More Chicken Little from Alberta Action on Smoking and Health

Today in the Edmonton Journal (Flavoured products a blatant ploy to target youth, Alberta anti-tobacco group declares) Keith Gerein wrote

New survey results indicating large numbers of Alberta teenagers are hooked on flavoured tobacco products is evidence enough that the province should immediately ban the items, medical professionals and advocates said Tuesday.

The supposed source for this statement was Health Canada’s 2010-2011 Youth Smoking Survey. To wit

Among youth who had ever tried smoking a cigarette, 30% (about 218,000) had used at least one flavoured tobacco product in the last 30 days, compared to only 1% (about 29,000 ) of youth who had never tried smoking a cigarette.

In my lexicon hooked is not quite the same as having tried something once in the last 30 days. Nor does this seem to be much of a problem if only 1% of non smokers try them (again maybe no more than once in the last 30 days).

Since smokeless tobacco, which as most who read this blog know, is about 99% safer than smoking, you can argue that 1. anytime those people who would have smoked used smokeless instead it was a good thing and 2. there is a chance that someone who might otherwise have become a smoker gravitated towards smokeless instead and ended up with the much less harmful habit. Of course no one wants the kids do be doing any of this – these are toys for adults.

One real problem with this survey is that the flavoured tobacco category conflated smokeless tobacco with menthol cigarettes and flavoured cigars. Considering the vast harm differences between inhaling and not inhaling smoke it would be no different than having a category consisting of e-cigarettes and menthol cigarettes together.

I suspect that Gerein did not read the survey which would have lead to quite a different sort of headline since the findings are that smoking (and marijuana and other drug use, and alcohol use) declined for all the groups. Isn’t that headline worthy? We can’t tell about smokeless tobacco since this was the first time that use was polled.

The language throughout the article suggests it was cobbled together from a press release from Les Hagen given the antiquated but incendiary cliches the anti-nicotine groups like to use. “Fruity spit tobacco” leads off the old argument that tobacco companies are targetting youth through the use of flavours. I have always found the implication that adults don’t like flavours odd. Humans like flavoured products. In fact, one of the things a lot of adult smokers found quite attractive about e-cigarettes, and sealed the switch, was the variety of flavours.

According to the article the most commonly used flavoured tobacco product by Alberta youth were cigarrillos. This seems to occasion a ban on flavoured tobacco products in general (again lumping them with the vastly different smokeless products). The real worry then from a harm reduction perspective is that flavoured smokeless tobacco has been gaining popularity as an alternative for smokers, and as a cessation aid. As the case is with e-cigarettes, once you introduce an effective and satisfying alternative to smoking, if you then remove it, you are then encouraging people back into a riskier lifestyle choice.

If we are going to ban something, why not ban groups from using public money (money from you and me) to agitate for removing healthier alternatives from the market?

Finally, the Health Canada report found that almost all youth obtained their products through social sources. In other words these products are not being sold to minors. I worry that if kids start liking Pernod even if they all get it from their parents that high minders will argue that it should be removed from liquor stores.

On a lighter note, the SAIT student paper had a nice little article by Sarah Pynoo – Health Canada’s E-Cig restrictions deserve to go up in smoke.

As for the criticism that cigarettes could lead towards children and young adults getting hooked on actual cigarettes, it seems a bit silly. For one thing, while both regular cigarettes and e-cigarettes have a variety of flavours, both are only available with ID to those over 18. Also, it’s pretty hard to imagine a kid getting hooked on candy-flavoured, nicotine-free vapour, and switching over to the harsh, lung-burning alternative of an actual cigarette.

We should really be doing this more often…

Over at ep-ology is a posting of some new research re the candy-tobacco issue. It’s called Demonstrating that children believe that deadly tobacco products are harmless candy, an experimental study.

Excerpt:

There has recently been an explosion of organized concern about the risk of accidental poisoning of children who mistake dissolvable smokeless tobacco products for candy. It is already known that that young children may be at risk of ingesting small objects that come within their grasp. However, since tobacco is completely unlike any other consumer product, previous research on other products cannot be considered informative. The nicotine lozenge variants of dissolvable tobacco products have already been implicated in a significant number of toxicant exposure events, which suggests that there is risk that one of the tobacco company products might someday poison someone also.

