Memo to public health grandees: vaping, vapers and you

Dear Public Health Grandees (you know who you are) I consider myself a public health advocate and, though I’m not […]

public health
No, you keep calm

Dear Public Health Grandees (you know who you are)

I consider myself a public health advocate and, though I’m not a vaper and have never smoked, I support vaping as a tobacco harm reduction strategy, with enormous potential to reduce death and disease globally.  It’s a good approach for public health as it doesn’t require prohibitions, coercion, punitive taxes or rely on fear and it goes with the grain of behaviour and what people want. I thought it might help you if I explained what I have learned about vaping and vapers, and why your relationship with them is so poor. You can also read very articulate views from vapers about your attitude to them at the links below.

1. What are vapers doing? A simple explanation was left by one of them, Mark Cowell, on my web site. “I vape because I like it, it harms no one, and I’ll live longer.” Let’s unpack that:

  • I vape because I like it. Vaping is a recreational activity – the use of the legal mildly psychoactive drug nicotine, currently used by about 10 million adults in the UK, mainly through its most dangerous delivery system – cigarettes. The drug itself is not very harmful to health and does not cause intoxication (violence or accidents). It is often compared to caffeine in terms of its risk profile. It isn’t even as addictive as you might think, and less addictive when vaped rather than smoked. Vapers are making a choice to use it without combustion of tobacco (hence the enormous health dividend), but with lots of technology, flavours, and personalisation instead – it’s more than just nicotine self-administration.  For many it is fun and geeky, and it is has a thriving sub-culture. Remember no one ever says “I like Champix” or “NRT is fun” and there are no “Patch-meets” to distract vapers from Vape-meets. Vapour products are not medicines. Vapers are not to be considered patients, in treatment, undergoing smoking cessation or in any way to be incorporated into any medicalised model of public health.
  • It harms no one. Despite efforts by many in public health to mine the literature for signs of the faintest risks to others, there really isn’t any material risk to others – if you read the most authoritative assessments of risk (here, here & here) rather than cherry picking studies that detect tiny traces of toxins this would be clear. As you know, the dose makes the poison and exposure makes the risk. That doesn’t mean it should just be allowed everywhere, but it does mean that use of the coercive force the law to ban it is inappropriate. Your obtuse theories for how introduction of a much safer product can somehow lead to greater harm are baseless and contrived: there is no evidence for gateway effects (other than exits), for renormalisation of smoking or that vaping is somehow ‘undermining tobacco control’ rather than supporting it. The opposite effects are more likely to be true and more consistent with the evidence there is.
  • I’ll live longer. Note he’s not saying he’ll live forever, or even live as long as possible. He is implicitly recognising ‘relative risk’ – that is that it will be much better for him than smoking. This is beyond doubt – the expert debate is where in the range 95-100% better.  The benefits go beyond life expectancy: many experience immediate gains in fitness, wellbeing, relief of chronic conditions, and improved self-esteem – feeling more socially at ease. It is never appropriate to label them ‘pathetic addicts’ or to instruct them to ‘grow a backbone’ and just quit smoking.  Though many argue that nicotine users should ideally quit nicotine entirely, this may not in fact be the welfare maximising option for some if they are left with persistent craving or a sense of loss. If they are taking the step of reducing risk by >95%, your professional public health concern should stop there. The next step to zero nicotine is purely their concern and choice.

2. Vapers think you don’t understand this model – and you don’t care what the evidence says. You have shown no sign of understanding how this works – and keep seeing it as a tobacco industry plot (they were late to the party) or some sort of rogue medical product. Neither is true. But vapers rightly suspect you are careless with the truth: most public health organisations united to support a ban on snus in the European Union in 1992, again in 2001, and once again in the 2014 Tobacco Products Directive. This is despite indisputable evidence that snus, a very low risk way of taking recreational nicotine, has been highly positive for public health where it is permitted and used in Scandinavia – displacing smoking, diverting smoking onset, and supporting user-driven quitting. There is no scientific, ethical or legal case for banning it – but you supported it anyway.  This is the same public health model as vaping, so it is no wonder they don’t trust you. Until you face up to the lethal error you have made on snus, you have not earned the right to a hearing on vaping. To the extent that smokers believe what you say, you are likely to be protecting cigarette sales by creating unfounded fear about a much safer alternative and causing damage to health that would otherwise be avoidable.

3. Activism explained. You seem surprised to find there are people who get up and do something, and do it for nothing – you seem to assume someone must be paying if vapers do anything. I can see why you might think this: it rarely happens in your world or it is a distant memory from your more idealistic youth. There are no grass roots or unpaid individuals campaigning for the things you want in this field. You should think of these people more like the activist campaigners you know in drugs or HIV/AIDS.  Many vapers are passionate about their experience: they have escaped the death trap of smoking – or are heading that way – and having feelings of pride, empowerment, agency and control, as well as immediate welfare and economic benefits, and a much better long term health prognosis. They want others to benefit from the experience and they really don’t want you to take it all away through clumsy or excessive regulation based on poor science, comprehensive misunderstanding or for ideological reasons. And they don’t want to be collateral damage in your war on Big Tobacco, which is of little relevance to them.

4. Coordination and conspiracy. You notice and sound the alarm that many vapers seem to act together and say similar things. Behind this you see a conspiracy, probably under the control of your nemesis, Big Tobacco. This is because you don’t really understand the bottom-up organising power of social media. What you are witnessing has a technical name: ’emergent behaviour’. This is what you get from complex adaptive systems like social media. People with diverse knowledge share and aggregate thousands of ideas and a kind of natural selection process sorts out who people listen to, how people think and what they do.  It never creates homogeneity and has no ‘command and control’ mechanism, but on some issues it can take on the appearance of a well organised campaign offensive. But it isn’t well organised or ‘top-down’ co-ordinated – it is emergent behaviour. If you engaged more interactively in social media, rather than using it to make announcements, pronouncements and denouncements you’d see this more clearly.

5. The relationship between vapers and public health people. Your relationship with vapers is asymmetric – and you really do need to understand this.  They are the ‘public’ in public health. They should be a matter of professional interest to you.  In your profession,  you need to understand them and why they do what they do, in order to make professional public health judgements. You need to do this with high standards of professional conduct and to approach them with humility and empathy. You might start by following the seven principles your own code of conduct. You probably have something to learn and you might even get to understand what inspires them. But they have no similar obligation to you. They have other jobs, other lives and no professional need to understand you or engage with you. If you think “there is a lot of mistrust & misunderstanding on both sides” that is your problem, not their problem.   Their interest in you, if any, is that you might spoil what they are doing, that you are making provocative or unfounded remarks about them or what they do, or you are dismissing their experience as mere anecdote.

6. Vapers are not one thing. You should never talk about them as if they are an organisation, a movement or as if they somehow act collectively – they are highly heterogeneous and atomised. If one vaper is rude to you it doesn’t mean all vapers can be damned as rude. Even if there is an emerging vapers’ organisation, you can’t blame them for how vapers behave any more than you can blame the AA for bad driving, nor can you ask them to stop it any more than the AA can stop someone speeding on the M1.  They are responsible for themselves but not for each other.

7. Should you be blaming vapers for being rude to you? No, under no circumstances.  This is the ‘public’ in public health again. The public is highly diverse – including elements that are raucous, bawdy, profane, satirical, sarcastic, insulting and so on. To complain about them as a public health professional is like sailors complaining about the weather, or politicians complaining about the electorate. They are the subject of your profession – get used to them, and learn to engage without becoming pompous and aggressive. If you think you can defend your professional failings by finding examples of people being rude to you or about you, then you misunderstand your role.  So please don’t try this as a defence, it will only bring you more shame and further opprobrium  The real public is not like the bland smiley types you see in NRT adverts or the dumb animations of Change-4-Life.  Public health is a gritty business, not about the provision of happy-clappy advice to a peasantry grateful for your wisdom and awed by your status. If that is how you think,  you’re in the wrong job.

