Happy New Year to you all as Britain prepares to go one better than the US by building a wall round the country and shutting it down all at the same time.
The blog title is a quote from Hamlet written by W. Shakespeare and set in Denmark because Bill ripped off an old Danish story for his plot. Even so, it’s a pity that the Danish authors of a paper basically alleging that all pro-vaping studies are compromised by associations with the tobacco industry, couldn’t have taken this quote to heart. In fact, so far from the truth is it, that the ever-estimable Carl Phillips has written the most damning indictment of a paper purporting to be ‘peer-reviewed’ that I have ever read. Because if you thought that conflict of interest only applied to academics supping at the table of commerce, then read on. It’s only 4th January as I write, but Carl’s review might already qualify as the ‘must-read’ of 2019. His forensic dissection of this eye-watering farrago of Danish anti-tobacco harm reduction nonsense is awesome. It’s long, but don’t stint yourself.
Having detailed how the authors themselves are compromised, Carl might have left something out, according to a posted comment which read: “Denmark is a “pharma country”. The Danish government (employer of the authors) has since 2013 dedicated itself to “help” the pharmaceutical industry to achieve economic growth in Denmark…This has resulted in a myriad of pharma-government partnerships in universities and national / regional bodies, and lately even in an open invitation, called “Start with Denmark” by the Ministry of Foreign Affairs to the global pharmaceutical industry to settle in Denmark with the help of public money:
Obviously therefore, the authors’ affiliation with the Danish government constitutes a conflict of interest in itself, as vaping and E-cigarettes are directly competing with the smoking cessation pharma products (NRT’s). Any research result in favour of E-cigarettes directly conflicts with the declared policy of the Danish government”.
And the sting in this tale is that, against all the trends in Scandinavia, smoking rates in Denmark are rising. Danish media reported there was a “significant increase” in smoking in Denmark for the “first time in two decades,” according to an annual survey by the Danish Health Authority which found that 23.1 percent of the population were smoking last year. Niels Them Kjær, a project manager with charity the Danish Cancer Society said the increase from 21.1 percent in 2016 represents a “catastrophe”. He said Denmark should pursue anti-smoking policies that are working in neighbouring countries, such as tax increases, stricter marketing regulations, and more no-smoking areas. Minister of Health said, “an overall cultural change in society is needed to push this curve downwards”. Encouraging a switch away from cigarettes to safer nicotine products might be a plan.
Another good read is this clear and concise review article from Linda Baud and Suzi Gage setting out all the pinch points in the young-people-and vaping debate, especially how statistical methodology varies between the USA and UK. One very important point caught my eye: “This transatlantic debate has wider implications because reports of study findings are played out in the global media, causing confusion in countries that have not yet decided how to regulate e-cigarettes”.
It is those American studies which purport to show the dangers of vaping which are most likely to capture the attention of the media (bad news sells) and therefore of politicians and policy makers, especially in some developing countries which already have sky high smoking prevalence predicted by WHO to rise still further. As the US government funds more research money than anybody else, it is able to foist its own ‘evidence-base’ on the rest of the world. Through a process of scientific imperialism, the USA led the way in promulgating misleading information about cannabis and spearheading opposition to drug harm reduction. The same is now happening with tobacco harm reduction bolstered by private investment from the Bloomberg organisation. Hopefully the forthcoming Global State of Tobacco Harm Reduction roadshows through the coming year, can help our regional partners deliver a much needed counter-narrative.
A very simple, yet extremely effective and easily understandable demonstration of the relative safety of vaping over smoking needs to go viral.
This study from Addiction demonstrates that a “large proportions of UK smokers and ex‐smokers overestimate the relative harmfulness of e‐cigarettes and nicotine replacement therapy compared with smoking; misattributing smoking harms to nicotine is associated with increased misperceptions”.
If fears about the ‘dangers’ of nicotine are the main barrier to smokers switching to vaping, then some simple risk-communication messages are vital to stop what seems to be increasing scepticism about the value of switching.
This is an interesting if not very surprising finding that NRT largely fails because smokers are being under-dosed with nicotine.
It always intrigues me that when anybody talks about Big Tobacco, curiously the biggest tobacco company in the world is never mentioned – the Chinese National Tobacco Co – a state-run monopoly which produces one in every four cigarettes smoked and clocks more profit than HSBC or Walmart.
One of the company’s units primarily responsible for procuring overseas tobacco leaf from countries like Brazil and Canada is about to be quoted on the Hong Kong stock exchange, something of a sick irony given that last October, Hong Kong announced a complete ban on safer nicotine products. I wonder in whose interests that ban really is.
And finally…..Chuck Norris, some sort of ‘movie and TV star’ has called for a New Year’s resolution to “put a stop to” underage vaping, which he calls an “affront to the health of our nation and the exploitation of young people”. Umm…and this from somebody whose whole career has been about the glorification of violence in a land where school students are gunned down with appalling regularity.