Category Archives: fun

How safe is celery….really…

Judging by the comments on our last post, concerns persist on whether celery is a safe enough substitute for cigarettes. Normally, we would just refer you to our website but it seems we have been remiss in covering this lesser known alternative. But just like e-cigarettes a few years ago, using celery is becoming common enough, and certainly prominent enough with Obama’s seal of approval, so as a precursor to developing a good fact sheet about this, it would be good to cover a couple of points.

(First though an observation and a development regarding Obama’s celery use. Observation: given the sentence “”There’s certainly days where I’ve got to grab a lot of celery sticks to make up for that bad habit that I gave up”” it sounds as though the very seldom smoking previously alluded to was probably a lot more common than was generally conceded. Development: Republicans refused to join Obama in endorsing celery and since the President is unable to pursue any action without consensus, he has now returned to smoking up on the roof of the White House.)

First of all, there is no doubt that using celery is much safer than smoking with the exception of those folks with severe celery allergies. This allergy is less common in North America than in Europe where food labels need to indicate whether they contain any celery but for those who do have it, it can be life threatening.

There has been talk of promoting tomatoes instead of celery for vegetable minded switchers. Not only are tomato allergies almost unknown, since the plant itself is related to the tobacco plant, there is some nicotine which though low level might twig just enough of a response to take the edge of any withdrawal symptoms. And of course, tomato consumption has been linked to lower incidence of cancer. The one worry though is that daily consumption of tomatoes does result in quite the increase in the risk of dementia stemming from being anxious about whether it is really a fruit or a vegetable.

Readers have raised the risk of tinnitus which appears to be too rare to worry about, and possible GI tract aggravation but tomatoes would allay either of these concerns. But the bottom line is that whether you prefer celery or tomatoes they are both preferable to smoking as their consumption is no more risky than using e-cigarettes or smokeless tobacco.

One interesting historical note on this. Using celery as an alternative was first proposed in the 70s but became a casualty of a vociferous faction in the burgeoning women’s liberation movement of the time. These activists were particularly anti-smoking due to seeing cigarettes as yet another phallic tools symbolic of male oppression. Women who smoked were considered (by this group) as undermining female expression and female avenues of power and buying into the patriarchy. This did not last very long. An even more vocal group, known as the Virginia Slims, countered that smoking was not capitulation but an appropriation of male hegemony. But by that time, celery use as a smoking substitute was so stigmatized that it virtually disappeared and only resurfaced in the last few years.

-Paul L. Bergen

Obama criticized for use of unapproved anti-smoking therapy

Reported recently at FoxNews:

US President Barack Obama has a secret weapon in his battle against his smoking habit — celery, he revealed in an interview gaining traction Thursday.

First Lady Michelle Obama said earlier this month that her husband had not smoked a cigarette for almost a year.

In an interview posted late Wednesday, Obama confirmed to that he had given up smoking for good — however the stresses of being commander-in-chief have seen him adopt a healthier addiction.

“There’s certainly days where I’ve got to grab a lot of celery sticks to make up for that bad habit that I gave up,” Obama said.

The POTUS has joined the legions of ex-smokers who have switched to using celery but officials at the FDA and some of the leading voices in public health warn that celery is not a proven anti-smoking therapy and is not a safe alternative to smoking.

Researcher Thomas Eissenburg who has investigated celery as a cessation aid described the results of that work as being inconclusive and not that promising. “We found smokers who had never used celery before and had them try it but found that most of them found it difficult to get a substantial amount of smoke while drawing on the stalk and subsequent cotinine testing found that not enough nicotine was being gleaned for this to really function as a satisfactory substitute for smoking.

Noted urinanalysis specialist Stefan Hesht warned that it has long been know that celery contains harmful chemicals.

Celery has always been known as a salty plant, containing a high level of what is knows as celery-specific salt, or CSNa. Consumption of CSNa has declared by major health organizations, like the Office of the Mayor of New York, to be a deadly hazard. To put the risk in perspective, if you consumed your entire calorie intake for the day in the form of celery you would eat well over 10 grams of CSNa, more than five times the recommended safe level.

