Tag Archives: ethics

Tobacco Wars collateral damage: feature, not bug

Posted on 17 April 2019 by | 6 comments

by Carl V Phillips

A single-observation post, inspired by the great consternation I am seeing this week about proposed FDA retail restrictions on vapes, ostensibly for the purpose of reducing vaping by minors. There are quite a few reasons this is a terrible policy (see coverage by Clive Bates here), but the theme of the typical criticism is that it will hurt legal “proper” vape consumers (primarily by denying them flavors they like or convenient purchase venues) more than it will “help” teenagers (by denying them something they want to do). The criticism is presented as if this supposedly odd perverse effect might persuade tobacco controllers to change the policy.

Here’s the thing: Hurting people who continue to use a tobacco product is considered a feature, not a bug. Despite the endless chatter about trivial policies, there is basically only one category of tobacco control policies that matter (by any measure), other than the bans that exist for some products in some places: the high punitive taxes on cigarettes and other products. These policies is lauded by many of the same people who condemn blunt-instrument anti-teen-vaping policies. Yet they are almost exactly the same from an ethical perspective. Continue reading →

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Tobacco control ratf**king

Posted on 5 March 2019 by | 5 comments

by Carl V Phillips

Sorry for the silence, though it may get worse. As some of you know, I lost my funding to keep working on THR issues, and I expect I have to fully move on to other work. But I thought I would pop in with some insight from the old guard. After that, I have an epic post that is almost finished (years in the making). These will be good notes to go out on.

For those not familiar, “ratfucking” is a term from the Nixon era that refers to political dirty tricks. The word has had a major resurgence in the age of Roger Stone, Stephen Miller, et al. [Fun fact: I was not sure of the spelling of Miller’s name, so I typed a search for “Trump advisor smug weasel” and his name appeared as the second entry after an article about presidential advisors in general.] The nuance of the word typically refers to sowing false information or allegations to harass and damage the opposition. The acts are usually barely legal (except perhaps insofar as they constitute a criminal conspiracy) or at least are impossible to prosecute, but they are a clear violation of norms of social behavior and other rules of conduct.

In the political arena, ratfucking includes such things as push-polls, doctored photographs, engaging in public bad acts while pretending to be a member of the opposition, and other methods of trying to exacerbate problems that are blamed on the opposition. As practiced by tobacco controllers, ratfucking includes, well, such things as push-polls, doctored photographs, engaging in public bad acts while pretending to be a member of the opposition, and other methods of trying to exacerbate problems that are blamed on the opposition. Continue reading →

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My recent contribution to Clive’s weekly reading list

Posted on 24 November 2018 by | 1 comment

by Carl V Phillips

As some of you know, Clive Bates puts out a weekly somewhat-annotated list of PubMed-indexed articles that are related to low-risk tobacco products and/or tobacco harm reduction (the search string for that appears at the end of what follow). It is a great resource; if you do not receive it, I am sure he would be glad to add you to the distribution list. As part of a planned projected that I have alluded to before, I am working on how to reinterpret this as an annotated weekly suggested reading (or knowing-about) list. To that end, this week I was a “guest editor” for Clive’s distribution list, and I thought I should share what I wrote here to broaden the audience. Yes, it is a little weird to publish a one-off “weekly reading” that is mostly based on an existing format that you might not be familiar with. But you should be able to get the idea. Hopefully I will be producing one every week before too long.

In the meantime, here is what I wrote that went out via Clive’s distribution lists. Sorry for the weird formatting — it is an artifact of the way the original PubMed search was formatted. Yes, I could have fixed the for aesthetics to re-optimize for this blog’s formatting, but since they do not hinder comprehension, I am not going to bother — sorry.

Greetings everyone. Carl V Phillips here, doing Clive’s list this week. I am trying out a new format for it, as follows: (1) They are not listed in the order that popped from the PubMed search string, but rather is in order of how worth reading they are. Obviously this is my own rough blend of various considerations, including importance of what is being addressed, value of what was produced, how potentially influential it is, and how much reader effort it takes to get value from it (note that I put relatively little weight on the latter). I have left the serial numbers from the search on the entries in case anyone wants to recreate the usual ordering. I add a full-text link if I think there is anyone other than specialists in the particular area would want to look at the full text. (2) I am not limiting this to PubMed-indexed papers. I am including popular press and policy statements (and would have included blogs but there were not any apparent candidates this week).

