Thursday, 22 December 2016

The Norwegian Institute of Public Health censored their own top researchers

Last week I wrote that the TPD and plain packaging passed in the Norwegian parliament. The Norwegian Institute of Public Health, NIPH, played an important role in this, not only through their response to the public consultation prior to the vote, but also through their reports on e-cigarettes (which I've written about before) and their statements during a committee hearing in October this year. Now, some of NIPH's own researchers reveals that important information was held back during this committee hearing, and hence the members of parliament, that voted in favour of the new tobacco act, had inadequate information. Norwegian newspaper Dagbladet has gained access to emails showing this and they've talked to Erik Nord and Karl Erik Lund about it. This was published in an article last week (sadly behind a paywall).
Erik Nord
Karl Erik Lund
"NIPH handled this case in a way that Karl Erik Lund's and my own views on e-cigarettes were never submitted to the Committee. (...) This was in my opinion contrary to the general desire for the best possible  information on the case, and disloyal to the parliamentary committee on health and care services", writes FHI researcher Erik Nord in an email exchange Dagbladet has accessed.
Both Nord and Lund have argued that what we know about relative harm and usage patterns strongly suggests that a strict policy on e-cigarettes can lead to loss of a lot of lives. They wanted to get this view across to the committee, but instead their calculations and summary on the research done on e-cigarettes were omitted when NIPH held their presentation to the parliamentary committee.

Nord directs harsh criticism towards the leaders of NIPH that he in this case says are driven by a wish to satisfy the politicians instead of a wish to objectively impart knowledge. Nord and Lund both have their background from the The Norwegian Institute for Alcohol and Drug Research, SIRUS, that earlier this year was merged with NIPH. SIRUS researchers then expressed concerns that they risked loosing their freedom, credibility and freedom of speech as NIPH has a less independent role compared to SIRUS. It looks to me that they had a very good reason to worry. The two institutes have often disagreed publicly for several years in different questions, for example the use of snus. Karl Erik Lund have been a strong supporter of harm reduction through both snus and e-cigarettes and have expressed this publicly a lot of times while he was Research Director at SIRUS, and I'm happy to see he and his colleagues from old SIRUS still puts ethics and science above satisfying egocentric politicians.

This is not the first time Lund and Nord have ended up in this situation after the SIRUS/NIPH merge. They also wrote a report contradicting Minister of Health, Bent Høie's views on plain packaging. Despite that an article in newspaper VG revealed that this report was ignored and left out of the background material when the proposed changes to the tobacco act was written, nothing was done. The Australian lies fit Høie's agenda better, so they kept those instead.
"After the VG article about snus packaging some time ago I sent out an email about a crisis of confidence in the NIPH. In a meeting immediately afterwards Camilla (NIPH director Camilla Stoltenberg, ed note) asked what was needed to restore confidence. I have since pointed out that action, not words, is needed. The handling of this case was the opposite of what is needed", Nord write in his email.
Talking to Dagbladet Nord estimates that between two and three thousand Norwegian smoker will die prematurely as a direct consequence of a strict e-cigarette policy. "This is the reality that the politicians will have to expect", says Nord.
"When the health care committee requests to be presented with the different views, it is natural to do so. Instead the area director chose to give a kind of unified presentation where our calculation was completely gone", he explains to Dagbladet.
In an email that Dagbladet has read, Nord writes that NIPH in some cases obviously has "issues dealing with its dual role as a research / information provider on one hand and advisor on the other, and that it's leaders unfortunately sometimes ends up being political actors".

Area director Knut-Inge Klepp have been publicly sceptical to e-cigarettes all along. This also goes for NIPH director Camilla Stoltenberg, and that suits Bent Høies agenda quite nicely. Lund and Nord research and views on the other hand, doesn't fit this agenda at all. So one can only wonder... why did they decide to merge SIRUS and NIPH?

Klepp, of course, does not agree with Lund and Nord and says: "I disagree that we in any way attempted to withhold information. We have been completely open that there is scientific disagreement within the institute" What a load of crap. What he's actually saying is that they admit that their researchers (the people that actually know something about this) does not agree with the leadership, but they chose not to present their views anyway. Why? Because they've found other science that fits the politicians agenda better?

