The celebrity chef and healthy food activist Hugh Fearnley-Whittingstall interviewed a director who was making a TV campaign to encourage kids to eat more vegetables. The director said that when he told people he was doing this their first response was ‘OK. What’s the twist? What evil company is behind this?’. And that is a perfectly understandable response when major food and drinks companies promote breakfast cereals, fizzy drinks and snacks loaded with sugar directly to children, and every type of store from supermarkets to garden centres have sweets and chocolates deliberately sited near the check-out to put pressure on parents.
This is exactly the same response I get when I say I am working within tobacco harm reduction on projects funded by the Foundation for a Smoke-Free World because of the link with Philip Morris. The “knowing eyebrows” go up once more and then I have to explain that there are people within the tobacco industry alongside independents who are actually trying to do some good while at the same time turning a profit. And no, there is no evidence of a Big Tobacco conspiracy, and yes, safer nicotine products (SNP) are substantially safer than cigarettes and no, that isn’t based on industry science and no, nicotine doesn’t cause any serious health problems. At one level, this is getting quite boring until you realise just how little people know about this stuff including many health professionals and so under my little mantra of ‘keep your eyes on the prize’, I will keep banging on about this stuff and I will not shy away from talking about industry involvement.
The subject of working with the industry was raised in the letters column of the most recent issue of Addiction. Six eminent academics including John Hughes and Karl Fagerström justified their stance on this by saying that, on the basis of the independent evidence about the relative safety of SNP, their work with the industry was restricted to these products. And in terms of the evidence being shanghaied by the industry, they say that with all the past history of tobacco industry malfeasance, the FDA are unlikely to let manufacturers get away with anything. [And see below]. Pointedly, their Declaration of Interest statement was almost as long as the letter.
In reply, Billie Bonevski, an Australian public heath researcher, acknowledged that despite all the risks, research engagement with the industry was important. The issue was not to run away from industry but learn how to navigate the risks and pointed to an article by Linda Bauld in Nature last August about managing partnerships.
Finally, Professor Wayne Hall, suggested that one way forward to fund independent research would be to raise the necessary cash by a tax on SNP. He may have a point, although there is no evidence that the growing body of literature in favour of tobacco harm reduction through the medium of dance (sorry, safer nicotine products) has been driven by industry-funded research.
A big stumbling block to grown-up communications is Article 5.3 of the Framework Convention of Tobacco Control which has been wildly and deliberately over-interpreted to forbid any dialogue between the industry and public health - from meeting with industry executives to denying public platforms to anybody with a scintilla of industry connection. Apparently in the fight against non-communicable diseases, the same McCarthyite dogma does not apply to the drinks industry or those wonderfully benign organisations whose products result in one in six NHS beds in the UK being taken up with people suffering the complications of obesity including kids with type-2 diabetes.
Actually, there shouldn’t be bans on public health talking to industry, whatever the product. The trouble in the tobacco world is that the WHO among others make no differentiation between combustible tobacco and the safer products. Many countries tax them all as tobacco products which makes no public health sense at all – and 39 countries ban them altogether. One way forward might be for an acceptance that if the conversation is just about SNP, then the full rigours of 5.3 need not apply. But that requires a massive decoupling exercise of Big Tobacco (red in tooth and claw) from those bits of the business dedicated to SNP and also nicotine from combustible tobacco. And the evidence is that the Cloud-Nine for many in public health is not just an end to smoking or tobacco, it’s ‘A Nicotine-Free World We Can Do It’. But hey, the Americans are talking to the Taliban, so come on guys.
Sadly, this link typifies the continuing face-to-face trolling that’s going on when anybody in good faith attempts sensible debating about tobacco harm reduction. Those engaged in this kind of public humiliation are a disgrace to whatever profession, discipline or organisation they purport to represent.
Having had a go at the supermarkets, it’s a high five to Sainburys for putting SNP where they belong, near the health products section and not under wraps where you have to give the secret handshake, knock three times on the counter and say, “It is very warm in Moscow for the time of year”. OK so I exaggerate to make a point.
New York Mayor Andrew Cuomo aims to treat vaping like smoking and raise the minimum age for cigarette and vaping products sales from 18 to 21. “We have made great strides to stamp out teen smoking,” said Cuomo, “but new products threaten to undo this progress to the detriment of millions of Americans. In New York, we refuse to stand idly by while unscrupulous businesses target our young people and put their very futures at risk.” He also wants to legalise cannabis. Welcome to the wacky baccy world of confused public health.
Markets Insider published a press release regarding research conducted by Frost & Sullivan, which found that 57 percent of Australian healthcare professionals “agree that alternative products to cigarettes should be legalised, provided they are strongly regulated to ensure there is no uptake among youth and non-smokers.” Managing Director of Frost & Sullivan ANZ, Mark Dougan, said the research indicates that two thirds of smokers would like to quit, while almost a third who “do not wish to quit” may benefit from “switching to tobacco harm reduction products.” This research was commissioned by Philip Morris International, but “the analysis contained in this research reflects the views of Frost & Sullivan analysts without any bias or influence from any third party.”
A good example of what happens when you rely on apparently credible, but ultimately suspect sources for your public health messaging.
The Philippine Sun Star reported Dr. Donnabel Tuvera from the local health department as citing a UCLA study claiming, “what they found out is that e-cigarettes cause different health issues and...it contains nicotine which causes cancer.” She also said, “Children now as early as 13-14 years old use vaping because they thought that it is safer than cigarette. What we are trying to say based on studies is that the World Health Organization does not recommend this as a thing that will help someone to quit smoking.”
Nice interview with people who know what they are talking about concerning smokeless tobacco.
“Dr. Rodu and Dr. Nitzkin strongly believe that smokers who are unable or unwilling to quit cold turkey should be informed about much lower risk smokeless tobacco or e-cigarettes. I spoke with both doctors to find out how they believe adult smokers can potentially be spared from life-threatening smoking-related illnesses. Here’s more about what they both had to say on this topic.”
This is not good reading from the FDA’s Scott Gottlieb. While he fully acknowledges the role that SNP can play in reducing the death and disease from smoking cigarettes, this welcome direction of travel has been entirely derailed by the panic over JUUL and may threaten the future availability of safer products for smokers wanting to switch or quit. This hysteria over JUUL is simply founded on the thorny question of addiction and the malignant images this word conjures up in the public mind rather than actual evidence of significant short or long terms physical health deficits from regular use of nicotine.
So here is the antidote to frothing nonsense:
And make this sensible information go viral:
Apparently, there is a new US group called Parents Against Vaping E-cigarettes (PAVE). Of course there is. Even with a fistful of dollars from Bloomberg, some clearly think The Campaign for Tobacco-Free Kids is just not cutting the mustard.