by Carl V. Phillips
I am assuming that there is no one reading this who did not already see yesterday’s post, so I will not even include a link. The release of Igor Burstyn’s paper was huge for THR, making clear that the apparent risk from vaping is not only lower than the anti-THR liars are trying to portray it, but probably even lower than those of us who are interested in the truth and familiar with the science thought.
On the same day, we won a victory in the fight against inappropriate e-cigarette bans and learned of an amazing success story about THR in a clinical setting (I am seeking permission to report that story here). Small scale in comparison to the study, I realize, but it makes for a good day. And at the even smaller scale and purely personal level, first thing yesterday, before writing the blog post and the release of the study, I did what turned out to be great interview on talk radio.
It all added up to me thinking, “this is one of the best days in the history of THR”. Not top five, but I found I had a hard time pushing it out of the top ten. As you might expect, that got me thinking about what other days should appear on such a list.
The top few on the list definitely include the release of the seminal Rodu and Cole paper (Nature, 1994) that was the first major science and ethical statement in favor of THR, and when Judge Leon prevented the US FDA from banning e-cigarettes here in 2009. I am also inclined (though obviously biased) to include up there the appearance of TobaccoHarmReduction.org, published by my research shop at University of Alberta in 2006 and updated for a few years after that; we got more press about that in Canada than “World No Tobacco Day” (the day we chose to release it) did, and the website is the source of a huge amount of the current popular wisdom about THR, even among many people who got here later and have never heard of it. (Like the 1994 paper, it is still out there but quite dated now, and yet still is often read — though I would recommend against citing it for any purposes other than historical analysis.) I am also inclined (and obviously biased) to include the creation of CASAA near the top.
At that point, I decided to crowdsource it. Any thoughts from biases other than my own? What are the best moments? It definitely does not have to be an identifiable day, but I am looking for the relatively concrete and not just general phenomena (i.e., the gradual appearance of e-cigarettes on the market does not count, nor the gradual success of THR in Sweden).
It would be great to include the introduction of specific THR products into particular markets, which does tend to involve a clear moment in time, but sadly most of those efforts flopped (maybe Camel Snus?). One or more of the moves by big companies into e-cigarettes might prove important, but it is hard to tell now, and for similar reasons hard to be sure something like the founding of NJOY should make the list; in such cases, it is tough to say that something really made the world different, rather than merely being a matter of who edged out competitors that would have been almost exactly the same.
No political victory compares to 2009, but what are the candidates for the list? Defeating the proposed New York ban? The original MHRA decision to allow THR to be an “indication” for use of a product would surly be high on the list, but for what has come later that seems to make that part of a larger picture that does more harm than good — so include it? The granting to Sweden of an exception to the anti-health EU snus ban comes to mind, but since Sweden would presumably not have joined the EU without it, it does not seem to count.
What other research publications? It is really hard to identify many individual publications that had much of an impact. Rodu’s book from the 1990s or others by him? There are a few candidates about smokeless tobacco. The nascent research on e-cigarettes does not seem to offer candidates — there are good and useful studies, but no game changers other than yesterday’s. I am partial to a few of my other publications, but I can’t say they made much of a splash at the time; my 2006 calculation about comparative risks is quoted constantly without people knowing they are doing so (“99% less harmful”), but it is hard to identify any “moment” for that one
Prominent policy opinion statements? The first Royal College of Physicians report on the topic is a clear candidate. (But please do not suggestion Clearing the Smoke — bleah!) Was there an identifiable moment for Bates launching his backing of THR (I honestly forget — getting old)? I can’t think of any clear “moment” for Godshall or Stimson, but maybe there was one. (All three of you read this, so I demand answers!! ;-) IHRA embraced THR for about five minutes, but we subsequently lost that fight, so no credit there.
So that is my brainstorm. Should be enough to get some thoughts flowing. Your turn.