They campaign, make representations to politicians, run websites, social media, exchange and provide information and are support networks for people wanting to make the switch away from smoking. And while they are angry about the attempts by those from the well-funded anti-THR cabal who apparently would rather see them dead than vape, they are nonetheless under the public radar.

But one brave woman in Australia is pushing at the envelope of bizarre laws in a country with a legendary reputation for getting hammered on alcohol, but strangely averse to people trying to take control of their own health through THR. She is trying to persuade her local constabulary to arrest her for vaping in public – and apart from the publicity that would generate, would presumably also allow her a day in court with expert witnesses which might at least prompt a public debate. Which got me thinking:

There has been a rise in large scale public protest starting with the anti-capitalist G8 Summit protests; the pro-democracy protests in Hong Kong, yellow vests in Paris and Extinction Rebellion. The latter has been peaceful, the others obviously not – and no way would I advocate violent action which would only serve to alienate. But some 55 million people use vaping devices globally – imagine a silent protest outside health ministry buildings in countries which have or are trying to initiate bans; a protest outside the WHO and its regional offices. People would bring their families and be discreetly vaping – no cloud chasers please. There would be banners; “Death to Cigarettes” [who could argue with that?]; ‘I’d Rather Vape Than Die”; “People Live for the Nicotine but Die from the Smoke; “I’d Rather Live and So Would They” [protesters with kids]. If people were vaping discreetly, by-standers would wonder what was going on; they could be spoken to, given leaflets. They might even start wondering what the fuss was all about – “It doesn’t seem that terrible to me”. Global THR Action Day? Just a thought.

There is a certain power in uncertainty. That was a major tactic of the tobacco companies who would muddy the waters about the bad effects of smoking with well-publicised ‘alternate science’ by credible-looking men in white coats. A similar playbook is at large undermining THR, and being delivered by those who have a veneer of credibility by virtue of the number of academic stripes on their sleeves. I could fill a blog every week with examples like this:

"Vaping is more dangerous than smoking and alcohol combined”, says Professor Sherif Sultan, President of the International Society for Vascular Surgery.

Bad enough; worse is this unsigned editorial from The Lancet

A few choice quotes will suffice:

"No solid evidence base underpins the marketing claims that e-cigarettes are healthier than cigarettes or that they can support quitting".

"Public Health England, however, continues to endorse e-cigarettes as safer than cigarettes".

"Surely it is time to align the public health approach to e-cigarettes with that of cigarettes".

And the icing on the turd?

“Many US e-cigarettes have an uncertain provenance, containing a mix of ingredients, which might be illicit or altered, meaning the cause of the outbreak is difficult to trace. As new data emerge, national bodies must re-analyse the evidence on e-cigarettes and ask: how different are e-cigarettes from combustible cigarettes?”.

Not only does this editorial claim there is no difference between vaping and smoking, but it tries to link the THC-implicated deaths in the USA with vaping ordinary industry standard e-liquid, sowing further doubt and confusion among health professionals already in the dark about this, as my many conversations with ordinary doctors and nurses confirm.

I understand that an unsigned editorial is supposed to reflect the view of the whole publication rather than one staff member. But this allows a degree of smoke and mirrors and undisclosed conflict of interest. Did a Lancet staffer really write this? If so, on what evidence was it based? If not, then who? It’s one thing for some Bloomberg-funded tub thumpers to put out laughable anti-vaping adverts, quite another for a globally influential medical publication to publish garbage like this. There may well be darker forces at work: it would be hugely advantageous for the pharmaceutical industry to have non-medical vaping outlawed so that they could capitalise on the medicalisation of THR. Who knows what money might lie behind regulatory lobbying to that effect backed by a compliant or naïve medical establishment which incidentally has never been shy of taking the Big Pharma dollar. Meanwhile, here’s hoping some honest academics and doctors will attack this boil on the bum of clinical evidence – and Lance It.