IDRC with respect to McDougall, it defends its record and states that it “has processes in place to ensure that no single member’s views or interests prevail over what are ultimately decisions by the Board as a whole.”  They also clarify that McDougall’s role was “as an independent, non-executive director of Imperial Tobacco.” An editorial by the Globe & Mail also defends the Board’s “exemplary track record” and calls for it to resist pressure to fire McDougall.

Regardless of all this, however, McDougall resigned from Imperial Tobacco, thus removing the conflict of interest.  The insistence from the anti-tobacco faction and the CMAJ authors that this conflict of interest has not been removed despite her resignation speaks to the prevailing attitude that once tainted by tobacco money, you will always be tainted by tobacco money.  This is no different for researchers working in the field of tobacco; once a tobacco grant has been accepted, you will be publicly expelled from the tobacco control clique, rejected from their conferences and sometimes even entire journals.

It appears that McDougall’s situation became publicized firstly because the Bill & Melinda Gates Foundation pulled $5 million in anti-tobacco funding from the IDRC, stating McDougall’s role at Imperial Tobacco as the reason, and secondly, because the FCTC guidelines exclude the tobacco industry from health groups like the IDRC, because they influence health policy.  The Bill & Melinda Gates Foundation was simply throwing its weight around with respect to the funding. Certainly if you’re wealthy enough, it’s easy to force your ideology onto others and punish those who don’t conform.  And as for the FCTC, the IDRC states that McDougall’s appointment had “predated the adoption of the FCTC Article 5.3 Guidelines,” and reiterates its support for the FCTC and its dedication to following its guidelines.  As we already know, the FCTC – what with its anti-THR and prohibitionist agenda – is unlikely to be anywhere near as successful in reducing smoking-related deaths as THR promotion would be.  The IDRC’s public dedication to the FCTC is even more chilling when we consider that because of the loss of funds from the Bill & Melinda Gates Foundation, there was a re-allocation of funds from other areas in the IDRC to the anti-tobacco area.  No doubt these other areas were likely to have more of an impact in the developing world than any tobacco control program would have.

The indignant cries to have McDougall resign reek of a kind of McCarthyism, and are just a distraction from the real goal of reducing smoking-related disease in the developing world.  To think that having McDougall step down from the Chair of the IDRC will somehow have an impact on smoking-related disease is laughable.  With the IDRC acknowledging their intentions to follow the FCTC guidelines (and the FCTC’s unwavering dedication to the abstinence-only viewpoint), we already know how unsuccessful they are going to be at accomplishing that goal.

 

-CMNissen

They just can’t let a good thing be a good thing

Of course Katherine Heigl’s success in switching from cigarettes to e-cigarettes couldn’t go without some negative spin.  In this exceedingly skeptical commentary on her public praise of the e-cigarette, we find that ubiquitous red herring: addiction.

The fact that e-cigarettes still contain nicotine and are therefore addictive is heralded as the e-cig’s main failing in this article, along with the other usual suspects (like the claim that it has not been proven in smoking cessation, and that it contains dangerous chemicals).  Addiction is that convenient go-to argument for when you really want to denigrate something, but there’s not much there to argue against; a necessary item in anyone’s backpocket arsenal of pejorative terms.  Unfortunately, its normative nature makes it difficult to argue against its invocation (unlike the others, which are empirical claims), and questioning it leads us into a circular argument.  Why is nicotine bad?  Because it’s addictive.  What is addiction?  It’s something bad.

Particularly embarrassing is the article’s quotes from three pulmonary experts, giving shameful advice to smokers to avoid these because they still contain nicotine.  These experts absolutely should be cheering the advent of the e-cigarette, but of course, they can’t just let a good thing be a good thing.

(Note that after I wrote this I noticed Michael Siegel’s post on it from yesterday, and he goes into some of the other statements made in this article.)

And to top it all off, we have Dr. Len Horovitz, a pulmonary specialist, claiming that nicotine replacement aids are the best way to quit smoking – patently false, since quitting cold turkey is by far the most successful way smokers quit, long-term.  That put aside, the fact that the article negatively spotlights the addictiveness of nicotine, and then recommends a nicotine source as the way to quit smoking, is just another example of brow-furrowing, baffling statements made by the anti-tobacco faction.

(Horovitz, by the way, is not new to the “We Hate E-Cigs” fan club… check out this link for some previously-made comments of his.  And it turns out he is a member of HD Reps, a talent agency for broadcasters.  Basically, he’s a convenient source for members of the media who need an opinion on something.  Interesting that he’s getting his 15 minutes from making anti-e-cig claims.)

 

-CMNissen

Stanford Raises the Bar on Useless Tobacco Research

It must be a slow year for anthropologists.

This article from the Stanford University News reports on a research project called “Cigarette Citadels”, initiated by anthropologist Matthew Kohrman.  The point of this project is to map out where every cigarette factory in the world is located, which supposedly “gives the public a better understanding of where the tobacco industry operates, and shares information that could combat the single largest cause of preventable death.”

While I don’t particularly have anything against such research, I do have a problem with the alarmist way this article reports on the factory locations, and the implication that this research will somehow be useful in lowering smoking-related deaths.  Kohrman speculates that perhaps activists may show up on the doorstep of these factories now that they have easy access to this information.  My imagination is taxed as to how that will lower smoking-related disease, unless more sinister actions by activists-gone-vigilante are taken to immediately reduce the supply of cigarettes from certain factories… but I don’t really want to go into that possibility.

Reading the article you would think this research was reporting on the presence of meth-labs in neighbourhoods, not perfectly-legal cigarette factories.  Imagine reading an article that reported on research that mapped the whereabouts of car manufacturing facilities or industrial sugar sources, as if knowledge of these locations would somehow curb traffic accidents and diabetes?

The article states that these factories “sit on sprawling campuses right off American interstates, pop up in the middle of crowded Chinese cities and fill Australian industrial parks just a short walk from tidy residential neighborhoods.”  Good grief, you’d think that they were stalking us.  I suppose the attempt here is to juxtapose these horrific death-factories against normal looking residential streets and rows of (no doubt happily-ignorant) trees.  Certainly the way Kohrman interviews does not give the impression that he simply wants to provide information to people; it’s quite clear he believes this serves some ideological purpose.  In one paragraph he states that just one factory in the Netherlands is responsible for some 80,000 deaths, but then in the next indicates that “The goal of the project is neither to agitate nor defend”.   Perhaps we’re to think that because he outwardly states his research isn’t there to agitate people, then the rest of his agitation-inciting statements aren’t to be taken seriously?

Again, I don’t think there is anything wrong with mapping out the locations of any type of factory, but it is complete folly to indicate that this research will have any impact at all on smoking-related deaths.

 

-CMNissen

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 (http://www.uab.edu/uabmagazine/2010/september/ecigs). 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)