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The American Cancer Society lies and lies and lies and…, Illinois edition

Posted on 11 April 2013 by | 10 Comments

by Carl V Phillips

Today, a government committee in the state if Illinois is holding a hearing on THR.  We should not expect anything to come from this since it is part of a series sponsored by RJR, with one expert testifying to a closed meeting which has demonstrated little traction in the past.  They have failed to bring in the consumer perspective that a decade of failure coupled with CASAA’s successes has demonstrated is needed to turn the science into effective persuasion.  (This is especially a shame since hundreds of vapers — living proof of the effectiveness of THR — are currently gathering in Chicago for VapeBash and would have been happy to drop by.)

One thing that these meetings do, however, is act as flypaper for the liars.  In today’s case, Heather Eagleton, Illinois Director of Public Policy and Government Relations for the American Cancer Society Cancer Action Network (ACS CAN) laid on the lies so thick that it could have been a parody of the ANTZ position.  Here are some excerpts:

The tobacco industry has marketed this new generation of smokeless tobacco products as a temporary way to deal with increasing cigarette taxes and smoke-free policies in public places. Despite the risks, these products, which include snus and dissolvables such as strips, orbs, and sticks, are being promoted by the tobacco industry as less harmful, more convenient, and more socially acceptable alternatives to traditional cigarettes. There is no scientific evidence that these products are safe, may be considered a safe substitute for, or are an effective means of quitting tobacco use.

Wow, where to even start?

Promoted by the industry as less harmful?  If this were really true, these ANTZ would be filing lawsuits, not issuing lie-filled proclamations, since the industry is forbidden from making that claim no matter how obviously true it is.  So the manufacturers are stuck with other messages, like “more convenient” and that it can be used anywhere, as their only ways to try to persuade smokers to switch to low-risk alternatives.  As for objecting to “more socially acceptable”, apparently the ACS is now claiming that producing environmental tobacco smoke is socially acceptable — a bold move!

And, oh look, the classic strawman game of suggesting that someone is claiming that the products are perfectly safe, as an attempt to hide the clear evidence that they are about 99% safer.  Some lies just never go out of style.  This is naturally accompanied by the out-and-out lie that there is not overwhelming evidence that switching to these products is a proven very effective method of smoking cessation.  With all of these lies, it seems hardly worth bringing up the absurd characterization of “new” for such products as snus, or even dissolvables (which ACS’s patrons in pharma have been selling for decades).

My favorite from this paragraph, though, just because it is not the usual lies, but a novel bit of stupidity, is the suggestion that these products are a “temporary way to deal with increasing cigarette taxes”.  Huh?  Is she claiming that cigarette taxes are expected to drop, so only a temporary response is needed?  What she is definitely admitting is that cigarette taxes are not actually intended to incentivize smokers to reduce their risks, since otherwise switching products would be considered a success and not a failure.

There is research, however, to show these products cause cancer of the mouth, pancreas and esophagus, as well as other serious health conditions.

There is just one problem with that claim: the research actually shows that there is no such risk (nothing large enough to be measurable).  You might think that the ACS had a competent scientist or two on staff who could actually understand the scientific literature.  I wonder what they are doing with all that money that people give them?

So long as tobacco products continue to be responsible for nearly one out of every five deaths in America today, tobacco product manufacturers cannot pose as being the solution.

To paraphrase, so long as automobiles continue to be responsible for almost all roadway deaths in America today, auto manufacturers’ efforts to improve safety features cannot pose as being the solution.

This is a new twist on the old tobacco marketing campaigns of the 1960s, 1970s, and 1980s that falsely promised health benefits to be derived from filtered, “light”, and “less tar” tobacco product alternatives that were “more safe” versus “less safe.” These “harm reduction” messages were false then and are false now.

Ah, now there is a classic.  Never mind that the public health community was the primary driver behind the light cigarettes failure.  The current “public health” community wants to memory-hole that inconvenient fact.  Just consider how faulty the parallel is:  Light cigarettes were a speculative intervention, based on little more than guesswork, and turned out to be a failure.  Smokeless tobacco products have been shown, after centuries of use and decades of research, to be low risk.  Exactly how are these similar?

