Tag Archives: fda

Gulf States discussing total ban of e-cigarettes

Just yesterday the GCC Health Ministers Council (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and UAE) set the stage for a total ban of e-cigarettes.

A statement issued by the conference underlined the “necessity for imposing a total ban” on e-cigarettes in line with the WHO guidelines and the findings of recent studies on the product.

Anti-smoking activists in the region have been campaigning for a ban on e-cigarettes, which are used as an alternative for traditional cigarettes, on grounds that it is more dangerous to the users compared to the traditional cigarettes.

I’m not sure why the level of misinformation regarding e-cigarettes is so astonishingly high in this part of the world but every few weeks there seems to be another outrageous statement such as:

Water vapour is absorbed by lungs, which can cause even lung cancer, says WHO report.

The US Food and Drug Administration (FDA) recently issued a warning to e-cigarettes users after it found the sticks contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreezes.

The recurring two items that seem to show up in almost every one of these articles out of this region are the FDA findings and the WHO advisory.

Oddly enough, the WHO advisory simply stated that there was no evidence yet for long term safety, and no non-anecdotal evidence that would support producers making cessation claims. This now close to three year old and rather restrained communication has through the wonder of the embellishment machine we call the media become a howling warning of danger.

And quite similarly, despite being widely dismissed as substandard work, the FDA report has become the official word on e-cigarette safety. What I fail to appreciate is why this report ever assumed the stature it did, and why (in the world) it achieved any prominence outside the borders of the United States. (Yes, I know they are a big country, and the FDA is well known but still, these are independent countries with their own research facilities, and some sense of national pride, are they not?)

Now of course it is quite possible that, just like most everyone else, the powers that be have an end in mind and then cast about for supporting (and tweakable) views.

One of the issues here is that we have authoritarian or tending toward authoritarian governments using tools generated in regions that are less so. As misguided as the FDA is, various agencies and the population itself act as checks on them, and as cynical as we might be about that process, it is still much more likely to end up benefiting the many than what happens in many other parts of the world. But then, these same tools generated in a democratic context, even if discarded on the home front, are then picked up by others to use.

So in summary, we have a substandard product assay from a far away country (otherwise often demonized in this part of the world) and a warning about proper product description from an international health agency being used as the main evidence to support the actions of a government to remove the availability to its people of a safer alternative to smoking.

And this too will be chalked up as a victory for the anti-smoking forces.

-Paul L. Bergen

FDA Loses Appeal, Can’t Ban E-Cigarettes as unapproved therapy (yet!)

[Corrected Version — see end]

A U.S. Court of Appeals today issues a judgment prohibiting the FDA (and thus the police powers of the U.S. government it was employing) from keeping NJOY (and thus others) from importing e-cigarettes into the country as an unapproved medical device/drug.   This is good news indeed for public health.

But let’s not get too excited yet. No one wants to rain on a parade, in particular when most of the news regarding this truly remarkable alternative to smoking tends to be either composed from fabricated health concerns or just dismissive.   Had this ruling gone the other way, e-cigarettes in America would truly have been in jeopardy.   So the first instinct is to be elated (and you will find plenty of that in almost every other blog about this, we would guess) but, and the metaphors are starting to pile up here, the war is not yet won.

Law and facts can change.  The appeals court emphasized that FDA had produced no evidence that anyone had ever been harmed by an e-cigarette, but the extremists tend to find whatever they are looking for, whether it is there or not, so though the evidence may not change, the “evidence” may change and another case might follow. As the appeals court pointed out, Congress can always choose to change the law so that e-cigs can be regulated however the FDA prefers, or could even ban them outright.

The law is what it is, and need not have anything to do with what is good for people. Eventually in free societies most laws find their way to being good for people, but there can be a lot of detours on the way. The court said that the law says that FDA’s new authority over tobacco means that they can only regulate e-cigs as they do other tobacco products, not as therapeutic devices (so long as the manufacturers do not make therapeutic claims). Kind of an amusing irony. But our amateur reading of the law suggested that interpretation was far from certain, and we will admit that we are not entirely sure whether an appeal to the Supreme Court or some new case might change this.