He then goes on with the usual "there is not much research done on the consequences of e-cigarettes and a fresh survey from the USA supports a stricter policy than Nord and Lund wants", and goes on:
The math is interesting. There is uncertainty about the numbers just as there is uncertainty about much of the knowledge about e-cigarettes. Here we get new results every week, and I think that it is wise not to be too firm, but monitor research on health effects both in Norway and internationally closely in the future. 
I'm not sure what to say to that? "Blah, blah, blah" might be fitting? There is a lot of research available, just not much supporting the views and agenda of Klepp and whatever politician he thinks he needs to satisfy to keep his job. Klepp goes on:
(...) It is not a problem that it appears there is scientific disagreement within such a large institute, but rather a strength. The challenge is of course that we can use the controversy to develop good research that can bring us results in this field.
More empty words from Klepp there. The research is already there, from researchers at his own institute among others. Still he was the one that chose to omit it when presenting what was supposed to be all the views and research to the committee, depriving them of the ability to make well informed decision.

Then again, would it really have mattered if Lund and Nord had been able to get their views across, telling the committee the real consequences of their actions? Apparently not. Tove Karoline Knutsen (Norwegian Labor party, AP) says that the committee members are well aware of the views of Lund and Nord but still:
Of curse we listen carefully both to NIPH and others, but for Labour it is also important to proceed somewhat incremental in cases where there is so little research as in this case, and in any case ensure that we don't do something that is irreversible. If at some point we get far more knowledge our view can be revised, but I think it is important now that we treat e-cigarettes as regular tobacco with the same restrictions, if they are primarily intended to be a tool for smoking cessation.
I get the feeling you've listened a lot to NIPH, and paid extra attention to Klepp's way of ignoring science. What really is irreversible is the damage done by the new tobacco act. Pigs will learn to fly before Norway removes or changes a law that complies with the EU TPD.

Last week I tried to figure out what motives the Minister of Health and his department have for doing this, even though they have to know by now that they will slow down the accelerating decrease in tobacco smoking. Here's a scary thought: What if that is exactly what they want? Why? From a purely egocentric point of view, just thinking of their own political life it makes sense though. Because no matter how poorly their plain packaging works, smoking rates will continue to decline. The Australian government have demonstrated how, by some simple statistical tinkering, they can make it look like this has worked. That looks great in a political campaign. Same thing with e-cigarettes, even if they manage to slow down progress, which will result in less lives saved, e-cigarette use will slowly become more visible and mainstream, and they can say that "hey, we legalized e-cigs... and have a look at our statistics now. Smoking is declining." (Which it would have done anyway, of course). What's even better from their point of view is that if the decrease in smoking is slow enough, they can continue to make up useless provisions to score political points for years to come as well.

The Norwegian Institute of Public Health has become the government's tool to deceive the public, making us believe that they're doing a great job for public health. As we've seen they are willing to go pretty far to do this, even censor their own top researchers if their research show the "wrong" results. We can only hope that Lund, Nord and the other researchers from SIRUS will create such hell that the house of cards eventually falls apart. These are the most experienced and best tobacco researchers we have here in Norway and they are the ones that should be responsible for NIPH's statements, views and presentations regarding this.


Tuesday, 13 December 2016

TPD and plain packaging passed in Norwegian Parliament

On Friday, December 9th, the Norwegian government published a press release stating that the proposed changes in the tobacco act will pass in Parliament. The proposed changes are, as I've written before on several occasions, the EU TPD and plain packaging for both cigarettes and snus. I recommend reading my previous articles on what this proposal actually means, and what lies our politicians use to justify this, either consciously or due to severe lack of knowledge and willingness to learn. I also submitted an answer to the public consultation on this case. The exact time the new tobacco act will be effective is not yet set, but it will happen some time during spring 2017.

I've been watching the speeches made by representatives from all parties when this case was processed in Parliament on Friday. A lot of the representatives have developed a remarkable resistance to facts, seeming almost immune to the realities of the case. I guess most of my readers don't understand Norwegian, so I'll sum up the arguments used in short: The gateway theory and nicotine in e-cigarettes will harm both the user and innocent bystanders (mainly children of course). Yeah... that's right. Norwegian government still believes that e-cigarettes will increase recruitment of smokers among young people, even if it has been shown over and over again that this is not the case at all. They are very concerned with the increase in snus use and e-cigarettes, and fails completely to see that this coincides with an accelerating decrease in young smokers. Karl Erik Lund's excellent article on the role of e-cigarettes in the tobacco endgame have bypassed them completely. Not that I expected them to read it anyway, but it seems very unlikely to me that no-one in the government or members of the parliament have seen these statistics and been wondering if there might be a connection. To me it is pretty obvious that they don't want to see the connection.