So the harm reduction messages, coming from both public health and the cigarette industry, were wrong in the 1970s, and therefore …um… no harm reduction message, no matter how overwhelmingly evidenced-based, can ever again be correct?  Frankly, it might be a good tradeoff to use that as a basis for disregarding messages from the industry today, so long as we could also use it as a reason for disregarding every message from “public health” today.  New rule:  Anyone who has ever aggressively pushed a health message that turned out to be wrong is not allowed to talk anymore.  And, yes, I am talking to you, ACS and Ms. Eagleton.

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Press Release: FCTC demands governments, researchers avoid talking to automotive industry

Posted on 1 April 2013 by | 12 Comments

FOR IMMEDIATE RELEASE

Geneva, Switzerland

1 April 2013

At the eighth meeting of the delegates to the World Health Organization’s (WHO’s) Framework Convention on Traffic Control (FCTC), delegates adopted Article 5.3, which forbids signatory governments from consultation and engagement with Big Auto and other parts of the automotive industry.  Governments are also to act to ensure that independent researchers are also prevented from such engagement, using such mechanisms as political imprisonment, press censorship, and blacklisting.

The FCTC is devoted to ridding the world of the use of passenger cars by 2050 as part of WHO’s Social Programming to Eliminate Non-communicable Disease initiative.  Automobiles are the leading cause of death in age groups from 4 to 50 years, and the second leading preventable cause of death in the world today.  They are also the leading cause of obesity, exposure to second-hand smoke, and death and injuries among pedestrians and cyclists.  In addition to their immediate health effects, automobiles are the leading contributor to global warming.

The automobile industry has a long-standing practice of influencing governments and manipulating consumers, including encouraging youth uptake, advertising in youth-targeted media such as television and magazines, selling vehicles that can achieve speeds far in excess of any legal speed limit, shutting down government-approved alternative transport, and covering up newly-discovered health threats.  Indeed, the influence of the industry is so pervasive that one corrupted government recently provided a 13.6 billion euro ($17.4 billion) bailout of its domestic industry, rather than letting it fail as it should have done.

Article 5.3 also requires that all future automotive research on such topics and safety engineering should be entirely controlled by governments and FCTC’s approved list of public health researchers.  Industry and those willing to constructively engage with them will be forbidden from conducting such research.  Only by excluding the world’s best automotive engineers from the research process, replacing them with second-rate sociologists and medics, can public health’s goals be achieved.

The new rules are urgently needed due to the industry’s initiatives to substitute new “reduced risk” products, an attempt to attract new customers that can only be explained by our successful denormalization of driving.  Recent attempts by automobile manufacturers to encourage “harm reduction” represent a blatant effort to make driving appear more acceptable.  Industry wants consumers to continue to be addicted to these new products, rather than sticking with government-approved driving cessation methods like buses, trains, and reclusion, which are clinically proven to be successful for almost 5% of the population.

Despite the industry’s marketing claims, no randomized clinical trials have demonstrated that their new products are lower risk.  Instead, these efforts recall the industry’s infamous “seat belt” fraud from the 1960s and 1970s, where they claimed that the installation of these features would reduce risk.  In fact, subsequent research found that deaths and injuries from automobiles continued to increase worldwide, and are now skyrocketing.  In recent testimony in Washington, former U.S. Surgeon General Richard Carmona reported, “No matter what you may hear today or read in press reports later, I cannot conclude that driving a new Subaru Forester, with all-wheel drive and computerized traction control, eight airbags, and a roll-cage-like reinforced chassis, is a safer alternative to a rusted-out 1971 Pinto.”

The new rule will bring all governments into alignment with FCTC policy.  FCTC has always had a policy of forbidding involvement by the industry or automotive consumers, having recognized that perfect policy can only be made if interference by all the real stakeholders is avoided.  Delegates are encouraged to never so much as converse with to anyone who considers motorized transport to be beneficial to people’s welfare, except in the context of clinical interventions.

FCTC recognizes that the industry will probably mobilize their front-groups to protest these rules, using their usual misleading language about “free choice” and “honest science”.  The industry has a long history of creating fake grassroots support to claim that people simply prefer to drive in spite of the risks.  But secret industry documents have revealed that every single person who expresses interest in cars is secretly in the pay of the industry.

Delegate, Michael Myers, CEO of the Campaign for Travel-Forbidden Kids, responded to these claims by industry-funded critics:  “Individuals are persuaded by paid industry shills like Bruce Springsteen to consider cars to be cool or a way to look grown up.  People who start driving as children become slaves to the industry.  Almost none of them ever again go without owning a car after they become addicted.  Motorized transport is far more addictive than heroin or even smoking.  The only way to keep people from driving is to stop the industry from enticing them to start.”