We as scientists, policy analysts, educators, and THR advocates have strong opinions about what the law should say in this matter, but find it unclear what the law actually does, let alone will, say. We were asked to file a brief in this case but declined because the decision was about what is allowed under regulatory law –something that we have some knowledge about, certainly, but cannot claim expertise. Though public health concerns entered the discussion, this was not a decision about what is right for public health or liberty.

From a public health and good government perspective what FDA did was unconscionable anti-tobacco extremism, and Americans’ health, welfare, and liberty were well served by this decision.  But the same FDA that wanted to ban these products will be regulating them as tobacco products, and is likely to target them to discourage THR and to flex its muscles, especially after being embarrassed the first time around. Among the FDA arguments leading to the decision was

“The FDA has also offered a consequentialist argument, namely, that understanding Brown & Williamson in this fashion leaves the FDA severely thwarted in any effort to nudge e-cigarettes toward relatively healthful forms (or at least away from relatively unhealthful ones).”

On the face of it, this is a rational argument for making products safer which would be to the public good. But the power to regulate is the power to destroy, and FDA can easily create safety regulations that effectively bring about the ban they wanted. Moreover, we already know that in tobacco regulation the FDA seems intent on focusing on products in isolation, making cigarettes a little bit safer and perhaps making smokeless tobacco a little bit safer, but ignoring the fact that all smokeless tobacco (or e-cigarettes) are safer than all cigarettes. In other words, the FDA claims to want to promote harm reduction at the product level but not at a user or population level. And the extremists still call the shots there, and they are far more intent on stopping people from discovering low-risk products than they are about reducing use of high-risk products.

In summary, the news is good even if it is not perfect. This has been a very good day for e-cigarette users, for smokers, and for public health in general. Let’s hope it is more than just one good day.

[This version reflects a correction of an error: We thought that this decision meant that there had to be one more final decision in the legal process to confirm it, rather than it being the final world as it is (unless the Supreme Court weighs in). This is further evidence that we should not be offering opinions about what the law says!  We will stick to assessing what it should say.  That and our main points here: our concern that the law could easily change and the concern that FDA still gets the last word.]

– Carl V. Phillips

FDA effectively shutting down e-cigarettes


Tamping down the urge to simply rant and rage against this “regulatory wrath” I find myself somewhat at a loss regarding the legal niceties at play. I just cannot tell if the FDA is acting within or outside its jurisdiction. But even if they do have the power, this is just plain wrong.

In January 2010, on the determination of just authority, Judge Leon ordered that:

“the FDA shall not detain or refuse admission into the United States of [Smoking Everywhere’s and NJoy’s] electronic cigarette products on the ground that those products are unapproved drugs, devices, or drug-device combinations.” (quoted in Brad Rodu’s excellent discussion of the decision)

Subsequently the FDA won a stay which allowed it to ignore the injunction until their entered appeal is heard. Since then CASAA along with Smokefree Pennsylvania, The American Council on Science and Health, National Vapers Club, Midwest Vapers Group, Michael Siegel, and Joel Nitzkin submitted an Amicus Brief in support of the Leon decision.

Now the FDA has sent warning letters to five electronic cigarette manufacturers, one being Gamucci whose website has already come down (at least this afternoon as I write this). Reading these letters indicates that the FDA is treating e-cigarettes as drug delivery devices and arguing that they have not met the appropriate regulatory standards but I suspect that some of these arguments might still hold up if these products were treated as recreational tobacco products.