Change 4 life
Vapers and the public generally are not like this

8. Are you a victim? Senior public health people are tending to cast themselves as ‘victims’ – fearless truth-tellers cowed into silence by aggressive on-line challenge.  No, you are not a victim under any lawful circumstances. As explained above, it is a matter of professional competence to deal with the public as you find it, not as the compliant supplicants that you would wish them to be. But there are other reasons why you aren’t a victim.

  • There is an asymmetry in the power relationship. You have academic prestige and institutional support that lends weight to your views (however ill-informed they are).  You have access to media and can write tendentious editorials in the BMJ apparently at will.  You have networks and allies who will defend you. You appear to have secure tenure and very little accountability for what you say if it is wrong or ultimately harmful.  You can advance your weird theories in paywalled and heavily moderated journals which protect you from symmetric criticism and are closed to most of your critics.
  • You have contributory negligence.  You have not approached the tobacco harm reduction issue with objectivity and rigour – you have not engaged with the evidence except to cherry pick it for obscure studies that support your pre-determined theories. The academics with the least published research and study experience in the field have been the most aggressively opposed and outspoken, even dismissing other academics who are leaders in the field as ‘tobacco industry apologists’.  The inverse correlation between experienced knowledge and opinionated criticism is striking.  You make gratuitously provocative remarks about vapers and wildly accuse innocent ordinary people of being stooges for the tobacco industry without evidence.  You take an abusive approach to scientific discourse: in one instance claiming the uncertainties with vaping were equivalent to those of Thalidomide.  The way you behave and carry on your professional responsibilities contributes to the hostile reaction you receive – much of it is your fault.

What should happen next at the Faculty of Public Health? I don’t want to discuss individuals, but a change is needed in public health leadership. This can happen in two ways:  either by the people involved changing their approach, or by changing the people. Bad language is a merely a surface manifestation of a deeper problem: it is the sneering, arrogant, boorish, contemptuous attitude; the disregard for evidence and analysis; the thuggish provocations and crass risk communication; and the ad hominem smears that are the issue.  What is needed is a new professional ethos based on objectivity, rigour, humility and empathy.  What would not help would be to dismiss this as an unfortunate, regrettable outburst that should just be forgiven and forgotten. Nor should there be blame shifting to vapers or shirking of professional responsibility. So, here’s what I think should happen to serve everyone’s interests…

1. Own up and apologise properly, do not try to reallocate blame or plea mitigation because you had a rough encounter with the public. That’s your job… suck it up.

2. Recognise that the issue is deeper than just a bit of abuse – it is about the professional ethos in public health.

3. Instil the Presidency of the FPH with the following values or traits: objectivity; rigour; humility; and empathy. Listen a bit more and lecture a lot less.

4. Commence a series of private dialogues – with vapers, with other academics and advocates who see the issues differently to you – ask a trusted intermediary to hold the ring.

5. Start to approach the tobacco harm reduction issue with the same passion you have approached harm reduction in other areas of public health – it is the same concept but with many more lives at stake.

6. Allow your position on vapers and vaping to evolve as the evidence and understanding accumulates – above all, approach the issue with an open and curious mind.

Update. Other people have written very well in the last week on similar themes:

Are there others?

Lettre ouverte à Mes Seigneurs de la Santé Publique – Traduction Français de la lettre ouverte de Clive Bates –  a French translation of his blog.

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152 thoughts on “Memo to public health grandees: vaping, vapers and you”

  1. Very good article, thanks once again Clive for putting things into perspective, we ‘vapers’ are so blessed to have you as our advocate!


  2. This absolutely hits the nail on the head Clive, I hope they read it and take it in board. Thank you for writing it.

    1. Will Carroll

      This is the best blog I have truly ever seen and it is all extremely true, I support ‘vaping’ and I’am very much pro vaping, nearly every one of my family members dislikes any kind of electronic nicotine provider and even my parents of all people to understand, strongly disagree and make every word they say about ‘vaping’ a very big deal. My mother does not understand how much of an upgrade to general public health, ‘vaping’ actually is, i’m reading this 2 years after this blog was published and there are still so many people who don’t understand and would rather support something that will quickly harm them or worse… kill them. Thank you

  3. For an intelligent man he’s internalised and personalised too much. And demonstrated why people should think twice before adopting new technologies – Twitter really isn’t the medium for him if he doesn’t like talking with (rather than at) the Public.

    1. Dave

      you could be right as Twitter is perhaps too superficial for Clive and the content of what he is saying! However, Clive considers himself as a ‘public health advocate’ and that is precisely what he is doing given the evidence to date. An Advocate in its fundamental sense is giving a person or group a voice. Further, based on my experience and knowledge (which is very extensive) he is spot on! So although I believe you have a point, I believe you are missing the point.

      Also, you talk of ‘new technologies’ – which would simply refer to the nicotine delivery device for EC. This again is missing the point as what is important is what is contained the liquid and vapour once vapourised? Toxicology tests show from the vapour that what the consumer receives is very significantly less toxic than cigarettes. Where would we be if we did not try new technologies? We could have held back on using mobile phones, for example. With regard to EC its not as if its counterpart, the cigarette is safe? Even before we had to data we have on EC (they seem to be safe and effective), it is almost inconceivable that they would be as bad for you as cigarettes if you know how they work and what is contained within them. Again you like others are advocating pushing out the good with the perfect: not acknowledging a world in which people actually smoke and have difficulty stopping.

        1. Kristin
          thanks for letting me know – I don’t have too much time to read all this as really busy – will look John Ashton’s ‘meltdown’ – what is it referring to?

  4. Richard Larkins MSc

    Thank you Clive, I don’t think you have missed anything there that needed to be said. Your empathy with the perspectives of vapers is perceptive and comprehensive.
    Much of that is not just sterling (and even inspiring) advice to Public health professionals on the vaping issue but on how to relate and respond to the public in general.



  5. That’s a superb critique, Clive, and I do hope it gets through to at least some of those whose attitudes have been laid bare over the last few weeks and months.

    Sadly, significant segments of Public Health do not, I believe, recognise smokers/vapers as being members of the Public they represent. Rather, they have in mind an idealised public whose health they wish to see improve, and it’s vapers/smokers who stand as both a corrupting influence and an intractable population who must be outcast in order to protect non-smokers.

    The use of the term “tobacco industry stooges” to describe vapers is somewhat revealing. I don’t believe this to be an accusation that vapers are in direct employ of the Tobacco Industry, but rather that their continuing use of nicotine unwittingly furthers the TI’s interests.

    This meshes into a wider sense that the public is not comprised of agent actors, in control of their own destiny, but of a mass controlled by corporate interests. One only has to read the “poetry” of Gerard Hastings to witness the sneering attitude laid out in its basest most six-form fashion.

    The ethics of stigmatisation as a utilitarian means to an end are interesting, and there’s quite a debate in the literature on this as regards smoking. What I find fascinating is that this seems to be a “done deal” – it was decided that stigmatisation was an ethical solution, given the magnitude of the problem, but has not been revisited. I would say that there might be justifications which could be applied to ethical stigmatisation (that’s not to say I agree with it, I don’t), but this approach should be consistently monitored for alternative solutions – not to do so is inherently highly unethical. It should have happened with Snus, and it should be happening with vaping products.

    1. I agree with Oliver on multiple points: That was suburb analysis, Clive — spot on.

      As well, I believe that a lot of this is driven by a bias that comes from thinking of the world in a corporatist way, in terms of guilds or feudal houses or such. This always strikes me when dealing with our collective world across the gulf of the Atlantic. There is a residual European way of looking at things, from the era of royal houses and guilds that we never had over here, that permeates things. I honestly cannot imagine “public health” people over here acting that way (with the exception of one sociopath in the mix, but he is such an outliar (sic) that we all know who I am talking about). Over here they are every bit as dishonest, clueless, and paternalistic. But almost none of them would go off on an anti-populist tirade like seems to be the norm over there. Yes, they subscribe to the same “stooges” conspiracy theory over here. But here they actually do mean it literally. That is the American bias — there really must be $$$ behind it. That actually tends to make it impersonal, and thus it does not get so personal.

      The one institution over here that seems to produce people who are act like what I see coming from Old Europe is the U.S. Senate, which is about as close as we come to having Lords. Coincidence? I don’t think so.

