New “public health” panic: Ecig users practice freedom of association without proper supervision!

by Carl V Phillips

This is completely trivial compared to the vast amount of genuinely threatening anti-THR that is out there. But it is funny — too funny to pass up. This paper was recently published. It seems that The Journal of Public Health Policy is a bit hard to access (good news in itself, really) and I am certainly not going to pay for a download. But we have the abstract, and for papers like this the abstract is really all you can stand to read anyway. It begins: Continue reading

CASAA comment on proposed FDA child-safety regulations for ecigs and dissolvables

by Carl V Phillips

The CASAA statement on this docket is now available at the main CASAA blog. It also appears at the docket page. It is pretty self-explanatory, but for background and a link to the text of the FDA Advance Notice of Proposed Rulemaking (ANPRM) that it responds to can be found at our Call To Action for it. (Note that this is being posted about five hours before the deadline for that CTA, so chances are that when you read this it is too late for you to respond to that CTA if you did not do so. [correction: you have until midnight, not EOB today, so there is still time if you are reading this early enough today])

The very short version is: A federal mandate for child safety labeling and packaging is a good idea, so long as the very modest benefits it offers are not achieved at the expense of creating substantial burdens for consumers. We also observe that other commentators are likely to use this ANPRM as an excuse to push their unrelated agenda of intentionally lowering product quality, and that any benefits from this and other beneficial regulation are dwarfed by the enormous social harms that would be created by “deeming” these products in the first place (as that proposal is currently conceived).

Ecig consumer wants and “needs”

by Julie Woessner and Carl V Phillips

[Julie Woessner JD is the Executive Director of CASAA and President of its Board of Directors.]

One more post about GTNF2015. Julie presented in a session titled “Consumer wants and needs”. It was one of at least three sessions with titles that, if interpreted generically, made them about the general question of what consumers care about regarding developments in tobacco products (which in practice made it mostly about e-cigarettes, since that is where most of the developments are). We decided to make this talk a little more specific, and deliver one of CASAA’s key messages, by taking advantage of the exact wording of the session title.

The following (between the “—–”) is Julie’s talk. It is the prepared script, not a transcript.


The basics of what consumers and would-be consumers of low-risk tobacco products want is no mystery. You have heard it a thousand times: Consumers want high quality products, innovation, variety, and the freedom to choose which products they want to use, along with freedom from punitive taxes and other unjust laws that restrict use and enjoyment.

That being said, what do consumers need in order to get what they want?

First, industry competition, which promotes innovation, price competition, and all those other wonders of the free market system. Second, freedom to choose, both literally and practically (which means allowing sales and distribution channels for a variety of products). Third, accurate information so that consumers can make informed choices that reflect their tradeoffs, particularly information about comparative risks within and between product categories.

You might notice that I qualified the word “need” with a rather simple phrase: “in order to.” So the question becomes not simply what do consumers need, but, rather, what do consumers need in order to — in this case — get what they want. A discussion of “need” in and of itself is largely meaningless — and sometimes rather dangerous — without that “in order to” qualifier.  

In fact, presenting something in terms of “wants” and “needs” usually implies that wants are self-indulgent and frivolous while true needs are properly determined by those who are in positions of authority, since consumers can’t be relied upon to know what they need or what is truly in their best interests. This is a terrible, but common attitude. Thus, when someone asks what consumers “need” without including the all-important “in order to” clause, we should be wary of hidden agendas and moral positions.

Regarding e-cigarettes, the most common agenda among those posing the question, “what do consumers need” is that they are actually asking, “what do consumers need in order to ‘cure smoking,” or even “in order to be just good enough to cure smoking, but not any better than that.” If one sees e-cigarettes and other low-risk alternatives to smoking as simply a “cure” for smoking, then they are much like medicines. For those with this mindset, things like medicines and nourishment are “needs,” which make them somehow superior to mere wants, like enjoying life. And, of course, there is no “need” for medicines to be enjoyable. Rather, they merely need to work well enough.

And so we see regulators and many members of public health seeking to impose restrictions that make e-cigarettes less enjoyable and less acceptable because simple enjoyment and pleasure are wants, but not “needs.” Consider the EU Tobacco Products Directive where e-cigarettes as consumer products can only have a maximum level of nicotine of 2% nicotine. The rationale? “This concentration has been shown to be adequate for the majority of smokers that use an e-cigarette to substitute smoking.” (emphasis added) Leaving aside the fact that this is a mischaracterization of the science, it is troubling that anyone would consider it to be acceptable to impose limitations that have the effect of making something merely “adequate” for a “majority” of smokers.