For instance, the FDA takes exception to any claims that this device can facilitate quitting smoking or is safer than smoking. As a tobacco product, they would definitely not be able to make those claims, even if they had plenty of supporting evidence. However, if they were in the tobacco category, and made no health claims of any kind, or of helping people quit smoking, there should be fewer barriers to them being available and thus even if not allowed to openly claim reduced harm could still as with smokeless tobacco be used by nicotine users for that purpose.

Back in 1987, a product very much like the modern e-cigarette was also turned down for being a new drug delivery device (originally noted on the NJOY site, and here is the official document). And the concerns of safety appear to be about the nicotine being addictive.

The FDA letters sent out today sound like rational responses to new unlicensed products and in a sense they are. We should not jettison quality control simply because a great opportunity presents itself. However, this particular small minded approach does not fit the big picture issue of the ongoing burden of smoking related disease (which in other respects the FDA appears to deem important), and the way e-cigarettes have already been operating in the culture as one of the easiest and most effective ways to quit smoking (without being promoted as such).

With any luck another judicial challenge will stay the execution of this product but this brought to mind my own dystopian daydream some time ago when the MHRA challenge in Britain first arose, and in memory of the Canadian ban which came slamming down so soon when this product came out. The daydream, which echoes the 1987 stop, was of years from now looking back at this time and thinking we had had one of the best answers within our grasp and it was shut down, and ironically it was shut down through a combination of simple bureaucracy and anti-smoking sentiment (the latter being most ironic of all).

Suppose now if the 1987 e-cigarette had come out in that year and been as successful as they are now. 23 years of smokers switching over. The math is beyond me but even if 20% of smokers switched there would be hundreds of thousands more alive today.

-Paul L. Bergen

FDA: Institutional culture a bad fit for dealing with tobacco

I have another post due up soon but in the meanwhile wander over to ep-ology where Carl has a thoughtful post on how the institutional culture at the FDA does not portend for the best when it comes to determining good tobacco policy.

Excerpt:

An institution that is used to being obeyed, and that does not function well in a realm where that does not happen, and that primarily measures life years saved and dollars spent and ignores most other human desires. Merge in a political movement that has been itching for more police powers and tends toward utopian (i.e., overly optimistic fascism) extremism. I am not sure whether the better metaphor is The Drug War or Afghanistan. Either way, I fear that even most of the pessimists have not predicted just where this is going to end up.

FDA’s Lawrence Deyton at the Tobacco Merchants Association conference

A few weeks ago at the TMA (Tobacco Merchants Association) meeting in Virginia, Dr. Lawrence Deyton told a story in which he recounted his experience as the primary care physician for a veteran who almost died from battle injuries suffered in Vietnam, then AIDS (which ended in remission), then drug addiction and kidney disease, but then ended up dying of lung cancer quite likely related to his lifelong cigarette habit. As Deyton put it “”The battlefields of Vietnam didn’t kill him; his use of drugs didn’t kill him. His HIV didn’t kill him; his kidney failure was being treated. . . . It was smoking that finally took that soldier.”

The story was told to illustrate his motivation in his new position as head of the FDA’s Center for Tobacco Products.

The Center and in particular, the recent stacking of the Scientific Advisory Panel with anti-tobacco extremists has come under criticism from harm reduction advocates in its concentration on trivial concerns in comparison to the huge benefit within reach simply by advocating safer tobacco products for smokers, a conclusion that any honest health researcher would arrive at within a week of surveying the topic.

The misplaced emphasis of this department is mirrored in Deyton’s flawed interpretation which misses the crucial point that this soldier would probably still be alive today if he would have used some smokeless form of tobacco, and it is quite likely that if he thought about switching at all, the lack of good information and the active dissemination of misleading information coming from health groups would probably have dissuaded him from ever considering the alternatives.

(Curiously enough, the veteran’s lung cancer was discovered while screening for a kidney transplant. To be eligible, the VA requires that the recipient be tobacco free three months prior to the procedure. There is no mention of eliminating caffeine and since it and nicotine are quite similar in effect, because this requirement does not distinguish between forms of tobacco use, it appears not to be an entirely health related requirement. If the patient had been able to quit smoking but continued some relatively safe form of nicotine use, but had then and therefore been considered ineligible, and then died from kidney failure, where then would the blame be laid?)

