Spilling nicotine: safety concern or clumsy researchers?

It takes something quite spectacular to take my attention away from any of the research coming out of the Prue Talbot labs but I will have to save that for tomorrow or the next day (hint: it comes from an even more disreputable source -Pediatrics Journal- and it has to do with smoking and the movies). But today the Prue.

There is no need to do any deep analysis of this research since it has been covered quite well already by the Old Rambler at StandFast, by Michael Siegel, and James over at Ashtray Blog.

I just wish to add a few additional points.

1. As opposed to any good news about harm reduction, this half baked nonsense is being repeated from here to India by every news agency without any analysis of the content.

2. The researchers conclude on the basis of their concerns about the packaging and instructions that the product should be removed from the market. To go once again to our beloved seat belt analogy, if there was some substandard accompanying information packet with the seat belts or even the odd one that caused an allergic reaction let’s say, would it seem reasonable to take it off the market considering the alternative (driving without)?

Once a product is off the market the greatest impetus for improvement has been removed. There is no assurance it will ever be let back in whereas in market there are customers to satisfy, and in general, products in the marketplace are redesigned to be more effective and safer over time. (This is really the secondary reason: of course the first is quite simply that removing it will result in the premature deaths of many citizens).

3. For some reason, people are taking more seriously the conclusions about the everyday workings of a product from people who are seeing it for the first time rather than the experience of hundreds of thousands who have already been using it for years.

Anna Trtchounian and Prue Talbot seem to be spilling nicotine all over the place and extrapolate their own clumsiness to the world at large. Of course, if you already believe in third hand smoke, any leakage of nicotine, no matter how small, is a serious concern. However, if you are a normal human being, it really isn’t.

This apparently horribly unsafe product is being used quite safely by the hordes, and might I add, much more safely than they could ever could use cigarettes.

4. This kind of research by those who remain quite alien to both the concepts of harm reduction in general (Prue labs discovering harm reduction cigarettes) or the product they are testing (once has a vision of the apes in 2001 touching the monolith and running away chattering and frightened) seems to be gaining in popularity. Not long ago we had Thomas Eissenberg saying there was not enough nicotine in e-cigarettes for the product to actually be satisfying.

This is unfortunately quite consistent with tobacco and addiction research in general where anti-tobacco researchers and advocates have managed to convince the world that only addiction keeps people smoking (no one really enjoys it).

And even more unfortunately, these few befuddled researchers in their labs, who are able to discount the world outside quite effectively, are having a disproportionate influence on that same world they dismiss.

– Paul L. Bergen

Despite what they say, when it comes to tobacco, the CDC is not that concerned about your health

A fairly popular bit of press these days are variations on the CDC spin on the stall in smoking rates (as witnessed here in the Los Angeles Times); of course straight reporting on anything related to tobacco from within the borders of California is way too much to ask for; just take a look at the “put smokers in jail” comments to the article. Let’s just call this another press release pretending to be journalism.

Now I’m sure that the Center for Disease Control is a worthwhile national asset but like Food and Drug Administration, when it comes to working with tobacco, nothing quite describes the machinations or statements like utter hypocrisy.

Even though harm reduction is the traditional strategy when it comes to every other issue in health involving human behaviors, when attention is turned to tobacco users, suddenly it is crazy and radical or, as in this case, it is simply ignored.

True to form, the article leads off with the bad news that one in five Americans still smoke and later how many people will die this year, and all that horrible second hand smoke, and the children, oh the children.
And with the “we are so concerned about health” established, it is straight to ignoring the strategies that would actually have an impact.

If the CDC really cared about smoking related illness, they would be out there banging the drum for smokeless tobacco and electronic cigarettes. Of course, they are already on record as opposing even the appearance of smoking:

As the nations prevention agency we need to protect our youth and the many generations to come from the seduction and influence of any form of tobacco use simulated or real. -Matthew McKenna Director of the Office of Smoking and Health
FDA Briefing July 22, 2009 (pg 10)

No, rather than address solutions which could actually attract smokers, they would prefer to escalate the segregation (which let’s face it affects a lot of nonsmokers too), keep treating them like wards of the state rather than citizens and maintain the current disease rates rather than give an inch to any alternatives that might be pleasurable.

