Independent review of tobacco policy in England misses the point

England aims to reduce smoking to less than 5% by 2030, but this will need mass switching to smoke-free products as a consumer alternative to smoking, and it must be achieved by consent rather than coercion

Meeting the 2030 smoke-free target (5%) requires an accelerated decline
[Source: ONS, Adult Smoking Habits in England]
Note: a linear trend continuing from 2010-2020 should not be assumed as a given or ‘business-as-usual’ in the absence of further measures

The government has established a ‘smoke-free’ goal to reach 5% adult smoking prevalence in England by 2030. This represents a significant acceleration in progress (see chart above with linear trends). As a prelude to announcing a plan to achieve the goal, Ministers appointed Javed Khan OBE to head an independent review of tobacco policy to make recommendations for measures to meet the target and contribute to reducing health inequalities.

Here is what Dr Khan has come up with:

These are recommendations to the government, not government policy. We have yet to see what the government will actually do and when it will get around to doing it.

In this blog, I set out an overview critique of the Khan programme and then look at each of the fifteen recommendations in more detail. Finally, a few words on what should be done.

Continue reading “Independent review of tobacco policy in England misses the point”

E-cigarette risk perceptions – an American crime scene

Most Americans now incorrectly believe that e-cigarettes are just as harmful or more harmful than cigarettes. US health organisations have unethically cultivated this misunderstanding and compare unfavourably with UK equivalents. Their duplicitous behaviour resembles that of Big Tobacco 50 years ago.

Note: ‘Don’t know’ is handled inconsistently across the surveys, so I have merged ‘don’t know’ and ‘never heard of e-cigarettes’ (some care needed)

I have drawn the chart above from the US National Cancer Institute HINTS survey, picking up results from 2014, 2017 and the most recent data from 2020. The current situation is shocking and the trend is a disgrace. But how has this happened?

In this blog, I compare the vaping risk communications of four major American health organisations with four similar UK organisations. The comparison is damning.

Continue reading “E-cigarette risk perceptions – an American crime scene”

Response to the extremely poor European Commission SCHEER preliminary opinion on e-cigarettes

….and another thing.

 

Further to my 30 Sept blog: European Commission SCHEER scientific opinion on e-cigarettes – a guide for policymakers.

I have made a short submission to the consultation on the European Commission SCHEER Committee preliminary opinion on e-cigarettes.  You can respond to the consultation on this very poor scientific assessment here, where you can find all relevant documentation.  The closing date is just before midnight CET, Monday 26 October 2020. All contributions are helpful, but keep it polite, objective and on the subject – the science of e-cigarettes – and most importantly, in your own words.

In my view, the problems with the report are too serious and fundamental to justify a line-by-line and paper-by-paper incremental review.  I set out the fundamental problems on my 30 September blog:  European Commission SCHEER scientific opinion on e-cigarettes – a guide for policymakers.  So rather than pretend that this dreadful report can be easily fixed with a few more references and some different takes on the evidence, I have reiterated the main themes of that blog in the “Summary” box of the consultation submission form and provided the blog as a link and upload.  I’ve no idea whether they will give this the slightest attention, but they should, because I’ll back when they’ve done the final report.

Update 26 Oct 2020. It’s the closing date and I’ve made an additional submission.

Here’s my response: Continue reading “Response to the extremely poor European Commission SCHEER preliminary opinion on e-cigarettes”

The past is not the future – what lies ahead for tobacco and nicotine?

“Prediction is very difficult, especially about the future” – Niels Bohr, Physicist

Let’s have some debate on the future of tobacco, nicotine, tobacco control and the tobacco and vaping industry. Here are three provocative pieces to get things moving. Continue reading “The past is not the future – what lies ahead for tobacco and nicotine?”

New nicotine science and policy Q & A published

I have just published a new question and answer (Q & A) resource on nicotine science and policy.  It is available as a page accessible from the top menu of this blog and also at this address: Nicotine science and policy Q & A.  I am hoping to keep it up to date… the questions as they stand at present are as below.  My answers are on the Q & A page above – please visit, leave comments, suggestions for other questions, better answers or further reading. Continue reading “New nicotine science and policy Q & A published”

World Health Organisation fails at science and fails at propaganda – the sad case of WHO’s anti-vaping Q&A

WHO’s anti-vaping propaganda is so bad it discredits the whole organisation

On 20 January 2020, the World Health Organisation published a question and answer page on “ENDS” (Electronic Nicotine Delivery Systems) or e-cigarettes and vaping products for nicotine as they are more commonly known: E-cigarettes: how risky are they? (current live version)

Update (31 January 2019) – WHO’s amended version: almost certainly in response to severe criticisms, WHO published an update to its Q & A some time on 29 January.  The 20 January original version, (archived) which WHO heavily publicised (e.g. see Twitter thread) is the subject of this blog, not least because it allows debunking of some especially absurd anti-vaping statements.  WHO has not notified readers of the changes or issued any acknowledgement of correction or error. So for comparison purposes, I have compared the original and updated versions side-by-side in the final section of this blog: go to Update: what WHO has changed.  Much of my original criticism applies to the amended version, which mainly removes some of the most blatantly false and misleading statements. Update ends.