In the U.S., there is an outcry against all flavors other than tobacco and menthol. Some phrase their opposition to flavors as being about protecting the children from target marketing — because the feeling is that only children could want fruit or sweet flavors. Others will acknowledge, perhaps somewhat grudgingly, that adults do enjoy such flavors, but believe that it is nonetheless acceptable and appropriate to eliminate those flavors to make the products less appealing to children. Again, they would argue that pleasant flavors — and an enjoyable product more generally — are not a “need” if one views e-cigarettes as merely being about smoking cessation.

But even if one is inclined to see the only legitimate role for e-cigarettes as a “cure” for smoking, given that there are hundreds of millions of smokers out there, any quality improvement in e-cigarettes is, for some of them, going to be the tipping point between continuing to smoke and switching. And likewise, for every restriction or limitation placed on e-cigarettes — whether it be nicotine strength, cost, flavors, or various other factors — there will be some smokers who will find e-cigarettes a less acceptable alternative to smoking.

I would suggest that when we talk about “needs” rather than “wants,” we are in danger of buying into an anti-consumer, anti-humanitarian view. There is nothing inherently wrong or immoral with consumers enjoying a consumer product, and there is absolutely no justification for purposely ignoring or deliberately reducing the enjoyment factor associated with the use of that product.

At the end of the day, the reason why e-cigarettes are such a tremendously successful alternative to smoking is because they are enjoyable, and anything we do to reduce the enjoyment will necessarily reduce their acceptability as an alternative to smoking.


Economists — which is to say, the scientists who study wants and needs and the like — generally object to the word “need” when it is used to imply something that is qualitatively different from a want. To paraphrase the great Jedi economist: Want or want more; there is no need. Of course, the word is legitimate with an “in order to” clause, whether you are talking about economics (“people need insurance to have access to modern healthcare”) or some other science (“you need to heat water to 100 degrees as standard pressure to make it boil”). But lacking such a stated condition, the word is economically meaningless. The typical response to that is “but you need food, water, shelter, oxygen, etc.” But buried in that is an implicit statement of “in order to still be alive next month.” Also, *yawn* — no one who is not discussing how to colonize Mars is ever actually talking about the minimal conditions for survival.

No, when someone uses the word “need,” there is always an implicit “in order to” statement buried there, and it is almost always “in order to get what I think they should want.” Put another way, the word is often a way of burying an illiberal and often anti-humanitarian premise that the author is trying to hide from the debate it deserves. Sustenance and medicine can be legitimately called adequate or inadequate, but such words are absurd for consumer goods. Even if you do not have the slightest urge to own a Ferrari, you do not want a car that would be described as “adequate” — which would basically mean “really lousy.” For an enthusiast, the concept becomes even more absurd.

This relates closely to the divides among different political factions that have emerged in the neighborhood of THR, but that are not actually about THR. For the first decade and a half of the THR movement (measuring from Rodu and Cole’s seminal 1994 paper), there was a pretty clear dichotomy: There were supporters of THR who were also supporters of smokeless tobacco (which was the only viable option) versus the “public health” people who opposed any tobacco product use more than they favored health. But the e-cigarette phenomenon has divided both groups.

There was no important political movement around smokeless tobacco enthusiasm — consumers merely wanting to defend their personal consumption choices, without it really being about THR, let alone “need” — but there now is for e-cigarettes. The “public health” faction also divided, with a few backing e-cigarettes as a cure for smoking, a de facto medicine. This is not about THR either, since it runs contrary to that philosophy’s ultimate grounding in individual empowerment and freedom. For this new faction of tobacco controllers, “need” is a natural concept and is used in the typical way: “needed in order to achieve what I think they should do.”

Right now, the three pro-ecig factions (consumers who are just motivated to defend their personal consumption choice, along with merchants who want to supply them; those who see them as a de facto medicine; and supporters of the THR agenda) are almost perfectly aligned in terms of practical political positions, due to the extremism and stupidity of the opposition. This has resulted in many proponents of either the enthusiast or “cure” factions, and even some who are strong supporters of the THR mission, failing to recognize the important differences among the groups’ goals, which are evident in language, occasionally manifest in practical contexts, and will become substantial divisions if the current round of fights is successful.

