WHO keeps ignoring evidence in Abu Dhabi

Last week the 16th World Conference on Tobacco or Health took place in Abu Dhabi. Of course the WHO and Margaret Chan was there, spreading their Big Pharma sponsored propaganda, but so was Dr. Farsalinos among other leading experts on e-cigarettes. Quite interesting to read this report on how most (if not all) of the experts defend e-cigarettes, with science to back it up, but the WHO is still stuck on the gateway theory that has been debunked over and over again:

"Non-smoking is the norm and e-cigarettes will derail that normality thinking, because it will attract especially young people to take up smoking," said Chan. "So I do not support that."

I have to admit it is kind of scary that the WHO actually just completely ignores evidence, and common sense, and seemingly have no problem telling straight out lies to the public as long as it keeps their friends in Big Pharma happy. Because that's what this actually is: A straight out deliberate lie. The truth, as Dr. Farsalinos stated is this:  

"there is not a single case of a never-smoker who used e-cigarettes and then became a smoker of tobacco cigarettes"

... and in addition to that, it would make absolutely no sense to do so. Banning e-cigarettes for this reason makes about as much sense as banning soda because it's a gateway to alcohol addiction. I mean, seeing that kids mix whisky and Coke, the obvious thing to do would be to ban Coke right?

Jean-Francois Etter, associate professor at Geneva University, was also in Abu Dhabi pointing out the obvious: That excessive e-cigarette regulations will only lead to less people being able to quit smoking, and that only Big Tobacco would be able to survive in a tightly regulated environment.

"I think that the WHO people should know better than kill alternatives to smoking cigarettes" - Jean-Francois Etter

You're absolutely right professor Etter, they most certainly should. The problem is that the WHO is now just Big Pharmas propaganda machine. A German delegate, who wants to be anonymous, reveals their true agenda (after telling the same lies as Chan of course):

"e-cigarettes could easily be sold in pharmacies where you have a controlled product"

 ... "that way my pharma-friends can easily have control of what products are sold and what information the customers get", she adds quietly to herself.

The presence of people like Farsalinos and Etter at such events, however, is an important step in the right direction. They will probably not be able to turn the WHO, with it's current leadership, around by themselves. They don't have the funding or lack of morale required for that, but we already see that they are able to influence what the media writes. The WHO is obviously lost, controlled by Big Pharma and just keeps on making things up, ignoring whatever scientific evidence proving they are wrong, but luckily the media is more powerful than the WHO and can still be won. Thanks again to Farsalinos and Etter and everyone else down there fighting.

The latest lies from WHO

Yesterday the WHO released an article (or something like that) entitled “What everyone needs to know about e-cigarettes”. This represents a new all time low from the WHO, and from the looks of it, their friends in the pharmaceutical industry. It is quite amazing that they have managed to get so much misinterpreted evidence, ignorance, contradictions and straight out lies in such a short article. So what's wrong with it? Well... to be honest, practically every single last bit of it is wrong. I'll break it down for you and comment on each paragraph:

What are e-cigarettes (electronic cigarettes), and how do they work?

E-cigarettes are products designed to deliver nicotine or other substances to a user as an aerosol. Using e-cigarettes simulates smoking cigarettes without burning tobacco.
Typically, e-cigarettes are composed of a unit powered by a rechargeable battery, a replaceable cartridge containing liquid and an electronic atomizer that, when heated, converts the contents of the cartridge into an aerosol that the user can then inhale. The liquid contains four main ingredients: propylene glycol and/or glycerine as a base for producing the aerosol, flavours and optional nicotine.
E-cigarettes are often shaped to look like their conventional tobacco counterparts (e.g. cigarettes, cigars, cigarillos, pipes or hookahs). Some are made to look like everyday items such as pens or USB memory sticks, or produced as larger cylindrical or rectangular objects.

They almost know what an e-cigarette is... but amazingly they managed to start out the whole thing with a lie. E-cigarettes are not designed to deliver other substances than nicotine. What they are trying to get people to believe is that e-cigs are designed to deliver other drugs as well. They can be used to deliver other drugs... but they are not designed with that in mind. That is like saying cars are designed to be means of transportation ... and murder. Cause it can easily be used to run over and kill pedestrians. It's an idiotic thing to write and they only do it to demonize vaping by connecting it to drug abuse. By this logic a plastic coke bottle, an apple, tin foil, shoe-boxes, asthma inhalers and even bibles are things designed to consume drugs (http://www.oocities.org/groda_lotsapot/bongs/dispbongs.html).

So e-cigarettes contain nicotine?

Yes, most of them contain nicotine, an addictive drug. E-cigarettes contain and deliver varying levels of nicotine, some of which can be similar to levels in cigarettes.