The stall is said to come from some states (like West Virginia and Kentucky) not being quite as tobacco controlling as others (California and Utah). Well, we know about the Mormon influence but the big difference here is not the programs but the fact that the states in which more people are smoking are a lot poorer than the others. It’s no secret that not only do the lower socioeconomic classes smoke more, they are also less amenable to these programs so you have a group that not only has more reasons to smoke but for whom these programs including increasing prices ends up being disproportionately punitive.

Did I mention that if you promote electronic cigarettes and smokeless tobacco you actually undermine the black market? Its better for the economy as well.

But I saved the best bit for last. Apparently, the failure to meet the goals the suits set was because of industry tricks:

Another reason for the recent lack of success in getting fewer people to smoke is that the tobacco industry has gotten better at sidestepping government efforts to minimize smoking, Frieden said. Among their activities, he said, are targeting price discounts at children to get them to start smoking and finding new ways to promote products, such as introducing flavored lozenges to get around the ban on flavored cigarettes.

So, not only are new alternative safer products simply a dirty trick to get around a ban but and I have to say even after reading hundreds of crazy statements this one had my jaw hitting the floor, the “targeting price discounts at children”. That sounds libelous to me. How are you even able to offer price discounts to a group that cannot even legally buy your products (and the evidence indicates that children do not generally buy tobacco, they steal it or get it from parents or friends).

The FDA and the CDC are public agencies and should be working for and not against citizens. All I see them doing is perpetuating disease by vigorously campaigning against proven safer alternatives, and adding to the increasing fragmentation of society.

-Paul L. Bergen

Residual tobacco smoke pollution in used cars for sale: more Nobel-worthy research

I was going to ignore any more of the 3rd hand smoke “research” for a while but this is just much too impressive a work of scholarship to pass up. And as much of the most important and well thought out tobacco related research, it comes out of California.

Though I have not been able to gain access to the source article yet, I believe the abstract (Residual tobacco smoke pollution in used cars for sale: Air, dust, and surfaces) gives us enough to comment on until that time. The lead author, Georg Matt, appears to be running with the ball that he originally kicked off a few years ago (you could say he is to 3rd hand smoke what Glantz is to smoking in the movies).

I’m sure that his team found exactly what they were looking for with their space age measuring devices (imagine a CSI scenario: barely lit but with flashlight beams striking out, and swabs, and knowing glances) -higher levels of nicotine contamination in vehicles used by smokers; the issue is what they have done with that information. The last sentence in the abstract reads: Disclosure requirements and smoke-free certifications could help protect nonsmoking buyers of used cars.

Protect them? So otherwise these buyers would suffer and possibly die if they bought one of these tainted autos? Or is Matt in the market to buy a vehicle and is looking for another way to get a discount?

If we buy the premise that we need to certify smoke free surfaces to protect consumers then any vehicle or structure that used to be smoked in remains contaminated and an actual risk to your health. You would need to be concerned about any airplane that is older than 10 years, any public structure and any house that was not built in the last few years. Though some might have never had a smoker on the premises, most have.

If you care about 3rd hand smoke, wait til they invent a personal device that you can use to scan for any contaminants on surfaces. You will no longer want to sit down anywhere, get into your bed, make food on your counter, and if you bother scanning your food, you won’t want to eat that either. And once you scan your own skin, it will be game over.

A contaminant free world is a sterile world, a dead world. Getting a little bit dirty is normal; it means you are alive.

-Paul L. Bergen

Canadian group adds in their two cents to the smoking in the movies issue

Canadian anti-smoking groups like to strut around crowing that they have consistently been at the forefront of tobacco control policy.

