Tuesday 28 February 2017

A Night At The Pleasure Zone (part 2) - The Balloon Debate

On Thursday I commented on an excellent presentation by Neil McKegany full of thoughtful insight and philosophy on the issue of smoking. As an academic, you'd think he would not be unusual in being able to deliver profound analysis like that, but then tobacco control is an abnormal discipline full of grifters, chancers and snake oil salesmen which, I suppose, is why it came as such a delightful surprise.

I promised that I'd also write up the balloon debate that followed which was sumptuously-ladelled with levity and brought peals of laughter out of the room. So here's a quick rundown of what I took from it.

The format was three minutes for each advocate to extol the virtues of why they consider their chosen nicotine delivery device to be the most pleasurable. In front of a well-oiled audience, they all did their best and raised many a chuckle.

First up was Andrew Stewart who made the case for pipe smoking.

He was extremely affable, a calming voice who almost made me want to try a pipe myself. Almost. I found his description of a lifelong love affair with pipes quite charming, and it was great to see him reminding those assembled that the RCP did once say that pipe smoking (like moderate alcohol consumption today) was found to be less harmful than no tobacco use at all. This would, of course, be heresy in these days of tobacco control extremist hyperbole, but considering tobacco control now lies more than the tobacco industry ever did, I'd take the RCP's word for it, frankly.

Next at the mike was Chris Snowdon who gave a barnstorming performance in favour of snus.

His three minutes was funny, roped in topical references to Trump, the Champions League and Brexit, and was everything a balloon debate contribution should be. I have to admit that his presentation won my vote for the night if only for the line "only an idiot would not accept snus has been good for public health, so therefore public health idiots don't accept it".

After such a frenetic presentation, Ranald McDonald of Boisdale then chose a more louche tone to champion cigars. In a relaxed, almost Barry White-esque voice, he took the aesthetic and arty line (he was later to claim that cigars enhanced sexual relations!) and almost dribbled in his appreciation of the Cuban mastery of cigar-making.

Mark Littlewood then rose to speak of his love of 'Heat not Burn' or heated tobacco (which I tried for the first time in December).  He boldly declared that he was there to "advocate the future", and enthusiastically waxed lyrical about the the science behind it.

He had a playful straw man dig at Simon Clark for not wanting brands to be advertised, suggesting that this was a new departure into endorsing plain packaging, but finished on a roll by dismissing Communist Cuba and boring Sweden for their choices of tobacco products.

He was followed by Angela Harbutt who took the seductive approach. A faux pas whereby a couple of misplaced vowels led to her mis-speaking Volvo to indicate she was talking about something completely different made the room erupt, but considering the rest of her presentation seemed designed to ooze finery and sensual appeal I'm still not sure it wasn't deliberate.

Angela was later to be crowned winner on the night after invoking Audrey Hepburn, more fast cars, and Champagne in the three-way run-off. Not, maybe, a surprise at a Forest event but it still had to be a good presentation to get that far, which it very much was.

Last up was Judy Gibson of INNCO, who had told me beforehand she had coveted the last position so as to be fresh in the voter mind.

She emphasised that vapers really understand that pleasure is part of enjoying nicotine, but admitted - via a reference to masochism which raised some giggles - that we all make our own choices as to what we enjoy. Armed with an impressive array of devices, she spoke from nearly five decades of experience but had decided to embrace the electronic kind of nicotine delivery rather than what vaping consumers sometimes call 'analogue'.

All in all, it was a wonderful debate (but then I'm biased cos I love the balloon type and I'm pretty keen on nicotine however it's delivered) and all should be congratulated for their willingness to get up there and speak for their cause. It also made a perfect foil for Nel McKegany's prior cerebral academic contribution to the debate about smoking, nicotine and pleasure.

I could say more but why when you can watch it yourself here. I recommend you do as it is very amusing.

Monday 27 February 2017

Guest Blog: Manufacturing Denormalisation

There have been guest bloggers here on occasion before, but I believe this is the first time I've re-blogged an entire article.

A fellow Twitter user, and enthusiastic vaper, posted some thoughts on "denormalisation" that I thought were both entertaining and almost perfectly spot on (I'd quibble with the bit about Communism personally, but hey).

So last night I asked @Raithtech_UK if I could re-publish here and he kindly agreed. I think he raises some very interesting discussion points so I'll leave my thoughts for below the line for a change.


The Denormalisation fallacy, and why it’s a waste of all our time.

Something that has seen a rise in public health policy lately is the concept of denormalisation.

Denormalisation doesn’t actually have a specific definition in public health/public policy terms (it actually originates to management of data in relational databases to improve read performance at the expense of write performance, effectively) as it is, in that context, a made up word, but the meaning is quite clear – to make something appear to not be normal.

To not be normal means to not be acceptable, or societally justifiable in broad terms of this context.

So lets take a slightly closer look at this.

Practical denormalisation

Denormalisation is something that typically happens – in the real world – from a grass roots level. For example, someone having sex with an animal is seen as being not normal, which is then accentuated by whatever societal rulesets are in place at the time be they religious tenets, or in more modern times, based around the rule of law, psychology, or just whatever societal norms are prevalent – these days, you could argue, it’s ‘what can you can get away with posting on social media without getting hundreds of nasty reactions’.

Although if you posted a video of you fucking your dog on Facebook, you’d get a bit more attention than just a few ‘angry reacts’ – you’d probably get arrested. That’s likely a good thing, as everyone can agree that shagging your dog is generally not a good thing to be doing, no matter how how short a skirt the dog was wearing at the time.

Sex with a dog is considered so abnormal that’s it’s seen as abhorrent – all without the input of government or religion. We just know it’s not something you should be doing.

What we see these days, however, is the attempt to *manufacture* denormalisation for far milder slights; this is far harder as generally, if society hasn’t already defacto agreed that something should be deemed wrong across the board (like animal abuse), and the subject is something that many people already do (unlike animal abuse), then the only way to do this is to create a narrative and disseminate it publicly, and see if the public picks up on it.

The real problem is when this comes to social habits that have always been seen as normal. Drinking, smoking, and illicit drug taking (which, regardless of what anyone will tell you, has been part of human culture since agriculture was a thing). have always been considered as normal, or not far off of normal, as having a long lay in bed on a Saturday morning; it’s just something we all do at some point and no-one really minds it, as long as it doesn’t impact on those outside of the person doing the behaviour.