When asked to comment on this, Leif Stock, a spokesman for the celery industry, responded that celery was historically considered salty tasting, but modern research has shown that it is actually contains more potassium, known as the “good salt”. He added that no epidemiology had ever shown a danger from celery and that the only tests of CSNa that had ever suggested any risk were animal tests, such as pouring large quantities of isolated CSNa on a garden slug. He added “when eaten in its natural form, the celery stalk poses no measurable risk, even to slugs.”

When asked to respond to this, Hesht replied:

Look, the fact is that when I test the urine of celery eaters, I find high levels of CSNa! It varies a little depending on where your celery comes from, Swedish celery for instance is quite a bit lower in CSNas but I can still measure it and if I can measure it, that means it cannot be healthy.

Among others commenting on this latest action by the President was Johnathan Winickoff, well known for his tireless advocacy in regards to public safety:

Of course being such an influential figure Obama places us in a difficult spot but the bottom line is that celery has not been submitted to the FDA for testing as a cessation aid. We really have no idea of what the long term effects of daily celery consumption are. Is it safer than smoking? Maybe. Do we know for sure? No, Nobody has done the tests that need to be done. I guess one thing I do know as a pediatrician is that celery seems tailor made for kids.

Roni Rabid, previously at the NYT and now at Legacy said that:

this sets a bad example for the kids. Our research has determined that if children see anything stick-like and particularly anything tubular being put in and out of the mouth, those kids are much more likely to end up smoking. This is why often as not you will see me sitting in the dark with Slanton Glance watching those scenes in those movies so we can better save the kids.

However, Jack Amis of the National Grocers Association said that while celery had no official clearance as a cessation aid, he himself was a previous smoker and was now entering his third year as a smoke-free but daily celery user. He said many celery buyers were former smokers or smokers who were curious about whether this would work for them. “We don’t really see kids buying these things” he added.

The FDA’s Larry Ditton said:

We realize that because Obama is Commander in Chief and thus technically part of the armed forces he is not allowed to use Champix or others of the class that could lead to a psychotic breakdown but it really is just a question of semantics. Champix is a proven cessation aid that has worked for a few people and celery is just a vegetable.

We cannot really promote celery in this regard and anyone who does is contravening WHO guidelines. And given the listeria outbreak of last year, our concern for public health means that we will keep fighting to take celery off the shelves until more testing has been done.

Could arguably the most powerful person in the world do a lot of damage due to an adverse reaction to this drug? Of course, and we or our good friends at Phizer would not feel any responsibility for any such actions but, we still believe that this sets the wrong example when instead of a vegetable he could be using one of the many fine drugs available to help him in these difficult times.

But it is not only presidents looking to this alternative. For those on the street, there are many who have found this to be the answer, at least for the time being. One long time celery user who preferred to remain anonymous said:

Other celery users I know feel a bit of pressure to then give up the celery as well but I don’t plan to. If its not hurting me and I enjoy it, why stop? I think what and the shape of what I put in and out of my mouth is my business and nobody else’s. And you know, I could never go back to smoking. Its just not as fresh and after you’ve used celery for a while you get to liking that crunch. I would miss the crunch.

But if they took it off the shelf. I don’t know. There’s a lot of us now and you take it off the shelves and you’ll just have some shady types setting up a green market, and then all these government types will have managed to do is make criminals out of many of us and back to smoking for the rest.

Nobody wants a President enslaved to Big Tobacco but is the tradeoff thousands of kids taking up the evil weed because they saw the big man on the stalk? Given his prominence this might be one case where a private hidden vice is more in the national interest than publicly flaunting an unproven substitute.

-Paul L. Bergen (with input from Carl V. Phillips)

End of the game? The last SuperBowl?

Spurred by the continuing injury rates in high school football and long term chronic health conditions associated with being professional players, Action on Sports or Health (ASH) is putting together a new task force.

The first two appointees come following a distinguished career in tobacco control. ASH Director Borzon said that though this may seem unusual, it was felt that not only was a new perspective needed but that the force had to be composed of people not afraid to make what might be unpopular choices.

People seem to be afraid to suggest an outright ban on the sport but we are going to keep that option on the table. The question we have to ask is: can this country afford to keep subsidizing a sport that adds disproportionately to the health burden?