This move by the FCTC follows on important anti-traffic efforts in several member states.  The proposed Traffic Products Directive in the European Union would prevent any personal vehicle (PV) from traveling at faster than 30 kph (equivalent to 18.6 mph or 4 mg/ml).  The US Department of Transportation requires that any automotive products either be “substantially equivalent” to technology that existed in 1980 and that any innovative products cannot be sold until 20 years of real-world data that proves their safety is accumulated.

The adoption of the new rule follows yesterday’s FCTC resolution to demand that governments devote all taxes collected on automobiles and gasoline, and other traffic-related taxes to anti-traffic efforts.  Only 0.000185% of such taxes are given to anti-traffic QUANGOs, which drastically reduces the potential income of FCTC delegates.  Indeed, the vast majority of the collections are devoted to maintaining roads and other actions that encourage driving, further evidence that governments are too heavily influenced by Big Auto.  A related proposal, to demand the elimination of all depictions of automobiles in movies and television, based on the claim that it causes 483,921.4 children to start driving each year, was rejected as being too wackadoodle for even the FCTC.

The FCTC is an international treaty, with 183 signatory countries (which include 22 who actively wanted to sign, in addition to those who were blackmailed into it with threats of losing WHO funding).  They are currently meeting in a 5-star resort hotel, thanks to revenue generated from a collection of extremely regressive taxes.

 Press Contact: FCTC Secretariat, fax (yes, we really still do have a fax machine): +41 22 791 5830, or for those living in this century:  fctcsecretariat@who.int

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Phillips testimony for FDA hearing on recognizing tobacco harm reduction

Posted on 11 December 2012 by | 5 Comments

by Carl V Phillips

The title overstates a bit, but next week’s FDA hearings (official government announcement here) on whether to allow pharma nicotine products to be able to officially (“on label”) be used for long-term THR rather than just for the magical rapid weaning off of nicotine that they are supposed to accomplish.  Since they are approximately useless for the latter and are mostly used for the former anyway, this is not a huge stretch.  But recognizing the reality of THR would be a big step for the FDA, similar to what the UK’s MHRA has already done.

FDA is not really admitting that this opens the door to properly recognizing THR, but it does, and so several of us who are interested in THR are testifying on various points.  Annoyingly, the government wanted us to submit not just our slides, but an actual text of our statements a week in advance.  There are various conspiracy theories about the reason for that, but mostly I just find it a bother since I never write out the text of my talks, but usually put a lot of detail in the slides.  But since I had to do it, I might as well make use of it here, so….

Testimony for: FDA Actions Related to Nicotine Replacement Therapies and Smoking Cessation Products; Report to Congress on Innovative Products and Treatments for Tobacco Dependence; Public Hearing

by Carl V Phillips PhD

17 December 2012; Silver Spring, Maryland

I am testifying as a private citizen and stakeholder, speaking for myself based on extensive professional experience and expertise.  I am a long-time advocate and researcher on tobacco harm reduction.  I have worked in this field for more than a decade as a researcher and educator, and have published roughly a million words on the topic.  I am also an informed, consciously-motivated, occasional user of low-risk tobacco products, which I find to be quite beneficial, and clearly worth the unmeasurably small risk that they pose.

In response to Question 4.4, which asks about identifying harm in this context and identifying which harms are of particular importance, I have the following observations:

[Note:  Full text is: 4.4. With regard to innovative products and treatments for ``reduction in the harm associated with continued tobacco use'': a. How should the ``harm'' be identified and measured? b. Is there a range of harms that might be addressed, and if so, which are the most important to address?]

Harm should refer to actual harmful effects.  This seems rather obviously, but there is a remarkable failure to follow this guideline in the discourse on this issue.  Life-threatening disease risk is an important harm.  Immediate problems of functioning are also an important harm.  “Addiction” is not a harm in itself (even setting aside that it is not even scientifically defined).  It might be a reason that people do something that actually causes harm, but it is only that actual harm that should be counted.

“Harm” must be considered in net term, as is done for treatment drugs or anything else the government properly regulates.  Nothing is harm-free, but harm may be low (or trivial) compared to benefits.  The common approach of naïve extremist activists approach, saying “this has a harm and therefore is bad” makes terrible public policy, but that is what you get if you do not consider full net costs and benefits.

