This week’s must-read cones from the ever-insightful Carl Phillips who has written a superb demolition of the latest piece of suspect science from the parallel universe of Planet Glantz. The Prof attempted to show that vaping isn’t all its cracked up to be as an aid to quitting and in the process, made some basic methodological howlers. It is hard to believe that he isn’t aware of these, so the conclusion must be an attempt to muddy the waters of tobacco harm reduction, to cause confusion and doubt among regulators and the wider public - an accusation, traditionally lobbed at the tobacco industry.
The publication of this paper is probably a coincidence rather than a conscious start of an attempt by the anti-tobacco harm reduction lobby to shift the goalposts on the debate about e-cigarettes and other safer nicotine products. What coincidence you ask?
Up to now, the primary official reports backing tobacco harm reduction have come from the UK. But the recent report from the National Academy of Sciences (NAS) and the position statement from the American Cancer Society (ACS), do gently chip away at the ground beneath the feet of anti-harm reductionists. The NAS stated that taken together all the evidence shows that “e-cigarette aerosol contains fewer numbers and lower levels of toxicants than smoke from combustible cigarettes”. The American Cancer Society has gone further, “Based on currently available evidence, using current generation e-cigarettes is less harmful than smoking cigarettes”….” Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation mediations. These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products”.
It would be wrong to oversell these as major tipping points; read in their entirety, they are hardly ringing endorsements of SNP and the precautionary principle still holds sway, although the ACS position statement is quite a shift for that organisation. Even so, it is now harder at least for those who perpetuate public misinformation to sustain the claim that e-cigarettes are at least as harmful as cigarettes. But is it possible the usual suspects will try and conjure up studies on the basis of, ‘OK vaping might not be quite as dangerous as smoking, but….it isn’t beneficial if there is duel use or if smokers don’t use e-cigarettes to quit”.
Flash back to 1930. A US Treasury agent, Harry Anslinger, who had a failed career trying to enforce Prohibition, landed the job as head of the newly-established Federal Bureau of Narcotic Drugs. Anslinger, an anti-narcotics zealot, found himself with an immediate problem. He had very few agents in the field, it was Depression time and so funding was scarce. For some while states on the Mexican border had been agitating for a federal marijuana ban because Mexicans coming into the USA had brought their drug of choice with them. Anslinger resisted for years because he had no means of enforcing it, but then realised that a drug scare was just what he needed to shake out some Treasury dollars. With the help of a sympathetic press and the backing of moral reformers and faith groups, he dug up a few lurid cases involving Mexican murderers whose crimes were allegedly committed under the influence of marijuana and created the myth of reefer madness. This worked from the late 1930s and into the 1950s, but the evidence was looking pretty thin until even US Senators were now unconvinced. To cut a long story short, Anslinger responded to the funding threat with ‘OK, marijuana doesn’t drive all users mad, but it is a gateway drug to heroin and cocaine”. Academic careers were subsequently built on this notion and the rest as they say – is rubbish. So let’s wait and see.
But two other very local stories from the US tell us that whatever might be swirling around in the upper reaches of public health policy, those goalposts are deeply embedded in the ground, providing support for all the vaping equivalents of reefer madness.
The first story comes from the local community website for Scarsdale in New York State which reported on a presentation to Scarsdale School District by Dr. Richard Stumacher, chief of pulmonary and critical care at Northern Westchester Hospital, and a smoking cessation ‘expert’. He told parents and school administrators that e-cigarettes, contain “42 chemicals” and 19 of them are “especially harmful.” He said e-cigarettes are “the next generation cigarette for the next generation addict.” He warned vaping will cause “a tsunami of lung cancer and emphysema, heart disease, diabetes, etc., etc.”
Then having scared the living crap out of parents with information which goes against every reputable study and overview, he then encouraged parents to “be patient and begin honest (my emphasis) discussions with their teens.”
The second come from the US Army base at Fort Bragg in North Carolina. Camp doctors reported that ‘vaping products’ were causing soldiers to experience a wide range of symptoms from headaches to seizures, amnesia and loss of consciousness. And the culprits? Not Berry Christmas or Chunky Monkey flavours (made those up actually), but from the symptoms described, synthetic cannabinoids also known in the UK and elsewhere as Spice. These are extremely potent compounds bearing no relation to cannabis except that they lock onto the same CB1 and CB2 receptors on the brain as cannabis. But the headline is “Bragg doctors warn of growing threat from vaping products" and you don’t find out until way down in the piece, that the doctors were not warning about e-liquid but something very different.