That Tobacco Products Directive clause is an example of the stupidity that maintains the alliance. As alluded to in the talk, it is not actually the case that 2% nicotine is adequate to provide a cure for smoking. The rule was slapped together by people who are clueless about nicotine use. We can guess that the thinking was that smokers should be forced to “step down” their consumption as they would with NRT. But the reality is that the ceiling increases the chance that a heavy smoker will try e-cigarettes and not compensate with enough extra puffing, and find that they do not deliver enough nicotine to make switching attractive. Meanwhile, experienced users who want more nicotine can just consume greater quantities, though this might not be what they really want. Thus, this rule pointlessly interferes with both wants and “needs”. But if the rule had been made thoughtfully by smart tobacco controllers who did not want to derail this cure for smoking — those from the faction that accepts e-cigarettes as a needed cure for smoking, but nothing more — they might have focused on a floor rather than ceiling. That is, they might have attempted to allow only the high concentrations that are the better “cure for smoking” while banning the low concentrations that could arguably be said to be used for the “mere want.”

The response might be that some people “need” the ritual or whatever to stay off cigarettes, but that is a difficult case to back (unlike the case higher concentrations being useful for transitioning smokers). The real objection to such a restriction, from the consumer or enthusiast perspective, is “I want to puff copious quantities of my 0.3%, and what possible business do you have telling me I can’t?” But if the “need” faction were ascendant (i.e., those who are pro-ecig as a medical cure for smoking), then this “mere want” would not be considered important.

Sunday Science Lesson: How they estimate deaths from smoking etc.

by Carl V Phillips

This continues, and finishes, the series that started here and continued here. (FWIW, the second one is probably more interesting than either the first or this one, if you want to read just one.) Recall that this series is the very long answer to a question along the lines of “how do they determine how many deaths among smokers, and especially among ex-smokers, are attributable to smoking?” In the first post, I discussed the causal contrast that anyone addressing that question should be thinking of (but probably is not), and noted that the outcome is badly defined (caused the death to occur how much sooner? they never say and probably do not even understand that is an important question).

Continue reading

Is “ecigs are a gateway” the new “addiction”? (i.e., fiercely debated in the absence of defining the term)

by Carl V Phillips

Just a quick note to vent my amusement about the never-ending war of commentaries about whether e-cigarettes are a gateway to smoking. That war apes a scientific debate, but it is not one for several reasons. Most notably, no one (on either side) ever explains what they would mean by “there is a gateway effect.” There are also serious problems about what would constitute useful evidence.

I suppose you don’t vent amusement, do you? You vent frustration. And it is frustrating that I recently spelled most of this out and yet even the ostensible scientists in the debate do not seem to have bothered to read that or any of the other serious scientific analysis on the topic. And they won’t read this either, so it does not seem to merely be a matter of tl;dr. I blame social media and the motivations it creates to write without doing the reading. And the thirty-second news cycle. And blogs. And Twitter. Also, would you kids please be so kind as to get off my lawn. Continue reading

Complaints about conflict of interest are designed to maximize conflict of interest

by Carl V Phillips

A colleague who found himself the target of the “you have a conflict of interest!” bullshit game was invited to write his analysis of the nature of conflict of interest as it relates to e-cigarette research. He asked me for input and several points occurred to me. I am writing them up here, in an admittedly disorganized fashion, for possible use in that project. Continue reading

Toward beneficial and practical standards for e-cigarettes

by Carl V Phillips

At the GTNF2015 conference I was on a panel discussing e-cigarette standards. The standards being discussed include manufacturing practices (e.g., clean rooms, hardware materials), specific technologies (e.g., whether a heating coil is capable of overheating, safe batteries), and ingredients (e.g., the perennial debates about whether some flavoring agents pose too much of a hazard). I decided to take the approach of addressing what the proper role for standards is, from a political economy perspective. What follows is the talk I gave (not word-for-word, and with a few additions to make it a document better suited for reading, taking advantage of the lack of time limit here). I follow that with some additional thoughts I voiced during the course of the Q&A and discussion. Continue reading

Sunday Science Lesson: Efforts to lower quality of tobacco products are poor substitutes for taxes

by Carl V Phillips

I am back from Italy and the GTNF2015, and mostly recovered. I have more to say about that meeting, particularly posting the content of my talk, and a backlog of a dozen unrelated or semi-related posts I want to write. Not knowing where to start, and it being Sunday, I will go for a science lesson. And, yes, I know I am in the middle of a science lesson series (and being a proper scholar, I am also in the middle of numerous other series) — next week, I hope.

I went to an interesting session about “plain products”, which was a cryptic way of referring to the intentional lowering of the quality of products, using anything from unattractive packaging, to limitations on flavoring, to lowering nicotine concentration. Interestingly, none of the presenters actually came out and said “lowering the quality of products” until I pushed them to adopt such plain language in the Q&A. I suppose their oft-repeated “affecting the value proposition” is the British synonym for that more pointed American phrase. But the former just does not seem to make it clear enough that these tactics are about lowering the benefits that are experienced by consumer — i.e., intentionally hurting consumers in order to manipulate their behavior. Continue reading