These are very strongly normal practises – they are how everyone (yes, even the more well-heeled of us, not just the working class) – unwind after a long week, after a hard day, after difficult personal times; this is about as normal as it gets.

You have a shitty week, you have a bottle of wine on the Friday night and you fuck Saturday off to the hangover.

The car breaks down and you need to drop a notable chunk of your income to repairing it, lest you lose your job due to not being able to make it in – you sit down and have a joint and let the cannibinoids unwind your neck and shoulders, and the THC lighten your beaten spirits.

You get a phone call that a relative has died, and as a smoker – perhaps a regular one, perhaps less so – you spark up a fag and let the nicotine rush to your brain and give you a few minutes to gather your thoughts.

These things aren’t considered normal because mass media tells or government tells us they are; they are considered normal because they’ve been normal since before mass media or even formal government was even a real thing.

So attempting to denormalise them is not only a challenge, it brings up the question of whether we *should* attempt to denormalise them, given that this concept predates attempts at social engineering – which is what this, at heart, is.

How does denormalisation work?

When it comes to the how, we have various examples of governments and pan-national bodies attempting this. Probably the most obvious example is the attempt to denormalise communism – a political movement. This took the might of the entire West working in concert to make The Red Menace appear to be a thing that screams “I am unnatural. I am wrong”. This, despite it being (at the time) a fairly functional, if slightly odd to us in the west, form of government. It was not what we in the west were familiar with, but it generally did what government was meant to do, which is to keep it’s populace mostly fed, and mostly not at war with each other. Mostly. It had its problems just like capitalism does, but it’s not as if communism is a fundamentally broken premise at heart – although to be fair, it only seems to last as long as their citizens start to realise the value of individual wealth, but that’s a different argument for another day.

Anyway, this concept mostly worked, but let's be honest, it wasn’t the government saying that communism was bad that got people on their side – it was the nuclear missiles and games of brinkmanship that really won the day – there were real stakes at play, and the public went with it due to them not wanting to see the result of those stakes playing out, rather then because they understood why communism was a sub-optimal form of governance.

More recently, we’ve seen massive public health ordnances to denormalise smoking, which have predictably failed, because the stakes are seen as being much lower; the reaction you get when someone kicks (or fucks) a dog is one of utter disgust. The reaction you get when someone finds out you’re a smoker is ‘meh’ with possibly a request you pop out the back of their house to spark up, as they don’t like the smell.

You are, in fact, more likely to get a strange reaction if you tell someone you don’t drink. Being teetotal is not considered a bad thing by anyone who has an IQ greater than 60, but it is considered to be quite outside the norm. Not drinking is something that society deemed to be unusual as it’s outside of the common accepted experience of most of us. It’s never been denormalised, because from a societal standpoint, it was never normal. Note, not good or bad, just not normal.

So how do we currently try to denormalise, let's say, smoking and drinking. Well, we have huge public health campaigns, most of them viciously demonising, and specifically designed to divide and conquer – to set one side up as the heroes (public health, non-smokers, non-drinkers) and one side up as the villains (smokers, drinkers, tobacco companies, alcohol companies). You then play a narrative which shows that one side is out to get you, and the other wants to save you, by infringing on the rights and behaviours of the bad guys, for the Greater Good. This description is hyperbolic, but at it’s core, is how it works.

However, this fails at the most fundamental step, which is making the assumption that the public don’t know that tobacco companies have a shady past, that cigarettes are dangerous to those who use them, that regularly drinking to excess is bad for you, etc.

It’s massively patronising, and often contains outright lies; the black lungs of smokers were always dyed pigs lungs (fun fact – smokers lungs are often used for transplants because they’re perfectly good compared to those of the person requiring them, and any damage clears up pretty quick when you take the act of smoking away – there’s barely a difference in recovery rates for the transplantee); the Helena Miracle (that is, that heart attack rates drop when smoking is banned in public) was an example of statistical number stretching of legendary degrees, literally never replicated anywhere, ever – but used almost everywhere as the basis to ban smoking in public despite being laughably poor evidence, if it can even be called evidence at all.

Those who pointed out that this evidence was low quality, and that harms from second hand smoke were being massively overblown, were excommunicated from the public health tobacco control field. This is not hyperbole, this literally happened on multiple occasions to people who, until they showed they were not going to toe the ‘party line’, were considered to be at the top of their field.

This is how far some factions of public health are prepared to go to ensure that their narrative to justify an attempt at ‘denormalisation’ is not upset.

Of course, what they seem to forget is that the public are, in short, not as stupid as many in government (and especially in public health) would like to think.

The Problem With Denormalistion

The main issue with this tactic is that while you can wheel out quotes about the power of stupid people in large numbers, this isn’t really a strong argument; it is, in fact, quite a poor one. The fact of the matter is that you can tell people till you’re blue in the face that smoking will kill them, but if they enjoy it, they’ll keep smoking (Indeed, see my last article - DP).

You can harp on about the social costs of drinking, but as 90% of the public don’t go out on a weekend long bender and get utterly wrecked and try to fight a lamp-post, then they will ignore you because they are not the ones who are part of the problem.

You can tell a cannabis smoker that it’s been shown in mice to slow mental processes, but they’re an account manager at a mobile network and they’ve been promoted twice in the last three years – that rather goes against that little theory.

When you try to deny any benefit of something, and only play up the negatives – that is, to demonise someone’s personal choice – then people stop listening to you. You undermine your own currency amongst most, and you seriously damage your credibility among those who take the time to look into it in more detail.

So what now?

Well, all this rambling aside, what’s a more useful way to get people to elect to change their behaviour? The answer appears to be fairly self evident, but instead of denormalising ‘bad’ behaviour, a likely more useful response is to normalise more desirable behaviour.

Take smoking – there are ways to massively reduce the harm from wanting nicotine, such as snus and e-cigs (my personal way), and even chewing tobacco – basically, any form of tobacco (or nicotine containing substance) that isn’t burned is massively, hilariously less harmful than burning the stuff.

Rather than trying to ‘denormalise’ smoking, instead, encourage and attempt to normalise the less harmful forms of nicotine.

