Wednesday, 30 August 2017

The VLNC Junk Science Fest Gathers Pace

As I have written a couple of times recently, the FDA's announcement that they are viewing very low nicotine cigarettes (VLNCs) as a possible policy tool is extremely sinister.

Tobacco controllers have been banging on about this over the pond for quite some time now and, I repeat, it's daft and nothing but a rent-seeking scam.
It's not just questionable, it's insane. One can only assume that the people endorsing it are either corrupt or mentally compromised. 
The US FDA seems to think this is a great idea though. They will mildly relax regulations (perhaps) around vaping while at the same time taking an innocuous ingredient - nicotine - out of cigarettes but leaving all the other crap in. They couldn't be more crazy if they announced that they were to embark on an expedition to find out where unicorns live. 
So, why are they doing this with cigarettes? Well, apart from being subject to an almost Calvinist religious cult of a tobacco control industry in the good old US of A, there are also many financial pressures which mean they are reluctant to rock the boat. 
What I find absolutely astonishing above all else though, is that US-based tobacco control are even considering this. For years, they have been painting the tobacco industry as animals for producing low tar cigarettes. The fact that this was partly due to legislators forcing them to doesn't seem to matter. 
But now the tobacco control industry has had this fantastic idea that reducing nicotine in cigarettes is a brilliant new initiative, what went before seems to have been conveniently forgotten, at least in the USA. Fortunately, we are not subject to as much ignorance in this country.
But now it is being looked at by the FDA, the big wheels of the global tobacco control junk science machine are starting to turn. Grant dollars will be shovelled at the subject with the express purpose of hoodwinking the FDA into believing it is a good idea.

The latest - and by no means will it be the last - is this study released last week on the effect of VLNCs on smokers with psychiatric disorders.
RESULTS: Among the 169 daily smokers included in the analysis (120 women [71.0%] and 49 men [29.0%]; mean [SD] age, 35.6 [11.4] years), reducing the nicotine content of cigarettes decreased the relative reinforcing effects of smoking in all 3 populations. Across populations, the 0.4-mg/g dose was chosen significantly less than the 15.8-mg/g dose in concurrent choice testing (mean [SEM] 30% [0.04%] vs 70% [0.04%]; Cohen d = 0.40; P < .001) and generated lower demand in the Cigarette Purchase Task (α = .027 [95% CI, 0.023-0.031] vs α = .019 [95% CI, 0.016-0.022]; Cohen d = 1.17; P < .001).
In other words, the subjects didn't like them, so wouldn't buy them.

To the rest of us, this means that smokers will, in reality, do anything other than spend their money on VLNC because a large part of the pleasure has been removed. The response to this will obviously be a huge black market in proper cigarettes. We know this because we live in the real world.

But to a tobacco controller, it means the smokers will just quit.
CONCLUSIONS AND RELEVANCE: Reducing the nicotine content of cigarettes may decrease their addiction potential in populations that are highly vulnerable to tobacco addiction. Smokers with psychiatric conditions and socioeconomic disadvantage are more addicted and less likely to quit and experience greater adverse health impacts. Policies to reduce these disparities are needed; reducing the nicotine content in cigarettes should be a policy focus.
This is nothing but blatant sleight of hand by people with a vested interest in seeing their pay packets continue for a few more years. Nowhere in the study does it even consider what will happen in the real world, because they don't want to blur the clear message they want to send to regulators; that VLNCs are a brilliant idea with no downsides.

This is how tobacco control 'science' works. Salaries are dependant on policies; this is a policy, so let's do it. It doesn't matter to them if it works or not because they are not a results-driven industry; are entirely unregulated, and accountable to no-one except their funders who generally want the same thing as they do. Screw the public's health, they all just want to get paid.

The BMJ's Tobacco Control comic emphasises this world of flowers and rainbows in an article for their September round of propaganda.
Cigarette makers today keep the nicotine at 1%–2% by weight, having found this to be the sweet spot for creating smoker ‘satisfaction’ (one of several industry code words for nicotine addiction). Reducing this percentage by a factor of ten—to 0.1% or 0.2%—would make it very difficult for cigarettes to create or sustain addiction. Reducing it even further would make addiction virtually impossible. 
This would essentially eliminate the cigarette as an engine of addiction, while preserving many of the other reasons people smoke—to ponder the wafting of the fumes, for example, or to obtain some form of oral gratification. Or to emulate Johnny Depp or Keira Knightley. Smokers would be able to start or quit at will, without suffering the robbery of choice that defines addiction.
And as if to prove my point further, The Lancet also published an opinion piece on the subject just under a fortnight ago.
Last week, the US Food and Drug Administration (FDA) announced a multiyear roadmap to begin regulating the amount of nicotine allowed in tobacco products. Researchers, including tobacco control advocates, have proposed nicotine reduction as a way of decreasing levels of tobacco use, and the USA may be the first country to seriously discuss using this form of regulation to produce a potentially less addictive form of tobacco. 
Many questions remain, but nicotine regulation may offer a promising tool in global tobacco control efforts.
So, it is apparently a "promising tool" even before they have answered these "many questions"? Isn't it odd how the precautionary principle is strictly applied to e-cigs (The Lancet amd Tobacco Control articles both mention concern that FDA controls which will obliterate the e-cig market are being delayed) and smokeless tobacco such as snus, but when it is tobacco control chasing a policy which could have vastly destructive unintended consequences, it's full steam ahead and nothing to see here?

Of course, if - as the study on smokers with psychiatric disorders did - you don't even address the possibility of the unintended consequences, and instead just pretend that they don't exist, it's easy not to have to answer those "many questions", now isn't it?

This is how it is going to be from now on in US tobacco control (and, I'm sure, consequently in other countries). Talk up the insane policy of VLNCs while stressing and amplifying the far less worrisome fantasy harm of e-cigs.

Now, which way do you think governments will jump under this kind of bombardment from the multi-billion dollar global tobacco control industry? 


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