Several previous studies demonstrate that there is a view that the public health community should encourage worry about the poisoning risk:

An anti-tobacco QUANGO of the Virginia state government calling itself “Virginia Foundation for Healthy Youth” issued a press release [1] reporting that when teens were presented with dissolvable tobacco products without any context, they often thought they were mints or candies. While it might be considered a minor limitation of the study that the methods and actual results of the study were never reported or that the research was designed and conducted by high school students without any apparent supervision by scientists, the subsequent wide coverage in the popular press confirms that it was credible, important, high-quality research.

We’ve been writing off and on about this for years (see Like candy to children and Iowa more worried about candy than cigarettes but take the time and check this latest one out. At least a couple of laughs guaranteed.

Canada’s health experts don’t mind lying to the public

Two items this week once again make me think twice about self-identifying as Canadian. I suppose I can take solace in the fact that one’s country and one’s identity is something quite different from what occurs in the corridors of power, or whenever prohibitionism rears its mishapen head.

The first item, brought to my attention via Velvet Glove, and reported in the Huffington Post, is about a spate of tainted ecstacy related deaths in Western Canada. What is crucial in the report is that the coroner, Lisa Lapointe, had pinpointed the unique look of the bad batch but did not make this information available to potential victims because “We don’t want to give the impression that these are the tablets that are risky, and other tablets are safe”.

While we might not be certain that the other ones are safe, we do know that the ones she found were poisonous, and in the interests of a political and not a health-related aim, she left the public at the same level of risk as before. Her job, as I understand it, is to find out what is causing harm and then taking the steps to reduce the likelihood of it recurring.

What is also remarkable about this is that the most prominent Canadian reports on this ceased to mention that the unique design had been uncovered and that that information was being deliberately withheld from the public.

How provincial are we getting when we need another country’s news agency to report on the most information in a domestic story, and the locally relevant life and death ramifications.

As far as I know, this dereliction of duty has not imperiled Lapointe’s appointment; how do you suppose we would treat a transport commissioner who did not label dangerous roads because that might give the false impression that all the other roads were safe?

The second story did get good local coverage but reported verbatim misinformation (lies to be perfectly accurate about it) from physicians who claimed to be concerned about public health. The story was a bit of a press release/ activism trying to raise support for the banning of shisha (flavoured tobacco used in hookahs).

The “good” doctors don’t seem to have much of a problem with unflavoured tobaccos but just tart up the product a bit and suddenly it is more dangerous.

They start with the old loophole complaint in that tobacco companies responded to the banning of flavoured small cigars by making them bigger and thus not subject to the regulation. What they seem to ignore is the ban was motivated by the belief that kids liked small cigars (which is why they did not target regular cigars in the first place). So if the company, which is well aware that there were plenty of adults who liked small flavoured cigars, sought to deliver a second-best choice to their stranded adult customers, how is that a loophole?
But I digress.

The passage I found such exception to was

Physicians for a Smoke-Free Canada wants all flavoured tobacco products banned, including shisha, because of their appeal to young people. Shisha, flavoured chewing tobacco and other flavoured products are sold with no warning labels, or with small ones, leading the public to believe they are not as dangerous as cigarettes, the group said.

“If Health Canada required these products to carry large health warnings like those on cigarettes, kids would be more likely to understand how harmful these products are,” Kapur said.

I find it quite strange when most of us regular folks are quite concerned about tossing around anything that could be construed as lies or ignorance, that this Dr. Atul Kapur, the leader of a national organization, has no problem parading, in full view, what is certainly one or the other. Insanity or arrogance, take your pick.

As in the case with the ecstacy, health officials are deliberately withholding information from the public which could affect their future prospects. Here they wish the authoritative line to be that cigarettes are no more dangerous than smokeless tobacco.

Of course what we really should all be clamouring for are large product descriptions saying just how much safer these products are than smoking.

More on menthol: contradictions and implications

As a followup to Carl’s post on the menthol issue and specifically in regards to his paragraph on how someone in harm reduction could be torn between supporting any drop in quality of cigarettes (since that would drive people to lower harm alternatives) and the wish to maintain individual liberty, I would like to add a few related (and unrelated) points.