To attempt to denormalise smoking is far, far too large a task and will never happen, ever – regardless of whether any given government sets goals to have a ‘tobacco free world’ (or more recently, as reduced harm options have become available, we see this being twisted to a ‘nicotine free world’ – so that they can demonise even those who have given up smoking) the fact of the matter is people enjoy their vices; it’ll never stop entirely and to claim otherwise is either rank stupidity or wishful thinking – backed by rank stupidity.

I am not exaggerating when I say that anyone – and I mean anyone who sincerely wants to see a tobacco free world and genuinely thinks they can achieve this - is utterly deluded; to the same degree that anyone who wants to see a murder free world and thinks they can achieve it would be – it’s a literal impossibility.

Such people should be ridiculed at every opportunity, because nine times out of then, they’ll be using taxpayers money to try to push for their demonstrably impossible goal.

When it comes to drinking, there is very solid evidence that moderate drinking – that is, a couple of pints here or there, rather than blasting through ten pints in three hours – is actually at worst, of no impact to health, and at best, somewhat beneficial.

Yet again, however, we see public health attempting to demonise almost any imbibement of alcohol, with the CMO recently stating that every time she has a glass of wine, she thinks about cancer; what she is actually saying is that if you drink and don’t think about cancer, you’re doing it wrong. This is clearly an insane position to take, and one that quite rightly got her lampooned in the press because you can be damned sure that when she’s at official functions supping on taxpayer funded wine, she’s not thinking that at all. It’s virtue signalling of the highest order.

The fact is that there is objectively little wrong with the odd drink here and there; the problem comes when you can’t get by without a drink, or when you must get falling-down-drunk to have considered yourself to have had a good time. And that is already considered to be socially unacceptable by the vast majority of the public. We have already denormalised problem drinkers; what needs to be done is to normalise helping problem drinkers, rather than demonising them, or sweeping the problem under the carpet.

As for cannabis, the only problem with it is that its supply is entirely illegal; legalise it for recreational use, and suddently it’s no longer viewed as dangerous and rebellious. Almost every ‘evidence’ of harm from cannabis is correlative, not causative, it’s important to note; links to mental health strongly side on it being self medication, not the cause of the mental health problems. There is a similar link between schizophrenia and smoking, but no-one seriously claims that smoking cigarettes makes you schizophrenic.

Make it better quality and price comparable with street cannabis (not difficult, frankly – cannabis isn’t something that requires massive reprocessing, unless you're cutting it with bulking agents, as illegal producers do…) and surprisingly enough, people might not be so tempted to try whatever else they get offered by their local dealer because they won’t be interacting with their local dealer.

Nor will they be offered freebies, or loans when they’re short, then end up getting beaten up in a back alley for not paying up, as dealers aren’t exactly known for being sensitive when handling debts.

If you normalise cannabis (or at least, stop trying to denormalise it) then it just becomes part of life. Hell, maybe encourage harm reduced ways of getting it (dry burners, etc) if you really feel the need to ‘do the right thing’ but denormalising it has clearly not worked, along with the rest of the war on drugs.

Long story short

You don’t denormalise existing behaviour, that’s just something that doesn’t really work at a societal level as that’s something society, not government, does – but you can encourage the normalisation of what you consider to be better behaviour, if you do it right and without stepping on everyone’s toes.

And chances are, society already agrees with you, so the best thing you can do is just get the fuck out of the way and let us get on with it by ourselves.

Follow @Raithtech_UK on Twitter.

Thursday 23 February 2017

A Night At The Pleasure Zone (part 1)

Last week I advised anyone able to do so that they should consider attending the IEA yesterday for Forest's Pleasure Zone event. I knew it was going to be an enjoyable evening - these things invariably are - but this one exceeded even my optimistic expectations.

I met up for drinks beforehand with good friends including the affable and always entertaining multi-culti mish-mash Afghan Dave, but there were so many excellent people there when we arrived that it would take a few hundred words to name check them all.

The evening was scheduled to feature a presentation by Neil McKegany on his Pleasure of Smoking report that was published around Christmas time (see my thoughts here) followed by a balloon debate on the best nicotine delivery device. I'm a big fan of balloon debates, which if you've never encountered one start with the premise that all contenders are in a rapidly-deflating hot air balloon, with passengers necessarily having to be ejected to leave just the one who has articulated the merits for remaining in the basket most eloquently.

I had been looking forward to the debate but thought - since I'd read the research and written about it - that Professor McKegany's presentation might be a trifle dry. I couldn't have been more wrong.

I actually bumped into him at the table where the wine was being served at the start of the evening and had a quick chat seeing as I'd seen him speaking at a City Health event in September last year. Apparently, that was about the time the research he was commissioned to conduct for Forest had been announced and I learned that he had received condemnation about embarking on it from academics - which you'd expect, of course - but also from some vapers, which was disappointing. He was refreshingly unfazed, though, saying that the people criticising were "unimportant" and that if he was receiving criticism he felt that he was doing a good job.

McKegany expanded on this during his presentation which, in my opinion anyway, was quite excellent.

Neil McKegany commenting on his survey research
I understand that the whole thing was filmed so if you get to see what he said, I'd highly recommend you do so. It was a very illuminating address in which he pointed out some of the interesting conclusions in his survey results, but also reflected philosophically on the tobacco control movement as a whole.

To give you a few examples, he began by explaining that he came from a background of talking about illegal drugs and how policies to reduce harm can be good for public health, but that he was very surprised once transferring that approach to legal drugs that there seemed to be an almost religious hegemony dictating matters. He noted that he was taken aback by the "stranglehold" 'public health' exerts over research in these areas and - harking back to what he'd told me at the drinks reception - said that he had been told by colleagues that studying why smokers smoke was "unacceptable".

Having come up against a mindset which had set itself to believe that smoking can never, ever, be pleasurable, he spoke of an "intellectual refusal" to ever consider such a concept. In his view, this was a two-way thing designed to come to only one conclusion amongst tobacco controllers. If you express a wish to quit, you are acting rationally and it's addiction which is stopping you; if, however, you like smoking and have no wish to quit, you are then acting irrationally and are not experiencing pleasure, merely addiction.

