This post examines how WHO and related institutions aggressively promote the prohibition of much safer alternatives to cigarettes, such as vaping and heated tobacco products. The effect, if not the intent, is to protect the cigarette trade from competition, to promote black markets, to stimulate harmful workarounds, to nurture criminal networks, to harm young people, and to prolong the epidemic of avoidable smoking-related disease. It’s a reckless policy, built on misplaced righteousness, defended by bureaucratic inertia, sustained by group-think, and cultivated by elitist billionaire foundation money. It’s a curse and a blight on public health, and government representatives should apply real-world policy disciplines and reject it.
I had an excellent conversation with Ethan Nadelmann, the founder of the New York-based Drug Policy Alliance for his outstanding Psychoactive podcast series about all aspects of drugs and drugs policy, which I highly recommend.
In this episode, “The E-cigarette revolution”, we covered vaping, nicotine, harm reduction – science, policy, politics and controversy – with Ethan as host putting the challenging questions. Listen via your usual podcast provider (search on Psychoactive)… or via these links.
The September 2021 edition of CHEST, the respiratory journal, features a point/counterpoint debate on the value of e-cigarettes for tobacco harm reduction. I am making the case in favour (the Point) and Dr Hasmeena Kathuria (Boston University) and Dr Frank T. Leone (University of Pennsylvania) are making the case against (the Counterpoint). We each provide a shorter rebuttal to the arguments made by the other. We also recorded a 30-minute podcast to air these arguments face-to-face. Recognising the broader interest in the subject, CHEST has kindly made this content open access so far.
Whatever you think of the respective arguments, it was refreshing to find a forum willing to air them in a respectful and measured way, I am grateful to Drs Kathuria and Leone for engaging and making their case and to CHEST for providing the platform. I wish we could have much more debate like this.
For ease of access, I have added the relevant links below.
This blog gives my take on how to think about the FDA’s decisions (some taken, some forthcoming) on approving or denying thousands of “pre-market tobacco applications” (PMTAs) to allow vaping products to remain on the US market. FDA must make decisions no later than 9th September 2021, following legal action brought against the agency. FDA’s Director of the Center for Tobacco Products, Mitchel Zeller, provides the background in a February 2021 blog.
There’s a lot to be written on this, but I will settle for 16 observations and questions that will shape my take on FDA’s announcements.
Health Canada is trying to ban almost all vaping liquid flavours. This is on top of measures to limit nicotine strengths and marketing. It is the nearest they can get to a prohibition without actually having to prohibit the most promising low-risk rival to cigarettes. The likely effects are obvious: more smoking. But in a bizarre twisting of reality and evidence, Health Canada finds that making vaping less attractive relative to smoking will… um … reduce smoking. And that’s how it justifies the measure. We respond with a counter-analysis.
It’s World No Tobacco Day and we have sent our detailed letter and multiple critical expert comments to the WHO Director-General. The covering note and links to relevant documents are reproduced below. I hope it causes them to pause and reflect. My guess is that Tedros has been very badly advised here.
It is first-class public-interest journalism, with some hard messages for Bloomberg but plenty of balancing comment too.
The response. The interesting thing is that this drew a joint response from Kelly Henning of Bloomberg Philanthropies, Matthew Myers of the Campaign for Tobacco-Free Kids and Robin Koval of the Truth Initiative. See Vaping and Philanthropy: Debating Strategies That Work (web archive). There is a substrate of anger and panic in the letter that suggests that Gunther hit a raw nerve.
What is unusual about this letter is that Henning, Myers and Koval actually try to defend their positions. Normally, they don’t defend their positions, they just assert them with millions of dollars of amplification. It offers a rare opportunity to provide a critique of their stance. So I have taken their response letter, broken it down into 15 propositions, and provided a response to each. Each section starts with a quote from the letter pulled out in a quote box in bold dark-blue. The letter is analysed in its entirety. Continue reading “Holding the Bloomberg anti-vaping propaganda complex to account”