Though some counsel patience with a new department in an agency which has little expertise with tobacco, all indications to date lead only to pessimism about where this group will take us. In his defense, it has been reported that Deyton had this advisory panel (now coming under challenge for conflicts of interest, though they really ought to be challenged on grounds of established opposition to harm reduction) foisted upon him (rather like making a fire chief work with arsonists for a crew, with the possibility that the chief is an arsonist as well).

The general tone of his address to the TMA was that despite his agreeing that dialogue with the industry was necessary, his approach would be hard line and traditional, and more in the nature of demands based in standard anti-tobacco philosophy than pooling resources to attain the common goal of safer tobacco use. In other words we were facing a new tool to advance the old tried and failed methods and not any attempt at looking for real solutions. It is telling that in Deyton’s address amidst the professed desire to reduce tobacco related disease runs the lack of distinguishing between different tobacco products which is the very essence of harm reduction; if you do not make product distinctions, you are either not familiar with the evidence or your priorities are political rather than health based.

At this time, the new Tobacco Center at the FDA seems to be little more than a means to constrain new safer products, to further complicate the lives of tobacco users of all kinds, and to keep policy on the quit or die trail.

Overall, the TMA conference was enlightening. Once again you had the strange realization that the accursed capitalists (the producers and sellers of tobacco) actually showed more interest in the health of their clients than the representatives of the government. The tobacco growers and sellers were more receptive to harm reduction than those whose job description included serving (and preserving) the public.

-Paul L. Bergen

Anti-smoking or anti-tobacco? More like anti-social.

I get the feeling that Betty would have no problem with vaping.

For some time now, and more intensely in the last few weeks, Michael Siegel has been railing against the insanity of the modern tobacco control movement (as exemplified by American Lung Association, American Cancer Society, the American Heart Association and the Campaign for Tobacco Free Kids). The only reason Action of Smoking and Health US is not on that list is that as counterproductive as those other organizations are, they do not even begin to approach the almost pre-literate and certainly pre-logical infantile mulings and screechings of Banzhaf’s self serving vehicle. I may not agree with Siegel’s actual yardstick (“Frankly, there is no longer any difference between the agenda that these groups are supporting and that of Philip Morris. And that is a sad thing.”) but would rather argue that the real problem here is a lack of internal consistency.

One reason that I disagree with Siegel’s parallelism is that what presently seems to be the case is that tobacco companies are developing safer alternatives while these organizations with the help of the FDA seem to be doing everything they can too discourage them. In other words, tobacco companies are working to improve public health while these organizations that profess to be working for that aim are actually discouraging any products that do not originate with pharmaceutical companies, and working to maintain the information barriers about any safer alternatives. (Strangely enough, these organizations also tend to promote pharmaceutically aided quitting over unaided quitting even though the latter has been found to be much more lasting).

If the above mentioned public health organizations had as their mandate to maintain the present levels of disease and death associated with smoking (and even though their funding derives from the continuing sales of cigarettes I will not even mention in passing that that could possibly be a factor), what would their policies look like?

I imagine they would 1. discourage any alternatives (like smokeless tobacco products or electronic cigarettes) that might make nicotine use safer 2. if they cannot make them illegal make sure that people think they are no safer 3. support regulations that do not conform to any other product information guidelines and demand that producers describe their products as more dangerous than they are.

And in this regard, they have been quite successful in making sure that little headway is made while at the same time giving the impression that they are valiantly fighting on our behalf.

And while these anti-tobacco organizations will embrace any pseudo-science that demonstrates exaggerated dangers of 2nd and 3rd hand smoke, they fight any measures that would actually reduce those effects.