There are nine questions and every single answer provides false, misleading or simplistic information, and this remains true of the 29 January update.  It is a disgraceful travesty of science communication and policymaking advice and again puts in question the competence of the WHO – if there is still any doubt about this. But it is so bad that it even fails as anti-vaping activist propaganda – and that is a low bar.

I will briefly set out the nine questions in the original Q&A and the World Health Organisation’s answers in quote boxes, each followed by my assessment of the answer. Continue reading “World Health Organisation fails at science and fails at propaganda – the sad case of WHO’s anti-vaping Q&A”

Vaping is still at least 95% lower risk than smoking – debunking a feeble and empty critique

An empty and feeble critique misses its target and adds nothing

This paper turned up in my weekly search of PubMed.

Invalidity of an Oft-Cited Estimate of the Relative Harms of Electronic Cigarettes.
Eissenberg T, Bhatnagar A, Chapman S, Jordt SE, Shihadeh A, Soule EK.
Am J Public Health. 2020 Feb;110(2):161-162. doi: 10.2105/AJPH.2019.305424.

The commentary claims to show the “invalidity” of the statements made by Public Health England (PHE) and the Royal College of Physicians (RCP) regarding the relative risk of vaping and smoking – in short that vaping is likely to be at least 95% lower risk than smoking.  As this is an important harm-reduction risk communication, it is worth asking: how valid is this critique?

I thought this might be a better critique than it actually is. But somewhat to my surprise, it is very poor indeed.

Short version

At best, the authors try to show the absolute risk of vaping is not zero and that some harm is plausible. In doing so, they are refuting a claim that neither PHE or RCP make and challenging an argument not used by anyone sensible in tobacco harm reduction. However, not a single word of their paper addresses the supposed foundation of their critique – that PHE/RCP are wrong and the risks of vaping are likely to exceed five per cent of those of smoking. As well as a number of baseless assertions that are not even relevant to the “at least 95 per cent lower” relative risk claim (gateway effects, smoking cessation efficacy and second-hand aerosol exposure), there is just nothing in the paper about the relative magnitude of smoking and vaping risks. No analysis, no data, no evidence – nothing that discusses relative risk and why PHE/RCP are supposedly wrong. Niente. Nada. Rien. Nichts. Nothing.

New (20 Jan 2020). See concise comment on PubPeer here: A critique that does not even address its target

Anyway, despite being an empty and feeble piece of work, it does provide an opportunity to discuss some of the issues raised, so I will proceed with a critique.

Longer version

The authors’ supposed refutation of PHE/RCP rests on six propositions.  You can read the article here and I will respond to the authors’ main points in the order they make them. Continue reading “Vaping is still at least 95% lower risk than smoking – debunking a feeble and empty critique”

Twitter Q&A: debunking tobacco harm reduction misconceptions

I did a Twitter chat with the Campaign for Safer Alternatives on the typical objections raised to tobacco harm reduction. For those interested in the responses but who missed the live chat or got as confused as I did in trying to follow threaded answers, here is the chat as it unfolded over 15 questions with everything in the right order.

Continue reading “Twitter Q&A: debunking tobacco harm reduction misconceptions”

Vaping risk compared to smoking: challenging a false and dangerous claim by Professor Stanton Glantz

This blog examines an extraordinary claim by Professor Stanton Glantz that the US public is right to believe that vaping is as harmful as smoking and that science is now catching up with public opinion. This claim is profoundly and dangerously false, and it demands a challenge.   This is a 13,000-word review looking in detail at Professor Glantz’s 700-word commentary and its supporting citations, examining thirteen claims that form the basis of the overall claim relating to cancer, heart attacks, stroke and respiratory illness, impact on smoking cessation and population smoking.

…and VAPING IS SMOKING

This is a 13,000-word critique of 700-word commentary by Professor Stanton Glantz: The Evidence of Electronic Cigarette Risks Is Catching Up With Public Perception. Read or print this blog as a formatted PDF.

In this blog, I examine an extraordinary claim by Professor Stanton Glantz of the University of California at San Francisco. Professor Glantz claims that the US public is right to believe that vaping is as harmful as smoking and that science is now catching up with public opinion.

This claim is profoundly and dangerously false, and it demands a challenge.  Professor Glantz makes his claim in a commentary in response to a substantive paper on perceptions of the relative risk of smoking and vaping. Both articles appeared in the American Medical Association’s JAMA Network Open.  This is an in-depth blog looking in detail at Professor Glantz’s short commentary and its supporting citations, examining thirteen claims that form the basis of his overall claim.  I am hoping the critique provided here will be a useful primer to some of the arguments in this controversial field.

For navigation, there is a table of contents. Continue reading “Vaping risk compared to smoking: challenging a false and dangerous claim by Professor Stanton Glantz”

Vaping research priorities – my top ten

What are the priorities for vaping and related research? Here are my top ten.

Following up on the guest post by Louise Ross: What are the vaping research priorities? Have your say… I have now had my say and wanted to share my top 10 priorities.

Here is a link to the vaping research priorities survey If you have ideas, please respond by 20 March 2019.

Here are the 10 ideas I have submitted (now updated with a postscript)

Continue reading “Vaping research priorities – my top ten”