If you pressure people to safer use by reducing cigarette smoking pleasure there is no reason to believe that such actions will remain specific even to tobacco. As the world generally becomes safer, the minimum standards for safety become ever more stringent and relatively low risk and common every day behaviors might end up generating similar regulatory responses. And then you start worrying about the loss of overall quality of life (as in the salt free future of Demolition Man).

Recall that the argument here has been not that menthol cigarettes are more harmful but that for enough people they are more appealing. Or as one Jonathan Turley put it: “The message seems to be: you can sell tobacco products unless they are too popular with consumers”. But you could just as well argue that for even more people non-menthol cigarettes are more appealing so in a sense you are penalizing smokers who happen to exhibit a certain taste preference. Much has been made of menthol cigarettes being the cigarette of choice in the African American community but could it not have been just as easily concluded that Caucasian Americans overwhelmingly preferred non-menthol cigarettes and perhaps that would be a more effective prohibition? The harm reduction argument of course is that some menthol smokers might stop or switch because they cannot abide non-menthol smoking but I would bet the same would be true of non-menthol smokers contemplating a future of undesired freshness.

If removing menthol products actually resulted in some people quitting (and thus lowering their health risks) this would end up as a benefit. However, it would be a cost if all that happens is that menthol smokers keep smoking but enjoy it less. So if there really is that racial divide on this, nobody is telling African Americans they can’t smoke, just that they won’t be allowed to enjoy it as much as everyone else. I doubt that anyone was really thinking this but it should have popped up on the radar considering that only a few decades ago, it was not uncommon to limit that same community to lower quality goods than would otherwise be the rule.

But to move this up to the level of a more general health-relevant concern, people who advocate reducing product quality have as their purpose reducing consumption and not shifting users to safer sources. What we have seen in tobacco is that the FDA flavoured cigarette ban has ended up being the impetus for attempted bans of all flavoured tobacco products and e-cigarettes. If the menthol debate results in menthol reduction demands for cigarettes, it is pretty well certain that it will generalize to smokeless products as well.

What would resolve the issue (from the harm reduction point of view) is if the same voice that promoted reducing the quality of harmful products would also promote high quality in the less risky products. Lower the menthol in cigarettes but leave it untouched in the safer products and actively promote them as mentholated products.

You need to make switching appealing and not just good for you. Safer alternatives should be given all the leeway in the world to be the tastiest nicotine products available. If product appeal drops across the board, there is less of an incentive for anyone to switch; you might as well then just keep on smoking.

By Paul L. Bergen

You were there! At the birth of a new anti-tobacco catchphrase!

Canadian NDP parliamentarian Megan Leslie probably had a few people in the corridors of various anti-smoking group offices hooping and hollering and giving the high fives when they read about what will surely be gleefully repeated whenever possible for the next while..

cancer shouldn’t come in candy flavours

She uttered these fateful words while she was publicizing her quest to make sure that Canadian smokers who are already denied electronic cigarettes will also have no access to flavoured smokeless tobacco (which in the real world translates to most of the good smokeless tobacco). (See the actual bill here.)

She actually got the phrase from a group called Flavour..GONE.

A small group of university students gathered on Parliament Hill Tuesday to demand MPs ban flavoured smokeless tobacco.

The group says the products are aimed at youth.

“When you have stuff like strawberry-kiwi going on, it’s kind of hard for youth not to be sort of interested in the taste,” youth advocate James McInerney said. “There is a lot of kids starting to chew it, and its starting to get scary.”

If someone at the group did the research they would realize that most of these new products are not chewed so it is more likely that the kids they saw were chewing one of the many fruit-flavoured forms of Nicorette.

I know I am making this sound funny however it is anything but. To many people that phrase will not sound ludicrous and will rally support to the anti-flavour cause. Few will notice that it expresses the very opposite of what the case is, that flavoured smokeless products are in fact a means to reducing the rate of smoking related cancer.

For other comments on this particular occurrence and on the packaging of these as well see Standfast.

You know if cancer shouldn’t come in candy flavours then

salmonella shouldn’t come in tomato flavour

concussions shouldn’t feel like skating fast for the puck to score the game-winning goal

skin cancer shouldn’t feel like a tropical holiday

STIs and unwanted pregnancy shouldn’t feel like love

by Paul L. Bergen

Iowa more worried about candy than cigarettes

While not the full out bans being pursued in Utah and Washington, Democrats in Iowa are working hard to have retail restrictions to be placed on dissolvable tobacco products.

