Monthly Archives: December 2013

Anti-THR Liar of the Year, the American Lung Association, and Runner-Up, the American Cancer Society

  • Anti-THR liar of the year Runner-up (#2): American Cancer Society (ACS)
  • Anti-THR Liar of the Year (#1): American Lung Association (ALA)

While neither the most aggressive liar (that was the apparently conscience-free Glantz at #8) nor the one causing the most harm with their lies (the WHO, at #3, has that homicidal distinction), these organizations top the list because of a combination of aggressive lying, influence, the particular policies they advanced with the lying and influence, and the baldness of the contradiction between their stated missions and their anti-THR efforts.  Their little friend, the American Heart Association, often signs off on the same lies, but has been relatively quiet this year so is not specifically ranked.  But AHA should be considered to be part of this, along with the American Cancer Society Action Network, ACS’s dirty-work non-charity (almost entirely pharma-funded) corporation that, unfortunately, no one other than the tax authorities distinguishes from the actual ACS.  ALA edges out ACS for first place because ACS started quieting down toward the end of the year, with ALA picking up the slack (though perhaps they were taking marching orders from ACS to run point — there are some reasons to suspect that).  

The lies from ALA and ACS are particularly influential because they have a lot of foot soldiers.  With offices across the country, they can easily send local people to regulatory hearings for some astroturfed lying (i.e., it gives the illusion of being local grassroots-ish activism, even though they are paid flacks and their salaries and orders are coming from a giant corporation’s headquarters).  In 2013, they used this in particular to try to block laws and regulations that would have forbidden sales of e-cigarettes to minors.  (If you find that shocking or do not understand why they would do it, you really need to read the archives of this blog — there is a lot of good stuff there, if we do say so ourselves.)  To do this, they deployed a random assortment of the usual lies, along with some unusual and particularly bald lies like “if you do this, it will interfere with the FDA’s ability to regulate them” or “we need to learn more about the harms from e-cigarettes before we take any action”.

Of course, they also showed up to offer lies in support of proposed state and local regulations that would restrict adult access to or use of e-cigarettes.  They were the go-to ANTZ for the local media in many cases, which almost always just transcribed their lies.  And they appear to have had substantial influence on many of those fights.  Before 2013, CASAA et al. won most of the fights over anti-e-cigarette regulations.  In 2013 the tide turned, and the forces of darkness were more often successful.  These organizations seemed to have played a critical role in that.  Fights over smokeless tobacco (mostly taxation, since bans are off the table) were relatively less prominent than e-cigarettes, but they also continued to bring their lies to those as well (as they have been doing for many years).

We admit that putting these two at the top of the list reflects our focus on the USA, though we suspect that these groups have more global influence than their counterparts in other countries.  Ranking them above the WHO did give us pause, given how much more damage the latter has caused.  But this list is about the lies, not about ranking the damage inflicted through other anti-THR actions.  (The government of China would top such a ranking since it could use its autocratic powers to encourage the use of e-cigarettes by about a third of the world’s smokers — with low shipping cost too! — but instead blocks their use and remains the world’s largest cigarette merchant.  Of course, they do not really have to bother to lie in order to do that.)

What really tipped the scales, though, are the issues of mission and credibility.  Few people who are not in thrall to the WHO are influenced by them.  In particular, Westerners who are, at least for the immediate future, the primary audience for THR, tend to completely ignore the WHO, to the point of barely even knowing it exists.  People who are aware of the WHO seem to recognize it as a “public health” advocacy special interest.  But most Americans tend to hear and trust the ALA and ACS and to believe that their missions really are to fight lung disease and cancer.  They have no idea that these organizations are actually anti-tobacco extremists and that they allow that goal to trump their titular missions.  So when they speak out against a THR product, they are abusing people’s faith in them and sending the message that their opinion is based on lung or cancer risk, not on the goal of eliminating all tobacco use regardless of risk.

Mission is also the ultimate reason that ALA beats out ACS for the #1 spot.  While anti-THR is a hypocritical position for both of those corporations, clearly contrary to their stated mission, this is more the case for ALA.  Smoking is a major contributor to cancer, of course, but there are a lot of other causes.  But lung diseases, in modern rich countries, are overwhelmingly caused by smoking.  Yes, e-cigarettes might adversely affect the lungs (though the risk is trivial compared to smoking, so this is no excuse for them opposing e-cigarette-based THR), but smokeless tobacco clearly poses no threat to the lungs.  And despite this,  ALA actively opposes smokeless tobacco use for THR also.  It is difficult to imagine a more blatant misrepresentation of an organization’s mission than ALA opposing smoke-free alternatives.

We wish all the readers of this blog a happy and healthy 2014.  As for those who made our countdown list (who undoubtedly do not read this blog for fear of accidental enlightenment), we wish them the development of a conscience, lawsuits, boycotts, and maybe even a little enlightenment — and, most of all, a continuing erosion of their undeserved credibility.

Anti-THR liar of the year #3: The World Health Organization (and a Dishonorable Mention for the Continuumistas)

Continuing the countdown of 2013’s top anti-THR liars, we should not forget that THR is not just about e-cigarettes or people who are rich enough to afford them.  Smokeless tobacco is still the leading method for THR in terms of number of users and proven efficacy and effectiveness.  The World Health [sic] Organization (WHO) — including its International Agency for Research on Cancer (IARC) and Framework Convention on Tobacco Control (FCTC) units — has long been one of the leading liars about smokeless tobacco.  While their lying is not as aggressive as it once was (and thus they rank only third this year in spite of their enormous reach), it is still going strong.

This matters because the lies have some influence on the knowledge of people in rich countries — for example, IARC played an important role in tricking people into believing that snus causes cancer to a measurable degree despite the lack of any such evidence.  But it matters much more because many poor countries simply take their public health marching orders from the WHO.

Among such countries are India and its neighbors, where there is great potential for tobacco harm reduction of a different kind.  Millions of people in South Asia use the dip product gutka and others that are similar to it, and these appear to create so much risk of cancer and other oral diseases that their health impact may be up with smoking.  The potential harm reduction that would come from persuading people to switch to smokeless tobacco — an obvious substitute that is low-risk and can be affordably manufactured locally — is enormous.  The number of users of those products is in the order of a tenth the number of smokers in the world.  Enter the WHO, which erroneously claims that these products are smokeless tobacco (tobacco is one of the ingredients, but clearly not the one that is causing the large health impacts).