None of this is really news, and perhaps the strangest thing of all is that the average person still thinks these organizations are working for the greater good. But what can you possibly think of an organization that on one hand loves to repeat that over 400,000 Americans are dying every year from smoking and on the other does all they can to keep people from moving themselves out of the group most likely to contribute to that number? Or what can you think of a federal agency that decries the health damages due to cigarettes, then sets up a board to deal with the problem, and then populates the board with individuals who have devoted their careers to fighting the best solutions to that problem?

It is time for us to rebrand these organizations. By their actions, they can no longer be identified as anti-smoking or anti-tobacco (since they fight solutions that would reduce smoking and tobacco use); they can only really be described properly as anti-social.

-PLB

Is it safe?

Sometimes I feel like Dustin Hoffman in Marathon Man where Laurence Olivier who plays the demented Nazi dentist keeps asking him “is it safe?”

Tobacco harm reduction, and harm reduction in general operates on the principle of whether an action or substance is safer than another, not so much their absolute safety. One of the most prominent anti-tobacco harm reduction strategies is to ask the question of “is it safe” in order to avoid the comparison (For example.). Other factors being equal, once you accept that nothing is absolutely safe but that some things are safer than others, only a moron would not see the advantage in going with the safer activity.

Today, Michael Siegel had a good post on the FDA forging forward under their new tobacco mandate and pledging time and money to determine the toxic elements in tobacco smoke. As he points out, we have plenty of evidence about it being pretty harmful and a better use of these resources, if health is the issue, would be to concentrate not on further determining how dangerous smoking is, but to finding and promoting safer alternatives.

On the other hand, we have anti-e-cigarette articles coming out daily on how e-smoking is or might not be absolutely safe. (See this BBC article.)

You could easily have made the same arguments against airbags and seatbelts. Those items, which have saved the lives of thousands to date, have on occasion caused death when otherwise it might not have happened. They are not absolutely safe. But they are safer, and that is why they are now standard equipment in automobiles.

-PLB

FDA regulation of tobacco

The following are the submitted comments from TobaccoHarmReduction.org regarding the U.S. FDA regulation of tobacco (see FDA page). We decided to post them here for easy access by interested readers since we think they contain useful observations that may not be widely presented anywhere else.

We are writing to urge the FDA, as part of its new authority over tobacco products, to actively support tobacco harm reduction (THR), rather than interfering with or ignoring it. Because the scientific facts about THR are well-known and likely to appear in other comments, we will simply summarize them and move on to less obvious points. More details and links to summary documents can be found at our website, TobaccoHarmReduction.org.

-There are nicotine products that are proven to be about 99% lower risk than smoking (Western smokeless tobacco of either the American or Swedish style) and others that are strongly believed to be roughly as low risk though there is no direct evidence of the exact magnitude of the risks (pharmaceutical nicotine, a.k.a. NRT; electronic cigarettes).

-Smokers who switch to these products, even if they continue to use them for the rest of their lives, get health benefits that are barely different from quitting nicotine entirely.

Most smokers do not know that switching to smokeless tobacco or other low-risk products is such a good option. There is an active campaign to tell smokers that the only options are to quit or die, which keeps many from switching. This persists despite the fact that switching to a low-risk product and using it for a lifetime is, on average, lower risk than continuing to smoke for just a few more months (see: Phillips CV, Harm Reduction Journal, 2009, for the calculations that produce that estimate).

With that background, we would like to focus on three observations that are not so well known:

1. It seems extremely likely that fifty years from now, unless an even better substitute drug is invented, a substantial portion of the world’s population (perhaps as much as one-third of those who can afford it) will use nicotine in low risk forms. There will still be some smokers, but far fewer than there are today. What is not yet predictable is how long smoking will remain the dominant form of nicotine use in particular societies, a question that hinges substantially on public policy decisions.