This pervasive way of looking at the subject matter had, in McKegany's view, perverted scientific and political discourse on the subject of tobacco and nicotine. To highlight this, he gave the example of how a British court (as reported by the FT here) has been hoodwinked into believing that there is a "causal" relationship between plain packaging and smoking, which is absolute nonsense.
The argument that plain packaging was ineffectual was largely dismissed by the UK appeal court judge, who noted that “research found that the designs and branding upon cigarette packaging and upon the tobacco products themselves exerted a causal effect upon consumer behaviour and encouraged smoking.”
There may be reason to believe there is an association (and that's heroic in itself based on the shit science - DP) but there is, McKegany rightly maintains, absolutely no way anyone can ever say it is even remotely causal. Yet a court, which is supposed to deal in cold hard evidence, has actually bought into anti-scientific tobacco control fantasy.

He also touched on the interesting revelation that, even amongst dedicated smokers, there was still a willingness to try harm reduced products like e-cigs. He said that the technology might not be there just yet to satisfy them, but expressed optimism that in time products might be available which replicate the smoking experience closely enough to tempt even the most ardent smoker away from combustion.

McKegany appears to me to be a rare thing in the academic community; someone who actually understands smokers and their motivation, as well as understanding vapers. The tobacco control industry doesn't understand either, which is a real problem. If you wish to solve what you see as a public health failure, it is first necessary to understand the people you are seeking to help. McKegany has proved that he really gets us, whereas ASH and their trouser-stuffing, policy-driven, evidence-manufacturing mates at the Department of Health, WHO and beyond simply don't (or don't want to). If it's about health, that should be their priority, but it's quite clearly not.

There was a lot to carry one's interest at this event and if I wrote about the extremely entertaining balloon debate now too it would send this article into essay territory, so I'll come back to that in part 2. Watch this space.


The presentation by Neil McKegany has now been posted on YouTube, do get yourself a brew or a scoop to last half an hour or so and have a watch.

Tuesday 21 February 2017

Hey! Bloggers, Leave Our Junk Alone!

In an unintentionally amusing article yesterday, the Editor of the BMJ's Tobacco Control Comic Journal, Ruth Malone, along with no fewer than six co-authors has expressed irritation at their policy-driven rag being criticised.
As editors of Tobacco Control we are always pleased to see readers thinking critically about what they read in this journal and using the ‘Rapid Response’ forum to engage in constructive academic debate.
However, the growing use of personal blogs to criticise published articles has led us to reflect on appropriate ways of engaging in such debate and how we as editors should respond to comments made outside the ‘Rapid Response’ forum.
Now, if I've read that right they seem to be saying that criticism of the studies they publish should only take place on their website where it can be subject to posting rules and, presumably if they deem it necessary, censorship.

I've not tried to post a moody red-mist rebuttal to anything there but maybe I'll do so in the future if that is an invitation, not sure how long it would last though.
Tobacco Control provides a valuable forum for analysis, commentary and debate in the field of tobacco control.
Debate? This is the same journal which decided in 2013 to ban entire tranches of research simply based on who wrote it. You could devise a product which cured all known forms of tobacco-related cancer but if the wrong people were behind submitting the research, Tobacco Control would still refuse to publish it. The tobacco control industry strives incessantly to close down all dissent, with policies deliberately crafted to enable them to stick their fingers in their ears. Debate, my arse!
Despite careful review and selection procedures, no journal can guarantee that everything published is accurate, or that all readers will agree with the authors’ interpretation of findings. 
Recent comments posted on some personal blogs impugn the objectivity of Tobacco Control and its reviewers, questioning our motives and the veracity of peer review.
Well yes. Because Tobacco Control itself has judged the peer review process to be utterly useless. Here's what they said about it back in 2013.
Critics may argue—as many did when journals stopped publishing cigarette adverts—that publishing such research does not constitute endorsing its findings and that, as long as funding sources are fully disclosed, readers can consider that information and make up their own minds about the quality of the work. Peer review should prevail, goes this line of thinking: it’s not the editor’s job to make these kinds of judgments. 
However, this view ignores the growing body of evidence that biases and research misconduct are often impossible to detect, and that the source of funding can influence the outcomes of studies in invisible ways.
This, of course, does not stop the BMJ publishing glowing reports on, for example, the efficacy of pharmaceutical products - all {cough} thoroughly peer-reviewed - by people with COIs from pharmaceutical companies which make your eyes water.

As for "inpugn[ing] the objectivity of Tobacco Control and its reviewers", it's the journal itself which has thrown its objectivity and credibility in the gutter over the years. Here are just a tiny few examples.

How about the one in 2015 which declared, from a telephone survey of 8,679 smokers asking them if they had purchased illegal products (see the flaw in that, do you?), that there had been no increase in illicit tobacco following plain packaging. It won't surprise you that the career professional tobacco control industry authors had gerrymandered the illicit brands they chose for the study and that the data didn't fit their conclusions anyway. Incredibly though, they declared their research was more authoritative and objective than a conflicting one conducted by KPMG which involved the collection of 12,000 discarded cigarette packs across 16 different towns and cities covering 75% of the population, to see what was actually being smoked.

Or, consider the one a couple of months later that surveyed 723 flight attendants to find out if they had ever seen someone using an e-cig on a plane or in an airport. Unsurprisingly, quite a few had. The 'objective' Tobacco Control then leapt to the unrelated conclusion that "allowing e-cigarette use in smoke-free places undermines the denormalisation of cigarette smoking" and that "given the growing evidence around passive vaping (yes, really - DP) and air quality associated with e-cigarette use, banning e-cigarettes on aeroplanes and in airports is a needed step-forward for the protection of both passengers and crew.".

Or how about the detached and not at all unhinged Australian Tobacco Control editor who said this in February last year?

Or we could scroll on to September last year where this bizarre research was published by Tobacco Control.
Use of electronic cigarettes in smoke-free environments 
Only 2.5% of those who used e-cigarettes in smoke-free environments reported negative reactions from other people.  
CONCLUSIONS: E-cigarette use in smoke-free environments was common, suggesting that most e-cigarette users do not consider smoke-free laws to apply to e-cigarettes. Explicit laws should be considered if jurisdictions want to prohibit e-cigarette use in public places.
Don't forget the study in October, too, which claimed to have found a miraculous reduction in heart attacks and hospital admissions following a smoking ban in São Paulo despite the data showing quite the opposite.