This country pioneered graphic warning labels on cigarette packages, restricting tobacco advertising and adding onerous taxes onto tobacco. We were among the first to have no smoking areas in restaurants. But to out lasting shame, we were remiss when it came to the issue of smoking in the movies.

Now that might have been because our industry was rather small compared to America’s but no more excuses, we are not going to be found lacking even if our press releases are preempted by the great missives of the vaunted Glantz of (to use Chris Snowdon’s spot on phrase) the People’s Democratic Republic of California.

Thanks to Neil Collishaw and the Physicians for a Smoke Free Canada we have even more precise statistics regarding the effect of smoking in the movies on smoking initiation. To wit: “Every dollar in film subsidies may in the end cost Canada $1.70 in societal tobacco losses, the group said”.

Imagine the statistical wizardry involved to come up with that remarkably precise figure. Not $1.67 or $1.74 but $1.70 (and what good luck for the number to come up with a zero at the end).

These are calculated via the flow of Canadian tax subsidies to American film productions and only those that make films that are “intended for young audiences that featured smoking”.

The activist commissioned study had a number of action suggestions which included: “Changing film-rating systems to ensure youth-rated films do not depict smoking except in historical circumstances”. I guess that makes sense since films strive to accurately reflect reality and people only smoked in the past. (Which leads to such bizarre anomalies as Thank You for Smoking where nobody actually smokes, and which logically then should lead to removing any portrayals of tobacco related disease so 80% less subsidies to any films daring to show lung cancer then.)

Another brilliant suggestion was to end all displays of tobacco brands in films and to remove all subsidies that depict smoking in any youth accessible films.

The mind stalls and sputters at the thought of where this is going.

Either you take a Singapore approach to film and remove all potentially objectionable elements (no smoking, no drugs, no crime, no obesity, no harsh talk) or you stop making films for youth. Or maybe you send out more of those vigilante youths who have been snatching the cigarettes from smokers mouths. Enough of that and you can then argue that cigarette free movies are imitating life.

Or perhaps this is even more nefarious than that. Perhaps it is an underhanded assault on e-cigarettes. Smoking in the movies is after all an illusion, so if you can outlaw things that look like smoking, it will be child’s play to outlaw e-cigarettes.

And god forbid these movie going kids start watching television (what! they do?) or read books (well, now that those are all digital it shouldn’t be too hard to remove those references) or even leave the theatre and see smokers on the streets.

Sweeping cigarettes under the red carpet is not the answer.

-Paul L. Bergen

California, marijuana and the tobacco companies

When future archaeologists dig up the remains of California, they’re going to find all of those gyms their scary-looking gym equipment, and they’re going to assume that we were a culture obsessed with torture.

–Doug Coupland

The Coupland quote is not entirely perfect but it does go toward illustrating the absurdity of life in California, a state often seen as odd, sometimes good, sometimes bad, and now a place that paradoxically hosts the anything goes dream factory that is Hollywood, was first in expressing and accepting gay lifestyles and now still the front runner when it comes to being narrow-minded and repressive with respect to health.

Take Proposition 65 which requires warning labels for any measurable levels of hazardous substances in foods (but as many non-Californians are aware, 1. few foods are entirely free of hazardous substances and 2. how much of it is in there matters a lot more than whether it is at all) which has been criticized for confusing consumers about real hazards especially when they appear on the same goods with FDA labels which attempt to provide more realistic guidelines. (See here.) These labels have not only given rise to many spurious lawsuits but have helped increase the already thriving toxiphobia with the healthiest bunch of people in history checking behind each door for some new threat to their goal of living forever.

And it is of course California which is the home of Stanton Glantz and his Soviet style actions to remove smoking images from the movies and from recorded history as well as the hotbed of the disreputable overstatement of 2nd hand smoking effects on heart attack rates. (Note to self: submit treatment to Hollywood re Glantz as deep cover Russian mole working to undermine American freedoms.) And while I am singling out this preposterous state, it is clear that the lunacy is no longer localized, that there is serious competition from Illinois (home of Pediatrics, the proud inventors of 3rd hand smoke), Washington (Banzhaf), New York (Bloomberg) and so many more.