Continue reading →

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Index of my Daily Vaper articles (2)

Posted on 11 November 2017 by | 1 comment

by Carl V Phillips

In my last post, I noted that most of my writing is currently at The Daily Vaper. I also promised that I would keep an index of those publications here for those who following this and not those, highlighting the ones that fans of this blog might be particularly interested in. This also provides an option for commenting on them, which DV does not have, and a chance for me to add a bit more about some of them.

[Update: Indexing is hard and unrewarding. I stopped after this one. Maybe someday I will circle back.]

Here is my belated second entry in the series. I will try to do this more frequently so the list is not so long (sorry — maybe keep this tab open and take a few days to get to all of them you want to see).

In rough descending order of what I think regular readers of this blog would find most interesting (I expect you will want to read at least the first seven):

1. I wrote a science lesson about anchoring bias and why it means that we should really stop describing the risks from low-risk tobacco products in relation to smoking (e.g., “99% less harmful”). I have hinted at some of this here, but I have never really nailed it before. This is new analysis. Anyone interested in my evolving thinking about accurate messaging — based on more years of experience and thought than anyone else involved in this realm — should definitely read this.

2. I reported on a court ruling that is fairly obscure, but truly delightful: The usual gang of anti-tobacco groups petitioned to be co-defendants, alongside FDA, in a suit against FDA by cigar manufacturers over aspects of the deeming regulation. The judge denied it. Why should we care? Because the ruling basically said that they are not stakeholders. For those of us constantly frustrated by the bullshit suggestion that they are (let alone that the primary stakeholders, tobacco product consumers, are not), this is just too good. Unfortunately I suspect I am the only one who will try to make anything of this. I strongly encourage those of you who are involved in advocacy (and especially those involved in lawsuits) to run with it. It really is a huge potential lever.

3. This piece is about the unethical scientific practices of tobacco controllers, specifically their flouting of human subjects protection rules. These are bright-line violations of codified rules, unlike the usual unethical behavior of tobacco control which is evil but not unlawful. I mention a couple of the reports about that which I have written here along with some new material. I suggest that perhaps a blanket boycott campaign would make sense. If I have time, I will write a piece about that specifically for this blog.

4. My personal favorite is this one, where I catch FDA chief Scott Gottlieb, in congressional testimony, offering basically the NIDA definition of “addiction”, a definition that clearly excludes tobacco products (including cigarettes). As my readers know, I have made a study of what people mean when they say “addiction”, and how there is apparently no viable definition that anyone wants to defend that actually includes tobacco/nicotine. In this case, Gottlieb was stuck because he had to talk about opioid addiction, and so was forced effectively undercut all the CTP rhetoric on the subject. Well, undercut it if anyone decides to challenge them based on this, which probably will not happen. The industry is not exactly known for being that clever.

(Foreshadowing note: I actually think I have figured out how to characterize what people mean when they say smoking etc. are addictive. One of these days I hope to write a major piece on this.)

5. In what could basically be an uncharacteristically terse version of a post here, I wrote about a recent “what parents need to know” statement about vaping in JAMA Pediatrics. It was all the terrible you might expect. I shredded it. If your appreciation for shredding exceeds your inclination to be annoyed by the terrible, you should find it a satisfying little read.

6. I reported how, after Senator Chuck Schumer launched an amazingly stupid attack on vaping in a press conference, Gottlieb practically fellated him on Twitter. (No, I did not put it quite that way.) This suggests that despite all the overly-optimistic talk of regime change at FDA, nothing has really changed in terms of who they consider their political patrons. (*cough* *told you so* *cough*)

5. My most recent piece was about the FDA’s Orwellian-named “Real Cost” campaign. I noted that they are about to aim this anti-scientific propaganda campaign, currently focused on smokeless tobacco and smoking, at vaping. I recount some of the campaign’s content and assess what they will do regarding vaping. I will write more about this shortly.