And, to bring us bang up to date, the claim made in Tobacco Control this month that vaping is “a one-way bridge to cigarette smoking among youth". Never mind that the research actually showed that - out of 347 non-smoking youngsters - they could only find four who had vaped and then smoked up to two (yes, 2!) cigarettes in the following year, and not a single youth who had gone on to become a regular smoker.

We could go on and on. How impossible heart attack 'miracle' junk studies are routinely to be seen in Tobacco Control but studies saying that plain packs "do not change smoking behaviour" will not make the cut. How fantasy nonsense follows incompetent wibbling follows bare-faced lies into the pages of Tobacco Control, unstemmed by any meaningful peer review, immune to reality, and unhampered by shame or embarrassment.

Yet Ruth and her colleagues seem to be saying that these things should only be tackled in the sterile atmosphere of the BMJ's 'Rapid Responses' facility where they can decide which remarks to allow and which humiliating junk debunking to suppress. In fact, so irritated are they at individuals having their say without the control part of tobacco control being able to stop it, that their (rather predictable) response is to withdraw even further into their echo chamber. They've thrown the toys, spat the dummy, and now want their ball back.
As a result of discussion about these issues, the Tobacco Control editorial team has now established a policy that editors will not respond to external blog posts or social media messages about specific studies.
If you've ever tried to engage with a tobacco controller on Twitter, you might look at the length of your block list and piss yourself laughing that they claim to even bother responding on social media at all. But this seems to say that - with the intense amount of execrable bullshit they've been publishing of late - they are feeling the heat and officially removing themselves from the kitchen.

Yesterday's article, funny as it is, tells you quite a lot about the mindset of those at Tobacco Control. They like having the microphone; you are to be spoken to from on high, not to wrestle the microphone from their grasp and go doing your own thing. They do the telling, you do the listening, and if you want to criticise it must be done in the way they direct you to or you are not to be listened to at all.

It's never been about health, and the biased and deceitful pages of Tobacco Control have never been about truth. Objectivity? There's never been any. Credibility? Do me a favour.


Further reading on this subject here:

Editors of Tobacco Control admit they publish indefensible junk science - Carl Phillips
Tobacco Control Journal: There Can Be No Legitimate Discussion of Our Articles Without Our Permission - Michael Siegel
Denial of the Echo Chamber - Facts Do Matter
Hey Ruth. This one is for you. - Storm
Open Letter to Ruth Malone - Facts Do Matter (Guest)

Monday 20 February 2017

How Tobacco Control 'Science' Works #94

Earlier this month, I briefly mentioned merchant of doubt Simple Simon's master class in cherry-picking 'evidence' in The Conversation to claim that truths about e-cigs are actually myths.

The comments under the line have since been quite a story in themselves, with Greek scientist Konstantinos Farsalinos revealing that he is embarking on the task of replicating some of the studies which led to garish scare stories in the media.

Click to enlarge

Established scientific convention dictates that research criteria should be made available to other scientists so they can check the results by exactly replicating the methodology to confirm its authenticity. It would appear that Farsalinos isn't too impressed with what he is finding while doing just that.

He is also having a lot of trouble with the authors of a recent study into flavourings in e-cigs. In short, they don't seem willing to disclose which products they tested, as Farsalinos mentions in the comments at The Conversation.
The authors published  a study showing 10,000-fold higher aldehyde levels in flavored vs unflavored liquids. It is not just the difference that matters; the levels reported are HUGE. Up to 7000 ug/g formaldehyde, up to 3500 ug/g acetaldehyde. If this is verified, i will be THE FIRST to openly and publicly recommend against the use of flavored e-cigarettes. When i say verified, i mean finding similar (not necessarily identical) aldehyde levels. Even 40% or 50% less would still be extremely high, and i would consider that a verification of their findings. 
So, why is the author repeatedly denying to reveal which liquids they tested? Publicly. The main author says that 5 samples are mentioned, but those were cigalikes and only 1 had problems. The crucial issue is to replicate Brand I in their study. Besides the public comments, i have personally sent 2 very polite emails (dates: 11 November 2016 and 25 November 2016) to the first author requesting information about the samples tested. I NEVER received any response, and it is the first time this is happening to me.
In the comments to the research itself, Professor Peter Hajek has also asked why "repeated requests" about the exact brands and flavours being tested are being ignored. The reply from lead author, Andrey Khlystov, either shows a laughable lack of knowledge about the subject matter, or an alarming unwillingness to allow his research to be replicated.
Contrary to what you suggest, there is little value in testing exactly the same liquids. Testing specific liquids or flavors was not the point of our study.
It may not have been, but to replicate the study it is essential that the liquids tested must be revealed. All that Khlystov will say is that they can be bought at this website. There are thousands of different liquid flavourings, all at varying levels of nicotine strength and differing blends of VG, PG, with differing viscosity and behaviour. With the generally piss poor understanding of how e-cigs work amongst tobacco control researchers, it's more that possible that these guys could have been pumping gloopy liquid through a low capacity power source and not even be aware of their fuck up (it wouldn't be the first time). To say, then, there is little value in testing exactly the same product is quite bizarre

You have to wonder why the secrecy. If he's confident in his results, why wouldn't he want the experiment to be replicated?

Not releasing the names of the liquids tested to another researcher is scientifically reprehensible; not releasing the names of liquids - which the study's own conclusions consider dangerous - is morally corrupt and incredibly irresponsible.

Imagine, for example, that one particular flavour is found to be extremely dangerous, someone dedicated to protecting 'public health' should be keen that the warning was spread widely, yet the authors of this study don't seem concerned with that, instead wishing the message to be directed at all flavours.

Do you reckon there might be an agenda at play here? It's almost as if they don't really care much about health at all, huh? It's certainly one to watch with interest. 

Monday 13 February 2017

What Is 'The Best Nicotine Delivery Device in the World'?

Now there's a question, huh?

If you weren't already aware, there is an event at the IEA on Wednesday 22nd February which will attempt to answer that question via the medium of an entertaining balloon debate. The evening will also feature a short presentation on ‘The Pleasure of Smoking: The Views of Confirmed Smokers’ by Dr Neil McKeganey, director of the Centre for Substance Use Research, which I wrote about over the Christmas period.