And now the latest from that most interesting place. (And in the interests of transparency, every time I have been to California I have had a great time. But living there must be frustrating.) California (and some other states) has been seriously considering making marijuana legal partly because so many people are already using it without it bringing civilization to its knees and even more because of the budget shortfalls and huge deficits that state is in the throes of. And thought the millions still flow in to fund anti-tobacco research, they are otherwise desperate for money, partly to pay for incarcerating so many drug users.

In the LA Times, the article If pot becomes legal, California’s health will suffer Stanford expert says, the main issue is that there would be increased health costs (could certainly be if more people use it but not if current users simply shift over from the illegal market). Fair point. However what is interesting is the political cant coming from this clinical psychologist (Keith Humprhies):

he says his No. 1 fear is that it would create a lucrative product line for tobacco companies or create an industry that would stand “shoulder to shoulder with them lobbying against every anti-smoking restriction and expansion of public health and every taxation initiative.”

So, the worry here is not so much about health but that legalizing marijuana might lead to 1. some people pofiting from a new lucrative legal product (that sounds pretty anti-American to me), 2. that an existing legal enterprise would expand its product lines (ditto) and that 3. they would express themselves in a legal and time-honored fashion within a supposed democracy.

I have mixed feeling about no smoking policies (many I approve of for purely aesthetic and selfish reasons, and some I don’t for a more defensible live and let live policy) but to be active within a democracy is to hold an opinion and to express it. Though less smoking is without a doubt better for public health, it does not follow that the only reasonable political position is no smoking. Smoking is only one of many things to be juggled to maintain a society which is built partially on respecting self determination.

Psychologist Humphreys should be worried though. Grass smokers are not quite the timid bunch tobacco smokers are. Though active criminals, they have not been stigmatized into inaction; they tend to be much more vocal, and if the statistics are right, they are close to outnumbering smokers.

In terms of harm reduction, legalization is almost always a good thing. Controlled production means quality control which has the potential of decreasing the risks of using. And though anti-smoking is rife with mythologies of all sorts, the effects on smokers themselves are reasonably accurate and this would be a welcome development in terms of marijuana where many users have some pretty strange ideas about how healthy it is. An open licit market means we can better determine how risky it is and how better to minimize those risks, and it makes it easier to educate people about safer alternatives.

-Paul L. Bergen

Schwarzenegger saves lives, and more good news

Few bits of good news out there today:

1. Smokers could get nicotine gum on NHS indefinitely.

From The Guardian, a citizen’s council (not sure at this point how much influence they actually have) is recommending that the National Health Service provide nicotine replacement products (gum or inhalers) indefinitely instead of the current guidelines of a couple of weeks.

The British Medical Association’s position stands as:

“In terms of harm reduction, effective alternatives need to be considered that allow an individual to obtain nicotine without being subjected to the risks of smoked tobacco.”

The BMA supported the use of nicotine replacement therapy products for harm reduction but said they were not licensed for long-term use and were not significantly cheaper than cigarettes.

-Good intentions and let’s hope it is adopted. This has been one of the problems with NRTs and why they are so unsuccessful for so many; that they are discontinued after such a short time. And of course, if society is on about the health costs of smoking, and in regards to how much is already spent in anti-tobacco activism, an investment in providing smokers with supplements is in relative terms quite modest. Or if you want to save even more money; make sure that e-cigarettes remain available and promote them. Smokers will even cover the cost of their own non-smoking efforts.

Which brings us to the big news story from California

2. Arnold Schwarzenegger vetos banning e-cigarettes

Once known as the Terminator, Arnold can add life saver to his list of accomplishments. Nice to see some common sense in a governor, especially one in charge of the most rabid paternalistic health activism in the Union. (See his letter here.)

-PLB