This is still a flavor motivated action as indicated on the Iowa Senate Democrats page. This is really quite the “wonderful” article; more misinformation per sentence than can usually be found, and worth addressing paragraph by paragraph.

However to fully make sense of some of this document it might be useful to present some of the expert input they relied on to get the real background on the issue.

Senator Mary Jo Wilhlem meets with Asa Shorkey and Claire Meyer, two children concerned about candy lookalikes that are loaded with nicotine.

I don’t see any of that tasty fruity, mint or cinnamon Nicorette on the table nor do I see flavored Viagra (orange, pineapple, banana, orange, or strawberry) but they could be behind the tic tacs. Also notice that these children are concerned about products they have no legal access to. Perhaps the good senator did not explain to the children that thanks to existing laws they would never come face to face with these products unless they circumvented those laws. Which raised the question of whether we may in fact have evidence of a crime in progress: flouting the laws she herself has sworn to uphold, the senator is exposing minors to products they otherwise not gain access to.

But on to the article:

Did you know that there are new nicotine products being sold here in Iowa that look like candy, smell like candy and taste like candy?

Given the demographics of our expert panel, pre-pubertal youths and politicians, of course they would pick what they are most familiar with as a reference point – candy. Anyone else might express this same exact sentiment as ” Did you know that there are new nicotine products being sold here in Iowa that look appealing, smell good and taste good?”

This is more of that usual nonsense implying that us adults do not want things we put into our mouths to taste good. I, for one, prefer a richly flavored and natty looking dissolvable tobacco lozenge to a bland gray pill, and tobacco companies know this. They need to attract adults to their product if they hope to make a go at it. But these Democrats must be visitors from another planet where children and adults are members of separate species with differing ideas of what tastes good.

But the anti-candy flavor argument which have no truck with anyone who possesses taste buds somehow tends to carry the day.

These nicotine-spiked products come in strawberry, banana and grape flavors to appeal to kids. Eating multiple tablets could cause vomiting, seizures or death.

Nicotine-spiked are they? This implies that these were originally candy products that were then “poisoned” rather than nicotine products that were then flavored. So with flavor now established as sufficiently evil, let’s turn it up a notch and throw in the risk, nay the certainty, of poisoning. Kids will be attracted to these and they will die. This particular unfounded panic, like the unfounded 3rd hand smoke panic, can be traced back to Pediatrics Journal (like Cassandra a doom sayer, but unlike Cassandra, believed more often than not).

I have no doubt that it is possible that eating too many nicotine tablets could lead to many adverse affects (but if we judged products by how they were abused whether by people taking too many or worse, very few products would remain available; Nicorette certainly would not.)

Even before these new products came on the market, tobacco poisoning was a problem. Between 2006 and 2008, the nation’s poison control centers received more than 13,000 reports about the ingestion of tobacco products by children under 6, according to a study that appeared in the journal Pediatrics in 2010.

Nicotine products are associated with some fatalities, but it might interest you to know that since 2004 there has not been a single death associated with nicotine or tobacco, and in 2003 the one related death was from ingesting a pharmaceutical nicotine product (see the AAPCC reports here).

In fact, the focus on smokeless products is rather odd considering how rare it is that children will ingest them. The just over 300 events a year are about half the number of people that are struck by lightning each year. Of course the lightning has more severe consequences with about a 10% fatality rate.

In general children prefer plain old cigarettes, eating them at about ten times the rate they do smokeless products. (The cigarettes are not flavoured so one could argue that the flavourings of smokeless products might actually make them less appealing to children given the distribution of events). To be fair, cigarettes are far more common than smokeless products and thus more likely to be found around the house. (Kids end up poisoning themselves more with quite a wide range of non-candy flavored products).

(As an aside: this whole report implies that this is a new threat. Though a wider range of products have recently hit the shelves, flavored smokeless products are not new. They have been for a long time and if they truly were so threatening we would already have a good history of child poisonings. We don’t.)

With tobacco companies finding new ways to target our kids, Senate File 154 would limit the sale of dissolvable tobacco to tobacco stores where children are not permitted.