It promises to be an interesting night out, featuring these speakers battling it out for supremacy in favour of their favourite nicotine product.
•    Judy Gibson, International Network of Nicotine Consumer Organisations (INNCO) advocating e-cigarettes
•    Mark Littlewood, director-general of the Institute of Economic Affairs, advocating heated tobacco
•    Angela Harbutt, founder of Liberal Vision, advocating cigarettes
•    Ranald Macdonald, managing director, Boisdale Restaurants, advocating cigars
•    Chris Snowdon, head of the Lifestyle Economics Unit, advocating snus
•    Andrew Stewart, Pipe Club of London, advocating pipes
There is a (free) drinks reception from 6.15pm, with the debate beginning at 7.00pm.

As I've mentioned before, the IEA's hospitality is always warm (courtesy of Forest and Boisdale for this event), so it's a date you should consider for your diary.  I'll be going along on the night and, I expect, on to a local boozer for a bit of post-debate banter afterwards. The debate lasts about an hour and a half, is completely free, the venue has a pleasant smoking area and is vape-friendly. What's not to like?

I'm sure there are many differing opinions as to which is the best nicotine device, but considering the audience is the judge in this type of debate, why not come along and support your personal favourite? To get on the guest list, drop an email to events@forestonline.org and maybe I'll see you there. 

Sunday 12 February 2017

Drafting An EU Tobacco Taxation Consultation Response

As regular readers know, we often take part in public consultations here, and there is an important one currently open which ends on Thursday 16th February (yes, this week) which I'd urge you to have a bash at.

The EU is planning to make changes to directive 2011/64/EU which deals with manufactured tobacco products, and one of the proposals is to make e-cigs liable for taxation as a tobacco product category. Obviously this is daft, but there is more than just that in the consultation survey, it also deals with new 'Heat not Burn' products (HnB) along with raw tobacco, cigarillos, cigars, waterpipes and other tobacco category items.

Ordinarily I'd write a guide suggesting how to respond but this time I don't have to, because Vapers in Power (ViP) have written one one already.

This consultation is pretty straightforward and won't take very long, so go read the ViP guide and then click on the EU consultation page here to let them know what you think. Remember, it closes on Thursday so don't leave it too late. 

Thursday 9 February 2017

The BBC And Suspiciously-Timed Snus 'Science'

Articles on the BBC about snus are about as rare as sightings of Willy Wonka factory tour golden tickets, but just such an occurrence was spotted on Tuesday.

What looks suspiciously like a well-timed piece of trademark tobacco control junk science to muddy the waters in the run-up to a CJEU challenge of the EU snus ban was - as can be expected with a study negative about nicotine - embraced warmly by Nanny Beeb.
Swedes warned snus tobacco raises diabetes risk
Researchers in Sweden have issued a warning over snus - the country's favourite nicotine hit - challenging claims it is a risk-free alternative to smoking.
Stop right there, BBC.

Haven't you been telling us all for decades that smoking is the root of every ill known to man - from lung cancer to ingrowing toenails - but now a tea bag of pasteurised tobacco placed under a person's lip isn't a better choice? I do wish these prurient bansturbators would make their minds up.
A study in The Journal of Internal Medicine found using snus increases the risk of developing diabetes. 
Researchers said that one or more pots of snus per day increase the risk of developing type 2 diabetes by 70% - the same risk level as smoking a packet of cigarettes a day. 
Five to six pots a week - a slightly lower consumption level - increases the risk by 40%. 
Researchers from Umea University, Lund University and the Karolinska Institute followed 54,500 snus users between 1990 and 2013 to compile the study.
40%, 70%, aren't they scary numbers, huh? Well when expressed like that, perhaps, but let's make a comparison.

Using the same terms, Cancer Research UK warns that the increased risk of lung cancer from smoking is 2600%. Yet even after years of stating how many other diseases smoking is supposed to cause, the BBC doesn't see fit to mention the plethora of other problems that snus simply doesn’t produce. Instead focusing on a vanishingly small risk of diabetes which even the authors of this research concede is so lightweight that the margin of error could mean there is no risk at all.

The risk is even more negligible when you consider that Diabetes UK doesn't even list smoking as a risk factor on its website, so why anyone should be concerned about snus being equally benign is anyone's guess.

Worse than that, the BBC also fails to mention that this meta-analysis has come to a polar opposite conclusion to other research that preceded it on the subject of snus and diabetes. In fact, even co-authors of this study - Sweden's pre-eminent anti-tobacco fake science factory, the Karolinska Institute - declared the risk of snus for causing diabetes to be non-existent in June last year.
It has been suggested that moist snuff (snus), a smokeless tobacco product that is high in nicotine and widespread in Scandinavia, increases the risk of Type 2 diabetes. Previous studies are however few, contradictory and, with regard to autoimmune diabetes, lacking. Our aim was to study the association between snus use and the risk of Type 2 diabetes and latent autoimmune diabetes of adulthood (LADA). 
The risk of Type 2 diabetes and LADA is unrelated to the use of snus, despite its high nicotine content. This opens the possibility of the increased risk of Type 2 diabetes seen in smokers may not be attributed to nicotine, but to other substances in tobacco smoke.
The June report also found that former snus users had a lower rate of Type 2 diabetes than never users, so when all previous studies on a subject say one thing but another says something wildly different, a responsible news source should be enquiring as to why, don't you think? Yet the BBC don't do so and - I could be wrong - I don't remember the BBC ever reporting on any of the other snus studies that dismissed the link to diabetes. A cynic could be forgiven for thinking that, by making a big noise about a rare outlier, the Beeb has resorted to clickbait journalism instead of calm analysis of serious subject matter, eh?

The BBC could also have looked into the meta-analysis itself which was weighted heavily towards extreme consumers in the north of Sweden. An area of the country which is renowned, amongst other dodgy behaviours, for impressive consumption of moonshine. Did this research control for other lifestyle factors such as this? No! No, of course it didn't.

Additionally, if the implication is - as the BBC article tends to suggest - that the nicotine in snus is the cause of diabetes, where does NRT figure in the analysis? It would surely have the same effects, yet has been issued a medicinal license and therefore had to pass through numerous clinical trials, none of which have flagged up any particularly nasty risk of diabetes presumably.

And as for this nonsense:
Dr Sofia Carlsson, a researcher at the Karolinska Institute, told The Local: "The current picture in Sweden is that snus is not as dangerous as smoking, and there is some evidence for that too - but importantly, there haven't been that many studies on Swedish snus.".
Haven't been many studies? What does she think this 805 page "review of the scientific literature on snus" was all about then?