Professional football players are much more likely to have dementia and Alzheimer’s and at a much earlier onset. Taxpayers are shouldering the heavy cost of long term care for not only these players but for the chronic ailments of many high school players, not to mention ten or so deaths every year, many of them still school age children. And these same taxpayers have to wait in longer lines in emergency rooms being flooded by football and other team sport injuries. We have the advantage of being able to discuss an actual ban since, unlike smoking, removing football revenues would not imperil state budgets.

There’s already been quite a bit of talk among the players and coaches already but we’re just not sure if those are the people who should be working on this. We’re taking a page from the tobacco control playbook and making sure that no one in this task force be compromised by association so no players, owners or holders of seasons tickets nor anyone associated with the sports media. Essentially, we want to block anyone with any knowledge of this sport so that we arrive at untainted solutions.

Borzon also indicated that there was some dissatisfaction with the whole helmet concept in this brutal sport. Though it appeared that there was some advantage to using helmets, it had never been proven through the accepted standard of evidence, randomized control trials.

As far as we’re concerned nothing reduces injuries like just not playing football. You can wear a helmet but its no substitute for just quitting.

Borzon said that while there was a process to satisfy to create a ban, in the meanwhile, they already had some of the funding to start the research. They already had a few good candidate locations – towns with a strong tradition of football and the it was just a matter of taking a few hundred kids, separating them into helmet and not helmet groups, and just following them for a few years

We’ll do the studies but were already pretty sure what we’ll find. This sport is a cost and not a benefit. It stresses the system and if it wasn’t for peer pressure, probably no one would bother. A couple of studies out of California have shown that almost half of high school footballers started after seeing Friday Night Lights or some movie that had football in it.

Years from now people are going to look back and be amazed that we let this go on so long.

-Paul L. Bergen

The whackier extremes in tobacco control: smoking in the movies and in the lavatory

(Before I forget I must thank Patricia over at NicotineBuzz for distributing as much tobacco related news as she does; in the last few days amongst them were these two stories which otherwise I might easily have missed.)

1. ‘54% youth take to smoking due to Bollywood, regional cinema’

We have written before about the ludicrous suggestion that the movies (as opposed to either the real world, or even television) are responsible for a substantial portion of youth taking up smoking (here and here and here and here; what can I say -it’s a great topic!). Well, take that story travelling over a few borders, and as they say, the gloves come off, and we find out that in India, the movies, or Bollywood, is responsible for 54% of youth smoking and 30% of the rest! (Article from the Times of India here).

Gladstone D’Costa of VHAG, pointed out that filmmakers often cited creative freedom as reasons for them to portray smoking in films.

“What is more important? The creative freedom of the film industry or the destruction of 114 lives every hour from tobacco related diseases?” he questioned.

Salkar added, “All creative film directors should visit hospitals offering treatment for cancer and see the suffering the patients endure. Only when the film directors see these struggles will they be aware of the consequences tobacco has on human lives.”

It seems that only the creative film directors should be visiting the cancer wards; plodding unimaginative film directors need not.  The good news is that we can keep Bollywood operating; all we really need to do is get rid of all those creative film directors.

2. Officials: Bathroom Stall Doors Removed To Prevent Smoking

NASHVILLE, Tenn. – Students at McGavock High School have lost some privacy after school officials removed nearly all bathroom stall doors.

School administrators said students have been smoking in the bathrooms, so they removed several stall doors in order to prevent them from lighting up in the lavatory.

Officials said there is at least one stall in each bathroom that still has a door.

Wait til others in tobacco control hear about this innovative move. I suppose staff (or civic minded fellow students) would smell the cigarettes but the malefactor would flush them and then claim innocence.

I can’t help but think that if one stall is left, the smokers will crowd into it while the non smokers will be forced to evacuate in full view of their fellow students. (And while I am sure that in the interests of fairness, the administration probably did the same in their own washrooms, they are probably too modest to say so.)

– Paul L. Bergen

Filed under: this is news?

Really super article in the UK Maidenhead Advertiser titled TV chef’s staff told to butt out.

