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s2smodern

Harry Shapiro Director DrugWise

As a student, Professor Ibrahim Al-Marashi wrote a thesis entitled Iraq: Its Infrastructure of Concealment, Deception and Intimidation. As revealed by the Chilcot Inquiry into the Iraq war, the thesis found its way into the UK Foreign Office where it was not only plagiarised but also altered, as the British government and intelligence establishment sought to strengthen the uncertain evidence about Saddam Hussein's efforts to develop weapons of mass destruction.

A similarly dossier of 'dodgy' provenance is being promoted to the effect that e-cigarettes cause heart attacks. Leading the charge on this is Dr Stan Glanz who has declared that we now have “the first study” to confirm his previous claims. However a brief 'glanz' at the study reveals it to be not a published peer reviewed paper but a poster presentation at a student science fair.

Dr Michael Siegel writes “The study was merely a cross-sectional examination of the relationship between any history of a heart attack in the past and current e-cigarette use. The study did not follow people over time to see whether those using e-cigarettes were more likely to have a heart attack. Nor did it identify heart attack cases and retrospectively assess e-cigarette use. Instead, it was just a cursory, cross-sectional look at e-cigarette use prevalence among people with and without a lifetime history of a heart attack”

“The study in no way proves that e-cigarettes cause heart attacks. It merely shows an association between ever having had a heart attack and currently using e-cigarettes, after controlling for smoking status. It is very possible (and quite likely) that many, if not most of the people with a history of myocardial infarction had experienced heart attacks years ago. And it is similarly likely that many of these heart attack victims had experienced the heart attack prior to starting to vape. In fact, it is likely that having a heart attack or a history of a heart attack was a stimulus that led the person to try vaping (because of the urgent need to quit smoking)”

For more on this go to http://tobaccoanalysis.blogspot.com/2017/03/vaping-opponents-have-lost-scientific.html

You just have to wonder if some so-called 'experts' are living in a parallel universe where you are actively involved in promoting the very opposite of what you really want. I have to assume that most public health scientists and clinicians want people to stop smoking cigarettes. And many of them don't want people to use e-cigarettes either. But to be so anti-HNB technology as to claim that smoking is no more dangerous than vaping or that vaping is just as dangerous as smoking is not only ludicrous but a major marketing opportunity for Big Tobacco if it was daft enough to follow through. For the latest example of this nonsense

http://tobaccoanalysis.blogspot.co.uk/2017/04/penn-medicine-expert-smoking-may-be-no.html

Reynolds have just submitted 450,000 pages of evidence to the FDA in support of a bid to market Camel snus. If memory serves, I heard at last years' GFN Conference that Swedish Match sent in 200,000 pages for its modified risk product and that was jaw dropping enough. If Reynolds submission was straight text at around 400 words per A4 sheet, that would amount to 180 million words. Even allowing (I assume) for lots of chemical symbols, that's still some submission. But if you have access to it, don't send it to me on Dropbox! I'm curious, but not that curious.

http://s2.q4cdn.com/129460998/files/doc_news/2017/2017-06-RJRT-Submits-Mod-Risk-Tob-Prod-Apps-for-Camel-Snus.pdf

So the headline in the Medical News Bulletin declared “Instagram and E-Cigarettes: How Celebrity Endorsements Can Influence Our Youth”. Looking at the abstract online it reads “Celebrities endorsing e-cigarette brands on social media may (my emphasis) exert a strong influence on e-cigarette uptake”. I haven't been able to access the full study in the Journal of Health Psychology http://journals.sagepub.com/doi/abs/10.1177/1359105317693912?journalCode=hpqa& so I don't know how strong the evidence is, but I do have a few thoughts.

Ever since the folk singer Donovan was busted for cannabis in 1966, judges and magistrates have solemnly intoned that 'pop stars' have a duty to set an example to their young fans, a cry which echoed down the years when Noel Gallagher of Oasis caused tabloid outrage by declaring that ecstasy was no more dangerous than drinking tea, although I have to say that a cup of PG Tips never made me want to hug anybody. I have taken many calls from journalists on this point and I have said repeatedly that at a population level, there is no evidence that drug taking celebrities in any way prompt legions of fans to follow suit. Teenagers may aspire to be great guitar players or footballers, go to the events and buy the merchandise, but decisions about drug experimentation are taken for very personal and localised reasons, not because some remote bling laden diva is photographed on a smart phone hoovering up half the gross national product of Colombia. As it happens in this case, it would be good if young people really were influenced away from smoking however that is achieved, but even in these days of the personal engagement offered by social media, I remain sceptical.

Don't read much from the Middle East about vaping, but here is a story from Iran, where according to anti-tobacco groups, smoking is actually going up while the vaping market remains in its infancy.

https://financialtribune.com/articles/sci-tech/61764/e-cigarettes-and-vaping-market-in-iran

Well here's a thing. Apparently the murderous Rodrigo Duerte who runs the Philippines and thinks it's fine to kill drug users - and is shockingly undeterred by a really strong piece of paper (called a resolution) from the EU, is suffering from Buerger's disease, a clogging of the veins caused by accumulation of nicotine. He has breathing difficulty and has to sleep next to a medical device called an oxygen converter.

So he is now considering a smoking ban across the country and no doubt this will be accompanied by his very own brand of justice where as mayor of his home town once went so far as forcing a tourist, at gunpoint, to swallow a cigarette butt for flouting his anti-smoking ordinance.

Writing in The Straits Times, Raul Dancel says that ex-smoker El Presidente “ has said that if he can really have his way, the only place anyone can smoke in the Philippines will be 5km from the shore. He's joking, of course” I wouldn't be so sure about that. Dancel wonders if a smoking ban will work. He reckons the best way of making it happen is a massive price hike. Or looking down the wrong end of a Glock perhaps. As he says, “ I plan to stay sober. The last thing I want is to mess with Mr Duterte”

http://www.straitstimes.com/asia/se-asia/smoking-ban-in-philippines-just-make-it-more-expensive-to-light-up

No points out of ten for the UK vape shops allegedly selling to non-smokers and in doing so contravening The Independent British Vape Trade Association (IBVTA) guidelines aiming to stop non-smokers from becoming addicted to nicotine. The Royal Society of Public Health went undercover in February visiting 100 shops and found that 45% did not check whether customers smoked or used to smoke. And even in cases where the staff did check, customers were encouraged to start vaping even if they knew they were a non-smoker. Of course what that means is that 55% of shops were conducting themselves responsibly. But that doesn't make for a good headline.

http://www.independent.co.uk/news/health/vape-shops-nine-ten-sell-non-smokers-break-industry-codes-undercover-investigation-e-cigarettes-a7670601.html

And finally on the subject of 10 – new estimates reveal that smoking accounts for 1 in 10 deaths worldwide, over six million deaths, half of which occur in four countries, India, USA, Russia and China. Maybe two out of those four need a re-think. http://www.huffingtonpost.com.au/2017/04/06/smoking-still-causes-one-in-10-deaths-worldwide_a_22028593/