You have to wonder why the (EU-funded) BBC seem to have dipped their toe in the scientific debate on snus at this particular time when they haven't before, especially with this particular research which has holes you could drive an Iveco truck through. Did someone say EU ban court case?

Who cares if the study is poorly-designed junk? Who cares that it contravenes a long-held consensus? Who cares that it could have adverse consequences for health?

The establishment that plays together, stays together. 

Wednesday 8 February 2017

It's A Good Country If It Agrees With Simple Simon

Simple Simon Chapman has been heroically doing his Canute impression at The Conversation by employing global cherry-picking on steroids to pretend a bunch of vaping truths are actually myths. Comical stuff like this for example.
9. There’s no good evidence for e-cigarettes being a gateway to smoking in young people 
Centers for Disease Control data from 2015 demonstrate a concerning sudden cessation and plateau in the previous decline of US high school students smoking tobacco, while e-cigarette use is skyrocketing.
Yeah OK, oddball.

Yes, the whole thing is as shit as that. Y'see, Simple Simon is one of the old guard of tobacco control who lied for decades about smoking and saw a bovine public actually believe them. So therefore now think all they have to do is lie outrageously about e-cigs and - hey presto! - they will again be lauded for protecting society from imaginary danger ... instead of hilariously destroying their ill-gotten reputations in favour of a place in history as an ignorant object of eternal ridicule.

The most interesting thing about Simon Chapman's article though - apart from his increasingly isolated battle with reality - was this exchange in the comments.
Prof Chapman said; “But 18 nations ban e-cigarettes outright,…”
To expand on that using the link provided, the 18 countries who have banned ecigs are: ARGENTINA, AUSTRIA, BRAZIL, BRUNEI, INDONESIA, COLOMBIA, JORDAN, MALAYSIA, MEXICO, OMAN, PANAMA, QATAR, SINGAPORE, TAIWAN, THAILAND, UNITED ARAB EMIRATES, UAE, including Dubai, URUGUAY, VENEZUELA. 
By contrast the UNITED KINGDOM, UNITED STATES, and the EUROPEAN UNION, along with a few other western democracies are all in the list of countries that permit (and in some cases encourage) the use of ecigs. 
CANADA and NEW ZEALAND are both in the process of liberalising their current restrictions on use. 
I don’t think I need to expand on the meaning evident in this information, but I will say that tobacco harm reduction seems to be favoured by more progressive, western nations.
Fellow commenter Mark haughtily objected to what he saw as disrespectful insinuation.
From what I can tell from your post you are suggesting that countries in which which legislation reflects your own views on vaping are “more progressive” while those that don’t reflect your views are not.  You should try and explain that.
Yes, what a terrible argument! I mean, who but a fool would dismiss entire nations simply because they disagree, eh?

You don't often see articles where a commenter defends the author while indirectly calling him a bellend, now do you? 

Monday 6 February 2017

British Vapers Leading Europe

One of the 'Big Four' accounting firms, Ernst and Young (EY), has today released a report on e-cig use in seven 'core' countries between 2013 and 2016. The results are quite interesting, especially for UK vapers ... take a bow boys and girls.
The British public are switching from traditional cigarettes to vaping devices (e-cigarettes) faster than anyone in Europe. In the last four years, the British have switched to vaping at the rate of one person every four minutes.

The EY report shows that 2.2 million British people now use e-cigarettes – this is up by 55% in just three years. In total, 4.2% of British adults vape. France has the next highest penetration at 3.1%.
In your face, cheese-eating surrender monkeys!

There are many other revealing stats in the report, such as how the vaping market has more than doubled in size since 2013 and - much to the chagrin of 'public health' dinosaurs who like to pretend e-cigs are a plot by 'Big Tobacco' to drive tobacco consumption - how dual use is declining rapidly in favour of sole use.

As usual, click the images to enlarge
Meaning that if tobacco companies really are investing in e-cigs in order to encourage dual use and therefore revive tobacco sales - as many deluded (or deliberately doubt-fostering) tobacco controllers claim - their cunning plan looks to be failing spectacularly. Something the industry-hating tobacco control community will duly celebrate, no?

EY also report that over two-thirds of e-cig users prefer to buy 'modular' devices, described as "can be refilled by the user, but also allows the user to regulate the power delivered from the system’s batteries to the atomizer". This must also come as a bit of a blow to tobacco control conspiracy theorists who like to tell the world that 'Big Tobacco' is a majority supplier of e-cigs to consumers; they aren't, because the tobacco industry sells very few devices which fit that description.

However, probably the most damning statistic EY has presented is on the drivers of e-cig use. In the UK, prevalence is still climbing despite furious scaremongering tobacco control junk science being published regularly in the media. However, it has declined in France where the government has been joining in with the hysteria.

The EY report discovered that around half of smokers enjoyed smoking and didn't believe that e-cigs would offer them the same experience, which is understandable. However, the research also revealed that, for around 30% of smokers, "I think e-cigarettes might be harmful to my health" is given as a reason as to why they had not tried, or did not intend to use e-cigs. Now, I don't know what the percentage switch rate is currently, but that means that tobacco control hysterics have convinced between 3 million and 4 million smokers that they should steer clear of vaping because it is equally or more harmful than smoking.

It's never really been about health, has it?

The good news, though - as I've said many times since I first wrote about them in 2010 - is that the more vapers there are, the more shrill and absurd detractors become and the more the public will realise that governments and 'public health' are lying their arses off about smoking alternatives. This EY report has assessed that the e-cigs market is currently worth around £6.1bn, up from £700 million in 2010, and predict that this will increase to around £12bn in 2020.

Just imagine how much that must smart for certain insane moon-howlers in California, Sydney and the London School of Hygiene and Tropical Medicine, eh? 

Friday 3 February 2017

Simple Simon Blatantly Lies To Australia

As I touched on in the last article, the Australian Therapeutic Goods Administration (TGA) yesterday decided to continue with their ban on e-cigs containing nicotine. Part of their flawed reasoning cited evidence from the US which is hardly surprising.

You see, one of the prime Australian 'experts' in tobacco control Down Under is the vandal-turned-clown Simple Simon Chapman, whose prejudice against e-cigs runs so deep that he has scoured the globe for straws to clutch in his attempt to obstruct vaping.