6. I did some original data analysis in this article, based on a recent CDC report of vaping rates across demographics and occupations. The authors could not see past the raw vaping rates. This is merely an uninteresting echo of the smoking rates; whoever smokes most is going to vape most. I looked at the ratio of vapers to smokers, which is actually useful. I found that across almost every group, the ratio is very close to the overall average. This effectively shows that the rate of switching from smoking to vaping is about the same across the different groups. The one big exception was African-Americans, where the ratio is much lower. That is, few smokers in that population are switching to vaping. I suppose this is worth a journal article, but I do not have time. (Free easy publication for any student or academic who wants to take the lead and write that with me! Seriously, let me know if you are interested.)

7. In this brief piece, I review the results of a recent paper that shows the anti-vaping bias in mainstream media reporting. It just confirms what we all know, but does a nice job of it. Most notably, it observes that anti-vaping statements tend to be attributed to people with supposedly expert credentials (though obviously they are really either clueless or liars), while the truth is attributed to advocates who the average reader will (mistakenly) consider less credible.

8. Here I analyzed a research paper out of FDA which is part of their assessment of how MRTP labeling might affect consumers. Unsurprisingly, it seems designed to make the case that allowing manufactures should not be allowed to tell the truth about their products. The study was bad, and they clearly intend to spin it worse.

9. I reported on FDA’s release of “adverse event” type records that they collect for tobacco products, which are really mostly about vapor products. I noted it is pretty much meaningless, but that it might be used in anti-vaping advocacy. I indicated my suspicion that FDA released it for just that purpose, not because of some belief it should be available because it is genuinely informative (it is not).

10. In this science lesson, I summarized my analysis that shows that the optimal tax rate for low-risk tobacco products is zero if the goal is to promote population health, or any other defensible stated goal. Not “lower than the tax on cigarettes” or “proportional to the risk”, but zero. My readers will already be familiar with these arguments, though if you are looking for a short summary, this is it.

11. I tried to assess the recent FDA “guidance” about the ban on free samples of vapor products (e.g., sampling e-liquid flavors), now that they are deemed as tobacco products, with all the rules that apply to them. I say “tried” because the guidance sort of says that it does not apply to adults-only venues (e.g., most vape shops). But how exactly this will play out — i.e., will flavor sampling be banned? — is not clear.

12. I analyzed a recent survey by BAT about beliefs about the risks from vaping. It is pretty straightforward “latest study” reporting, though I got some additional data from the researchers that allowed me to offer a better assessment than those who were just working from the press release. The main takeaway is that even in the UK, a ridiculously large portion of the population does not understand that vaping is much less harmful than smoking.

13. I introduced readers to the CASAA Testimonials collection that I created in 2013. Long-time readers of this blog will be familiar with it. I plan to publish more little articles that are excerpts from that collection.

14. Finally, I reported on the fight over vapor product taxes in Pennsylvania. The upshot is that tax structure, not just tax rates, matter a lot. A rather more interesting aspect of that story — and of another story that got spiked — does not appear there. I hope to get time to report it here sometime (ooh, more foreshadowing).

(Damn, that is a lot of material. Comments welcome. I suggest using the serial numbers if you are commenting on one in particular.)

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Tobacco control’s violations of human subjects ethics, and other implications of the RSPH “sting” of ecig vendors

Posted on 8 April 2017 by | 26 comments

by Carl V Phillips

So apparently there is a UK organization known as the Royal Society of Public Health which presumably had some importance back when the East India Company was not just a retail brand. And apparently they did some secret shopper research of vape stores for purposes of generating publicity for themselves (like a retail brand would). The main payload was the breathless observation that half the shops did not interrogate the customer about their smoking status before selling e-cigarette products to them, and that most of the rest did not refuse to sell upon learning the faux-customer was playing the role of a nonsmoker. The RSPH then portrayed this as a violation of a largely-nonexistent “code of conduct” and managed to get this non-story all over the press in the UK.

I write that so dismissively — about the organization and the research — for a reason. This was much ado about nothing (as Paul Barnes entitled his post about it, which you can read for more of the basic details; see also Clive Bates’s post in which he dismisses it as a “cheap publicity stunt”). But despite this just being a blast of silly throwaway junk — what we observers of the public health industry simply call “Friday” — blogs and Twitter just lit up about it.