2. The FDA is very skilled in many areas of science, but should avoid exceeding its core skills, mission, and mandate to engage in social engineering. The political actors who dominate quasi-scientific discourse around tobacco will try to steer the FDA’s tobacco policy toward actively pushing the moralistic social engineering goal of eliminating all self-administration of nicotine, regardless of health or welfare concerns.

3. Companies that make nicotine products, including many of the major tobacco companies, will be the biggest engines of innovations in reducing the health effects of smoking if they are pushed toward and allowed to go in that direction.

Regarding point 1., nicotine is so vilified that many people do not even pause to think about its benefits. This is quite strange given that such a large portion of the population chooses to use it despite the costs and is quick to espouse its virtues. Nevertheless, the benefits are great and range from medication for clinical-level psychiatric disorders, self-treatment for subclinical or undiagnosed (including depression, schizophrenia, post-traumatic stress, attention deficit), and a mild drug to promote pleasure, relaxation, focus, productivity, and alertness. While the FDA does not officially recognize these benefits, any honest scientist or casual observer of the human condition cannot help but recognize them. Moreover, nicotine is quite simple to produce and acquire. Thus, we can confidently predict that many people throughout the world will choose to use nicotine indefinitely.

What happens in the near term in the United States, however, is not so predictable. If the government policy discourages THR, by interfering with the introduction of low-risk products or by communicating to the public that all nicotine products are similarly unhealthy, smoking prevalence might continue to slowly creep down. But there is reason to expect that nothing other than a heavily-enforced prohibition would cause the last 10-15% of the population to give up the benefits they get from nicotine. The only proven method of reducing smoking prevalence much below what it now is in the U.S. is substitution of a low risk alternative. If such substitution is discouraged in the U.S., THR will likely not catch on until it is well-established elsewhere in the world, resulting in tens of thousands of needless deaths every year.

Inaccurate scientific claims about the risks from smokeless tobacco and other low-risk products can discourage switching. So do literally true but obviously misleading claims like the warning that smokeless tobacco “is not a safe alternative to smoking”, which most people read as “equally unhealthy”. This message tells nicotine users that they might as well smoke rather than using low-risk alternatives. On the other hand, if the FDA gives consumers honest information about comparative risks, or even just allows manufacturers to freely provide such accurate information, widespread switching – which is roughly as good as abstinence from the perspective of life-threatening disease and much better for many people in terms of psychological conditions and general welfare – is likely to begin almost immediately.

This leads in to point 2. The steps necessary to promote THR and thus dramatically reduce the health burden from nicotine use (i.e., from smoking) are simply to provide honest scientific information and let people make an informed autonomous choice. Short of nicotine product prohibition (which is not allowed and would be a law-enforcement nightmare), this scientific honesty would also best fulfill the mission of serving the nation’s health and welfare. Health and welfare are not, however, the goals of many of the people who dominate the discourse on tobacco and nicotine use. The dominant activist faction makes it quite clear that their goal is to eliminate the use of tobacco (and, increasingly, other nicotine products like electronic cigarettes). They are unconcerned with the welfare effects of denying nicotine to those who benefit from it. Indeed, they are even unconcerned with health, making no distinction about whether nicotine is being used in a way that is clearly extremely harmful (smoking) or in ways that present minor risks, comparable to everyday hazards and consumption choices; they generally actively oppose THR.

This extremist faction will inevitably try to enlist or co-opt the FDA into supporting their goals. A key part of supporting that mission is discouraging the long-term use of low-risk nicotine products, even more than discouraging the use of high-risk products, because a consumer who knows he is using a low risk product – and who gets substantial benefit from doing so – is unlikely to be persuaded to quit entirely. His health risks will be minimal and the net welfare effects will be positive, but the extremist activists will consider him to represent a failure rather than a success because he is still choosing to use nicotine. Thus, they will try to steer the FDA into not providing accurate comparative risk information, discouraging the use of low-risk products far more aggressively than their real health risks warrant, and other acts of social engineering (i.e., manipulation of the population to do what they would not otherwise choose to do). Does the FDA really want to join other agencies of the U.S. government in participating in a “war on drugs” with all that implies for the Agency’s reputation and public image?