On first consideration, the action itself does not sound unreasonable. What could be bad about limiting the sale of these tobacco products to tobacco retail outlets? Nothing at all. Except, as far as I can tell, this rule does not apply to cigarettes or any other tobacco products. So what you have is a regulation that will limit the purchase of safer alternatives to just a few locations which you can interpret either as an impediment to people trying to use safer forms of nicotine or as protecting cigarette sales. It certainly has no effect on children’s access since they are not allowed to purchase them anywhere.

The aggressive marketing we’re seeing from big tobacco companies underscores the need to protect Iowa’s successful tobacco-prevention and cessation efforts, including JEL (Just Eliminate Lies) and Quitline Iowa.

It seems a real concern is that the possible success of these alternative products could put the tobacco control programs at risk. And they could. In contrast to the expensive and ineffective tobacco control programs all they have to do is leave this on the market, make sure it is at least as available as cigarettes, and tell people the truth rather than continue with the lying that not only ignores the science but eats up tax dollars.

But it does not need to be seen as competition. Though JEL doesn’t add much to the debate other than more misinformation mixed with the news everyone already is quite aware of, for some smokers who are trying to quit, quitlines can be of use, just like the option of switching to safer smokeless nicotine products. If the cause is to get people off smoking, to reduce smoking related disease, then quit lines and dissolvable tobacco products both work toward that end. A false dichotomy is being promoted.

In summary, what is happening in Iowa appears to be part of a concerted effort to remove new low risk alternatives from the marketplace, resulting in fewer options for health minded smokers. Whether this is a clever means to protect the lucrative pharmaceutical market or just sheer anti-tobacco ignorance, it is an insult to everyone concerned to use the bodies (and opinions) of children to infantilize the debate.

The kids are already well protected but it seems smokers are unworthy of any consideration at all.

One ban deserves another….

When the FDA banned flavored cigarettes in 2009, an action that resulted in quite a bit of press and plaudits but affected a negligible portion of the tobacco market, one wonders given the lack of any real evidence supporting that action, if it was simply to leverage more substantial actions.

Now we see the threat of a ban on menthol which since it actually affects many smokers is generating some resistance. Unlike ‘fruity” cigarettes which even most smokers did not know existed, menthol is huge. (I am sure the shadowy types invested in the black market are crossing their fingers hoping to see the ban happen.)

But even if the flavored cigarette ban seemed like a lot of ado about nothing, anything the FDA publishes is interpreted as grounds for like and extended actions (such as when their laughable e-cig assay was used to support a potential e-cig ban in the Middle East).

In the first iteration, in New York City, the ban was supersized to include all flavored tobacco products. The same is currently being considered in Washington state but Utah is where the real action is.

In Utah, the ban is being considered for not only smokeless tobacco products but also e-cigarette liquid. And addition to this, only e-cigarettes that have an on/off switch will remain legal.

Apart from our obvious concerns about smokers losing access to good and safer alternatives, these red herring child scare statements, and the nonsense that adults don’t appreciate flavor (because if you argue that flavor is targeted at children you are kind of implying that), this removal of flavor (and that e-cig switch) which are presented as “reasonable” conditions are anything but. They function as de facto prohibitions. (So far the only real complaints have been that pipe tobacco is at risk; Representative Ray suggested they buy it when they are travelling in other states but wasn’t concerned “flavored tobacco is flavored tobacco”.

Vapers and snus users are much more attuned to flavor than smokers. If you look at the user boards and blogs you have a plethora of talk about flavor and experimentation. In contrast, most smoker discussions (other than cigar and pipe) center on rights more than anything. It does not really matter whether this flavor orientation is a function of the products themselves or of how users are contextualizing them but that they appear to be intrinsic to the use. Remove the flavor and you are removing what appears to be quite important to just about everybody using them.

You know they also tried this in Wisconsin but when it was suggested that state money be used to persuade local governments to support a ban, ran up against a spoilsport Representative with with common sense, who said “the state shouldn’t be paying groups to influence local governments or public opinion”.

Now I am not one for conspiracy theories but if I were I just might tie together the facts that:
1. the board of the FDA Center for Tobacco was dominated by individuals with one foot in pharmaceutical products and the other in general anti-harm reduction and
2. Utah is specifically exempting flavored nicotine replacement products from the ban (because there is no way that kids would find candy flavored nicorette appealing) and
3. there seems to be a rising demand across the country that public funds subsidize these nicotine replacement products at the same time that
4. these safer alternatives that seem to actually help people quit smoking are being systematically attacked.

