by Carl V Phillips
Granted, the position statement on dissolvable tobacco products by the Iowa Counties Public Health Association matters very little to the world (though at CASAA we do like to highlight absurdities from Iowa, the new home of one of our directors). But it tells us a lot about how phenomenally clueless “public health” people on the ground are. They should really stick with practical matters they understand, like restaurant inspections — and you do not want to think too hard about the implications if their understanding of how to do restaurant inspections is as poor as their understanding of tobacco.
Keep in mind that this statement was published this month (h/t Jan Johnson for reporting it), not two years ago.
Background: In response to increasing restrictions on the use of cigarettes and other products limited by the implementation of smoke-free air acts in multiple states, the tobacco industry has produced and begun to distribute new dissolvable products including Orbs, Strips, and Sticks, and Ariva and Stonewall tablets. Flavored tobacco products are considered the potential third wave of tobacco addiction.
Notice that they lead with the top-down “it is all about us” presumption that I analyzed in detail recently. They then go on to mention five products. The first three, from RJR, have been dismal failures (which is 1/3 a shame: the Strips and Orbs are as unappealing as NRT, but the Sticks were a good product, and smokers who tried them often found them a very good substitute; I have suggested to RJR, only half-joking, that they re-launch the Sticks as “battery-free eco-friendly e-cigarettes” or something). The other two lozenge products, from Star Scientific — very much not part of “the tobacco industry” — have been off the market for more than a year.
I have no idea what the “third wave of tobacco addiction” even means. Despite their passive voice assertion, I have never heard that phrase before. But I suspect it is not compatible with “all of these products sunk beneath the waves because they never caught on with consumers.”
I could probably just stop there and observe just how amazingly clueless the anti-harm-reduction industry’s local useful idiots are. But a bit more…
Concerns regarding the potential health impacts of these products include the following. These products are not FDA-approved cessation products. They do not help people end their addiction to nicotine.
Um, how is either one of those a health impact? And, actually, they kind of are/were FDA approved, in the sense that FDA has jurisdiction over them but has not quashed them. They may or may not help people end their “addiction” — given their minimal sales, it is hard to argue that there is evidence that they do, but clearly there is no evidence that they do not, as is asserted.
Dissolvable tobacco contains higher levels of nicotine than cigarettes. The typical cigarette will give the smoker a dose of between 1 and 2 milligrams of nicotine over the time it takes to smoke the cigarette (10 min or so). These products are designed to dissolve in the mouth in 3 (strips) to 10 (tablets) minutes but they can also easily be chewed or swallowed whole. Arriva delivers about a 1.5 mg dose, Stonewall delivers about 4mg.
Seriously, these are the people who presume to be offering advice to others. Swallow nicotine and very little of it gets absorbed. The numbers for those (non-existent) products are — or, rather, were — the nicotine content of the objects, not how much gets absorbed. They cannot even get the time periods right (e.g., the strips dissolve in less than a minute and so give a bit of a kick, though not nearly as much as a couple of puffs on a cigarette; the lozenges, if you can stand them, last a lot longer than a cigarette). Do you think anyone involved with this report even talked to someone who had used one of these products?
These products are intentionally marketed in colorful packages, sweet flavors, and convenient sizes that are very attractive to youth and are very easy to hide. Kids can use them at school, at home–anywhere. Their discreet form, candy-like appearance, and added flavorings may make them very attractive to children, and increase the risk of unintentional ingestion of toxic levels of nicotine. Further, access to these products may increase youth initiation and addiction to tobacco products.
Yes, that has always seemed like a concern ANTZ should have about NRT (except for that “toxic” bit — you would have to consume more product than you could shove into your mouth to get to toxic levels). Oh, wait, you say, they were not talking about NRT? No, they must have been, because those dissolvables had about the least appealing packaging I have ever seen, whereas NRT is pretty much packaged to look like candy. (Btw, if you have never read the “study” at that link, you really should — I think it is the funniest thing I have ever written.)
Of course, what is most clueless about this whole 2014 position statement is that they obsess about products that were removed from the market in 2012 and yet fail to mention that the currently most interesting existing product in this whole NRT/dissolvable tobacco sector (they are basically the same niche) is RJR’s Zonnic. They are strangely silent about the evils of the tobacco industry selling an NRT product. It makes the tortured distinction between NRT and dissolvables a little too obvious.
Dissenters argue that tobacco products already cannot be legally sold to anyone under the age of 18; however, these products are being aggressively marketed to youth via social media channels. Youth will access these products in many ways, including from legal purchasers, just as they have done with other illicit products in the past.
Once you stop laughing (remember, this was published this month), consider that this is something we do not make a big enough deal about: These same people who predict that e-cigarettes, etc., are going to have some horrible impact also claimed the same thing about dissolvables, which basically no one consumed. I suspect there are more kids using meth in Iowa than ever used dissolvables. We need to point out that they use the same dire language about everything, regardless of being proven wrong in the past.
Policy Recommendations: To prevent tobacco-related disease and death, ICPHA recommends three measures designed to control the sale and distribution of these products within Iowa based on ordinances that were recommended by the Linn County Board of Health to the Linn County Board of Supervisors:
Read: The biggest clueless obsessives in the word, re this issue, live here in Iowa. Thus we should defer to them.
Prohibit the sale of Dissolvable Tobacco Products;
Prohibit the sale of Buy One Get One Free Tobacco Product Offers; and Prohibit the Distribution of Smokeless Tobacco Samples at Qualified Adult-Only Facilities.
Did you catch their analysis of the dangers of BOGO and ST samples in their claims? Neither did I. (I left out a bit because it is tiresome to respond to the same lies all the time, but nothing about those.) This is what public health looks like: Write the conclusions based on whatever personal bias you happen to have; write some words above them; don’t worry if the latter have nothing to do with the former.
Oh, in case you wanted to weigh in on this:
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Wouldn’t want to risk someone pointing out how clueless they are, would they?