Nicotine In the News

12 February 2017

Harry Shapiro Director DrugWise

As a newcomer to the world of tobacco harm reduction, I am continually impressed by the expert forensic scrutiny of the published research much of which is aimed at undermining the positive impact of heat not burn technologies when compared to smoking cigarettes.

 

Most of the expert criticism appears in personal blogs or online comment pieces, less often in the scientific journals themselves. But nevertheless thanks to the internet, it is 'out there' for everyone to read and is a vital counterpoint to what must appear to the ordinary reader as authoritative sources. And of course, we mustn't forget that bad news always trumps good news (pun intended).

This week's example comes from Dr Michael Siegel and his demolition of a survey published in Tobacco Control dramatically headlined in the UK Daily Mail New study concludes that vaping is a one-way bridge to cigarette smoking among youth; http://tobaccocontrol.bmj.com/content/early/2017/01/04/tobaccocontrol-2016-053291?papetoc 

It is worth reading all of Dr Siegel's commentary http://tobaccoanalysis.blogspot.co.uk/2017/02/new-study-concludes-that-vaping-is-one.html , as he has robust criticisms of the methodology, but then the killer question, “How many youths is the sweeping conclusion of this paper based on? (i.e., how many non-smoking, recent vapers at baseline progressed to having tried a cigarette at follow-up?). The answer was 4(!) and the key word was tried so not frequent - and to get to that you had to dig into a separate online appendix. In other words the actual size of the survey sample was hidden from view. Dr Siegel rightly goes on to criticise the authors, the peer reviewers and the journal itself for this glaring lack of transparency.

Meanwhile, the Campaign for the promotion of Nicotine Nonsense (CNN) ran this story about the US Department of Smoke and Mirrors funded 'research' into 'dripping'. http://edition.cnn.com/2017/02/06/health/dripping-e-cigarettes-teens-study/index.html

Expert comment suggests the young respondents to the survey probably didn't know their drips from their drops, something the researchers helpfully failed to define.

When I attended last year's Global Nicotine Forum conference in Warsaw, it was gratifying to hear praise for the UK in relation to official reports endorsing e-cigarettes as a tobacco harm reduction intervention. Now Cancer Research UK funded research published in the Annals of Internal Medicine concludes that e cigarettes (and NRT) are less toxic and safer to use than smoking cigarettes. http://annals.org/aim/article/2599869/nicotine-carcinogen-toxin-exposure-long-term-e-cigarette-nicotine-replacement

Alison Cox, Cancer Research UK's director of cancer prevention, said: "Around a third of tobacco-caused deaths are due to cancer, so we want to see many more of the UK's 10 million smokers break their addiction. This study adds to growing evidence that e-cigarettes are a much safer alternative to tobacco, and suggests the long-term effects of these products will be minimal. Understanding and communicating the benefits of nicotine replacements, such as e-cigarettes, is an important step towards reducing the number of tobacco-related deaths here in the UK."

And finally, one for you conspiracy theorists. The Australian Therapeutic Goods Administration received a number of highly articulate public submissions urging an amendment to the poison schedule to allow lawful sale of nicotine e-liquids. Yet many names and significant portions of some submissions were heavily redacted for public consumption on grounds of 'confidentiality'.

The TGA privacy policy for the submissions states:

The TGA will disclose your name and (if applicable) your designation/work title on the TGA Internet site (i.e. make this information publicly available) if you consent to the publication of your name on the TGA Internet site (please complete the coversheet).

Any text within the body of your submission that you want to remain confidential should be clearly marked 'IN CONFIDENCE'.

It is most unlikely that so many authors would have wanted to remain anonymous or wanted so much of their submission redacted on grounds of confidentiality. Maybe the TGA were simply embarrassed at the weight of expert opinion in favour of law change. As William Burroughs famously remarked, “ only the paranoid know the truth”.