Not only does this basically guarantee that there will be no attempt at harm reduction in South Asia, but it then carries back to the rest of the world that is tricked into believing that smokeless tobacco causes risks similar to gutka.  This leads to harmful lies like this, where the claim is that smokeless tobacco is 17% as risky as smoking (the absurdity of making a claim that precise, even beyond the fact that it is wrong by an order of magnitude, is a topic for another day).  This tends to discourage smokers from switching to this proven low-risk alternative.

The WHO has not spared e-cigarettes from its anti-THR lies, though they are a relatively minor player there, in contrast with being singularly devastating in their history of lies about smokeless tobacco.  Hat tip to Clive Bates for compiling this list of tweets, which speaks for itself:

WHO lies about e-cigarettes

Dishonorable Mention:  the Continuumistas

Another tribe of semi-liars are the “continuumistas” (not the best neologism meme ever, but useful), those who persist in mistakenly claiming that there is a “continuum of risk” among tobacco products.  This relates closely to the above points about different products and comparative risks.  The “continuum” claim may have been made more times in 2013 than in all previous history.  However, we did not rank the continuumistas on this list because it not really the same as the other lies:  While this is often an anti-THR tactic, in many cases it is not intentional and, indeed, many pro-THR commentators make this error.  Still, it is important and harmful, so deserves a mention.

Some of us have been pointing out for years why this claim is wrong and harmful.  For more details, read this, but to summarize the key point:  Claiming there is a continuum of risk suggests that tobacco products are spread out across the spectrum from zero up to the risk of cigarettes.  If someone believes that is true, they try to fill in the space, and so they dramatically elevate the claimed risk from some products, as with that 17%.  The reality is that there are basically just two relevant points: cigarettes and “about zero”.  The latter includes smokeless tobacco, NRT, and e-cigarettes, as well as abstinence.  The risks from all of these are so close that we cannot measure any differences, and so if you were to graph these risks versus smoking, they would all occupy the same dot on the graph.

So what explains the continuumistas in light of that distribution being about as far from continuous as is possible?  Some of them are out-and-out anti-THR liars, who are trying to suggest that no one should use the effective and satisfying THR products — or even that such products should be banned — because there is something else that is even lower risk.  Historically it was smokeless tobacco that was inaccurately moved into the empty zone between cigarettes and zero, but increasingly it has been e-cigarettes.  In many cases this involves absurd made-up numbers (e.g., “smokeless tobacco poses 10% the risk of smoking” or “why reduce your risk by half by switching to vaping when you can eliminate it entirely”), though sometimes it is similarly misleading graphical representations.

The claim is also actively perpetuated by industry in an attempt to muddy the waters and distract from the simple message: “combustion = bad for you; all else that currently exists and matters in the marketplace = no measurable risk”.  (In fairness, industry is trying to develop some smoking-like products that might occupy that middle space, with much less risk than smoking but more appeal to many smokers who do not like the smoke-free options; still, this does not make the continuum message accurate.)  Regulators also tend to like the notion because they like complication, and it keeps them from having to admit that the best choices — which they are often not making — are quite obvious and simple.  Finally, many THR supporters who are trying to position themselves as “moderates” seem to like the concept because it lets them avoid stating the highly confrontational implications of the simple message (“we can all agree there is a continuum of risk, right?… aah, good, so we are all on the same page”).

But whether used as intentional manipulation, a highly-toxic compromise between the truth and politics, or mere thoughtless repetition, the continuumista message is harmful for THR as a classic case of “the perfect is the enemy of the good”.  By suggesting that abstinence is perfect and thus “merely” good alternatives are too far away from it, many people are discouraged from taking the good options that are so close to perfect that the difference does not matter.

Anti-THR liars of the year #6, #5, and #4: Minnesota, NYC, and the EU

The countdown continues with:

  • Anti-THR liar #6: Minnesota: politicians, the University of Minnesota, and Kelvin Choi
  • Anti-THR liar #5: New York City politicians and activists
  • Anti-THR liar #4: European Union politicians and civil servants masters

No, we are not calling particular land areas liars. Instead, today’s “winners” in the liar derby represent the rhetoric surrounding these places’ THR policies. These three cases share the characteristic that the lying has been more the outgrowth of a particular policy goal than the cause of it.  That is, the anti-THR policies were not motivated by factual claims, whether true or false.  The lying followed the policy process rather than leading it, and served merely to try to win over a few more votes and rationalize the policy to the masses.  Unfortunately, it also spills over into influencing policy decisions in other jurisdictions where the facts (and thus the lies) are considered by the decision-makers.

As with most entries in this list, they are standing in for other similar examples (or at least Minnesota and New York are — there is nothing in the world quite like the EU).  So if you think Oklahoma should be there along with Minnesota, or any number of cities alongside New York, please consider them included by reference.  And for the majority of humanity that does not share CASAA’s geographic focus, I invite you to expand that to other places in the world (though we do mention both Europe and Canada today — and the rest of the world is represented tomorrow — because our analysis is not so USA-centric as our political activity necessarily is).

But though there are other candidate examples, there is something quite interesting about these that make for an interesting tale of three place.  The lies coming out of these places run the usual full spectrum of what is covered in this blog, and each represents a classic case of throwing every possible claim against the wall to see what sticks.  When the lying is an ex post rationalization rather than actual reasoning, those uttering the lies tend to be quite promiscuous.  Thus, today’s entry does not delve into the specific lies, but on the stories of how they happened.  The tales start out quite differently.

Minnesota is a small state that in many ways is pro-freedom.  But it is also the most Canadian part of America, meaning that it shares Canada’s unfortunate problem of having a relatively efficient bureaucracy and a communitarian-tending population that puts up with that.  It is also insular in a million little ways, thus not liking things that “ain’t from ’round here”.  When most people think of aggressive “public health” measures by US states, they tend to think of Massachusetts and California, but this stereotype overlooks the fact that Minnesota is similar in attitude, but often is much “better” at implementation.  So, like Canada, Minnesota moved to hurt the market for e-cigarettes long before any pro-THR opposition organized.  Specifically, Minnesota imposed a huge tax on e-cigarette products coming into the state (which due to its specifics creates some interesting distortions in the market that tend to favor mods over disposables, but that is beyond the present scope).  More recently, one Minnesota city after another has pursued usage restrictions on e-cigarettes.  This resulted in a deluge of lies by the anti-THR activists to try to trick lawmakers who had not (unlike the activists) already made up their minds before seeking information.