I thought this was worth repeating in its entirety because it is so groundbreaking, so edgy, and cuts straight to the heart of so many contemporary issues. This is journalism at its finest.

So sit yourself down (but not for too long, bad for you you know -perhaps better just stand pat), take a firm grasp onto your hat, bestill your heart already beating in anticipatory fervor and read on.

Staff working at a celebrity chef’s restaurant have been smoking and leaving behind cigarette butts in a quiet churchyard, say Bray Parish councillors.

They say that Hinds Head employees have been using a bench in St Michael’s Church, to smoke, in a quiet spot used by recently bereaved families.

Cllr Christine Aspey said: “It is disrespectful and a misuse of the area.”

The issue was highlighted at a Bray Parish Council meeting on Monday after the clerk said the council had been approached by Heston Blumenthal’s company with an offer to replace the bench.

The council agreed it would not accept the offer because the company may feel that by replacing the bench, it would mean it owned it.

A ward councillor volunteered to contact the company and ask staff to not use the area.

Speaking yesterday, a Hinds Head spokesman said: “It was brought to our attention that Hinds Head staff were using a bench in St Michael’s Church during break period to smoke.

“This was immediately addressed by our management and stopped. We have offered to cover any repairs or renewal necessary and we are extremely sorry for any upset this has caused.”

I thought it prudent to provide an executive summary for those who either couldn’t make it through that intellectual thicket or who were just too enthralled to keep their eyes firmly on the page.

The story: 1. some people were smoking in an area where other people did not like it 2. they were asked not to 3. they apologized and left.

-Paul L. Bergen

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 ( 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)

A case of life-threatening rectal administration of moist snuff

A colleague ran across this and just had to pass it on. Though it does not exactly qualify as harm reduction, it does raise some important issues. But first the citation and abstract:

Clin Toxicol (Phila). 2010 Jun 19. [Epub ahead of print]
A case of life-threatening rectal administration of moist snuff.

Knudsen K, Strinnholm M.
Surgical Sciences, Anesthesia and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.

Case report. We report a case of self-administration of 75 sachets of moist snuff rectally in a previously healthy, 42-year-old man. He presented with symptoms of nausea, discomfort, and dizziness. He had dry and warm skin, a pulse rate of 53 bpm, a mean arterial blood pressure of 135 mmHg and fluctuations in consciousness. The patient was treated with mechanical ventilation because of respiratory insufficiency. No specific anti-nicotinergic treatment was given. Plasma levels of the nicotine metabolite cotinine were 8,691 mug/L 7 h after admittance and 9,814 mug/L after 12 h. Levels of cotinine in the urine were above >50,000 mug/L. The patient developed a mild pneumonia, but he was uneventfully extubated after 12 h of mechanical ventilation. All physiological parameters were restored and he was discharged from hospital after 36 h. Conclusion. Excessive rectal administration of moist snuff may be life threatening. Patients may require intensive care. Long-term sequelae were not seen in this case

My questions are these:

1. Is this simply a case of misinterpeting the label?

2. If not, does the label adequately warn against stuffing 75 snus packets up your behind? And in case language is an issue, is there a graphic illustrating against this use?

3. Ok, one or two could have been an honest mistake, but 75?

4. Could he have picked up the wrong box and meant really to insert 75 normal suppositories?

5. Is this the start of a new trend related to autoerotic asphyxiation -some sort of deviant sex game gone awry?

6. Is it possible that this gentleman had not heard that Guinness had discontinued the nicotine use category?

7. Isn’t this taking product placement a bit far?

8. How long before this shows up on an episode of House?

-Paul L. Bergen

This is not a parody post

Yesterday’s posting generated the most hits so far of any posting on our blog to date. It was, as most of you discovered, an exploration of how tobacco is reported in the news in the form of a parody. I strove to create something as perfectly camouflaged as possible so as to pass for the real thing but I also made sure to leave many clues indicating that this was in fact a false report. The last thing I wanted to do was to have someone look at it and immediately identify it as false. I wanted to draw you in and then have you laugh when you realized the absurdity within and with that laughter illustrate the idiocy that all too often passes for respectable journalism in this area. (The kind of effect I was going for was either the LOLs which appeared initially (Treece –thanks), the second response from Anon1 which ended up with a thoughtful comment re this issue –thank you. or a combination of the two (Janet –thanks, as well.)