  6. Well, why don’t you just say what’s on your mind Clive:-)

    Thanks for verbalising so well what is on vaper’s minds – spot on.

    In fairness though, leadership aside my experience is that many in public health are positive about the potential for health gains e-cigs promise. Unfortunately, as you point out, they are led by people who are wedded to the idea of eliminating all non-medical use of nicotine and who are committed to following that route, by any means, regardless of the consequences to others.

    As so often, lions led by asses


    1. Phil – I agree … there are many in public health who are positive about vaping and have a thoughtful and empathetic approach to harm reduction through alternatives to combustible tobacco [some are listed at the end of this letter to WHO]. They tend to be quiet, thoughtful and careful with evidence and assertion. This letter is not addressed to them and to those with open minds and even skeptical curiosity.

      It is addressed to a certain type of public health academic, practitioner or commentator, who takes opinionated stances and likes controversy for its own stake, is often found in radio or TV studios, and usually hasn’t done much work on the subject. There are many in ‘tobacco control’ who think that the main thing is to oppose everything the tobacco industry does, and that the health benefits will somehow flow from that as a secondary consequence – the letter is also addressed to them. They are missing the point.

  7. alasdair henley

    exactly what me and thousands of other vapers would say if we had the
    words,intelligence and eloquence of mr bates

  8. Excellent letter! Having spent 18 months of my own time unpaid and without any semblance of Tobacco, Pharma or any other organisations influence or request in trying to educate and inform politicians and public health that “I” matter, my health and well being matters, and more importantly the opportunity for others to reap the same health benefits that I have found through vaping certainly matters, only to read, hear and subsequently surmise that for many in Public Health the success of vaping in replacing harmful tobacco addiction isn’t what they actually want to see or hear has been eye opening. Actions speak louder than words and the conclusion that I have reached is that the protection of other vested interests seemingly takes priority over both the public’s’ health and any true and effective attempt to eradicate the harm from tobacco smoking. The EU banning of Snus is simply all the evidence that any person actually needs and the Public Health/Political attempts to then attack and eradicate all the reasons why 2nd/3rd generation ecigs are so effective is another compelling reason. “Public Health” sadly, if a consumer product, would be a misrepresentation under the sale of Goods Act and thank you Clive for describing so eloquently why.

  9. WOW!!! Clive, this is undeniably the best yet – hats off to you man, looks like you’ve covered all bases with this one. It is the concept that we vapers are an evil, organised army, financed by Big Tobacco, that gets to me most. Now well into my fifth year of vaping with all the benefits you have named under my belt,I have sat at this computer burning the midnight oil and (let me be honest) sometimes wondering why I bother. I have enough vaping equipment and nicotine to last my lifetime, being fairly senior. I then think of the 14,000 deaths per day from smoking related disease, and I know IT HAS TO STOP. Public Health on the whole seem unconcerned – so if not me, who? and if not now, when? What kept coming up in the Lancet twitter discussion was “long term effects” – how long do they need? Nobody has died from the proper use of e-cigs in the time I’ve been vaping – can’t say the same for the approved anti-smoking drugs, and when you’ve smoked for 60+ years you need an alternative, not a cure, and that’s what the e-cig is. Thank you for a brilliant piece of writing – please God they’ll read it.

  10. We live in hope whilst at least some professionals remain pragmatic. Thank you Clive. The voice of reason in a sea of ideology.

  11. Great stuff Clive. I wonder where vaping in the UK would be now if it weren’t for our many non-vaping friends who unstintingly support us when uninformed announcements get made. Thanks.

  12. Wow, as a scientist and a vaper, I have to comment on how spot on this entire article is. So much to comment on and I can’t do it nearly as eloquently as Clive did.

    Point 1 is excellent and accurately expresses my feelings on why I vape. I wanted to quit smoking, and tried many times. I tried many methods to quit. None worked, I was miserable. I certainly didn’t ‘like’ any of the aids I tried, but felt they were the only available options. I truly thought my only choices were to either quit or die. I never managed to quit, so I just accepted that I would die. Along come e-cigarettes. I was skeptical and held off giving them a try, thinking they sounded too good to be true. There is the conventional wisdom, “if something sounds too good to be true, it probably is”. Most people forget the ‘probably’ in this statement. I imagine that throughout history some things that have seemed too good to be true actually turn out to be true (indoor plumbing, antibiotics, air travel, just to name a few possibilities). Electronic cigarettes are probably not 100% safe! and I’m willing to accept this! but all available evidence suggests they are much safer than burning tobacco. I also have hope that with real unbiased research, we can improve their safety even further.

    Point 2 is similarly spot on. Again, as a scientist (in the apolitical world of basic research) I was absolutely shocked to see the amount of bias in reports on electronic cigarettes. As I dug deeper I discovered snus and the world of snus research. I had grown up with the idea that all forms of tobacco were equally dangerous, and in fact convinced my cousin (an oral tobacco user) that dip was just as dangerous as smoking. Perhaps as a consequence of this, or perhaps it would have happened anyway because of the widespread mis truth, my cousin switched from dip to smoking. This is a consequence of the public health lie that all forms of tobacco are equally dangerous. If all forms of tobacco are said to be equally dangerous, there is no incentive to switch to a different form except for personal preference. If public health entities were honest about the range of harm, I would not have been misled. My cousin would not have been misled. He might have switched to snus instead of dip. He might not have become a cigarette smoker. The lies about the continuum of harm are morally reprehensible and completely unethical. I understand that completely quitting is the gold standard for any sort of tobacco or nicotine user, but lying to achieve that end is repugnant. These lies forever damaged my trust in public health entities.

    Point 3 is perhaps the phenomenon that irritates me the most. I am not the most engaged of activists, but I do participate some. I have been called a shill numerous times. This is infuriating, as there is no way to defend against it short of completely exposing my personal information. Even then, who is going to go to the trouble of looking me up and certifying that I am not in the pay of big tobacco. The previous points nicely sum up some of the reasons I am passionate about harm reduction. As a smoker I was lied to by public health, I was used as a bottomless pit of income by pharmaceutical companies peddling practically useless, and sometimes dangerous, medical treatments. I was also treated as a bottomless pit of tax income for governments who can always justify a sin tax, and are in fact, quite addicted to taxes derived from tobacco sales (this is a huge conflict of interest, I feel obligated to add).

    I am passionate about tobacco harm reduction. After failing to quit so many times, after being labeled as a filthy weak smoker, I found something that worked. I have reduced the harm from nicotine use. I am much healthier, and my health records verify this fact. I want these products to not only be available, but I want them to be embraced. To scare current smokers away from these products by inflating tiny risks infuriates me. As I said, I am a scientist, though I am currently a stay at home mom to my two children. I could use a paycheck from big tobacco or “big vapor”, but I certainly don’t get one.

    I don’t really participate in activism for myself. I have plenty of supplies to last me for many many years, and I have no qualms about going to the black market or ordering overseas if my supplies do run out. I do not fight this fight for myself but for the current smokers who will not have supplies and who will be filled with fabricated doubts and disproportionate scare-mongering.

    I will stop with the individual commentary on the points here, but say that I agree whole-heartedly with the rest of them as well. You public health ‘grandees’ need to stop slinging shit, stop accusing us of being shills, or pathetic addicts. Stoping making the perfect the enemy of the good. Start acting in an academically upright manner. It burns me to no end seeing science warped and twisted to fit your agendas. Start listening to and working with Vapers, part of the public in ‘public health’, and a part of the public who has found a way to benefit their health when none of the approved methods worked for them. Open your minds to a paradigm different than “quit or die”.

  13. Eloquent as ever Clive. Sadly, the phrase that comes to mind is “Pearls before swine.” The question is, is this going to be read by the people that matter. This very day, I read an article about the situation in Hull. They have one of the highest incidences of smoking in the country, at over 33%. The funding for their Stop Smoking service is to be cut by one million pounds a year, and evryone is complaining. E cigs did not get a mention in either the article or the comments. It is as if they had yet to be invented.

