CASAColumbia are liars

by Carl V Phillips

Normally we would not bother to respond to a letter to the editor that responded to a fairly typical news story about e-cigarettes.  No, it is not that the name is bugging us (they were probably CASA before we were CASAA, after all).  Rather, this seems to forebode the possible entry of a new tobacco control industry group into active campaigning against THR.

The group in question is The National Center on Addiction and Substance Abuse at Columbia University.  They justify their existence based on the following claim:

Today approximately 16% of the U.S. population age 12 and over meet clinical diagnostic criteria for addiction to nicotine, alcohol or other drugs and another 32% currently use one or more of these addictive substances in ways that threaten health and safety.  Together, addiction and risky substance use affect a staggering 48 percent of the nation—nearly every other American —and constitute the largest preventable and most costly public health problem we face.

Those are some remarkably precise statistics they are throwing around there, especially considering that they do not (anywhere I can find, and I looked) explain what “addiction” even means.  Or “risky” (anything that entails any risk? I believe that encompasses everything).  Or how “abuse” differs from “use” (usually it is implicitly defined as “any use that I personally do not approve of”, and it appears that they follow that standard).

Nor do they explain what constitutes the clinical diagnostic criteria for addiction to nicotine.  There are no such accepted criteria, though of course various people have thrown out quasi-definitions (never real definitions to my knowledge — they are always mere “I know it when I see it” checklists).  So what did they do, add up everyone who seems to qualify for one of those definitions?  By that standard, 100% of all people are idiots (just add up everyone who qualifies under someone’s statement of a sufficient condition for being an idiot).

It is not as if there is disagreement about their basic premise.  Most tobacco use (except in Sweden) is quite bad for the user.  Much of the use of alcohol and other mind-altering drugs is bad for the user and also creates serious problems for the rest of society.  But never trust those who try to dress up their political activism in these areas with junk scientific claims, and that seem unaware that many people like to use these drugs (or tries to hide that fact behind weasel words like “addiction”).  For when as someone goes down that path, you can bet that their targets include the rational and beneficial use of drugs by thoughtful adults.

To wit, the attack on e-cigarettes in that letter to the editor, signed by Jeffrey B. Lane, chairman of the board of CASAColumbia, which states:

E-cigarettes are a very effective delivery system for the addictive drug nicotine. Nicotine is particularly dangerous for our children, since early use increases the risk of addiction involving both nicotine and other drugs.

Not off to a good start there.  It is difficult to justify the “very effective” claim given how much less effective existing e-cigarettes are at delivering nicotine than is smoking.  But, moving on from the random silly statement to the lies, what do we know about children using nicotine?  Nothing.  We know a fair amount about children smoking, but there is basically no data about children who use just nicotine.  There is a bit of information about children who use smokeless tobacco, which is closer to “nicotine” than to smoking in most ways.  But do we know that any of these “increases the risk of addiction”?  No.

This is basically the classic “gateway” claim used by drug-warrior types.  Even setting aside the lack of definition of “addiction” all we really know is that an inclination to use the products in childhood is associated with use as adults.  But does the use really increase the risk of “addiction”, or is this just the obvious point that “deciding to do something is an indication that you like to do it, and therefore someone who makes that choice at a young age is more likely to do so later, as compared to someone who displays a lack of interest from the start”?  That is, is early use causing later use, or just predicting it?  We do not know because the “research” on the topic generally fails to distinguish these (largely by design, I would venture).

Flavorings like chocolate, cherry and peach are clearly not aimed at the typical middle-aged consumer seeking to quit an addiction involving tobacco, and these products have not been proved to be effective in accomplishing that goal.

I trust I really do not have to explain why this is a complete lie.  I should note that it quite probably the case that Jeffery B. Lane is so clueless about this topic that he actually believes this is true, and that so the lie is claiming expertise.  It does pretty much put CASAColumbia squarely in the mainstream of anti-harm-reduction activists, and their willingness to say anything — without regard to whether they know it to be true — to further their pet cause.

It appears that CASAColumbia is really more anti-corporate than they are pro-health, as is often the case for “public health” types.

With its enthusiastic endorsement of e-cigarettes, the tobacco industry is once again marketing the disease of addiction to this most vulnerable customer base. As the old saying goes, “The best way to get a lifetime user is to start him early.”

More than one in seven Americans already have the disease of addiction. Are we prepared to knowingly stand by and allow Big Tobacco to increase that number in the name of profit yet again?

So the “tobacco industry” is marketing the products to children?  Well, e-cigarettes sellers (whether they are part of what is normally known as the tobacco industry or not) are allowed to advertise their products, so you can look at the advertising and see that it is clearly targeted at existing smokers.  The ability to advertise contrasts with cigarettes that so many children start using, that somehow are still attractive in spite of the ban on using effective marketing methods.  So if the goal is to sell e-cigarettes to kids, rather than selling them cigarettes, no one is doing a very good job of it.  You might think that experts on tobacco use would realize all this.  (And you would be right — experts do realize this.)

As for that “old saying”, I have never heard it before.  I googled it and the only hit for any similar sentence was this letter to the editor.  Of course, if you are making up statistics, why not make up old sayings too?

But the real telling bit is in that last sentence — that evil profit.  Because we certainly do not want big, effective, efficient corporations providing people with something that they want and that reduces their health risks.  Oh, no.  Improving people’s health has to be left to little, ineffective, inefficient activist groups, and as for making people happier — well no one should be doing that.

It was always clear that the entry of major corporations into the e-cigarette market (whether tobacco companies or otherwise), though extremely promising for public health, was going to mobilize out the anti-corporate types in opposition to THR.  (E.g., that seems to be the explanation for Glantz who had not previously attacked THR.)  Fortunately, this probably does not matter much.  But it is worth noting that when they jump in, they always seem to lead with lies.