by Carl V Phillips
I interrupt the analysis of the deeming regulation, because this article simply must be commented on. CDC Director Tom Frieden “explains what he hates about electronic cigarettes” to the Los Angeles Times. That is the actual headline — I paraphrased based on what he actually said.
“I’ve treated so many adults who are desperate — desperate — to get off tobacco. They all started as kids,” Frieden said. “I see the industry getting another generation of our kids addicted. To me, as a physician, when 1.78 million of our high school kids have tried an e-cigarette and a lot of them are using them regularly … that’s like watching someone harm hundreds of thousands of children.”
Ok, first, what business does a high-ranking executive branch official have making national policy based on personal pique. That is simply grossly inappropriate no matter what his pique is. He has fiduciary duties. He is not just some celebrity talking head like the Surgeon General or Vice President. Second comes the obvious point that e-cigarettes are a great answer to that whole “desperate to get off tobacco” thing. Third, stop lying about how many kids are using e-cigarettes. It is not nearly that many (trying a puff is not the same as using), and almost all of them are smokers.
In addition, he said, “people have a misconception that the tobacco epidemic is a thing of the past. Tobacco still kills more Americans than any other cause. It still kills more than 1,000 people a day. As a doctor, I can tell you it kills them in really unpleasant ways — gasping for breath with emphysema, with cancer, with heart disease.”
Yes, because only a physician would understand that dying from smoking — or dying from those diseases when they are not caused by smoking — is horrible. Thanks for the insight, doc. Oh, and see above about e-cigarettes doing more to make those deaths from smoking a thing of the past than anything the tobacco control movement has done in decades.
What does that have to do with e-cigarettes?
Score one for the reporter, who is in full transcription mode for most of the article. She probably did not have much choice about how to report this, so credit for getting that dig in.
Frieden rattled off five reasons why e-cigarettes are as dangerous as tobacco cigarettes:
–“If they get another generation of kids more hooked on nicotine and more likely to smoke cigarettes, that’s more harm than good,” he said.
–“If they get smokers who would have quit to keep smoking instead of quitting, more harm than good.
–“If they get ex-smokers who have been off nicotine to go back on nicotine and then back to cigarettes, more harm than good.
–“If they get people who want to quit smoking and would have taken medicines to think e-cigarettes are going to help, but they don’t, more harm than good.
–“If they re-glamorize smoking, it’s more harm than good.”
If you take the word “they” to mean “Coca Cola” or “chewing gum” or “the latest episodes of Game of Thrones”, you could say the same things. It is hard to go wrong when you start a sentence with “if”.
Of course, he still did get it wrong. Unlike chewing gum, if e-cigarettes did cause one of those things to some extent, they might still do a lot more good than harm, because of the enormous good that they do. So he is wrong even in his hypothetical claims. And since there is no evidence that e-cigarettes cause those things any more than does chewing gum, this series of hypotheticals needs to conclude with “and therefore, there is no apparent problem.” Certainly the lead-in statement, “are as dangerous” is absurd, since none of those bullets actually makes a claim.
Just for good measure, Frieden threw in two more problems with e-cigarettes: People who use them can expose kids, teens and pregnant women to nicotine via secondhand smoke; and enterprising smokers can put marijuana or hallucinogens in an e-cigarette “tank.”
What smoke? And do you have any idea how little nicotine there is in the environmental exposure? (No, probably not.)
As for the shark-jumping “they can be repurposed” silliness, Mr. Frieden, here is a video of how to smoke weed using an apple. When can we expect your crusade against apples? Also, if we eat one a day, will you stay away? (Note: please don’t ban apples. I like them. And it turns out that if you ban both e-cigarettes and apples, there is still a way to smoke marijuana using little bits of paper.)
Frieden acknowledged that “stick to stick, they’re almost certainly less toxic than cigarettes” and that many people have quit smoking tobacco cigarettes with the help of e-cigarettes…
The mind boggles at how someone who knows that (even with the ignorant “almost”) can say everything else he said.
…However, he said, “the plural of anecdote is not data.”
Technically, that is right. One anecdote constitutes data, so you do not need the plural. Don’t try to talk about science, Mr. Frieden. You are not good at it.
“If the e-cigarette companies want to market these to help people quit, then do the clinical trials and apply to the FDA,” he said, in a reference to the Food and Drug Administration. “But they don’t want to do that. They want to market them widely.”
You are not much better at logic. How, exactly, does the lack of clinical trials suggest that e-cigarette manufacturers are not trying to get people to quit smoking? How does not wanting to go through a near-impossible approval process suggest that they do not want to market that way? And for that matter, how does wanting to market them widely suggest that they are not selling them for the purpose of replacing smoking?
“The challenge that the FDA has is that they will be challenged by the tobacco industry, as they have been at every step of the way,” he said. The federal agency “tried to regulate e-cigarettes earlier, and they lost to the tobacco industry. … So the FDA has to balance moving quickly with moving in a way that’s going to be able to survive the tobacco industry’s highly paid legal challenge.”
Do you think he really does not know that it was two scrappy e-cigarette companies that stopped the FDA from banning them in the first place? That the tobacco companies did not get into the market until much later? That the sector of the industry that has the high paid lawyers is likely to benefit enormously from these regulations, and thus is not likely to fight them? Perhaps he doesn’t. There is a lot of ignorance out there. But surely he can afford to hire a research assistant to write him a memo about it.
Yes, this is America’s Centers for Disease Control at work. Is it any wonder that we now have a diphtheria outbreak to go with our resurgence of measles? At this rate we will forego this in favor of this.
