In the previous post, we presented some thoughts on a webcast that was designed to empower (with innuendo, ad hominem attacks, disinformation, and suggested dirty tricks) local “public health” officials and activists to harm the public’s health, specifically by restricting access to e-cigarettes. Following on that, some additional observations (a random series, followed by the most interesting part of the whole conversation).
As we noted in the previous post, one of the speakers made clear that nothing that local or state governments did could interfere with eventual FDA regulations. They could impose stronger restrictions than the feds, but there is no way they could weaken them. This put the lie to the American Cancer Society’s claim that they have been opposing regulations to ban sales of e-cigarettes to minors out of concern that it would interfere with FDA regulation. Of course, we had already identified that as a lie, nothing that the ACS must know the truth, and went on to surmise their real motives.
All but one of the questions during the question period were about the chiiiiiildren. Probably almost none of the people watching the webcast were even aware that ACS et al.’s policies are the main reason that children can legally buy e-cigarettes some places in the USA. (Presumably the insiders who savvy enough to know the real game that the anti-THR people are pursuing has sense enough to not waste time listening to webcasts — score one for them over us on that point.) Interestingly, however, one of the questions sounded like it came from someone who had just read our posts about ACS. Maybe the ANTZ are getting smart enough to read things.
Comments that smoking is no worse for you than vaping were rampant. Of course that is not quite how they phrased it. They said “we do not know that these are safer than smoking”, but those statements are exactly equivalent.
Someone — I believe it was Jeanne Finberg, California Attorney General’s Office — asked the listeners to start reporting, for purposes of legal action, examples of e-cigarette vendors making cessation claims. Never mind the stupidity of living in a world where merchants cannot make simple nonspecific true statements about how one consumer product competes with another. Her examples of “cessation claims” included statements that if you use an e-cigarette you will not smell like smoke, as well as the fact that you can blow vapor rings with them unlike with a nicotine patch. Um, yeah. By those standards, ads for pizza are making smoking cessation claims.
Of course, even more bothersome was the mere fact that the state Attorney General’s office was actively campaigning for particular policies. The claim was that rampant lawbreaking is going on. And yet no one has taken legal action against e-cigarette vendors — other than workplace safety claims and, interestingly, a few cases (or maybe just one) of failing to enforce minor sales bans — since the FDA lost their attempt to ban e-cigarettes. I thought it was the job of attorneys general to act against lawbreakers — apparently in California it is to ignore that and to try to make policy.
The only audience question not about the chiiiiildren that the moderator chose to read (i.e., planted) was about what the research priorities on e-cigarettes should be. A valid question, but not such valid answers. It was a bit of a muddle as to which of the panelists were talking (there is no transcript of the meeting, of course), but one claimed we needed clinical data about whether e-cigarettes help people quit smoking. That is the standard “clinical” lie (which shows up in lots of contexts, not just e-cigarettes): Clinical evidence is great for assessing clinical activity — say, which of two drugs is best for treating a particular cancer — but completely inappropriate for assessing social phenomena. We do not judge particular methods of reducing traffic hazards or how consumer confidence affects the housing market by creating an artificial laboratory situation. Similarly we cannot judge the effectiveness of e-cigarettes that way. (If the question is, “if you recommend e-cigarettes to enrollees in clinical smoking cessation program, what happens?” then clinical research is useful, but that is a much less important question than what is happening in the real world.)
Another answer was that we need to learn more about dual use because it is “giving people the false impression that they are reducing harm when they are not.” Of course, if people are substituting e-cigarettes for some of their cigarettes (and especially if they are trending toward even more substitution) they are reducing their risk. But the phrasing of this response was quite telling. This and other response included the subtext “we need to do more research in order to find more ways to attack THR”. This reflects the standard ANTZ relationship to research — the same way a drunk uses a lamppost (for support, not for enlightenment).
Someone actually said, “if we had the answer to these, we would know what policies would be possible.” Notice the statement was not “we would know if we should pursue these policies” or “if these policies are a good idea” – that is not a question that even occurs to them.
This leads to the one bit of honesty, from two employees of the Tacoma/Pierce County (Washington state) health department, reporting on the blocking of that department’s attempt to restrict e-cigarettes. They wanted to do it, of course, but their presentation was an honest report with little or no editorializing that they were stopped from doing The Right Thing (though undoubtedly many of the listeners supplied that as their own personal subtext). The restrictions did not happen, they reported, because the public did not support them, except for the one on sales to minors, which everyone supported — apparently the ACS and friends were too busy elsewhere to jump in on that.
To their enormous credit, the officials did not mimic the games of ANR et al. (mentioned in the previous post) of trying to blame the public’s views on manipulation by evil corporations or evil consumer advocacy groups. They matter-of-factly stated “we did not have a lot of community support” and moreover that “we do not have evidence-based research to back up our concerns.” The latter is a borderline case of assuming that if the research were done it would support their policy, but about as good as can be expected.
Indeed, they acknowledged that they faced a challenge, as a public health department, because they could not show that e-cigarettes posed any threat to the public health. Perhaps, then, they should not have been trying to act in the first place, you might be thinking. But at least the Board of Health ultimately reached that conclusion and stopped the effort. The bad news is that even these fairly honest presenters emphasized that they “were left in the lurch” by the lack of support and evidence, rather than suggesting that perhaps the lack of support and evidence means that they should not have been doing this.
Perhaps the worst of the honest messages in their presentation was that they endeavored to “strike a balance”. Among what or whom, you might ask. They did not clearly say, but reading between the lines it was a balance between, on one side, the genuine preferences of the real stakeholders, along with those who do not think a public health department should interfere with something that does not hurt public health (and, incidentally, those who realize that e-cigarettes are beneficial for public health), and on the other side the ANTZ busybodies and their anti-THR agenda.
And that is what is so toxic about the entire taxpayer-funded project that we witnessed. A tiny minority of a few thousand busybody activists with no legitimate stake in the matter are considered (by themselves, anyway, and since they have money and power, that matters) to have a legitimate voice, whereas the similar number of people who comprise the industry are treated as a vague malevolent force and the 1000 times that many people who benefit from e-cigarettes are completely ignored.