No. That just can’t be right because all those good people really care about you and me and they are working day and night to make sure we don’t make the awful mistake of quitting smoking the wrong way.

-Paul L, Bergen

Like candy to children

Experience helps determine perception. If you let a child have a whiff of ouzo, they would say its kind of like licorice allsorts. And you would be reprimanded for waving liquor in front of children.

If you take a group of children, have them smell some flavoured oral tobacco products and ask them what they think, they will say it smells like some kind of candy they are familiar with. (The better test would be to have them taste it but even though there is no real risk involved, that would be considered tantamount to child abuse, and the authorities would no doubt search high and low for some arcane statute to use to lock you up. But if they did taste it, they would be more likely to notice it was not really like the candy they would actually prefer.)

This most recent “study” (in English, study can also have the meaning of “stupid waste of time”) out of Utah, has state officials along with Santa (yes, really!) exposing children to these products and asking what they thought they were like.

Now, for those who are sticklers for the rules of evidence and such, no worries. This must generalize quite well to the population since all of three children were used but more importantly it did end up on television and online so it does qualify as good evidence that the tobacco companies are targeting children once again. Those bastards!

Actually, I would question whether these children are representative of the population since they seem to have accepted a rather unusual Santa.

Santa demonstrates danger of 'sweetened' tobacco products

Its a good thing it was not tobacco companies doing this study because that would qualify as enticement, but since anti-tobacco officials (and the jolly red fat man) were behind exposing these children to their first experience of tobacco and letting them know that these flavoured versions existed, just for them, it remains good public spirited tobacco control science.

Now, let’s blindfold those kids again and have them smell some fruit flavored sexual lubricants. If they do not identify them as sex aids and rather as candy, then we can be damn certain that those lubricant producers are targeting the child market. And mark my words, take those same kids a few years down the line, and they will be engaging in sex.

(Its laughable but could end up as tragic too since this sort of nonsense could actually lead to banning these products from adult users who otherwise would smoke.)

– Paul L. Bergen

Letting Africa take the hit

Recent WHO-FCTC declarations regarding restricting tobacco flavorings (and other additives) have raised considerable concern in the African burley growing countries (burley tobacco tends to be processed with additives). Their justification in their own words is

One major cause for concern is flavourings and additives being widely used in cigarettes and other tobacco products to increase their palatability and attractiveness – particularly among young people.

Though no one supports the creation of unwilling users, there is certainly some concern about deliberately making a legal pastime enjoyed by millions less enjoyable. Though this is business as usual when it comes to the treatment of tobacco users, there really is no precedent in any other area of consumption.

There is also no evidence that this will do anything other than reduce the enjoyment of smoking. Surveys have shown that kids do not usually start with flavored products (they start with whatever is at hand). At some level of engagement, people are pretty resilient. (Even very particular coffee drinkers will settle for substandard products rather than forgo their drink and most people knowingly eat sub-par food quite regularly.) Smokers who do not have their brand available will usually buy another; at the extreme smokers in prison have been known to roll up patches and smoke them. So all flavor restrictions are likely to do is make tobacco users (because this will affect smokeless tobacco users too) less happy.

Outside of tobacco control, that is known as sadism.

But let’s say just for a minute that the evidence is all wrong and this could really change the world and fewer people would smoke. Given that the developed world is most attuned to quality products, one would expect the greatest drops there. (As a rule, the more money you make and education you have, the less likely you are to smoke and if you do smoke, the more likely you are to quit.) So you have a “reasonable” justification that fewer people will smoke as a result.

And let’s say that this destroys the market for burley tobacco. That is, it is no longer a viable crop for African farmers. Though the FCTC and anti-smoking NGOs suggest they should just take up alternative crops the problem here is that while they are globally competitive in burley, they would be at a disadvantage with any other crop, not to mention that given the characteristics of the soil, only certain crops will grow there in the first place. (Tobacco is a plant that flourishes under conditions where many other plants do not.)

And would the FCTC even dare to proceed in this fashion if this were a developed world industry (this smacks of global paternalism in the worst way). Consider that in Malawi (just one of the nations that would be affected) that burley production comprises 60% of its export revenue and a full 13% of its economy.