Part of the heightened reaction, as compared to all the other bullshit press releases, can be explained by the strange British obsession with anything containing the word “Royal”. Partially it is because the core failure — the notion that legal retailers of a consumer good should be policing their adult customers to see if they were “the right kind of people” — is something everyone can spot the flaws in; it is not some arcane matter of sample selection bias or confounding. So, for example, we can observe that no retailer ever checks to make sure an adult customer is a smoker before selling her cigarettes. This also makes it particularly easy and fun to satirize. (Incidentally, if a retailer in the USA discriminated in the way RSPH demands, refusing to sell to a potential customer because of his nonsmoker status, there is a good chance it could be successfully sued.)

But I also think the widespread reaction to this silliness, even among those who recognized it was just a publicity stunt, reflects a gut-level feeling that there is something more nefarious here than the surface level reaction implies. Since I try to point out the forest that is hidden among the trees (or should I use the royal “amongst” today), I will point out three deeper issues here. As I often do, I am trying to make a case that just responding to attacks like this at the level of their specific merits, even when the response is that they have no merits at all, is a fail. It is a terrible strategy to treat research like this as if it were fundamentally legitimate but merely flawed, as if it exists in isolation, and as if it were the work of decent ethical people who merely erred. That remains true no matter how effectively you eviscerate it on the surface. Continue reading →

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Editors of Tobacco Control admit they publish indefensible junk science

Posted on 20 February 2017 by | 19 comments

by Carl V Phillips

Ok, that is not exactly what they said. But it was seriously so damn close to that it is not really an exaggeration. This appears in today’s editorial by the journal’s editors, Richard O’Connor, Coral Gartner, Lisa Henriksen, Sarah Hill, Joaquin Barnoya, Joanna Cohen, and Ruth E Malone, with the bizarre title, “Blog fog? Using rapid response to advance science and promote debate”. Continue reading →

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Anti-muslim fanatic and tobacco control fanatic, a dialogue

Posted on 4 October 2016 by | 11 comments

by Carl V Phillips

Somewhere in an imaginable land, a dialogue.

ANTI-MUSLIM FANATIC: Hey, I wanted to thank you. We have adopted your blueprint.

TOBACCO CONTROL FANATIC: You’re welcome. … Wait, what?

AMF: Yeah, we now have a plan for the endgame for driving Muslims from this country.

TCF: That is terrible. What does it have to do with us?

AMF: I told you, we are following your blueprint: Punitive taxes. Limiting where people can practice Islam. Vilification campaigns. All your favorites.

No more immigrants. That last one is a bit different, but we adapted your plan to forbid the development of new products.

Also, a ban on little rugs.

TCF: But that is a gross violation of people’s rights and the norms of our society. Religion is an intimate private decision. Even if you think your goal is a good idea, are you saying you want to trample on people’s happiness and the fundamental glue that holds our society together in pursuit of some personal pique?!

AMF: Are you sure you want to go down that path?

TCF: Um, fair enough. But how are you ever going to get support for that? We always had a plan to expand beyond those with the burning pique to enlist a lot of useful idiots.

AMF: It’s all in your blueprint. We can do it. Get this: “Think someone being Muslim does not hurt you? Well 9-11 cost America over $5 trillion. That’s $17,000 from every man, woman, and child.”

TCF: But that’s absurd. Most of that cost was the result of people like you making the country lash out in the wrong directions, impose security theater, and such. The attack itself caused only a small fraction of that loss.

AMF: Um, “quit smoking because it is expensive, makes you leave your friends in the pub while you go outside, and could cost you your insurance or your job.” Again, are you sure you want to go down this path?

TCF: ….

AMF: ….

TCF: Ok, props for that.

But that attack was a few foreign militants and their international support network. It had nothing to do with the practice of Islam among people living here. If you are worried about terrorism, wouldn’t it be more effective to withdraw our active support for Wahhabism, to whom much of it traces; not arm “moderate” warlords, because there is no such thing as a moderate warlord; back off on policies that inspire such attacks; and avoid destroying the social structures in the mideast that provide a bulwark against the rise of such factions?