[See also the next post, which continues on this theme.]
Tobacco harm reduction, anti-THR lies, and related topics 
No admonishment for that admittion!
Frieden, like many members of the medical establishment, has a narrow view unpleasantly combined with arrogance and ignorance in equal measure. There are many great medics out there. They tend to practice quietly.
It’s hard to work out if the guy is a barking-mad crackpot or a corrupt liar. As the money inevitably comes into it, no doubt it’s the latter.
As a New Yorker (he started out here as head of Bloomberg’s DOH) I can tell you he’s a barking-mad crackpot AND a corrupt liar who likely knows he’s lying but really doesn’t care because, as he sees it, his control-freak, eerily God-complex ends justify any kind of lying means. Ads he ran about the mortal dangers of soft drinks were exposed as lies that he knew were lies– even exposed in the NY Times (which rarely meets a health scare it doesn’t like) but the ads weren’t either dropped or changed. But I don’t really think he’s in it for money, just for the glorious personal satisfaction of changing as well as controlling the world. Much more dangerous and insidious.
Yeah, ban e-cigs because people could put drugs in them, unlike tobacco products. No one I knew in high school would use pipes, cut open cigars/cigarettes/cigarillos, or tobacco rolling papers to smoke marijuana. /s
This guy is a complete tool. I smoked for ten years, starting at 17, and my PV is the first thing to get me off the cancer sticks. Maybe these simpletons just get confused and frightened when I list the 4 “complicated” ingredients found in FDA regulated food products that are in the juice I make at home in my kitchen.
And the “for the children” argument is idiotic. You don’t see these crack-pots going after flavored coffee, blunt wraps, alcohols, or diabetes causing sweets.
Knee-jerk bans are NEVER a good answer and only cause suspicion of those attempting to ban the “offending” item. Maybe one of these days I can actually live in “The land of the free.”
1. Um yes, that was my point about the repurposing — that the lack of this option would not change consumption. 2. People mixing e-cigarette liquid in their kitchen is probably a major motivator for these regulations. So long as you do not distribute, they do not really care, but they do consider it their job to make sure products like that are not distributed. This is indeed probably the most legitimate justification for regulations, the problem being that the proposed regulations actually eliminate clean manufacturers and may increase DIY. 3. “Public health” does indeed go after alcohol and sweets (which, btw, are not conclusively linked to diabetes incidence other than through delivering excess energy that causes obesity).
My favorite thing about this article is that he dismisses the evidence that e cigarettes really are helping people quit smoking because “the plural of anicdote is not data”, but all of his arguments are “What if this hypothetical scenario happens? That would be bad!”
Perhaps instead of trying to direct people to the actual data we should start saying, “if people started using ecigarettes instead of combustible cigarettes that would be good.”
You think that is hypocritical? Check out the next post (coming shortly) — it shows CDC being even more precisely hypocritical.
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I’ve had to do battle with the “anecdotes” vs. “data” argument in the past and have two examples to offer from the War On Smokers. The first has to do with the claim that bans don’t hurt bars, and can be seen in the listing of 1,000 or so “anecdotal examples” (along with some great quotes) at:
http://www.nycclash.com/Philly.html#ETSTable
and the second comes from the “Wall Of Hate” poster of 130ish examples derived from four densely packed pages of TobakkoNacht:
I like to explain the difference in this way: When your Aunt Matilda tells you that her hairdresser’s cousin has a daughter whose brother-in-law knows someone who experienced something, that’s anecdotal data. When you have a thousand such examples then the “anecdotal” descriptor is justifiably dropped.
– MJM
The first of those, I think, would be called a rumor. That does point out that the word “anecdote” is faulty as a denigration also. What users of the word seem to be trying to say — but generally do not understand that is what they are doing — is that there is “not enough data” (as is the case with one case study when you are trying to say something beyond existence) or that it is “a biased sample”. But it turns out that “anecdote” is not sufficient for either of these. When you have 1000 examples, that is enough data for a lot of conclusions. And you could do a systematic sample of a population and ask them for testimonials. Those would still be anecdotes, but they would be as representative as any other survey data.
You might find this 2006 interview with Frieden (like a bio almost) of use. It’s a look into his mind.
http://www.oberlin.edu/alummag/fall2006/life-on-the-cutting-edge.html
“the value of an action can be measured by the effect it has on the well-being of the majority.”
Interesting. Euthanize the bottom 49% and transfer their wealth to the remaining 51%. Good to know what Frieden’s philosophy is at least.
– MJM
I also had to admire this, though it needed some improvements:
“Bloomberg took a huge amount of political heat for challenging the tobacco companies by proposing a ban on smoking in the city’s bars and restaurants, and for a time it looked like that issue would cost him a second term. But he didn’t back down, (he just used a few hundred million dollars of his own money to buy votes,) and I think that displayed great leadership.”
Funny, I did not know tobacco companies had some many votes in New York. Perhaps the problem was that the smokers didn’t like it. No matter how many times you are reminded, it is still always striking how these Masters Of The Universe types, even the ones trying to get votes, only care about corporations and rich people.
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I just can’t believe a man this ignorant is in charge of the CDC! That’s appalling, just outrageous! He’s in charge of some of the most dangerous microbes on the planet, and he’s THIS ignorant/stupid/evil??? HOW DOES THAT HAPPEN???
Wow. Feeling morbidly impressed at Frieden’s managing to cram so many logical fallacies into one interview (presumably while keeping a straight face).