Kelvin Choi is just a bit player, but happens to be the only Minnesotan noted in the blog by name this year (though some other Minnesotans contributed to the upcoming first and second place awards).  Choi seems to be actively trying to set himself up as an Ellen Hahn or Stanton Glantz-like figure — doing pretend science with preordained conclusions for purposes of becoming an activist spokesman — though it seems unlikely he will succeed at this because he lacks the Barnum-like showmanship the other two have.  But though he will probably remain just a minor annoyance, his institution, the University of Minnesota, is among the most anti-THR organizations historically, playing a substantial role in anti-THR in the pre-ecig era.  His activism suggests it might regain some of that role.  That this university includes anti-THR activists seems to be coincidental with the state’s tendencies, but it does make this inward-looking state much more likely to be anti-THR.

New York City politicians and activists (is there even a difference there?) deployed the full armada of anti-THR lies in their move to treat e-cigarettes as if they were cigarettes in terms of onerous place restrictions.  Once again, the policy seemed to have little to do with the facts.  Indeed, given how lopsided and inevitable the vote was, there was not really even a reason to lie to win votes.  Instead, it is more a case of the local extremist activists (Bloomberg, et al.) creating policy as an effort to promote the lies.  In almost diametric contrast with Minnesota, New York is the meeting place of the world and thus has a lot of influence.  It was not local insularity as with Minnesota or Canada; it was local politicians trying to affect the policies of the entire world.  Still, the lies that came out of each (some of which were recognized here yesterday) looked pretty much the same.

The European Union is responsible for the worst anti-THR regulation in the world, the ban on snus (outside of Sweden) which has kept Sweden’s great THR success from spreading to most of its nearest cultural and geographic neighbors (in contrast with its impressive spread into non-EU Norway).  But they largely do not even bother to lie about it anymore — they just keep the policy without trying to justify it.  This says a lot about their motives as they deliberate how to regulate e-cigarettes (if what they are doing could be called deliberation).

Whatever the European Union ends up doing with e-cigarette regulation is, of course, huge.  It could still be anything between a de facto ban and minimal intervention and it forcibly affects hundreds of millions of people; thus what is in play is as momentous as anything happening in THR today (the only competing candidate being what the US FDA decides to do with e-cigarettes and its MRTP process).  But the EU does not top the list of liars because there has been remarkably little effort to aggressively lie.  The proposed bad policies are largely not influenced by the anti-THR lies.  Instead, the roots largely trace to simple officiousness.  Unlike the American system where “allowed unless specifically prohibited” is the legal and moral norm, nations that still put the pictures of hereditary monarchs on their money have found it all too easy to create an institution that defaults to “banned unless specifically permitted by the royal court”.

Interestingly, one corner of America that does use a banned-by-default rule is the FDA.  And what the EU started with (though it now appears to be off the table) is very similar to what FDA tried to do in 2009, which is to effectively ban the products as unapproved drug delivery devices.  In both cases, this seemed to have little to do with intentional policy making (and thus had nothing to do with the lies) and everything to do with just blindly following onerous rules according to the worst stereotypes of government bureaucrats.  In fairness, it is not entirely clear that the rule-makers should be included with the liars in this case, since it is usually the UK government sock-puppets that dominate the anglophone anti-THR lying related to the EU process.  But the lies are, again, following the policy.

In some sense, these top liars of the year blur the lines between speech and action.  In this case, the policy making — by communicating the message that these bad policies have some legitimate justification — is in itself the lie.

Anti-THR liar of the year #7: Cheryl Healton and the Paleo Tobacco Control Industry

Continuing our countdown of the top anti-THR liars of 2013, we have a last-minute entrant, Cheryl Healton, who seems to be the perfect representative of the stone age (i.e., c.2003) faction of the tobacco control industry.  Even as the post-Healton leadership of the American Legacy Foundation seems to be moving toward realizing the value of THR (though they continue Healton’s tradition of just hoarding the Foundation’s money, not actually doing much other than paying extravagant salaries), she writes anti-THR lies with the simple-mindedness of a past era.

Of course, she is not alone in this, and thus is symbolic in the #7 spot for thousands of people in local health departments, schools of public health, and the media who also traffic in the simple-minded lies (another recent example).  For years the tobacco control industry did not need to say anything other than “we think this is bad” to win over a gullible public.  But the public has become much more sophisticated about this topic and about mass communication in general, and of course have betters sources of information than whatever some county health official told the clueless local newspaper.  The better liars have learned how to deploy sciencey lies rather than just assertions and innuendo, which is more effective at tricking people, and also at not making the speaker look like an idiot.  But there is still a large paleo contingent — a far larger headcount than those who have gotten more sophisticated — who are not really part of the debate and thus have never been schooled that they cannot just lie like it is 1999, a time when there was little organized opposition to their lies.

My favorite example in this case is Healton, in urging New York City to ban the use of e-cigarettes anywhere that smoking is banned (see above link), deployed the paleo-tobacco-control tactic of calling for extreme restrictions on freedom — and the resulting damage to public health — in order to solve a simple problem.  Perhaps she is right that not allowing vaping on packed subway trains is reasonable, but what, exactly, does this have to do with not allowing bars to choose for themselves whether to allow vaping and how does it justify banning it throughout Central Park.  The one other specific place she cited, in terms of suggesting that upstanding citizens like herself should oppose e-cigarette use there, was walking down the street.  Of course, this is about the only place left where people can vape (or smoke) given the restrictions.  That is just classic tobacco control:  imposing restrictions that do not even address their own stated goals.