Regarding point 3., once it is recognized that harm reduction and low-risk products should be encouraged, it follows immediately that the innovators and manufacturers of such products are part of the solution. They might, of course, be part of the problem too. The FDA’s core missions leave little doubt that while food and drug manufacturers are tremendously beneficial sources of nutrition and treatment, they also need to be pushed in the right direction and forbidden from taking profitable but harmful actions. Thus, the FDA can extrapolate from the regulation of pharmaceutical companies to tobacco companies and other manufacturers of low-risk nicotine products (some of whom are pharmaceutical companies who could be encouraged to market their nicotine products as long-term substitutes rather than marginally useful cessation aids). The situation is quite similar: Those companies are the only source of the good products we should want to encourage the development and marketing of, but like most any organization will also often favor self-interest over social welfare.

Thus, regulation of various kinds of low-rise products is in order, though not regulations that are intended to strangle the companies or discourage innovation or marketing of low-risk products (as the FDA will be encouraged to pursue as noted above). Indeed, regulations that are designed to hurt companies rather than help consumers are very likely to backfire, and would likely encourage companies to retreat to their core business rather than trying to switch their cigarette customers to their low-risk innovations. Regulatory action that encourages manufactures to innovate and help consumers switch to low-risk products is perfectly aligned with doing good science and honestly communicating it, as well as standard government policy that tries to penalize and discourage health hazards and negative externalities.

In summary, regulating tobacco calls for recognizing that nicotine is a popular drug that it is a “lifestyle” consumption decision and/or self-treatment for many conditions that are not formally diagnosed, making it different from carefully controlled medical treatments for specific diseases. Demand will likely never be eliminated, and trying to eliminate it will take the FDA far beyond its mission and competencies. Like the products that FDA is experienced at regulating, the market will be dominated by major corporations; this should be recognized and turned into an asset rather than futilely resisted. Because this popular drug is caught up in so much politics, attempts at social engineering often overwhelm the good science. However, good science and honest provision of information will improve people’s health efficiently and without causing a net reduction in overall welfare.

Prof. Carl V. Phillips, MPP PhD
Paul Bergen, MLIS MSc
Karyn Heavner, MPH, PhD
Catherine Nissen, B.Sc.

The authors represent the TobaccoHarmReduction.org research group at the University of Alberta School of Public Health. The research group has benefited from an unrestricted grant to the UASPH from U.S. Smokeless Tobacco Company. Dr. Phillips consults on tobacco harm reduction to any interested organization, some of which are companies that sell products that will be affected by FDA actions, and is sometimes compensated for that work. No one other than the signed authors had any input into this statement or influence over its content.

Who would you believe? Doctors or politicians…

Two news items today…the first is the news release Physicians Urge FDA to Justify Condemnation of E-Cigarettes.

The letter specifically targets the new tobacco legislation that passed through Congress this summer which gives the FDA power to regulate tobacco products in the United States and notes that the success rate of current smokers who attempt to quit by using pharmaceutical aids is as low as 5%. Making smokers more aware of less harmful alternatives, snus and e-cigarettes included, could significantly reduce the amount of smokers who die due to tobacco-related illnesses.

This doctor group is advocating the availability of healthier alternatives for smokers but these politicians while condoning the continued supply of a proven dangerous product are taking steps to ban a safer alternative. (The video is laughably nonsensical being based on obviously scripted children saying they are being sick of being targetted by tobacco companies).

It would be easy to suggest this has something to do with coming from Utah but the fact is that the story is all too common even in supposedly liberal and compassionate jurisdictions. Castigate smokers for smoking and then make sure that if they won’t quit that they do not have access to safer products.

When it comes to health I will look to my doctor and not my political representatives.