Increasingly he has been drawn to the US where the CDC continues to lie about the subject by classifying e-cigs as a "tobacco product" despite containing no tobacco. That way, they are able to pretend that tobacco use remains unchanged as more youth vape and fewer smoke.

I highlight 'tobacco use' because it is a clever manipulation of statistics, however it's quite clear when you look into the data that youth smoking in the US has been falling to record low levels. For example, here is a graph taken from CDC data by Reason's Jacob Sullum in April last year.

Yesterday, though, Chappers appeared on Australian national broadcaster ABC's PM show and declared this to the nation.
"The fall in youth smoking that we saw for many many years in the United States last year, for the first time, stopped falling; and while that was happening, e-cigarette use was rising dramatically."
As you can see above, even if the CDC may try to argue that tobacco use remains overall the same if you fraudulently include e-cigs in the same category, it is completely untrue to say that youth smoking has stopped falling.

It's the same if you look at National Youth Tobacco Survey data, as Chris Snowdon did last month ...

... and also if you look at US Monitoring The Future surveys.

Contrary to what Simple Simon told Australia yesterday, nowhere is there a hint that youth smoking rates have stopped falling in the US. Yet if you're an Australian citizen who is largely uneducated on the subject of e-cigs, yesterday you would have heard someone called Professor something-or-other declare a falsehood as fact on Australia's state broadcaster.

In many professions, this kind of behaviour would be punishable by suspension or even dismissal. But in the unregulated Wild West world of 'public health' - where you would think accurate information should be far more important than in any other sphere - Chappers will get away scot-free with deliberately lying.

Sadly, he is just one small part of a broken and corrupt profession in which lying is viewed as an acceptable tactic, and which is actively harming social cohesion and liberty the world over. 

Thursday 2 February 2017

The Wild West Of Public Health

Tobacco controllers do love sound bites. If you've ever read an article by any one of them you know that generally you can skip the first paragraph of anything they write because it will be sound bite after sound bite and you'll have read it before, many times.

When e-cigs started to threaten the cosy existence of some of the more extreme tobacco control grandees, one of their favourite sound bites - repeated regularly - was that vaping was unregulated (it wasn't) and that the vaping market is "like the Wild West!".

I'm sure that portraying themselves as valiant Davids fighting industry Goliaths (and the public astroturfs who object too) helps ease their consciences, but it's a fairy tale, isn't it. While they restrict freedoms, brutalise communities and bully people making free choices to consume legal products, they can kid themselves that they're not utter bastards by accusing others of being unregulated.

The truth is entirely different. Who, for example, effectively regulates them?

Take Public Health England, for example. They have just released a report on alcohol which is an insult to science, 'public health' and the taxpayer. They don't apologise for cherry-picking research, lying by omission, ignoring evidence which disagrees with their pre-determined conclusions, and prioritising their prohibitionist agenda over the health of the public.

We know they are lying; they know they are lying. But they do it anyway. Who regulates them? Who can we complain to when they do? Who pulls them into an office and gives them the hairdryer treatment for misleading the public, advancing policies which are misguided and evidence-free, making decisions which are arguably bad for public health, and flagrantly abusing the taxes they are funnelled to produce their nonsense?

It's not just here, this is a global problem. Australia today displayed exactly the same idiotic and harmful ideology by reinforcing a ban on nicotine in e-cigs, effectively criminalising people who vape instead of smoke. They did so by completely ignoring any studies which didn't agree with their prohibitionist mindset and by unquestioningly citing easily-debunked guff from career extremists in the US with conflicts of interests as extensive as the Channel Tunnel.

Likewise in New Zealand today, heat not burn technology was deemed illegal without even a cursory glance at possible unintended consequences and with barely a nod to the science.

Groups like ASH, PHE, Action on Sugar, Alcohol Concern, Alcohol Health Alliance, Healthy Stadia, the BMA, and many many more are lying literally on a daily basis. The only control on their regular faux science bullshit is peer review which is utterly meaningless considering the Gatling Gun regularity of provable falsehoods they produce.

No-one ever pulls them up on it though. They shoot their mouths off, lie as a matter of course, safe in the knowledge that there is no sanction or threat when they are routinely caught having spread lies and falsehoods. When businesses are caught lying they are fined or their executives prosecuted.

Yet where is the Sheriff in the Wild West of 'public health' and tobacco control industry propaganda to throw them in jail where they belong and deter others in their profession from doing the same?

They like to submit scatter-gun complaints to the ASA all the time about vague messages that could perhaps be misconstrued if looked at through a kaleidoscope by the kind of prissy prick who considers a role in public health a worthy career instead of the arrogant, snobby, deceitful assault on free choices that it really is. But where do you complain when public health and tobacco control deliberately mislead the public?

They squeal that industry is not transparent but considering groups like ASH have been in receipt of taxpayer funding for over 40 years, why are they excluded from Freedom of Information legislation? Seeing as they take billions of our taxes and play fast and loose with the truth regularly, who regulates their output? Why can't we request to see minutes of their meetings? Who do you complain to when they lie? There's the Charity Commission but they only look into compliance, who looks at whether their pronouncements are factually correct instead of the customary blizzard of half-truths and cleverly-worded mendacity?

ASH, and others like them, bang on about organisations like the IEA not disclosing their funders but they are voluntary donations from businesses and private individuals, ASH - and hundreds of other NGO which have followed their lead - uses OUR money and uses it to manipulate the government that handed it to them, but they are effectively accountable to no-one. They are also immune to the usual rules of competitive tendering for public contracts.

In short, the entire 'public health' movement - both nationally and globally - is a gargantuan deceitful tax-sucking gravy train. Firing off wilfully mendacious research, reports and studies on a whim; entirely unaccountable; and completely unregulated.

They accuse industry of lying when they themselves do so on on a daily basis (here is an example today); they accuse industry of "marking their own homework" when the only control on 'public health' is peer review by mates who think the same way as they do; they ridicule, insult and ultimately ignore the public when the public challenges or objects to their dogma; if you try to engage on social media they block you; if you try to email them they don't reply; and none of them ever get fired because there is no-one to pull them up on any of it. Now that's what I call the Wild West, that is the very definition of unregulated.

When 'public health' talks dismissively about how industry is 'unregulated' or not regulated enough, they should look in the fucking mirror.