An important distinction needs to be drawn between Healton (and others like her who are getting rich off of anti-THR) and the workaday health department bureaucrats and clinicians who act as the footsoldiers for paleo tobacco control.  The latter are merely useful idiots who Healton and company manipulate.  They tend to be non-specialists and do not even pretend to be scientists, and are victims of the lies that are crafted by the actively dishonest puppet masters.  The knowing liars are clearly the most guilty.  Still, this does not let the ignorant liars off the hook — they may not pretend to be scientists but they do pretend to be experts on the topic when talking to the press, the public, politicians, or clinical patients.  They repeat the lies that they have been told as if they have assessed them to be true, when really they have no clue about the truth — and know it — and are merely transcribing what they have been told.  People living in the information age have no excuse for allowing themselves to be brainwashed by widely-debunked lies.

Anti-THR liars of the year (and #8: Stanton Glantz and UCSF)

2014 might be the year that determines whether tobacco harm reduction (THR) will sweep the world (at least the wealthy parts of it) by 2025, or whether its delay, and the resulting suffering and death, will drag out for another decade after that.  That made 2013 an interesting year for those of us who monitor the extremists who are actively working in support of the suffering.

After we decided we should do a year-end countdown for 2013, it quickly became apparent that this does not lend itself to just listing particular individuals.  The lying is really not about particular personalities, though we do mention a few who stand out (not in a good way).  Thus, the list is a hybrid of people, types of liars, and types of lies, with the named entities mostly serving as symbolic representations.  It also became apparent that it was not all that useful to just base this on some rough counting of the lies, how blatant they were, and how loud they were shouted.  Rather, this is a gut-level hybrid that considers that, but also how much the lies and the liar matter and other considerations.  So you will see that the entity whose actions matter the most on this list is at #3, while the most blatant and aggressive liar is #8.  Also, rather than forcing the count to match the number of fingers humans happened to evolve, we identified those worth mentioning and went with that count.  Thus, we start with #8: Stanton Glantz (from the archives) and the University of California, San Francisco, whose once good reputation among real scientists has been heavily damaged by Glantz and his anti-tobacco extremist colleagues.

Now some might be surprised to see Glantz so low on the list because, as noted, he does earn the special award for Most Aggressive Liar.  For the course of a decade of all the anti-smokeless-tobacco lies, he was relatively silent about THR, despite being one of the most toxic anti-smoker activists, in terms of both his lies and general innumeracy and cluelessness about science.  But this year he turned his superpowers — an apparent inability to distinguish lies from truth (or the sociopathology to not care about the distinction) and ability to trick people into thinking he understands science at better than a middle-school level — to anti-e-cigarette activism.  He ranks low, however, because he is just an accident of history, the person who happened to stumble into the crazy jester niche that someone always fills.

For any contentious and important topic, there is room for someone to gain fame and fortune by being the extremist liar, and so someone always fills that niche.  For most lie-based activist positions, the Loudest Liar niche tends to be filled by some entertainer or gadfly of letters, or an organization that can attract a few wealthy backers.  But when there is government grant money backing the lies, it is often an unscrupulous mediocre professor who fills the niche.

Still, Glantz is worth mentioning as more than a generic type because of a few particular propensities.  Most notably he excels at relentlessly repeating lies about what research shows, even after being explicitly publicly corrected by the researchers (and anyone else with basic literacy skills who weighs in), who point out that he is completely misrepresenting their results.  Those are some serious crazy-liar chops.  Few people, even among the other major anti-THR liars, will so baldly misrepresent what the science shows (except when it is the junk science from their tobacco control industry fellows, and thus the authors misrepresent it in the first place).  Fewer still are so unconcerned with their reputation that they will keep repeating the lies after being pointedly reprimanded for them (or perhaps they actually have a sense of decency).  For that, Glantz rises above (which is to say, sinks below) just being a font of generic lies.

He further secures a position on the list, in spite of having descended to jester status — even within the tobacco control community — because he and UCSF won one of FDA’s huge Tobacco Centers of Regulatory Science (TCORS) grants.  Frankly, this award says more about the process used to decide these awards.  (Aside:  it is not just those of us who prefer real science over tobacco control who feel that process was an embarrassing failure.  In addition to turning down some excellent applications from politically neutral centers and industry-academic cooperations, they turned down quality applications from established tobacco controllers who are good scientists — and were also livid about this — in favor of the UCSF hacks who apparently do not even know 101-level concepts like the difference between correlation and causation.)  Unfortunately, that center grant is going to lend some credibility to the hacks among the ignorant masses even though, among the knowledgeable, it instead serves to damage the credibility of the granting process.

The one bright spot about funding in this story is that UCSF sought grassroots crowdsourced donations to support one of their anti-e-cigarette “research” efforts but were offered only a pittance from a few donors in spite of offering incentives.   (If you click that link, notice that they already declared what conclusion they would reach in the request for funding, much as they did with the TCORS application — they do not do research, they write political propaganda and do not even try to hide that plan.)  Contrast this with CASAA’s research fundraising, in which we secured that sum for the Igor Burstyn research in four days.  There simply is no grassroots support for the likes of Glantz and UCSF, and tobacco control in general.  There might be millions of people who will express pro-TC and anti-THR opinions in opinion surveys, but their feelings are only a millimeter deep — they would not spend a dollar or a minute of their time supporting that cause.  As some of the rest of this countdown will further illustrate, anti-THR exists only because extremists have seized control of some government and other institutions, but that control is eroding as their lies become more widely understood.

New York Health Commissioner Nirav R. Shah lies about e-cigarettes

by Carl V Phillips

In a letter to the New York Times, probably fueled by anger that that newspaper did not toe the “public health” party line per usual, the Health Commissioner of the state of New York tries to criticize Joe Nocera’s wonderful pro-ecig NYT op-ed.  Having no valid complaints available, he naturally adopts the usual anti-THR tactic, lying.  He starts with,

Nocera…implies that the science related to e-cigarettes is being ignored by the public health community. It is not.

But what he then goes on to present is the little corner of the science that supports an anti-ecig position — a corner that is mostly filled with the worst junk in the field.  I suppose he might argue what he said is technically right, since the “public health” community merely ignores almost all the science, including in particular the most useful science.

Early studies of the value of e-cigarettes as a smoking-cessation device have found that they are no more effective than nicotine replacement therapies approved by the Food and Drug Administration.

