Tuesday, 12 January 2016

All Things Not Being Equal ...

Now we've always known The Conversation website to be something of a 'public health' poodle, but they've excelled themselves with their latest article on e-cigs. It is so incredibly piss poor that it doesn't surprise me that it took three people to write it ... there's simply too much stupid in there for it not to have been written by a committee.
E-cigarettes could now be prescribed by doctors as a way of giving up smoking, after regulators granted one such product a drug licence for the first time. This marks a significant point in the growing popularity of vaping, which has created a global market for e-cigarettes now worth over US$6 billion. Yet the technology remains highly controversial.
It's only controversial because hideous people with vested (or bigoted) interests have been talking up imaginary dangers and spreading junk science to promote illegitimate scare stories. Before their intervention no-one really cared much, it was a non-story. Just from the intro we can safely presume this article is going to be more of the same baseless rhetoric which created the 'controversy' out of evidence-free windbaggery and hot air from people who profess to care about health but clearly don't.
Proponents of e-cigarettes argue that they have helped increase the rate at which people are quitting smoking. But sceptics fear that vaping might make smoking a more socially acceptable habit again, that it could become popular among children who may then move on to conventional cigarettes,
Well it's clear that the proponents are correct then, especially amongst youth. Anyone who fears vaping will lead to smoking being popular among children and lead them to smoke is quite plainly nuts considering the exact opposite is happening worldwide, and quite dramatically too.

Source: US National Youth Tobacco Survey

That's the USA, where the effect of e-cigs couldn't be more stark, and in France it's been the same.

"A spectacular decrease in four years"
So straight away we have the three authors' agenda. They don't wish to look at incontrovertible evidence, just spread smears, rather like this.
and that it even poses a possible direct health risk due to the chemicals it involves.
This is yer common-or-garden anti-vaping tactic, point to some cherry-picked study - in this case an already-debunked one involving mice in a lab - and completely ignore that e-cigs have been around for over a decade now; have been used by millions of humans worldwide; yet have not offered up a single verifiable death anywhere when used as directed.

So now they have set out their agenda of doubt and misdirection, they then go on to create the straw man they intend to attack in the piece.
One important area identified for further research by academics, organisations and government is the nature and impact of the dual-use of electronic and conventional cigarettes. Instead of simply assuming that vaping is a way for all people to cut down on smoking for health reasons, we should consider that they may be complementary activities for some. Regular smokers are often subject to regulation and social pressure. For example, they may no longer be able to smoke in their workplace or in places where they meet with friends or family.
The assumption they want you to take away from that is that there is no possibility for smoking in any of those situations; that the rules are so strict that the only escape is to vape. This is quite simply not true, of course. I don't think the family or friends would stay that for long if they forbade anyone to go outside to smoke, likewise almost all companies allow smokers to go outside for a puff (it's sadly more likely that they would ban e-cigs but allow smoking breaks instead!). Rather than accept that in the absence of e-cigs these people would, indeed, go outside and smoke, the authors pretend that the act of using e-cigs in those situations is only competing with abstinence. Which is execrable garbage.

In those situations, e-cigs are not competing with abstinence in all but the most extreme of circumstances, they are replacing opportunities to smoke. Their entire argument falls apart on this point, which is why they pretend that reality doesn't exist and focus instead on a fantasy scenario which only exists in their own imagination.
So smokers now have the option to smoke regular cigarettes where they can and complement this with the use of e-cigarettes where it is not possible or appropriate to smoke tobacco.
How awful that smokers have options, eh? Yet they skimmed over the most important part as if it was a bug and not a vital feature of the huge popularity of e-cigs.
E-cigarette use, on the other hand, is often unregulated and provides both the nicotine fix associated with cigarette use and some of the social element.
This is why smokers are switching in their millions all over the world, because of exactly that. You'd think 'public health' would be pleased wouldn't you? But then, it's never been about health, so why would they?

It carries on in the same vein, always relying on that critical straw man they created.
If e-cigarettes were only adopted as substitutes and helped more people to quit smoking, they could increase the associated health and financial benefits that come with this by cutting tobacco use. But where e-cigarettes act as a complementary product, they could instead blunt regular anti-smoking regulation and keep more people smoking for longer.
But they are cutting tobacco use, every jurisdiction where e-cigs have not been banned shows exactly the same trajectory in smoking prevalence ... downward. For every time an e-cig is used where smoking is prohibited it removes the need to go outside and smoke, which is why these charlatans pretend that option isn't available when it quite clearly is.

This straw man riddles the piece from start to finish, it's like they were committed to proving their pretend theory before they started or something.
If the public is focused on the success stories of those who have used e-cigarettes and ceased smoking, they will underestimate the extent of complementary vaping.
It matters not if it is over or under-estimated if 'complementary vaping' is a net benefit by way of fewer fags being smoked, which is undoubtedly the case.
However, just because some people use e-cigarettes as a complement to tobacco doesn’t mean they don’t want to quit. Our research actually found that complementary users were more likely to be using another quitting method or product, such as nicotine gum or patches, in addition to e-cigarettes. This suggests that for some trying to quit, their progress may be hindered by e-cigarettes.
No it doesn't. It just proves that NRT can also be used in situations where "they may no longer be able to smoke in their workplace or in places where they meet with friends or family". Like e-cigs it replaces the opportunity to smoke with something else because NRT is also endorsed as a harm reduction aid by NICE. Yes, for 'complementary use' too!

If the authors cannot understand that the principle is the same, you have to wonder what their underlying motivation is. I suppose we can look forward for their next piece which will debate "instead of simply assuming that NRT is a way for all people to cut down on smoking for health reasons, we should consider that they may be complementary activities for some" and their extended reasons why patches and gum "instead blunt regular anti-smoking regulation and keep more people smoking for longer".

2016 is beginning to look like becoming a year of evidence-free health mendacity on a vast theatrical scale, and we're not even two weeks in!

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