AMF: Um, look, I realize that the necessary conceit of this dialogue is that both of us are far more thoughtful, honest, self-aware, articulate, and willing to engage in open dialogue than anyone who actually espouses either of these positions. Still, that statement seems to strain the conceit beyond any semblance of reasonableness. And I don’t just mean that “to whom much of it traces” grammar.

TCF: Yeah, fair enough. Ok, try this: If your goal is to prevent terrorist attacks, a goal very few people would question, why not focus on policies that are targeted at discouraging militants rather than discouraging the practice of Islam more generally? Doesn’t attacking law-abiding members of society actually hurt the goal?

AMF: Oh, I didn’t say that the goal was stopping attacks. In fact, a few more attacks would really do us a lot of good. Playing on fear and costs is just how we build support for the campaign. We hate it that anyone around us practices Islam and want to put a stop to it. We don’t care if their personal faith is perfectly peaceful and harmonious. We don’t care how much it might mean to them. It is still Islam, and it has to go.

TCF: With all due respect, you are monsters.

AMF: Um, actually we got all that from you too.

TCF: From us?! How…? Oh, I see.

AMF: Thanks again, by the way.

TCF: You are still monsters. We are fighting against a scourge that people get habituated to it at an early age, before they are capable of understanding the ramifications of their choice. They are innocent victims of what they see around them being considered normal, and of the machinations of huge corporations who can only keep going by recruiting at an early age.

AMF: [raises one eyebrow]

TCF: Yeah, ok. But the same is true for being a Christian or any other religion. What right do you have to decide the indoctrination of being brought up in one religion needs to be stamped out but another is fine?

AMF: We both know the youthful brainwashing claim is meaningless for either one of us. It describes countless behaviors and beliefs, like patriotism, studying hard, playing sports, eating meat, reading fiction, masturbation, cooking with curry, drinking soda, respecting one’s elders…

[seven pages of transcript omitted]

Anyway, to answer your question, we decide. We can decide because we are ascending in influence here. Might is right.

We got that one from you too.

TCF: Yes, I suppose you did. But it is still different. Tobacco is addictive.

AMF: “Addictive” refers to compulsive drug use that seriously impairs someone’s functioning. Tobacco use does not do that.

TCF: We just mean that using it makes you more inclined to use it. You get cravings to do more of it.

AMF: That describes about half the things on the list I just recited.

TCF: Well addictive also means it makes you very unhappy to give it up once you start. And people who choose to quit are really glad they did.

AMF: You might be over-generalizing a bit there. But anyway, that still probably describes about quarter of the things on my list. Notably including being a Muslim.

TCF: Hmm. So you are going to portray the people you are abusing as dupes who thus are really being made better off by the abuse. And do that after you anchor everyone’s thinking on the worst-case product …er, people… to condemn the entire practice. I guess we really are on the same page. Your ideas are starting to grow on me.

But, wait! No! No no no! You are trying to trick me. The difference is that your goal is just the zealous preference of a group of fanatics who have no right to judge how others choose to live their lives, while our goal is….

AMF: [other eyebrow]

TCF: Our goal is good! It just is. We know we are right. And we know that is right because we know we are right. Turtles all the way down. We will have to agree to disagree.

AMF: Why is there any need for agreement in order to disagree? I’ve never understood that.

TCF: Moving on, I think you have a serious implementation problem. I really don’t see how our blueprint will let you pull off an endgame.

AMF: One might say you also have a serious…. Nah, I’ll go a different direction here: There are a lot fewer Muslims in our country than there are tobacco users. And more people who hate them and want them to go away. So I would say we are better positioned than you.

TCF: But the tactics won’t translate. I see how immigration controls can work. But how are you going to tax people for being Muslim?

AMF: First you strip the tax-exempt status from mosques and Islamic organizations. Someone will have to pay that, and it can only be the individual Muslims because all taxes are ultimately paid by consumers.

Ha! you probably assumed that because I am espousing alt-right ideas that I don’t understand basic economics.

TCF: Well, yeah, that seemed like a good bet. But I do remember the conceit of this conversation, so ok. I’ll have to take your word for it, though, because the conceit cannot possibly go as far as to give me credit for understanding economics. Anyway, go on.