Here he is employing the standard liar tactic of pretending that some fairly useless research is what we should focus on, rather than the overwhelming evidence from other sources that shows that e-cigarettes work.  Moreover he lies about even that:  there was only one such study (not plural) and it did show that e-cigarettes did better than the NRT.  Of course, they did not do nearly as much better as they do in real life, but that was because the study was pretty much useless:  poor-quality e-cigarettes, given to people who do not necessarily want them in an artificial situation are not terribly effective.

No expert real scientist puts much stock in that study.  The real science can be found in the evidence about how many people have switched, which Shah pretends does not exist.  At least he implicitly admits that NRTs are not effective.

We also know that the smoke that comes off an e-cigarette is not just “vapor,” a term probably promoted by the industry to make it sound innocuous.

The funny thing is that he is technically correct, though he probably is too innumerate to know it:  The “vapor” is, of course, mostly aerosol, with very little actual vapor.  I cannot fathom what he could possibly mean by the “just”, though — no one claims that because it is vapor (or aerosol) it poses no substantial health risk.  That would be stupid.  And I mean “public health”-level stupid.  There are obviously a lot of vapors and aerosols in the world that are very harmful.  Indeed, the word “vapor” has, in the history of public health, generally been associated with source of harm.

The real argument is, of course, that we know what the exposure actually is (consumers care about the actual chemicals, unlike “public health” that is satisfied to just assign labels).  Based on that we know that the risk is very low.  Shah lies by setting up a straw man.

I like that “probably” in there.  It is like he was saying “I would like to lie and claim that the term is a product of industry action and not popular culture, but even among the anti-THR liars I cannot find any assertion on which to base that lie, so I pretend to be honest by hedging.”

There has been an increase in use of e-cigarettes coincident with the aggressive marketing of the product. But there has been no concomitant increase in the incidence of smoking-cessation coincident with the use of e-cigarettes.

Notice the cute trick of implying (but without actually saying) that e-cigarette use is caused by marketing and not by, say, the fact that people really like them and find them to be a great way to quit smoking.  Gotta get that “demonic possession” theory of tobacco use in there.  And, of course, as anyone who knows about tobacco use knows (i.e., apparently not Shah), smoking cessation has increased at a rate that is remarkably similar to the uptake of e-cigarettes.  (Of course that does not prove causation, though there is no doubt that the “public health” types would insist that it was causation if it went in their favor to do so.)

Much remains unknown. How will smokers and former smokers use e-cigarettes: to reduce tobacco use or to maintain nicotine addiction by smoking e-cigarettes where they would normally have to abstain?

There is no doubt that many are using e-cigarettes to quit — it is a lie to say that is unknown.  It is also known that some are using them primarily because they are not so restricted.  Um, so?  It is still making them better off, without hurting their health, so what’s the problem?  Of course, he is implicitly admitting that in the mind of “public health”, making smokers happier is the problem because the purpose of place restrictions is to torture smokers into quitting.  But if you are going to restrict e-cigarettes because they can be used for this, you obviously need to restrict NRT also, since more of it is sold for this purpose than to quit smoking.  (And, of course, if we avoid bone-headed anti-harm-reduction efforts by “public health”, smokers who are using low-risk products some of the time are excellent candidates for completing the transition.)

Does the doubling of e-cigarette use by youth in the last year portend an increase in tobacco use that will reverse the significant reductions in cigarette use since 2000?

The “doubling of use” claim is a well-documented lie, of course.  But even if it were not, it obviously would do nothing to cause cigarette use.  It would tend to increase the reduction.  Of course, pretending not to be lying, Shah did not actually assert the claim that he is carefully implying.  He phrased it as a question, a classic liar tactic.

Most would agree that there is no public health value in youth nicotine addiction and that regulation by the F.D.A. as a tobacco product is necessary.

Wow, you could use that as a dictionary example of “straw man”.

The lack of science on critical questions should be cause for close regulation of e-cigarettes until these questions are better answered, rather than careless optimism with the lives of our youth.

Oooh, if we do not ban these it will kill the chiiiiildren!  Except that they are close to harmless and substitute for far more hazardous behaviors even among chiiiildren.  We have enough science to know without a doubt that there is no dire hazard here that calls for precipitous action.  Yes, some science would be helpful in making regulations.  Isn’t that what the “public health” types always crow about: science-based regulation.  So why is it they are always asking for regulation that is explicitly based on a lack of science (or more precisely, in pretending that there is a lack of science)?

Cheryl Healton lies (a lot!) to try to get NYC to restrict ecigs

by Carl V Phillips

This analysis, of this blog post, might seem a little more brutal than usual.  That is because the author, Cheryl Healton (the former head of the leading anti-tobacco organization, American Legacy Foundation — a fact that is omitted in the introduction of her in the blog in question — and now head of the public health program at NYC), knows the truth.  This is not a case of someone who is too innumerate to not know she is lying, or a useful idiot that is being used by the anti-tobacco extremists.  Healton is one of the puppet masters who manipulates her useful idiots (like New York Assemblywoman Linda Rosenthal), which she is doing in this post.  Notice in particular the many times that she lies by using literally true but highly misleading statements, the mark of someone who knows she is lying but wants to be able to pretend otherwise.

The post appears in the blog of the “NYC Coalition for a Smoke-Free City”, an obviously misnamed group since they are campaigning not against smoke, but against e-cigarette use.  The thesis is that NYC should go ahead with its proposal to prohibit e-cigarette use anywhere that smoking is prohibited.  It is remarkable how close Healton comes to lying in every single sentence.  The first few about the fact that NYC is about to act on this are true, but most everything that follows is a lie:

Who is the e-cigarette industry?  Increasingly the e-cigarette industry is owned by the tobacco industry, an industry that would not be permitted to exist were it invented tomorrow because it would violate the consumer protection laws of all states and virtually every country in the world.

As I have pointed out, this “would not be allowed to exist” claim is at best pure speculation, and probably wrong.  But apart from that, it refers to a product (cigarettes), not an industry.  If the industry came into being right now selling low-risk products like smokeless tobacco, e-cigarettes, and NRT (all of which are sold by “the tobacco industry”), it would be allowed to exist.  But, of course, this soup of words is not meant to analyze the actual claim, but to lie about e-cigarettes, suggesting they are some industry plot.  In case the innuendo is lost on the reader, she goes on to lie,

For this reason, a healthy degree of skepticism about the industry’s ultimate goal in buying up e-cigarette manufacturers and creating more “efficient” e-cigarettes should prevail as policy makers establish regulations governing them. It is quite possible that the net effect of e-cigarettes will be to induce greater youth initiation of smoking and reduce the adult cessation rate, but the jury is still out.