(Now I have to admit that on further musing I realized that doing this on the web was a bit of a sucker punch. After all, this is the home of Wikipedia that often passes as authority even though some of their “facts” are determined by their popularity or by how senior the editor happens to be. People don’t so much read as skim on the web, and like one of our friends did with this, I too, have forwarded some web article with my endorsement before I realized it was not what I thought it was (I have never done the same with any print version of anything). )

A few readers commented that I was in error to mislead with the “I received this in my inbox…” but that was deliberate and served the express purpose of setting up the readers for the longer payoff. Creative writing 101. I was not trying to fool anyone by accident.

No one reading this critically could mistake it for the real thing. Not only is there no United Press Association (and I did my research to make sure of that), no such organization would or could demand the inclusion of specific passages of the sort I mentioned. It is not impossible that some specific anti-tobacco organization might ask all their publications to include similar passages but no news organization no matter how compromised would do so.

While it is true that these phrases repeat in a way and so often that it would seem to indicate some sort of agency at work, like most trends or commonalities, they build up as a result of many independent (even if influenced) actions rather than a result of any controlling agency.

But the biggest clue of all is the ludicrous article attached as an example. Even a bad editor would have rejected the first sentence as ridiculous. And while it might take a 15 second search to find out that those names and the University do not exist, and another rather ordinary article of this type does, the bit about children being scared of tobacco plants is perhaps the most obvious HELLO that this is a send up. I will concede though that the Banzhaf inanity sounds like something he would do.

This was an exercise in bringing some light and fun into the often dry world of tobacco harm reduction. It was meant to be the pastry with the surprising but tasty filling. And for most it seemed to be. But it was also dead serious.

How anyone can interpret this as counter to the aims of THR is unfathomable (and implies that I strayed from some party line). Some have even worried that were this to go viral it would cause harm. I believe the exact opposite is true. One of the main tenets of THR is paying attention to the details and to be critical of the evidence. We like to think that we push our agenda on the basis of responding to the evidence rather than avoiding it as seems to be the case with many of the anti-tobacco groups. THR is all about reading between the lines. And when we research or write about these things, we expect our audience to hold us to the same standards that they would the people they disagree with.

When I read anything by Carl Phillips or Brad Rodu (who I consider colleagues and friends and both of whom have probably forgotten more about THR than I may ever know) I still read with a critical eye (as they do me). Though we agree on many things, at times we disagree as well. I am certainly predisposed toward their interpretations but unlike the opinions expressed in a few comments on the parody, I do not feel that because I know them I should just turn off my filters.

Just to the left of this post you will see our disclaimer. This blog exists in order for us to discuss various aspects regarding tobacco harm reduction but with a kind of freedom and playfulness that is not possible on our website. In academic terms, the website is more like the lecture hall and the blog is the beer seminar. If nothing else, a lot more people than usual got involved here, and part of that discussion involved whether this kind of a posting is at all appropriate or whether I succeeded or failed at what I attempted. And that is good.

Finally, this and the parody post was my creation alone so if you dislike it the blame is mine alone. This blog represents individual opinions and not any group consensus so it is not inconceivable that Carl might disagree with not only my posting but my follow up and may post his own take on this. We’ll see.

Apart from trying to break up the usual straight talk, this was an attempt to apply a few lessons learned from a group that I think does some of the most effective political criticism on the planet; comedians. One good South Park episode or one Louis CK or Bill Hicks can turn on more light bulbs than a hundred academic papers. There is nothing I enjoy more than have my head just about snap off doing that 180 degree turn from acceptance to criticism thanks to the skills of these artists. This was my attempt at the same.

-Paul L. Bergen

SCOOP! Leaked UPA Guidelines for Tobacco Reporting

-The following inadvertently ended up in my inbox via a BCC re a starting writer at a major newspaper who probably was not aware that it was intended to be confidential. There is little need to comment on this since it pretty well speaks for itself.-PLB.