  14. In case anyone is interested, I have now been banned from The Australia Cancer Council’s FB page. I privately sent a list to their press officer of pharma companies which back the CC after she distinctly said they did NOT take money from big pharma. As far as I am concerned their stance against vaping is all about protecting their own interests, it is appalling. They are playing straight into the hands of the big tobacco companies and they try to make out they are the good guys. Well they are not! Many many lives will be lost if they succeed in their dreadful campaign to ban e cigarettes, they should be totally ashamed. This list I made up is public knowledge as by law big pharma have to reveal who they donate to. I am sure there are plenty more if anyone cares to look. But I am pissed off as we little people do not have a voice.
    Pharma Companies who sponsor The Cancer Council
    Sponsor for Cancer Council’s skin cream
    May 20, 2010 – any pharmaceutical company operating in …. Amcal is a proud sponsor of the Cancer Council’s Pink Ribbon Day, an international awareness.
    I have just laboriously ploughed my way through The Cancer Council Tasmania’s 2011-2012 annual report.
    I know they categorically deny receiving funding from Big Pharma BUT.
    I noted that two of their corporate sponsors were retail chemists and one was a private medical insurance provider.
    Conflict of interest here?? Link from CC which says they have “restrictions” around sponsorship from pharma…checklist.html
    Now this get’s even more interesting, Pharma Co “Bayer” lists who they support……Bayer Australia – Our partnerships with patient organisations The word CANCER keeps popping up here!
    Novartis Pharma sponsored this…….…D=crad001jic6
    Dosed up on donations and addicted to drug company money
    ◦ FEBRUARY 23, 2010 12:00AM…11f8f1668ccbe0
    And More !…-Ingelheim.pdf
    Boehringer Ingelheim recognises that it has many common interests with organisations which represent or support the needs of patients and caregivers. We form these meaningful partnerships to help improve the health and quality of life of consumers and raise awareness of health issues and conditions.

  15. Negatives of NRT’s

    Adverse events

    Long term use of nicotine gum

    Overdose on nicotine patches

    Advantages and disadvantages of NRT products

    NRT’s VS e cigarettes

    Replacement nicotine’s killing fields

    Chantix/Champix kills. But don’t tell the smokers

    Champix Strikes again? Dick Puddlecote

    Chantix linked to more than 500 suicides

    Ongoing Issues with Chantix

    Chantix Death

    1. I’d prefer comments to stay more or less on topic if possible.

      The danger of a list of links is ending up with the same sort of cherry picking that public health fake experts are prone to. Much nonsense is written about NRT, which is basically pretty safe to use, but not very effective at helping smokers quit or providing an enjoyable alternative to smoking – I recommend the Cochrane Review on NRT for reliable science overview.

      There is definitely a serious case to answer with Varenicline: the FDA’s 2011 positions on neuropsychiatric events (e.g. suicide) and cardiovascular disease suggest real cause for concern.

      What is interesting about this is the silence from public health… Can you imagine if evidence emerged that e-cigarette use was associated with depression, hostility, suicide etc? It would be like all Christmases had come at once for certain academics. You wouldn’t be able to get into a TV studio without tripping over an public health commentator drooling into the camera. Yet no-one in public health seems too bothered about a real world medicine that actually does come with the following advice:

      If a patient develops agitation, hostility, depressed mood, or changes in behavior or thinking that are not typical for them, or if a patient develops suicidal ideation or behavior, they should immediately discontinue Chantix and report these symptoms to their healthcare professional. (FDA, 2011)

      WTF? What if they off themselves between developing ‘suicidal ideation’ and reporting in to a healthcare professional? I have never heard a peep about this drug from tobacco control or public health, just that they think the risks are worth it to get you ‘clean’. And by the way, when tobacco control people go on about medicines regulation of e-cigs guaranteeing ‘safety, quality, efficacy”, this is what they mean. Again there is MASSIVE misalignment between their risks they think are important with vaping (minute and implausible) and the risks they cheerfully accept on behalf of smokers when a pharma product is involved (serious and dread).

      The reason for this:
      1. Many are heavily conflicted with pharma money and a pro-pharma mindset that doesn’t even recognise the conflict
      2. It supports their abstinence-only agenda for nicotine
      3. It is a highly controlled and controlling medical model of the type they favour
      4. There is no pleasure involved – it dulls the brain to nicotine.

  16. “who is going to go to the trouble of looking me up and certifying that I am not in the pay of big tobacco”

    Oh, it would amaze you. I have a few little canaries out on the internet, and it’s amazing how much I’ve been searched since cuntgate kicked off.

  17. The grandees agree between themselves what new measures might work,then fund and carry out the supporting research with CRUK/public money.This always justifies the policy which is then sold to an ever-changing,here today,gone tomorrow public health minister.

    The same grandees are then funded by DH to see if the policy worked and hey presto!, it did.

    What role is there for the public in this seamless monopoly?

    1. That’s the process in a nutshell, Dodderer, it’s been played out and perfected over decades. With tobacco, they’ve become so over-confident that they even detail how they connive to “handle a government” in documents such as this.

      Now the gun turrets have turned on e-cigs, we can only expect – and are seeing daily – the exact same dirty tricks.

      1. “advocates in the UK worked over many years to develop support”

        Interesting. They even admit that the support wasn’t there until they manufactured it.

  18. This should be required reading for every – and I mean every – person who works in Public Health at whatever level. The cry “Nothing about us without us” was adopted by HIV sufferers years ago and is as relevant to day for equip users as it ever was then. I tip my hat to you, Clive – you have summed up everything that frustrates and annoys those of us who are aware of the great benefits ecigs can bring. Kudos.

  19. I have read this twice, and now I am going to read it again. This is therapy. It is honest and hard hitting – thank you Clive.

  20. Here is the sad part: The many years of hard work and effort of Tobacco Control DID pay off! Without all their hard work, how would Hon Lik have known what killed his father? How would he have seen that he, Hon Lik, was next in line to die from the heavy smoking? Without TCI there would be no electronic cigarettes. We need to congratulate them on their victory, don’t let BP convince them their efforts are threatened by ecigs when they were actually fulfilled by ecigs!

      1. Yes, for all of those genuine Public health advocates, what you say is true, and there are some, I am sure, who will stand back and consider the words of Clive bates, and see that a change in stance is needed, and will work towards that change, and I wish them well.

  21. Thank you so much for all that you do for us vapers! This memo is excellent! You summed up all our concerns with the so-called “public health” self-appointed “experts” just perfectly! You said precisely what is going wrong and why.

    And yes, we (vapers) are the “public” in “public health”. It is our (!) health that those so-called “experts” should be concerned about.

    But nothing is farther from the truth. To them (as you have rightly pointed out) we do not exist as human beings, as people. Those self-appointed “experts” see and treat us like garbage, like cockroaches – to be stomped upon, to be stamped out. Because these nasty little cockroaches do not fit into their silly oh-so-clean ideal world, their lala-land utopia where “public health” commands and grateful peasants fall down on their knees and happily obey.

    They call us “addicts”, “astroturf”, “industry shills” – or they call us .. different things … , as some recent events have shown. But they do not call us people, persons, human beings. Because they do not see us as people, persons, human beings. And it is high time that this attitude changed.

    We owe them nothing. As you have rightly pointed out.
    But they owe us something. They owe us – the “public” in “public health” – to leave us the h*** alone. To stop their lies, their propaganda, their attempts to take our healthier choice away from us.

    Well, you have put it much better than I ever could. And I thank you!

  22. I think everyone has covered what I would like to say, so Thank you very much Clive for your support. Impressive reading

  23. Yes! This!

    As a never smoker/never vaper turned e-cigarette advocate, I have been shocked and dismayed at the way vapers are dismissed. I fear that the efforts by the public health community to stigmatize smoking have resulted in a deep seeded stigmatization of smokers themselves. Tobacco control started to reduce the toll of death and disease from smoking, now it seems that saving the lives of smokers is much less important that maintaining control. I often wonder if the way many (not all) in public health have overlooked the lives being spared by vaping, is that they have conditioned themselves to see smokers as the enemy and thus have little compassion for them.

    When was the last time smokers were excited about quitting? I sure can’t remeber one. Waisting this opportunity would be such a shame.