To consider net effects, first requires considering the health benefits of using a tobacco harm reduction (THR) product as compared to abstinence.  There are psychological benefits and aids to basic functioning from nicotine use for a non-trivial minority of the population, and this is a highly important consideration.  Second, the net must consider health benefits that may not be considered “health”.  Acting as if nicotine is purely a treatment for disease, rather than recognizing it as a consumer good that serves other preferences, is simply out of touch with the obvious reality.  Many people use nicotine because they like the effects, and this is another highly important consideration.  If the “D” side of FDA are not accustomed to dealing with such goods, perhaps those on the “F” side could help (or anyone else in government who regulates any non-drug consumer goods).

Third, net health benefits need to based on the probability-weighted “but for” choices.  For example, if there is a 20% chance someone would be abstinent, but for the promotion of the THR option, and 80% they would continue smoke, then you need to compare any harms from the THR to .8 times the risk of smoking (a comparison that overwhelmingly favors the latter).  It is simply out-and-out wrong thinking to compare the harm from one option to some unrealistic world that some people consider a best-case.  This is not an odd concept: treatment drugs are evaluated based on their net effects, considering the harm from not getting the treatment.  Moreover, the calculation of the net harm needs to recognize that some of the methods for pursuing abstinence (e.g., Chantix) are quite hazardous in themselves.  And, most important, if someone tries to achieve abstinence but relapsing for a while, and as a result smokes for just a couple of more months, the resulting risk is (for the average smoker) greater than from than using a low-risk alternative for a lifetime, as I argued in my 2009 Harm Reduction Journal paper.  This means that pursuit of abstinence is often a higher risk alternative to THR.

In response to Question 4.6, which asks about how FDA and other HHS agencies can help promote public health in this context,…

[Full text: 4.6 In regulating the innovative products and treatments referenced in section 918(b), how can FDA and other HHS Agencies act to ensure that the three effects mentioned in section 918(b)--total abstinence from tobacco use, reductions in consumption of tobacco, and reductions in the harm associated with continued tobacco use--are achieved as broader outcomes, in a manner that best protects and promotes the public health?]

…far and away the most important thing to do is:

Stop lying!

Units of HHS are the world’s biggest anti-THR liars, and have been since I started documenting anti-THR disinformation campaigns about a decade ago.  The pervasive message to smokers about low risk tobacco and nicotine alternatives coming out of HHS has been and still is “you might as well smoke” (a phrase that was the title of my 2005 BMC Public Health paper that reports some of my research on this disinformation).  FDA has now joined other agencies in publishing disinformation designed to discourage smokers from switching to low-risk alternatives by grossly exaggerating the risks of those alternatives using false and intentionally misleading claims.

These anti-THR messages encourage people to smoke when they would otherwise use a smoke-free alternative that poses risks that are two orders of magnitude lower.  No conceivable amount of low-risk product usage could cause as much health harm as the smoking this causes.  Following the phrases from Question 4.6, respectively “total abstinence from tobacco use” and “reductions in the harm associated with continued tobacco use”, the current practice of promoting the former at the expense of encouraging the latter is guaranteed to be bad for public health.  Obvious and simple arithmetic makes that clear.

Regarding Question 4.7, about what to consider in FDA’s premarket evaluation of new product candidates,…

[Full text: 4.7. How can these broader outcomes be taken into account in FDA's premarket evaluation of new product candidates?]

…I reiterate that focusing on the net on smoking is most important.  Indeed, from a population health perspective, it is the only thing that matters.  Everything else is a rounding error.

In addition, premarket evaluation depends on having a correct basic model for what motivates consumers to choose particular products.  People act based on incentives which include health risks, of course, but also include many other factors.  Consumers making choices are not mere patients – sick people seeking treatment for a disease and nothing more.  If they are treated as such when predicting what they will do, the predictions will inevitably be wrong.  Even worse, if they are just treated as black boxes who are assumed to just make choices at particular rates because that is sort of what other consumers did in the past under difference circumstances, then you will have garbage in yielding garbage out.

I have a lot more to say about this, but only seven minutes total, so that is where I will end.

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Aside

Just a quick aside today.  I only just noticed the hilarious “warning” message on the shopping page SnusCentral.com: US Government Mandated Warnings for Americans:  Depending on the month, this product can cause mouth cancer, can cause gum disease and tooth … Continue reading →

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Posted on 26 November 2012 by