I cannot imagine that Healton is stupid enough to actually believe that.  It is impossible to come up with a story to explain why the existence of e-cigarettes (let alone the acquisition of a few companies that she led into that with) could cause smoking at all, let alone to cause a net increase in smoking initiation.  E-cigarettes, like any popular low-risk alternative, will replace smoking initiation, not cause it.

Both youth and adult smoking rates are at their lowest levels in decades, so much is a stake for the health of the public.

Setting aside the fact that the “so” is a non sequitur, is what she is saying is that having almost 20% of the population smoking is such a success that harm reduction should be avoided?  It appears so.

There is also much at stake for the tobacco industry as it seeks to apply its considerable marketing acumen and seemingly endless resources to maximize profit by increasing the number who start smoking by enticing youth worldwide to smoke and by trying to retain current smokers.

Complaining about “endless resources” is pretty funny coming from someone who is at the apex of the billions-per-year tobacco control industry.  But the real question is what this passage has to do with e-cigarettes at all, let alone restricting where you can use them.  It is typical tobacco control misdirection:  “Cigarette manufacturers profit from more people smoking and remaining smokers, and therefore we should restrict where people can use e-cigarettes.”  Huh??!

Who might be hurt by e-cigarettes?  The tobacco products the industry has historically manufactured and promoted as “reduced harm” are not benign products created to meet the broad range of consumer preferences in the United States, rather they are deadly products that when used as directed kill over 400,000 Americans each year and are predicted by the World Health Organization to kill a billion people worldwide this century, 10 fold more than they killed in the 20th century. To put the scope of the current tobacco-related epidemic in perspective, in a few years, global lung cancer deaths will surpass AIDS deaths as the steady march of tobacco industry marketing continues to engulf the world’s poorest nations.

Again, huh??!  Does anyone see any connection between that question and what follows?  (Yes, I realize that the reader might now be questioning my assertion that Healton is too smart to not know she is lying.)  Her allusion to historical products is the usual tobacco control canard about the introduction of “light” cigarettes four decades ago, products where there was no evidence to suggest they would be lower risk.  And yet they were actively endorsed by the public health community, not just the manufacturers.

However, a mistake by everyone a couple of generations ago about what might be lower risk tells us nothing about the present world of products that are known to be lower risk.  It is an utterly absurd and blatant lie to suggest otherwise.

None of what she says in this paragraph is true about the actual reduced harm products that have been introduced by the tobacco industry and by others.  Smokeless tobacco, e-cigarettes, and other low-risk products do not cause the harms she is citing; cigarettes do.  (Well, cigarettes cause and will cause a lot of harm, though not as much as she claims.  But that is another story).  She seems to be trying to invoke the conjunction lie, that cigarettes plus low-risk alternatives do that much harm (which implies the harm is shared, even though it is basically all caused by cigarettes), but she screws up doing even that.  She actually is claiming that the low-risk products alone cause all the harm from smoking.

Nicotine addiction is in and of itself a gateway to tobacco product use because once addicted many will broaden the products they use and included among these will be the most dangerous products like cigars, cigarettes and hookah.

It is true that people who like to use one tobacco/nicotine product often try other products.  But what she is trying to imply (carefully avoiding actually saying it) is that using e-cigarettes will cause people who would not have otherwise smoked to do so.  There is no reason to believe this would be the case, and certainly no evidence of it occurring.

And it is worth pausing to remember that the title of this post says that NYC should include e-cigarettes in its smoking place restrictions.  I have skipped a few sentences but have not left out anything that addresses that.  There has been nothing yet.  Even if the previous quote were not a lie, it would still only be an argument against letting kids use e-cigarettes, not about forbidding adults from using them at their desks or in bars.

Most tobacco-related deaths are the culmination of substantial suffering and societal cost from heart disease, emphysema or various cancers and are the direct result of nicotine addiction.  Moreover, nicotine addiction is considered by many scientists as the most intractable of all addictions as measured by the percent of ever users who become addicted and the percent who remain addicted until death. Half of lifelong smokers lose their lives to tobacco addiction and among these people nearly half die before retirement age.

A pretty good argument in favor of encouraging e-cigarette use.  The bit about “most intractable” is nonsense, of course.  The reason users have more incentive to quit, say, meth than to quit smoking is the high level of short-term damage it is doing them.  And the “half” is a made-up number that is higher than what the evidence suggests.  Most important is that claims about the “addictiveness” of smoking tells us little about e-cigarettes, given the evidence that e-cigarettes are much easier to quit.

And, once again, this has nothing to do with whether there should be a place ban on e-cigarettes.

E-cigarettes are a complex product and their availability and the regulatory framework for governing them may have different implications and considerations for youth non-smokers compared to adult smokers. E-cigarette policy could produce sharply differing results by population sub-group.  Data demonstrate that a significant swath of adolescents already are using e-cigarettes. Time will soon tell whether e-cigarettes function as one more point of entry to cigarette, cigar and hookah consumption among those using e-cigarettes initially. One thing is clear however, since cessation efforts have thus far not worked with teens, e-cigarettes will likely not do anything good for kids and may well entice many to start smoking in view of the broad array of sweet, candy flavors and slick e-cigarette marketing already blanketing the internet, mall kiosks, TV and radio, which have to date eluded regulation.

Blatant lies and clueless nonsense.  (Ok, I will admit I am starting to doubt my previous assertion that Healton really understands what she is saying.)  Skipping past the distractions that the first few sentences comprise, we have the lie that many adolescents are using e-cigarettes, a repeat of the lie that there is any reason they would cause smoking, the lie that because other cessation efforts do not work for kids that harm reduction will not work for them (it might be true, but probably is not, and it is nothing more than speculation asserted as fact), and of course the usual canard about marketing.  Once again, the biggest lie here is that this has anything to do with restricting where adults can use e-cigarettes, or anything else about adult use.

Whether e-cigarettes will offer an incremental boost to cessation rates nationally also remains to be seen.