  24. Awesome! This needs to be read by the widest possible audience. Base your talk at this year’s summit on this?

  25. Awesome is the right word. I read this post with amazement, as so many of the things that I have thought were put into eloquent words.
    Like others have said, I just hope this reaches the people who need to read it, and that it results in some change. Even if just one public health mandarin has a change of heart as a result of reading this, that would be awesome indeed.

  26. On the other hand, tobacco control has done just fine while doing everything wrong, at least according to Clive Bates. So why should they ever want to give up their thuggishness, bullying, dishonesty, arrogance and smugness, etc.? They have not only been honored (and imitated) for these traits by politicians and the media; these are the feelings that give them the most pleasure in life.

  27. I for one am very excited as finally after 47 years of being a slave to the weed, after 6 months vaping I AM FREE!
    This is a cause for celebration!!!!!

  28. Pingback: Memo to public health grandees: vaping, vapers ...

  29. Well said sir!
    one of the most well rounded blogs that I have read on this.
    In one year I have gone from 60+ a day roll ups to zero nicotine. on my own!
    My choice, My decision and yet there are those that wish to take this away from me.
    Why? It obviously works and works Well.
    I have probably helped somewhere close to 50 others also stop smoking completely and are vaping only, Just from my example and helping them with info.
    So, that is now 51 people that No longer smoke, 51 people that will have Less affect on the NHS, 51 people that will spend less time off sick in their later working years, 51 families and friends that will no longer breath in second hand snoke.

    1. Cynically speaking “that’s 51 people who will still be claiming their pensions for longer, 51 people who won’t require Pharma’s smoking related drugs and 51 people who aren’t paying excise duty on tobacco products” the result of using a product that is 95-100% less harmful than tobacco. Time has come to admit that “health” itself is a business and subsequently Public Health seemingly appears to promote the businesses and organisations that profit from harm and to totally segregate any Pharma funding directly or indirectly from Public Health policy or decisions.

      1. sad but true.
        Who cares about our health when there is money to be made from our sickness, money to be saved from our early death?

        Paying lip service to the oh-so-bemoaned “premature deaths” from smoking is cheap. Loss of Pharma revenue and longer payments out of the pension coffers are costly.

        And that is precisely what those so-called “public health” self-appointed “experts” are fighting so hard to preserve: cash flow. Not health. No wonder they despise us. We cut into their profits and those of their paymasters.

  30. Excellent article, Clive.

    Further to your point 3), the activism is also driven by a feeling amongst vapers that they were once bullied smokers and are now, increasingly, being bullied as vapers. They’ve done what they were told to do for decades, only to now be ignored, insulted and derided; that they are still “pathetic addicts” who should “grow a backbone”. This not only explains the enthusiasm to advocate in spare time after work etc, but also the frustration which sometimes leads to the attacks PH is apparently so horrified by. But if you ignore, insult and dismiss people – often with blatant inaccuracies, half-truths and bare-faced lies – what are they supposed to do?

    Secondly, in relation to the insistence that quitting must be nicotine-free as well as smokefree, here’s an anecdote from yesterday you might be interested in.

    I had a meeting with a supplier yesterday and saw that their credit controller was using a 10 Motives cigalike. When I talked to her about it, she said that she hadn’t smoked since last October. One thing that cropped up in the conversation was that she had been really upset by a friend of hers telling her that “you haven’t given up smoking if you’re still using one of those!”. She said she felt totally deflated, threw it in the bin, and told her husband she was going out for a packet of cigarettes. He had to calm her down and persuade her not to, and tell her that he was happy for her to use the e-cig for as long as she likes. She had been browbeaten by others into thinking that e-cigs would harm her and that she’d not quit anything at all. That’s how damaging – and plain nasty – all this black propaganda from the PH industry is.

  31. You have surpassed yourself with this one. Than you!!!

    I never wanted to quit smoking. I was a cancer epidemiologist who taught students about smoking and lung cancer and still continued to smoke. I knew the risks but I enjoyed smoking, collecting lighters (especially Zippos), the ritual of transferring cigarettes into a nice case before going out, the maintenance of my petrol lighters, having something to do with my hands when nervous, and the pleasure of a long draw on the cigarette itself.
    There were also things I didn’t like about smoking; namely no longer being able to smoke in pubs or at social events, having to go out in the cold and wet, the waste of money, having my breath and clothes smell and the probability that it would harm my health.

    Vaping gives me all the things I enjoyed without any of the things I didn’t like. In the long term vaping may have adverse consequences on my health, but the cumulative evidence to date suggests this will be considerably less harmful than continuing to smoke.

    As others have said, restrictions on vaping do not give me many concerns; I know how to continue obtaining the supplies that I need even if it is likely to be from less trusted sources than I use now. However, what does concern me is that adverse publicity and negative attitudes to harm reduction mean many smokers, who are much younger than I am, are being denied the information that may encourage them to switch to vaping.

    What many in TC fail to appreciate is that a significant proportion of smokers do not want to quit. Stigmatisation and alienation may convince some to stop smoking, but is that really an ethical way to generate behaviour change? We are adults. Smoking is legal. Smokers who do not want to quit know the risks of their behaviour and have made an informed decision to continue smoking. I wish the nanny state would leave them in peace, or, at least encourage them to try vaping as an alternative.

  32. Pingback: 16 Sep 14: Memo to public health grandees: vaping, vapers and you (by Clive Bates)

  33. Clive Bates – if I was a man of a certain age, I would doff my cap to you. Well said. You’ve encapsulated the half understood thoughts I had up top and laid them out with aplomb.

    Thank you

  34. Thank you for seeing the truth so clearly and for being so honest. As normal you are spot on. I hope PH will take notice so we can work together to improve public health.

  35. Absolutely spot on Clive.

    The Lancet (I think) had a twitter session with vapers recently, I wasn’t involved but saw some of the comments afterwards. One of their people commented you are all such reasonable people & he had been expecting a bunch of ‘mad trollers’. Theres a lesson there for PH people.

  36. Clive, you missed out on one fact.

    We’re all ex-smokers,

    so we all have a lifetime behind us as smokers with nothing but abuse and maltreatment from tobacco control; never afraid or ashamed to twist and turn the truth to justify their bullying. Not easy to forget, especially since now as ex-smokers we’re getting it twice as intense.

    Great blog, the difference between someone who understands and a professional health bully who doesn’t have clue.

  37. Spot on, health care professionals please listen, this is someone who understands what we are and what we do, and why we do it.

  38. I found that struck a very deep emotional chord with me. CB has succinctly described the world from my perspective. After being a victim of a stupid decision at age 12 and big tobacco it never fails to astound me how PH seem to want to give control of my life-line to big tobacco with the micro managed regulation.

    I am 48 now and have been tobacco free for more than two years, with only 3 one day lapses, one of which was last week. Tobacco use has been a way of life and experience has shown I will never be free from the desire having quit for more than 12 months 3 times in the past. Vaping has freed me form the terror of tobacco, with out it I will revert sooner or later.

    Thank you for your empathy and insight Clive Bates, and you courage to speek up for us.

  39. Thank you Mister Bates for the wonderful presentation of the many issues surrounding electronic cigarettes and the pending rules/regulations/laws that seem to be popping up like weeds. You point out very well the many logical fallacies that exist in the information disseminated by the Public Health community in their crusade against technologies they will not take the time to understand and the people they are “protecting”. I look forward to seeing more of your articles and, I hope you do not mind, am sharing links to them with my vaping friends. Please keep up the good fight.

    With much respect.

  40. Fantastic article. Thank you for putting into words what many of us are thinking but don’t have the skill required to express it so wonderfully.

  41. Thank you for this. It has effectively articulated many thoughts from my own mind, that I could never have so eloquently written.

    I can state as a ‘vaper’ that this receives my endorsement.

  42. Clive,

    I am blown away, not just by your article, but by the incredible comments I’ve read here! So many people hitting the nail (at least MY nail) right on the head!

    I hope that this gives the folks in Public Health at least some idea of the kind of (female anatomical expletive deleted)s they are facing, and why they are in for a battle of epic proportions.