It doesn't help that our department of health refuses to retract or correct their report that falsely stated that nicotine in vapor can be harmful to bystanders. Hell, they even refuse to comment on Dr. Farsalinos last critique, and it's pretty obvious why. Farsalinos shows above all doubt that they are wrong, they stand no chance of making any reasonable argument to why they should not correct this in the report. This would also force them to rewrite the conclusion of the report stating that there is really no harm from so-called second hand vaping. So they just shut up and hope this thing goes on unnoticed by most people, including policy makers. Cause without any harm from passive vaping, their house of cards is starting to fall apart. Same thing goes for the harm from, and addictive properties of nicotine alone. Take that myth away and you'll rip away the whole foundation for their regulation. The sad part is that their strategy of complete silence and just ignoring evidence seems to have succeeded.

An argument that is presented several times in the debate about plain packaging is that this has been so successful in Australia. First of all, this is simply not true. It hasn't been a success in Australia, it's just the Australian government that have twisted some statistics in an effort to hide their failure from the world. I pointed this out in my consultation answer (first point, and also pointed out by Dick Puddlecote among others) so there is actually no excuse for this other than "not bothering to even read the consultation answers". Secondly, let's say plain packaging actually did work, just imagine that the Australian government did not lie about this. How can you argue that even though snus is a lot less harmful than smoking, we should introduce plain packaging for this product as well, making it less attractive compared to smoking. Makes absolutely no sense at all if you ask me. So not only do they base their policy on a lie, but they've created a policy that makes even less sense if the lie wasn't a lie but rather reality. Now that's just priceless.

Minister of Health, Bent Høie, showing his
useless plain packages.
Again... the Norwegian government shows clearly that they are really not that concerned with public health. What their motives really are seems a bit unclear to me. In one way, money is the obvious answer. Handling this in the right way, to promote public health, will cost money in the short run, mainly due to lower income from sin taxes. It's a long term investment in public health that will pay off economically as well, as I've explained before. The problem is that we won't see the effects while this government is in power. It will take some time before we start seeing how much less we need to spend on health care for smokers and the benefits of a healthier population in general. A more healthy population is a more productive one. In a way this government would pay the price while the next once will see the profit. But money is not the only answer here. In my opinion we have a minister of health, Bent Høie, that uses most of his time and energy trying to make it look like he is doing a good job, or at least like he is doing something. He has gotten a lot of press on the plain packaging case and clings on to the Australian lie so he won't have to admit that he's wrong. He is too weak to stand up to the EU and use our right to reserve ourselves from stupid regulations, so he sticks to the lies in this case as well, showing up everywhere with a worried look on his face... "Think about the children! We need to protect the children!". Last time I saw him on TV he was after sugar, and now plans to implement rules that forces food manufacturers to reduce the amount of sugar in their products gradually and grocery stores to move their candy out of sight so we won't be tempted to buy it. In other words... force or trick the public to reduce their sugar intake rather than using the money on education and measures that encourage people to make these choices themselves. Of course he gets to go on national TV to tell everyone that he'll make sure we don't need to worry about our sugar intake any more... he'll just be a hero and fix it for us. Just sit back and relax and let me handle this...

I'm not going to compare raising a dog to altering the behaviour of a population... oh wait, I just did. Kind of a weird comparison maybe, but anyone who have (successfully I might add) raised a dog will know giving the dog a treat every time it does something right works a hell of a lot better than yelling at it for doing it wrong. Now here in Norway it seems like they decided to try out the same thing to get people to switch to electric cars. Give them treats that is. They removed almost all taxes, let them use the bus lanes and even gave them free parking with free charging included. Guess what... it worked. It worked almost too well. When I drove to work today I noticed that the bus lane was just as congested as the other lanes. Now, instead of giving out treats to people for switching to electric cars, the government could have taxed all other cars heavier. It most certainly would also have worked... but not nearly as well or fast. It seems to me that the politicians are surprised how well it worked and now they're scratching their heads wondering how they can justify taking some of the treats away again to put on the breaks to be able to handle the new situation. Where am I going with all this talk about electric cars you ask? Well, the strategy that the government have chosen to fight the tobacco epidemic is quite the opposite to their electric car strategy. I guess this goes for the whole world, not just the Norwegian government. For decades they have tried to scare, force and bully people to stop smoking. And it has worked.... but very, very slowly. E-cigarettes (and I guess also snus) have proven to be much more effective than any other effort to get people to stop smoking, or even better, not to start in the first place. Why do you think this is the case? It's because they are treats in themselves. They give the smoker something more than the cigarettes gave them. So you see... raising a population isn't really that different from raising a dog. The EU and the wimps in the Norwegian government sadly fails to see this, even if they've got good documentation at hand that shows how well it works, and have now decided to keep beating the poor puppy until it gives in and obeys. Sad ... just sad ... cause you know what, they will never reach their goal of a tobacco free population this way. Maybe we should try buying Høie a dog... no wait... that would be animal cruelty.