United Press Association Guidelines for Tobacco Reporting

As a new reporter or perhaps as a more seasoned journalist considering taking on tobacco news, this field may at first glance seem daunting. After all, tobacco is not only a major global agricultural product and business concern but also has come to be a focus of both governments and health agencies as a major negative influence on public health. There is a great deal of research being done on and journals devoted to all aspects of tobacco.

But have no fear.

This guide will show you how to master tobacco issues with a few easy steps and create articles any editor will accept (as long as you remember to use that spell checker!) and you will find that in practice, this seemingly complicated area, requires no background knowledge or experience to adequately manage.

Included in this package you will find examples of actual articles that were accepted as well as verbatim passages which need to be included in almost every tobacco relating article to pass editorial muster and to qualify for eventual publication. These passages might seem inappropriate for some articles but history has shown that in almost every case including these passages greatly increases the likelihood that an article will be printed and just as importantly also sends a clear message to the reader that you are a trustworthy writer. As an added bonus, these passages will without any effort on your part other than cutting and pasting, add up to 150 words, and if you are being paid by the word, that is money for next to nothing.

The basic article template is as follows:

1. Don’t worry about the headline: that is not under your control.

2. In your first paragraph have some sort of generic lead into the theme which includes the phrase “tobacco use (or smoking) is the leading preventable cause of death (or disease)”. Though this is ubiquitous in tobacco related articles, paradoxically, it signals that you have done original research and that you are well versed in the topic at hand. (Including this phrase is not optional: you will have some freedom in the body of the article but if you omit this phrase, chances are good that an editor will simply refuse to read further.)

3. In the body, you can simply use your reportage skills and describe the events or issues. As already mentioned, the area of tobacco covers many aspects and oddly enough as long as you refer to death and disease, or express concerns about the motives of producers, it will be interpreted as thoughtful criticism. Even if the concern is for instance about a shortage of water affecting tobacco crops, a collection of historical corncob pipes or whether cigarette butts are a major source of litter, it will only help you to add something about the impact of tobacco use on public health.

This might now seem an over simplification when you will encounter lesser known aspects of the world of tobacco and tobacco use but through experience you will find that when it comes to tobacco, less is always more. If you have explored scientific or health issues in the past you will have had to interview experts for quotes and insight into topics you are new to. You may remember hours spent trolling through expert databases at universities trying to find out who knows anything about nanotechnology, or walking through endless buildings trying to find the professor or scientist everyone is pointing you toward. You will be relieved to find that when it comes to any tobacco issues, any person you use will be accepted as an expert if they happen to be employed in the anti-smoking industry. These people are capable and ready to comment on any tobacco related issues and do not exhibit any fear of helping you in areas that they have no background knowledge in.

One other note on sources. Tobacco issues are also unique in that it is the only area in which you can not only report the opinions of children and teenagers about something that has some factual basis but those opinions can be considered the equal of any evidence. In fact, in this area they are better than evidence, and add that needed human touch to the story. (For example, if you get quotes from children saying they are being targeted by tobacco companies, it means that tobacco companies are targeting them –if you have some background in science reporting this may seem odd but consider that federal agencies and renowned health organizations will use this as evidence).

4. Finally, the summarizing paragraph(s) should contain the phrase “every year over 400,000 people die as a result of tobacco use”. (The only acceptable substitution for this phrase is one which has a global rather than national figure).

The above holds true for all tobacco related articles but if you happen to be writing about any issue that encompasses or refers to second hand smoke in any way, you will need to include, not instead of but in addition to the above, the phrase “there is no safe level of exposure to second hand smoke”. As with the other phrases, there is no need to cite any source since, technically, they fall into the category of self evident truths.

A few general points about writing the article

Back in journalism school, no doubt you were told to show both sides of every story and while that is quite true in most areas, here it has a specific manifestation. If you are reporting anything that is optimistic (let’s say a decline in smoking rates) always follow up with a cautionary note of some kind (but smokeless tobacco use is up). The opposite however is not required. In tobacco, all news is bad news, even the good news.