    This MATTERS to us! This MATTERS to ME. And you have stated the reasons totally on-target! (That’s American for “spot on” I think…)

  43. I think the reason so many people are getting p**sed off is because for years and years they have been demonized for being a smoker then when they finally find something that works they find themselves being demonized all over again. That is how I see it and that is how a lot of people see it.

    It’s about time these people wake up and face facts, the e-cig genie is out of the bottle and it’s not going back in, no matter how much crap the ANTZ sprout.

  44. Thanks Clive for what must be one of the best posts I’ve ever read. It has become clear to us all that tobacco control really means tobacco support. In other words, tobacco controllers are dependent on SMOKERS to earn their living. The less smokers they have the less they can justify their existence. Vaping is becoming so successful as to pose a real threat to their existence. Need I say more?

  45. Clive – Wow! Helluva post! Thank you from the bottom of my heart for your relentless pursuit of the truth in THR! As a vaper of 3 years now, it warms my heart to know people like yourself “get it”, and can write about it with such articulation and poise that I nearly cry in jubilance. Keep ’em coming, as they say!

  46. You covered everything in detail. Every. Single. Thing. You covered most of the points why I feel such revulsion towards them. I knew they were sociopaths but I didn’t expect an academic for “public health” to go on a Twitter binge and show the rot within through his own limbic loquaciousness.

    It’s a Pyrrhic victory: It’s nice to have confirmation but these “public health” charlatans will not reform themselves. The rot is that deep.

    The only real intervention they truly deserve is to be tarred, feathered, and pilloried in the public square. Their words may be locally deleted but the ‘net never forgets.

    So who’s up for a little civil disobedience? A million-vaper march in Central Park in NYC, perhaps?

    Otherwise, all these words will go unheeded by the ANTZ. They’re that far gone and insulated from reality and the public.

    — Mark B.

  47. Always love your work CB but this is by far one of your greatest pieces. Have linked it to one of your old colleague – Mike Daube’s FB page (Australian Council on Smoking and Health). He could do with some advice.

  48. Great stuff as always, Clive.
    Let’s hope that those who need to, read it and take your suggestions to heart.

    ps. does this mean I’m famous at last? ;)

  49. Hi Clive,
    I see that my posts regarding the Cancer Council are still awaiting moderation and I can fully understand why. In the meantime I would like to say that I kept copies of all messages between myself and the CC, which they of course deleted. Here is the post where they deny funding from big pharma.
    This is such a difficult situation for all of us as they have the money and the power. And I for one am so grateful to see all of your hard work on our behalf.

    Write a comment…



‪Cancer Council Australia‬‬‬ Hi Christine,

    Thanks for your posts and email. We appreciate you are passionate about this, but would like to remind you about our house rules in relation to repeatedly posting the same content on our Cancer Council pages, you can view our house rules here: ‪‬‬‬

    We are not funded by big pharma and do not sell, nor receive any funds from the sale of NRT products.

    As mentioned previously, we have outlined the reasons we are cautious about e-cigarettes here: ‪‬‬‬

    Like all independent public health organisations, we are interested in the scientific evidence on electronic cigarettes. If independent scientific evidence shows e-cigarettes would do less harm than good on a whole-of-population basis, we would support their use in controlled conditions like any other therapeutic good designed to treat a harmful addiction.

Cancer Council Australia | House rules 
Welcome to our Facebook

    1. Sorry I thought I’d cleared it. It is automatically put into moderation because of the number of links in it, not for what it says. I’m at work in Zimbabwe at the moment and don’t have good comms – but will try to release it soon.

      Btw – it is a bit off topic and CCA have denied your main allegations.

  50. Thanks Clive,
    I really appreciate your reply. Yes of course they denied my allegations but I find this denial very hard to believe with all the evidence that is readily available.
    Agree it is a bit off topic as well but I am fed up with their dishonesty.
    Anyway say Hi to Mugabe lol.
    Thanks for all your great work.


  51. Another well written article Clive. Tobacco Harm Reduction is the goal. Public “Health” officials who would rather see people die from smoking rather than help them transition to vaping should not be called “Health” professionals at all. From my view point those “Health” professionals are on the payroll of Big Tobacco and Pharmaceutical companies…and there IS evidence to support that claim!

  52. Yet another excellent post Clive.

    Unfortunately, as Clive is well aware, for more than a decade I and many other public health activists have been sending the scientific and empirical evidence on smokeless tobacco and e-cigarettes to many/most THR opponents who work at or who are funded by public health agencies, and to Big Pharma funded health and medical groups CTFK, ACS, AHA, ALA, AMA, ADA, AAP, and to drug industry and government funded researchers.

    For more than a decade, their collective response has been to continue denying the existence of the evidence, to lie about it, to marginalize and censor tobacco harm reduction advocates including myself (e.g. not allowing us to speak at tobacco control conferences, not publishing THR research in their journals, and not allowing us to post comments on their tobacco control websites and blogs), and to falsely accuse THR advocates of being tobacco industry shills and to deceitfully accuse us of promoting nicotine and tobacco addiction to children.

    E-cig and snus prohibitionists are not only unethical and inhumane, but they’ve been committing public health malpractice on a scale never seen in human history (threatening hundreds of millions of lives and causing the deaths of tens of millions of smokers who would have otherwise switched to smokeless tobacco or e-cigs.

    Their public health malpractice is nothing less than a crime against humanity, and their co-conspirators (including the WHO’s Margaret Chan and the US FDA’s Tom Frieden) should be charged with Crimes Against Humanity at the Hague as well as in federal courts.

    Further, all researchers, public servants and Big Pharma shills who have grossly misrepresented the risks and benefits of smokeless tobacco and e-cigs should be treated the same as Andrew Wakefield (who falsified research and lied about the risks of childhood vaccines).

  53. My previous post inaccurately stated that Tom Frieden worked at the FDA. Frieden is the head of the US Centers for Disease Control, which has conspired and colluded with the US FDA to protect cigarettes by lying about, demonizing and lobbying to ban e-cigs (and by unlawfully funding state and local health departments to lobby to ban vaping and restrict e-cig sales).

    In April 2009, Obama’s FDA revealed its unscientific, unethical and inhumane policy to deceive Americans about e-cigs and defend the FDA’s e-cig ban and nearly 1,000 product seizures by US Customs agents: “We don’t want the public to perceive them as a safer alternative to cigarettes.”

    In July 2009, Obama appointee (and former Waxman staffer) FDA Deputy Commissioner Josh Sharfstein held a press conference with CDC’s Matt McKenna and Big Pharma funded AAP’s Jonathan Winickoff(to defend the FDA unlawful and unwarranted e-cig ban from lawsuits by two companies whose products were seized) where FDA’s e-cig lab findings were misrepresented to scare the public to believe e-cigs are carcinogenic and toxic, where e-cig companies were falsely accused of target marketing to youth, and where it was alleged (without any evidence) that e-cigs are addicting children, can be gateways to cigarettes, can renormalize smoking, and don’t help smokers quit.

    Thankfully for the rule of law, public health, civil liberties, market competition and common sense, all 12 federal appeals court judges upheld Judge Richard Leon’s Janaury 15, 2010 ruling striking down FDA’s e-cig ban as unlawful.

    But the e-cig prohibitionists never clarified, corrected or apologized for any of their many fear mongering lies about e-cigs since 2009. Instead, they doubled down during the past several years, and have included many more lies in their talking points to demonize e-cigs (which only protects cigarette markets).

  54. Thank you Clive.

    Living proof that someone who doesn’t vape and has never smoked can understand what we all think and feel.
    If you can do it, so can others.

    I know that most of the readers will be vapers, but hopefully one or two senior members of Management within PH will stumble across this. If that does happen then just maybe some of it will get filed in their thoughts and processed for future reference.

    We can only hope so.

  55. Clive ‘I dips me lid’.

    Somebody in the above comments actually said it all- “we are all EX-smokers” – that is something that is not getting through to the authorities, at all. None of us are non smokers, entrapped by this new technology. Rather we are the most enthusiastic ‘quitters’ the world has ever seen!