Tuesday, 6 December 2016

Review: Wotofo Serpent Mini 25mm RTA

Last summer when I went to Denmark on vacation I had some time to kill one day so I decided to see if I could find a vape shop. I did... and needless to say I ended up buying something. This something was a Serpent Mini and another Minivolt to go with it, and this little setup has become one of my favourites lately. The Serpent Mini produces just excellent flavour and decent vapor on pretty low wattages, I usually run it around 20-25W on a 0.8 ohm build, which is great since the Minivolt actually lasts quite a while. Today I'm reviewing what you might call the Serpent Mini's big brother, the Serpent Mini 25mm RTA. The name of this feels kind of weird to me though... I mean it's really not that mini. Then again, it looks very similar to the Serpent Mini, with a lot of the same features. It's just bigger... so there is room for some more of the good stuff.

In the box
    • Serpent Mini 25mm RTA with single coil deck installed.
    • Dual coil velocity style deck
    • Pack of spare o-rings and a multi-tool
    • Pack of Japanese Organic Cotton
    • Pack of Wotofo Comp Wire (3 pre-made twisted coils)
    • Spare glass tank
    • User manual 
        • 25mm diameter, 48mm height
        • 4.5ml juice capacity
        • Dual coil and single coil deck included
        • Adjustable airflow control
        • Top filling

          Look and feel

          As I said, the 25mm edition of the Serpent Mini looks pretty much like the original on steroids. Same external design, clean with just the name engraved on the top cap. Nothing to fancy, and I like that. I've got the Stainless Steel version of this and I'm happy with that actually. My original Serpent Mini is black... or at least was black when I bought it. Now it's kind of a mix between black and SS :) I guess the SS version won't have this problem. I have to say though, that my original has been used a lot and has just been carried in my pockets when I'm out and about.

          In use

          As with the Goblin Mini that I reviewed last time, the Serpent Mini 25 also comes with two different decks, one for single coil builds and one velocity style deck for dual coils. Switching between these are pretty damn easy, you simply unscrew them from the base. There is an o-ring there however that you need to make sure does not disappear. It's quite loose and easily comes off.

          You will recognise the single coil deck from the original Serpent Mini if you've tried that. I for one find this deck pretty easy to build on, just make sure you keep your coil a bit elevated so it doesn't touch the base of your deck. When wicking it I prefer to just keep the knurled ring, that kind of keeps your wicks in place, on a all times and just use a pincer to stuff your wicks down there on both sides. The dual-coil deck is also a dream to build on... well it's not really a surprise since it's a velocity style deck, which is my preferred style of decks atm. The post holes are 2 mm which I'd say is sufficient for my use at least. Wouldn't build with any thicker wire in this atty anyway.

          The top filling is excellent with huge fill holes and a top cap with nice smooth threading. Same goes for the airflow control, nice and smooth and plenty of air when fully open.

          The whole thing is easy to take apart and clean. You can also unscrew the base and re-build your atty without emptying the tank first. Pretty much standard stuff on these kind of atties these days I'd say.


          You can, obviously, fit some bigger and more crazy builds in the 25mm version of the Serpent Mini than you can in the original. Which means you can hit it with some more wattage, producing more vapor. Still, I think the flavour is just excellent, as it was in the original. I like it both in dual and single coil setups. As always with an RTA, the performance depends on your build, but I really like the flavour that the twisted coils that come in the box produces. This goes for both single and dual coil setup. Since this is a 25mm atty you'd probably end up using it with a quite powerful mod, which means you can do some more crazy builds and hit it with quite a lot of power for some huge clouds, but you can also go more easy on it and have an all day build that won't empty your tank in a flash.
          Pros and cons

          ++ Great flavour and vapor production
          + Dual and single coil decks
          + Easy to use and clean
          - That loose o-ring on the build decks that tends to disappear when you're changing decks.


          It's tempting to compare this one to it's little brother, the original Serpent Mini, of course. Still, this 25mm version is a lot bigger and you will probably end up using it differently. The original is still superb for small, lower wattage setups, while this one is more ideal for bigger setups, either for huge clouds and lots of power, or for long lasting all day builds. The flavour however, is excellent on both of them. You can get the 25 mm edition for around $30-35ish (NOK 319 at, making it a great buy if you ask me. I've used mine a lot since I got it.

          Thanks a lot to Dag Einar at for sending me this atty for review.

          • All my reviews are my honest opinion even if I am affiliated with the company manufacturing or selling the product.
          • This product was sent to me for free for the purpose of this review.
          • This review does not contain affiliate links.