Some writers have taken the position that as with other areas of journalism, changing the pattern will make them stand out, and they have written tobacco related articles and deliberately omitted the “leading preventable..” and “over 400,000…” phrases. Some of them have even written articles that suggest there may be some benefits to tobacco use or that there might be some downside to higher tobacco taxes. Some have written about the lucrative anti-smoking industry or how current policies actually work against public health. These seem like worthwhile areas for investigative journalism but be wary. Those writers have stood out but where they have stood out is on the unemployment line. Be creative if you like but follow the basic template because even if you get your unique approach by your editor, you will cause confusion in readers who have come to expect these touches no less than they expect good grammar.

Follow these basic guidelines and you will find tobacco reporting easy and quite remunerative. With every state and municipality wanting to report on their individual wars against smoking, and the continual growth in regulations (and even some of the challenges to those regulations, as well as the new products coming out, and the growing awareness of tobacco markets abroad, there is no end to things to write about. Big area, no end of stories, no research required, and this ready template – there is no better area to cover than tobacco.

-and here is one of the articles that was attached to the e-package (PLB).

Article example 1: Insulin produced in genetically modified tobacco plants

Despite tobacco use being the leading preventable cause of death, US researchers have successfully expressed the precursor protein of insulin in lettuce and tobacco plants. Moreover, feeding these genetically modified plants to mice that have a tendency to become diabetic protected the animals against inflammation of the pancreas.

Generating the proinsulin protein in plants is a low-cost alternative to standard production methods, Dr. Lendl Trott, from the University of Florida in Palmetto, and colleagues note in their report in the Plants and Biotechnology Review.

In the study, the scientists describe the creation of lettuce and tobacco chloroplast lines that produce a fusion protein consisting of a subunit of cholera toxin joined to human proinsulin. Giving powered tobacco leaf to diabetic mice helped preserve insulin-producing beta-cells in the pancreas, Trott’s team reports, and this was associated with lower levels of glucose in their urine and blood.

Children who saw the tobacco plants said that “they are scary looking” and “I think they want to hurt me”. The children’s conclusions indicated that the tobacco industry was taking advantage of an unforeseen loophole in marketing regulations so researchers are moving on to using genetically engineered lettuce instead. They add that in light of the encouraging results in animals, testing in humans is now underway.

Despite the potential for helping millions of diabetics, tobacco use is responsible for over 400,000 deaths every year in the United States alone. It is the main cause of lung cancer and a major cause of many more. Cigarette smoke contains over 4000 different chemicals. Deb MacIntosh, the receptionist at the Ohio Freedom for Non-smokers Association said that these scientists have offered no assurance that these plants cannot be cured and smoked. “They might help a few diabetics but just one of these plants if smoked could cause the deaths of many non-smokers. Everybody knows there is no safe level of second hand smoke. We know that stopping tobacco will stop those deaths so it is utterly irresponsible that anyone would engage in this kind of research”.

Another concerned expert, John Banzhaf at ASH-US offered to represent any relatives of diabetics who might have been exposed to this new threat. In the meanwhile, despite the children, scientists continue to research manufacturing proinsulin.

-Paul L. Bergen

Social relationships and mortality risk

This has only the slightest relationship to tobacco harm reduction issues but it is just too interesting not to mention.

Just published in PLOS, the meta-review Social Relationships and Mortality Risks is bound to make the news for some time. And rightly so.

While I can see many points of debate regarding the specifics within the review, the overall conclusions appear to make good sense along the lines of Michael Marmot‘s work on socioeconomic status as one of the determinants of health.

The three questions I have regarding this (perhaps more appropriately characterized as lazy thoughts) are:

1. If these effects hold, what does this mean for other studies on mortality?
Is it a case of some of the traditional causes being weaker than we thought or is it more a case of competing causes where if one thing doesn’t kill you the other will?

2. How do the relatively recent emergence of virtual networks play into this?
Could FaceBook participation actually contribute to longer life or do virtual networks have the opposite effects of increasing the effects of lacks in non-virtual networks?

3. How long will it be before John Banzhaf sees the potential for another billion dollars to chase?
If you recall, though never leaving the anti-tobacco money trough, he was distracted by the anti-obesity issue and went chasing fast food. (He is getting older and food stalls are much easier to catch than ambulances). My prediction is that he will sue divorce initiators for decreasing the life spans of their partners.

– Paul L. Bergen