    1. That was me. And of course all what Clive is saying is nothing new, we have been exposed to the lies and stigmatisation all our lives. The only difference is we can no longer be silenced out of guild we harm the people around us and we have found a way to speak up about the maltreatment that is going on for decades already. By vaping and finding a solution completely outside tobacco control we are accusing them of malpractice with every puff we take… (ref. snus that exist as long tobacco control exists but has been banned)

  56. Thank you for speaking for us. We ex smokers are so tired of being bullied, of the lies in truth of all the HARM that has been done to each of us personally by public health. They have proven to me over and over they do not care about the people only about money and power and control. They are in the wrong so often is has come to the point very few thinking people including never smokers/vapors believe any of them anymore and as in the story of the boy who cried wolf well………….they need to change.

  57. Well guys, I´m with you completely, yet I´ll throw in the other side of the coin.

    Literally millions of people make a living out of the tobacco industry plus all the countless efforts of tobacco control.
    This has been good business on all sides due to one simple fact, the near nonexistent success rate of tobacco control.
    From farmers planting tobacco, over the tobacco industry up to every singly tobacco shop in the streets, they all made a living out of it.
    At same time 1000s of organizations coming up with all kind of nonsense, from gums and patches up to acupuncture and hypnosis, get paid loads of money for research, pharmacies and doctors make good money trying to help those who want to quit smoking and treat those who developed smoking related diseases, while at same time the tiny fraction of smokers that manage to quit (or die) is more than compensated by new smokers from the next generation.
    Last but not least the states cash good money in tobacco tax and save loads of money for pensions of smokers dying earlier.

    So everybody was happy, as long as this situation was stable, where even upon dropping percentages of smokers, due to a growing world population the total amount of smokers kept growing, the tobacco control could justify their existence through dropping percentages while the cash flow of big tobacco was still growing.
    But then came along an alternative, the ecig, where I don´t even like the word, because a so called ecig has nothing to do with a cigarette.
    On start no big deal, few people using it, loads of manufacturers and shops popping up, creating jobs, selling small devices and pretending they would be cheaper than smoking.
    Smokers tried them, few got a hang of it, but most found them not sufficient and/or too expensive (especially the liquids) and returned to smoking, so no problem for the big picture, just a tiny little extra competition for gums and patches.

    But then vapers became creative, starting with individual vapers designing and producing repairable atomizers as well as searching and finding the ingredients of liquids outside of vape shops there popped up a gigantic industry around a growing number of DIY vapers.
    Unfortunately those don´t spend $10 a day, they spend maybe $0.10 a day, they use their money to go on vacation or save it, so they don´t need a loan for their next car.

    At this point the entire world is at a loss, except of the vapers themselves, drastic cuts in cash flow, where absolutely everyone loses money, except of the vapers themselves.
    I guess I don´t have to make the list, it goes down to every single individual non smoker worldwide now having to pay the pensions of former smokers who would have died by now.

    Does anyone here honestly believe we vapers could convince the entire rest of the world with scientific research?
    We are literally showing them, that their fate is actually far worse than their worst nightmares.
    Do you really believe if only we bombard them enough with the facts they will all voluntarily ruin their lives?
    I´m absolutely sure, “they” aren´t dumb, they know perfectly what they are doing and they are perfectly aware they are literally committing murder among smokers who could be potential vapers, they just don´t see any alternative of how else they could survive themselves.

    1. All true, but there’s about 6 billion people who do not directly benefit from tobacco, in most countries they are voters. So we have to bring the message out we are deliberately brought to the slaughterhouse (for money, out of ideology, ignorance,… who cares, that is not the point). To politicians who are needing those votes in order to survive this is undefendable on the long run…

      1. I believe you´re wrong there.
        If ecigs remain freely available as they are, all of these 6 billion people will feel a direct impact of it, even though most of these 6 billion aren´t aware of it yet.
        Companies closing and tobacco sales dropping means higher unemployment rate, means States losing taxes, means they either have to raise other taxes or cut social services.
        As long as politics and big tobacco can manage to keep the prices for their cig alikes way up the problem may be manageable, that´s why they try to wipe big devices off the market and keep the cig alikes, so they can say vaping is not forbidden, just regulated.
        If more vapers would start DIY there is no way the financial world and together with it all of us, wouldn´t feel the impact of $9.90 per day and vaper missing in the cashflow.

  58. Are you having a laugh??? I assume this is a satyrical comment.
    I will definitely give you the benefit of the doubt, as no one in their right mind would be happy to live a better life at the expense of smokers killing there selves……to prop up the economy.

    1. I´m a DIY vaper who paid his last vacation from tobacco savings, so I´m all in for “our” cause.
      I´m just trying to point out why all our attempts to convince our enemies have failed and will continue to be ignored.
      We vapers have to change our strategy.
      Either we find a way to solve the economic disaster for the tobacco industry and the states, which might be pretty hard to do since they haven´t found a solution to that either.
      Or we find a way to owerpower politics, which might be even harder, since civil war is not really something I would want to live in.

  59. Thank you Clive for all the good job you do for us.

    Merci Clive, puisse les décideurs lire et changer d’attitude devant tant de bon sens.

  60. This is one of the best (if not THE best) pieces you have ever written, Clive. Truly brilliant. Now each of us needs to send the link to some of our acquaintances in PH.

  61. I agree with you 100% regarding my list of “Negative benefits of NRT’s”. It is definitely “cherry picking” but as you have implied if this list had come from “the other side” the press would all be over it like a rash.
    It is such a shame that only one side of the argument ever get’s into the press though. It is like pulling teeth here in Australia to get even a whisper in to the press as it is all tied up censored and modified, so only one side of of the story ever get’s aired. So bloody frustrating!

    1. Yeah. Democracy is great, innit!
      Dunno about anyone else on here, but my political consciousness has been raised – massively – by the ecig issue. Was not that interested in politics before this, was very very very naive. I just assumed “they” (politicians, the WHO, public health, the media, etc.) were mostly telling me the truth, more or less. Now I look askance at everything. Especially anything coming from anyone in PH. And I will be looking very carefully into things before deciding what to think, how to live my life and where to put my vote.

  62. Clive – You never cease to amaze me with your words. You just have an amazing way of making things so clear. Even when it is not something I can relate to as easily as this posting, you make things very simple with your explanation. You have spent a lot of time learning about the people who use this product and the industry around it and I will say the same thing I said to David Abrams – never stop explaining to your colleagues what you see so clearly that they can’t quite grasp. Thank you for “getting it”. :)


  63. In 5 days (the 25th sept) I will have been tobacco free for 2 years, I smoked for over 40 years & had given up giving up … that is until I tried an ecig.
    I stopped smoking within 24hrs, I now feel fitter my bank account is noticeably fitter, It’s like I turned the clock back 20years. But then PH people are not really interested in people like me because I don’t know what I’m talking about.

    The people who are interested in people like me are the ones who have done proper science/evidence based research & have rather different views to the ‘so called experts’ who like to get in front of the TV cameras at every opportunity.

  64. Fantastic article.

    Having finally quit smoking after 20 years and trying everything from the useless gum to the black pit of despair and rage that is Champix, it is heartbreaking that the one thing that really works for me is being attacked and threatened by powerful officials whose job is supposed to be about helping me.

    It’s like I have been trapped in a burning building and have just burst out of the fire exit, taken a gasp of clean air and then run straight into a fireman who tells me “I’m afraid you’ll have to go back inside sir, this fire exit hasn’t been properly tested yet.”

  65. The thing I hate the most?

    I hate being right.

    Smokin’ Ashton is back at his job just as I predicted.

    What will it take for these imbeciles to recognize that WE ARE THE PUBLIC in “public health“?

    The irony? They claim to be against smoking but those packs of real ciggies, smoldering paper tubes filled with shredded tobacco leaves, remain on the shelves. I guess due to how cheap the raw materials are the added taxes mean more $$$ as opposed to the batteries and electronics for vaporizers which would be quite cost prohibitive for consumers if taxed just as proportionately.

    Remember: It was never about health. It’s about that addiction of “public health” to hate and greed that keeps them going. And going. And going.

    Gee, who are the real junkies with monkeys?

    — Mark B.