AMF: We also impose a head tax on them. We will make it low to start with so people just get used to paying it. Then we will crank it up until it impoverishes them. The first bit has a long history. The second bit we got from you.

TCF: Ah, so then they eventually succumb and abandon their faith. Yup, that should work. But, wait, can’t they just declare they renounce Islam it without really doing so? It is not like they have to buy anything, or that you have a test for it like we do.

AMF: Actually, we don’t expect many of them to either give it up or pretend to. We just like the idea of impoverishing them. We got that from you too. People don’t just give up true belief. The cost of pretending can also be rather steep, especially if you still want to do a Hajj. It is not a cheap and simple evasion like buying black-market cigarettes to avoid the tax.

TCF: But then what is the point of doing it?

AMF: Same reason you do it: To give governments a financial stake in the War on Muslims. If they want the money, then they have to support our policies. That’s when we get them to unleash the rest of your tactics:

We start ridiculing Muslims, using their own tax payments to broadcast the message that they are vile. God, I love that part!

We teach every child in school that any practice of Islam is vile. Kids are great, aren’t they? You can claim everything is being done to protect the little naive innocents, and then sell them simplistic generalizations because they are so naive and innocent.

Also, we are going to ban proselytizing immediately and then expand than to ban anyone associated with Islam from making any positive statements about Islam, whether true or not. And if anyone else says anything, we will accuse them of being secretly in the pay of Big Muhammad and try to get them sent to Gitmo.

TCF: But that tramples over so many of the fundamental freedoms that our society cherishes. It is a slippery slope to all kinds of other actions. It is difficult to imagine where that could end.

AMF: Yes. So?

TCF: Nothing. Just making sure we were still on the same page.

AMF: At some point, we will make it illegal to bow toward Mecca except in designated areas. We got that from you, but it turns out ghettoizing works for religions too.

TCF: Um, actually we may not deserve credit for originating that idea.

AMF: Oh, and then we will slowly move those designated areas to even more remote locations. Also we will embed broken glass in the pavement.

TCF: I think maybe we could learn something from you. We will have to stay in touch. Secretly, of course — you are still a monster.

AMF: Back atcha.

TCF: So what else of ours have you figured out how to use?

AMF: Here is one I have been working on: “Treating law-abiding and peaceful Muslims differently from terrorists is like getting hit by a jetliner in a 7 story building rather than a 110 story building.”

TCF: That’s…. horrific.

AMF: So you don’t like it?

TCF: No, I love it! You really have studied the script.

AMF: How about these: “I get it dude [sneer], yours is a noble and peace-loving faith.” …and… “Allowing muslims to integrate into our pluralistic society will give you oral cancer.”

TCF: Um, what?

AMF: Yeah, that last one needs a little work. Still, it is no further from the truth than how you use it. Oh, and we have a great one about “third-hand salat”, but I am keeping that under wraps until we need a media boost.

TCF: Clever. So what is your timeline for endgaming the Muslims? We always attach a year to our slogans, like “a tobacco-free world by 2020”.

AMF: We are not setting a deadline. We only wanted to borrow your tactics. We did not see any reason to borrow your hubris and embarrassing legacy of failed promises.

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“E-cigarettes are a gateway” is a genuine scientific claim

Posted on 21 June 2016 by | 18 comments

by Carl V Phillips

The latest entrant into the Dunning-Kruger gateway follies is ASH Wales, with this report that is headlined, “New research shows e-cigarettes are not a gateway for young people to take up smoking”. What evidence do they present that supports this remarkable claim that a universal negative is true? None.

The gateway claim, that using e-cigarettes causes some would-be never-smokers to smoke, is a legitimate scientific hypothesis. As such, it should not be asserted to be true (to a nontrivial extent) without useful evidence, especially since it is such an unlikely causal sequence, as I have explained elsewhere. The assertions that gateway effects are occurring have been based on evidence that does not actually show that. This is certainly the major problem in this area. But similarly, the claim should not be dismissed with word games or junk science. In this particular case, ASH Wales — like many others before them — seem to not understand a 101-level point from epidemiology, the difference between “not many people are at risk” and “it never happens among those who are at risk.” They claim that because a large majority of e-cigarette users among teens have already smoked, there is therefore no gateway effect. Um, yeah.  Continue reading →

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