No, it doesn’t.  Close to every e-cigarette user is either a former smoker or a current smoker who has replaced some smoking with e-cigarettes and could be persuaded to complete the transition.  Many of those who quit smoking report that they had not been able to succeed at cessation until they tried e-cigarettes, and only then did they quit.  Therefore e-cigarettes have increased cessation.  This is not really a difficult concept to understand.  (She goes on in that paragraph to lie about what the research shows, but I will stop at debunking her thesis claim.)

This is the epitome of the ANTZ tactic of declaring every negative they can concoct to be a real concern, even if there is zero evidence and even if the evidence clearly shows it is a non-issue, while denying every positive by pretending that the evidence does not exist.

We should also remain open to another highly plausible effect of e-cigarettes-that they will function in the same manner “light” cigarettes did when they were introduced in the 70′s, promoted by the tobacco industry as a step smokers could take to feel safer without actually quitting smoking. As many subsequent studies showed, in fact they were not safer and millions who would have quit had they not been introduced failed to do so costing innumerable lives.

And (setting aside the lies about “light” cigarettes themselves) there is that lie about the situations being similar again.  The obvious difference is that e-cigarette users are “actually quitting smoking”, unlike light cigarette users, and they are using a product that genuinely is low risk.  What does a public health failure of the 1970s have to do with e-cigarettes?  Absolutely nothing.  It is basically the same as saying leeches turned out to be harmful rather than helpful in treating infectious diseases, and therefore we should avoid antibiotics.

Do we really want everyone vaping where they once could smoke?  

Oh, look, she is finally addressing the question she claims to be addressing.

The proposed extension of the SFAA to e-cigarettes, which will be voted on tomorrow, also will reduce the “walking billboard” effect of thousands of New Yorkers once again lighting up in bars, subways, parks, office buildings and restaurants throughout the city. But banning e-cigarettes in some locations solely for this reason is un-American in a country that prides itself on maximizing the freedom of its adult citizens to choose to engage in a range of risky and frisky behaviors. 

Interesting.  It is not a very risky behavior, of course, but it is nice to see that New York is still part of America.

The “billboard” claim is utter nonsense, of course.  How is someone vaping in their office, rather than outside the front door, a billboard?  E-cigarettes could still be restricted on the subway and restaurants could make their own choices about what is best for their patrons and vibe.  The proposed ban would eliminate all discretion, reasonableness and common sense, going beyond a few specific restrictions that some might argue are reasonable and imposing rules that are clearly absurd and harmful.

Take a step back and see what she is doing with all of this.  She is appealing to people who are worried about kids using e-cigarettes and do not like people vaping on the subway, and trying to trick them into supporting a rule that bars cannot choose to allow their patrons to vape.  If she actually cared about kids and subways, she would propose something that affects kids (this rule would not) and would endorse a rule that just applies to the subways (which could probably be done by administrative fiat).  Notice she never once offers any reason why banning vaping in bars, private offices, and many outdoor spaces would do any good for anyone, and indeed tries to hide the fact that this regulation would impose such restrictions.  Classic tobacco control bait-and-switch.

It should be noted, however, that while we in general embrace this ethos, when it comes to public drinking we often do not. We do not embrace wandering down the street drinking a cocktail, hopping into the elevator rum and coke [sic] in hand or whipping out a flask of whiskey on a plane.

Ok, so no vaping on elevators and planes.  I suspect that even most dedicated vapers would not find those to be terribly unreasonable restrictions.  As for walking down that street, the street would be one of the few places vaping was still allowed under the restrictions.  The anti-THR people cannot even keep their own stories straight.

Do we know enough to allow vaping in public spaces?  So what are the real risks of public vaping? Is it as its promoters would like us to believe a benign, reduced harm practice that is at worst a passing fancy?

Um, no.  Its promoters think it is here to stay.  Also, the ban is mostly about private spaces, not public spaces.

Or is it a potentially toxic practice that places those in its immediate vicinity at risk. The answer is we do not completely know yet, although already studies have shown elevated nicotine levels among those exposed to secondhand vaping, and this in and of itself is ominous. Not definitively measured as yet among second hand vapers [sic] are the myriad other toxic substances which are contained in e-cigarettes. 

Cute, huh, that use of “completely” and “definitively”.  Of course we know, from ample evidence, with a very high degree of certainty that the risk to bystanders is zero or utterly trivial.   But we never know anything completely or definitively.  Someone can always use weasel words like that to intentionally trick the reader into thinking she made a statement about what we really know, rather than merely a statement about the fact that there is never proof or complete information in the real world.

And if anyone is aware of any study that shows elevated nicotine levels from people exposed to “secondhand vapor”, I would be quite interested in hearing about it.

Under these circumstances, the prudent course is to extend the SFAA to encompass e-cigarettes until, if ever, sufficient evidence exists demonstrating their safety.

Right.  And what might that be?  Oh, you say, no evidence would ever be sufficient for that.  Thought so.

And why exactly would this be prudent?  I do not think that word means what she thinks that word means.  Is it prudent to restrict a very personal freedom when there appears to be no reason to do so, just because such a reason might be found later?  (Sounds like an argument for banning, say, the building of mosques in America — there are many who would make the same “we just don’t know if this will hurt the children” arguments about that.)  Is it prudent to ensure that cigarettes remain as attractive as possible as compared to low-risk alternatives?

The only conceivable downside of not extending the SFAA to e-cigarette use is the loss of any incremental harm reduction for smokers associated with being permitted to smoke e-cigarettes in locations where smoking is now banned.

TrANTZlation:  The harm it would inflict on those not able to vape at their desk, in bars, etc. is of absolutely no consequence.  We are tobacco control.  We don’t actually care if tobacco users suffer.  In fact, we prefer it.

And, of course, making e-cigarette use less attractive creates the public health harm of encouraging smokers to keep smoking.

It is highly unlikely that such a benefit, if it in fact exists, would outweigh the harms to youth, to non-smokers exposed to vaping nicotine laden vapors and potentially other toxins, and to recovering smokers who now stay quit in part because smoking has become less ubiquitous than it was 50 years ago when the Surgeon General released the first report on Smoking and Health.

Huh?  It is highly unlikely?  Care to quantify?  I would love to hear about the harms to youth from people vaping at their desks.  What harms are caused by (barely) “nicotine laden vapors”?  What possible impact is there on “recovering smokers”?