    1. Despite tweets from Allyson Pollock, claiming Ashton would be back at work on Monday (22nd Sept)…

      …it is now Tuesday 23rd and the FPH web site still has a statement saying he is on leave of absence while the investigation continues. So amateurish.

      1. Funny thing is how many people like Aston still do not understand that anything they say on ‘twitter’ will be picked up and mirrored, for all of eternity. PS if he can behave like in a public context, imagine what he would be like in a more private office. No wonder he is so ‘authorative’ , of the people who have to work with him who would want to be the bloke or blokete that says: ‘john I think you have really got the wrong end of the stick, take a stress pill.’

      2. What is known is that this is defacto evidence that FPH, “the standard setting body for specialists in public health” (FPH’s words, not mine) never cared about the public. And while this is a UK-based organization it sheds light upon the rotted innards of that worldwide movement known as “public health”.

        Even if Smokin’ Ashton is censured, a symbolic act at that, he’ll still have employment possibilities. Just look at Simon Chapman, fer instance. The only difference is that Smokin’ Ashton will remain a mentor behind the scenes. He ain’t going anywhere and will keep his position but only under different departmental nomenclature for the sake of farcical hierarchical order.

        Really. One can work wonders with org charts.

        Either way, it’s a clubhouse of crass cronyism. And anyone who has witnessed this firsthand, I don’t believe the witnesses to the breakdown will neither forgive nor forget.

        The Lancet has already made a broad defense:

        And here I am, keying away a few days after October. And now it’s okay to call someone the c-word only because they vape.

        Gee, I wonder what vulgar word they’d give a smoker?

        Or someone who enjoys snuff?

        Or simply anyone who doesn’t obey the dictates of this perverted professional class of plutocrats?

        WE ARE THE PUBLIC! If pissing on the public is how they get their jollies then I wonder if there are laws against such gross acts of public urination.

        Or do they get the UN pass of “diplomatic immunity” only because they view the human race as a unified group of piss drinkers?

        I have a feeling that the public didn’t consent to that.

        — Mark B.

  66. Wow….do, does the Board’s decision mean that calling vapers c___ is part of their official standards? And, of course, ignoring medical science……..

    Professional Standards

    The Faculty of Public Health (FPH) is the standard-setting body for public health in the United Kingdom. FPH provides professional advice to employers and others on statutory and good-practice procedures for senior public health appointments.

    FPH strives to maintain professional and educational standards for specialists in public health, as well as quality-assuring the profession, through its established continuing professional development (CPD) scheme and through the development of a revalidation system for public health specialists. For more information on these, please follow the links on the left.

  67. Clive the current issue of New Scientist has a interesting article on Imagination,

    The articles concluding parras on the downside of imagination struck me as quite relevant to understanding the over the top, out of all proportion , near to moral panic, reaction of some Authorities to e-cigs:

    “So, according to Bloch, the thing that was stirring in our brains 10,000 years ago and that triggered the sudden world domination of our species was a significant upgrade in human imagination to a level that can conceive of the existence of abstract concepts like laws, nationality or religion. Since then, he says, humans have been using their remarkable imaginations to dream up and then create social structures and institutions, including religion, money, laws, nation states, science and much more. That is an amazing feat that may explain why we alone among the creatures on Earth have developed technological civilisations.

    But Bloch suspects there is a subtle downside. The imaginary fabric of human society makes it inherently fragile, he says. “This is only a hunch for now, but I think there are moments when suddenly the arbitrariness of the system appears.” Legalising gay marriage may be one such momentous issue for some people, he suggests.

    “I’m fascinated by the people who have been demonstrating against gay marriage in France,” says Bloch. Talking to them, he found that “what really worried them was this notion that if gay marriage is possible then everything will collapse. What I think is going on is suddenly an awareness of the imaginary nature of the institutions that we live in.””

  68. The use of electronic cigarettes is unlikely to attract anyone who is not already addicted to Nicotine via tobacco products.
    This is due to the fact that the cost of buying the equipment & liquids to start `vaping` is far in excess of simply purchasing a pack of cigarettes!

    Furthermore, it is important to realise that the vapour e-cigs produce is almost identical to that which is already allowed to be used by `smoke machines` in public places such as theatres, nightclubs & rock-concerts etc.!

  69. My first visit. Initially I was skeptical. Clive is not a Vaper, smoker, Scientist, MD, or PHD. A former Civil Servant. I silently mused, what the heck could I learn. Was it worth my time to even read this Blog? I was wrong! It is precisely because you are “not” that provides you with a unique perspective of THR, regulatory challenges, and Vaping. Combined with your ability to convey your valuable thoughts in an easy to read manner. Well done Clive! Spot on! Thank you and best wishes from the other side of the pond.


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  71. I’m a lowly public health servant, and, frankly, I have felt attacked by gangs of hostile and rude vapers. But your post helped me see some major flaws in the role I’ve taken in this issue as I try to discuss it in social media and elsewhere.

    “Their interest in you, if any, is that you might spoil what they are doing, that you are making provocative or unfounded remarks about them or what they do, or you are dismissing their experience as mere anecdote.”

    Those few sentences were eye-opening and will certainly have an impact on how I approach e-cig/harm-reduction issues as I post on Twitter – until I get banned by my senior public health managers from that social media site for trying to keep an open mind, that is.

  72. Clive,

    Your article was like a voice in the wilderness. It contrasts with my comment to the FDA on smoking tobacco in a pipe. In the case of the e-cigarette there is the panicked call for more evidence. In the case of pipe tobacco there is already 500 years of evidence.

    My comment begins with “To deem or to discern?”

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  77. My Dearest Clive:

    What an incredible piece! Excellent analysis of a problem, which is definitely not only a local concern. We are battling the same demons in the United States, so it is refreshing to see other stories as well as possible alternative solutions to them from other corners of the globe.

    I will save and share this piece, in the hopes that others can become better educated on the topic. As a former smoker of more than 28 years, I salute your fine piece! I am also looking to find a copy (in English) of the piece from France.

    J Ervin Bates
    (doubtful that we are related, but honored to message you, nonetheless)

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  89. Exactly, Electronic cigarettes release negligible amounts of nicotine into the environment, and no health risks to bystanders have been identified.

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  94. With havin so much written content do you ever run into
    any issues of plagorism or copyright infringement?
    My site has a lot of exclusive content I’ve either authored myself or outsourced but it
    seems a lot of it is popping it up all over
    the internet without my permission. Do you know any techniques to help reduce content from being ripped off?
    I’d definitely appreciate it.

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  97. Wow Clive late August 2017 and this article is still relevant. Particularly in Australia where our recent social media campaign to encourage vapers to submit to several enquires was attributed to big tobacco by one notable retired public health grandee. Interesting and I’m sure unintentionally his comments made several journalists very curious and we got some pretty good coverage from it.

    So maybe in the long run those in public health should be aware that you can fool some of the people sometimes but you can’t fool all of the people all of the time.

  98. If you think things are bad now in terms of accusations of being “Big Tobacco,” I think they used to be even worse.

    Back in the 90s and even into the 00s accusing anyone with a solid argument who stood against them of being Big Tobacco was the Antismokers’ most used weapon against their enemies. It was bad enough that when I wrote my “Brains” back in 2003 I felt I had to disarm their gun right in the first two sentences of the Author’s Preface:

    I am not now, nor have I ever, been a member of the Communist Party.

    I am also not now, nor have I ever, been affiliated with Big Tobacco or their stocks, nor do I have any plans to be.

    By so blatantly throwing out the welcome mat to have myself discredited I was able to show that there was nothing to discredit. Even so, two years later when I worked with a friend to discredit Glantz’s “Great Helena Heart Miracle” study we came under attack because my co-author had worked twenty years previously for 7-Up Soda Company as a soda flavoring chemist. Evidently 7-Up had been bought and then sold at some point in the 80s by Altria/PM so my friend was painted as a “tobacco industry researcher” and our publication efforts thrown in the dirt. See for more details.

    Discrediting by even the weakest of connections is an old game for Antismokers and it’s still being played by them as they don their shiny new Antivaper caps.

    – MJM

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