Removing (or adjusting to) that portion of the economy of even a strong nation would be momentous but in the case of Malawi where 70% of the nation are already below the poverty line, and where the unemployment rate is a staggering 95% the results of this would be catastrophic.

Even if a burley ban is only a worst case scenario, it is a threat to a country that already is a worst case scenario.

And it seems somewhat immoral to scrabble to add a few more years onto the already long Western average lifespan at the expense of Malawi where the lifespan is under 50. The greatest threat to health is being poor so we could expect a trade here which would result in an even lower average.

What everyone seems to forget in this whole rush to eliminate smoking related disease is that it is actually a sign of great success when smoking related causes lead. What it means is that you have removed high infant mortality, diarrhea, diptheria, cholera, typhoid, and malaria; it means that you are living longer than 50 when most of these luxury conditions kick in.

So as a result of us beating those horrible conditions Malawi is still prey to, we will ask them to bite the bullet so that we can outlive them by even more than the 24 years we already do.

– Paul L. Bergen

Thinking about the tobacco black market

The Canadian Convenience Stores Association have asked “the Federal and Provincial governments to adopt a freeze on new regulation or taxation of legal tobacco products until the authorities have significantly reduced the contraband tobacco rate to under 10 per cent for a sustained period”. (Story here.)

Reports of increased black market activity in tobacco have become quite regular and not surprisingly most often from those countries that regularly increase the price of cigarettes (see here for a good five part series in the illegal trade in Canada, or in Ireland ).

Though people will remain loyal to the usual outlets with reasonable price increases, there is a point at which going elsewhere becomes a better choice, and if the market is as tightly controlled as with tobacco, the only real reduction in spending can be got by going to black market sources.

The odd thing about tobacco is that though the original rationale behind the added tax was to address the increased health costs to society though still a popular discussion point, the argument loses strength when you realize that society as a whole pays somewhat for almost all forms of consumption or activities. However, as common a justification these days is that higher cigarette prices will stop some from starting to smoke and give those already smoking a greater motivation to stop.

That probably works on some people but not quite as well as the sin taxers would like. The problem is that this supply side policy does nothing to change the demand. The person still wants to smoke just as much but now the only difference between before and after is that to satisfy their desire they have to pay more. With every other good, they can sacrifice some quality, they can shop around, find a cheaper brand but with a controlled market they have to leave the market itself, step outside of the norm, to restore their previous quality of life.

Among other factors that could drive one to the market is the increased stigmatization of tobacco use (wouldn’t it be less stressful to purchase from someone who appreciates the business?). But buying contraband instead of licit cigarettes could also function as a political act.

First and foremost, everything should have the same sales tax. Picking and choosing who gets taxed more is simple discrimination and that’s wrong. However, if you are going to discriminate, you must allow another source, so that a product can be bought there as a protest. That’s why the native cigarettes, or “reserve rockets”, are so important. Buying them for a lot of people isn’t simply a matter of saving money, it’s a protest against a government that taxes the product 500% (compared, of course, to the 13% most things are taxed). (posted on LiveJournal)

People have been known to withhold taxes because they do not approve of it supporting a war effort. I can think of quite a few reasons why a smoker would not want to pay the tax that have nothing to do with the amount of money involved.

Some of the money collected on cigarettes goes toward social budgets but only some. That money supports organizations that stigmatize smokers, that actively campaign against safer alternative products for smokers, that on one hand work hard for ever more graphic warning labels and on the other for plain packaging, that campaign for ever more encompassing non smoking regulations, and ultimately use these funds to promote efforts to raise the taxes even higher.

Ultimately the most bizarre thing about tobacco taxes is that the user is giving money to the very people who are doing everything they can to remove any pleasure from their consumption. Instead of a sin tax it should perhaps be called a misery tax because that its purpose, to fund the people who make the lives of smokers ever more miserable.

There is much more to be said on this topic and though it might not appear to relate strongly to harm reduction it actually does.

Harm reduction works best as freely chosen within an atmosphere of acceptance and trust and good information. Any stigma works against effective harm reduction and certainly any actions that drive consumers to black markets do the same. Harm reduction also encompasses the concept of someone not participating. Its all about having all the information, having a range of options (some safer than others) and then having the power to choose.

-Paul L. Bergen