Sadly e-cigarettes may lead to four negative outcomes: the initiation of more youth to nicotine dependence and subsequent conventional smoking; the use of e-cigarettes by current cigarette smokers who would otherwise have quit but instead use both conventional cigarettes and e-cigarettes in combination and therefore delay quitting or never quit and; the relapse to smoking by those who have already quit, first to smoking “benign” e-cigarettes and then to conventional cigarettes; and the exposure of people to e-cigarettes’ emissions unknown risks.

And how does all of this other than the last bit (a lie that has already been addressed) relate to the question at hand?

Who loses, if anyone, by extending the SFAA to e-cigarette use? Virtually no one loses. Vapers can still smoke everywhere current smokers now do. Let’s do what NYC has become known for and enact a policy that saves lives, not costs them.

Just in case the above trANTZlated passage was not clear enough, here she comes right out and says that the hardships suffered by vapers as a result of the rule do not matter.   Smoking place restrictions are designed to make smokers less happy — tobacco control advocates generally admit that these days — so obviously imposing the same restrictions on vapers will make them less happy too.  I wonder if it is a Freudian slip when she says that “vapers can still smoke” — because that is exactly what will happen:  Some would-be vapers, upon having to go out to the smoking areas anyway, will indeed smoke.  As a result, some of them will die from smoking and their blood will be on the hands of liars like Healton.

Chi-Ming Hai is a liar – nicotine does not cause measurable risk of CVD

by Carl V Phillips

You have never heard of Chi Min Hai.  He is not an ANTZ (though he became an instant ANTZ mascot), but either he or his institution (Brown University) is aggressively trying to spread anti-e-cigarette lies about his research.  I do not know if Hai is culpable or just a naive dupe in this — that will be determined based on whether he steps up and points out his results are being over-interpreted.

Hai has done some toxicological research on why smoking causes atherosclerosis.  This, unlike most research on smoking from “public health” people, was not useless.  It is actually not well understood why smoking causes some particular cardiovascular diseases (CVD), and it might explain how to make smoking less harmful.  What Hai discovered is that in his particular experiment (the details of which are not important), cigarette smoke, smoke without nicotine, and nicotine alone all caused vascular tissue damage.

Ok, fine.  It might be generally true for this situation, might be lab error, might be idiosyncratic.  It might be interesting for informing further science.  What it most certainly is not, however, is any reason to believe that nicotine use, ex smoking, causes heart disease to any consequential degree.  Yet this is exactly the message that Hai and Brown University are aggressively communicating to the press, trying to get into the news by claiming that his conference paper about a completely artificial experiment has real-world implications.  And of course, the innumerate health press corp is buying the whole lie (example, Jen Christensen, CNN), and reporting that this is evidence that e-cigarettes cause heart disease.

I know that it has been aggressively touted because a week ago one reporter sent me a copy of the research to ask me about it, and told me it was being aggressively touted.  Because he was sensible enough to not just copy-and-paste the press release, he was able to include my comment that this is nonsense.  (He also asked me why the university would aggressively tout something that was nonsense.  I pointed out that it happens all the time, and they just want to get their names in the paper, and do not care how.)  Unfortunately, the reporter just quoted a soundbite assertion from me and did not explain to the reader (as I explained to him) why it was nonsense, which made what could have been a penetrating article into a fail, just a he-said-she-said.

That reporter did, however, provide evidence suggesting Chi-Ming Hai is indeed a liar and not a dupe, quoting him as saying,

In my opinion, if taking nicotine for a short time can lead to complete cessation of smoking, e-cigarette included, then it will be beneficial to take nicotine for a short time as a bridge to smoking cessation,” he added. “However, our data suggest that long-term consumption of nicotine by e-cigarette smoking is likely to increase the risk of developing atherosclerosis by stimulating invasion of vascular smooth muscle cells.

The reason that the claim is nonsense and thus this quote qualifies Hai as a liar is that we know that nicotine use does not cause a measurable risk for heart disease.  We have extensive epidemiology about smokeless tobacco use that has failed to show measurable risk.  Epidemiology (the evidence about what is happening with real people in the real world) trumps toxicology (the search, under artificial lab conditions, for phenomena that might — but usually do not — translate into the real world).  Sometimes it is tempting to just say that all toxicologists are liars any time they make conclusions about real health outcomes, though this would be a bit too strong.  But there is no question about this case, which is one of the classic toxicologist lies that goes something like this:  “We have discovered why exposure E causes disease D, though we already know E apparently does not actually cause D.  Therefore, this E causes this D.”

Granted, a small risk of CVD from nicotine would be completely buried in the confounding, so we cannot rule it out.  Indeed that is the reason that the conventional wisdom is that smokeless tobacco and e-cigarettes are 99% less harmful than smoking.  The reason for that remaining 1% is not because of any affirmative evidence of risk, but to be conservative about CVD risk from nicotine that may exist but is too low to measure.  Thus, it would not be terrible to offer an interpretation of this toxicology data in terms like “while we know that nicotine without smoke causes very little risk of heart disease, this evidence suggests that it might not be zero.”  Even that would be an over-interpretation of the toxicology; you can basically damage tissue in a lab with any chemical that is not completely inert if you want to.  But at least it would not have been the full-on toxicology lie.

But Hai seals his liar status by not just making false epidemiologic claims based on what he could concoct in a lab, but by going so far as to make behavior/policy recommendations based on his incredibly tenuous results.  (Until I reread that quote, I had a more equivocal title for this post, but that sealed it.)  He further suggests his ANTZ-wannabe status by referring specifically to e-cigarettes.  He clearly has little understanding of the real world he just threw his baseless opinions into — he apparently does not even know the epidemiology, let alone the politics.  I will give him a few weeks to speak up against the (inevitable) misuse of his results in anti-THR propaganda to establish himself as an honest scientists and not an ANTZ or dishonest self-promoter.  But I am not holding my breath, because I suspect the ANTZ are already writing him big checks from their copious warchests to pay him to go full-liar on this.

As for us, here is the soundbite we need to use in response to the inevitable deluge of lies from this:  “That claim is based on only one very abstract lab work that probably does not relate to the real world.  We have extensive evidence, from smokeless tobacco use, that nicotine without smoke causes no measurable risk for heart disease.”