Congratulations, you got something right. But of course not everything. Actually it's the e-juice that contain nicotine and one e-cigarette can be used with both nicotine and non-nicotine e-juice. When it comes to nicotine being an addictive drug... well I know most people accept this as the truth... but what about the medical expertise? Have a look at these two posts:

• Nicotine - a supersheep in wolf's clothing? 
• Nicotine addiction: When and why it all started

What exactly am I inhaling when I use e-cigarettes?

About 500 e-cigarette brands are available today, but only a few have been analysed. A lack of knowledge about the contents of the inhaled mixture is linked to the problem of quality standards. Nevertheless, sufficient evidence shows that e-cigarettes’ aerosol is not just a water vapour, as the industry usually claims. The literature shows a great variety in the levels of the toxicants and nicotine produced by e-cigarettes.
The aerosol usually contains cancer-causing compounds (such as formaldehyde), but at levels 1–2 orders of magnitude lower than those in tobacco smoke. E-cigarettes are therefore likely to be less toxic than conventional cigarettes. Nevertheless, the levels of carcinogenic agents in some of the analysed brands are as high as those in the smoke produced by some cigarettes.
In addition, user behaviour – length of puffs, depth of inhalation and frequency of use – may affect nicotine absorption. Some users modify e-cigarettes at home to alter the delivery of nicotine and/or other drugs. Products vary widely in the ease with which they can be modified or filled with substances other than nicotine solutions.

First of all, no one in the industry claims that e-cigs aerosol is just water vapor. Again, a lie placed there to demonize the industry. Then there is the levels of toxicants. Here they're not straight out lying... the literature shows a great variety, but what they fail to mention (of course) is that the vast majority of the levels measured varies from zero to microscopic compared to cigarette smoke. "The aerosol usually contains cancer-causing compounds (such as formaldehyde)" - and we're back to lying again. This is simply not true. Some flawed studies found formaldehyde when using an e-cig. Even the authors of this study admits this is not what the aerosol usually contains. And in the next sentence the WHO even explains why... the user can control their use and who in their right mind would use it in a way that would taste like shit and cause them harm? And of course they manage to end the paragraph with some more demonizing crap about modding e-cigs for drug abuse. Lets ban plastic bottles cause they can be used to do drugs shall we?

Are e-cigarettes safer to use than cigarettes and other tobacco products?

No, using e-cigarettes carries some health risks.
These devices have become popular over the last 4–5 years. Little is known about the impact of e-cigarettes on health. As they contain fewer toxicants at lower levels than conventional cigarettes, e-cigarettes are likely to be less toxic. Nobody knows, however, how much less toxic they are.
Nevertheless, nicotine can affect brain development in fetuses and in adolescents, may contribute to cardiovascular diseases and may promote tumours, playing a role in malignant diseases. In addition, reports from both the United Kingdom and the United States of America indicate that the incidence of nicotine poisoning has risen significantly as the use of e-cigarettes has increased.
Further, there is evidence of health risks from the toxicants in e-cigarettes’ aerosol. While long-term effects, such as links to cancer and other diseases, will not be known conclusively for some years, enough evidence indicates that these toxins are of concern for pregnant women who either use or are exposed to e-cigarettes.

So... in one paragraph they say that e-cigarette aerosol "contains cancer-causing compounds (such as formaldehyde), but at levels 1–2 orders of magnitude lower than those in tobacco smoke." Then they say it's as harmful as smoking tobacco? What is this? An attempt to keep people smoking? Even the most stubborn anti-e-cig advocates I've seen asked about this admit that e-cigs are safer than tobacco cigarettes. There are other things, like the gateway theory (we'll get to that further down), that concerns them. But saying that e-cigarettes are not safer (by denying that they are safer like the WHO does here) is again, lying. Try to find a medical professional that is willing to publicly claim that e-cigarette aerosol is as dangerous as tobacco smoke. You won't find any. The WHO knows this very well... so they haven't even bothered trying. As for the rest of the paragraph... they are focusing on harm to people that everyone, the users, the industry, commentators and e-cig advocates agree that should not use nicotine (like fetuses for example). To finish of they are trying to make us believe in a thing they call second-hand vaping, for which there are NO SCIENTIFIC EVIDENCE WHATSOEVER! In 4-5 years with all the money big pharma and the WHO has used to try and find such evidence, the fact that they haven't been able to is a VERY STRONG indication this in fact does not exist.

What are the health risks of using e-cigarettes?

According to WHO’s 2014 report, “Electronic nicotine delivery systems”, the main health risks from e-cigarette use come from the inhaling of nicotine and other toxic emissions from these products, either directly or second-hand.

1. Nicotine is the addictive component of tobacco. It can have adverse effects during pregnancy and may contribute to cardiovascular diseases. Although nicotine itself is not a carcinogen, it may function as a tumour promoter. Nicotine seems to be involved in fundamental aspects of the biology of malignant diseases, as well as of neurodegeneration. In addition, fetal and adolescent nicotine exposure can have long-term consequences for brain development. In addition to inhalation, the main health risk from nicotine exposure is overdose by ingestion or through skin contact. Users fill e-cigarettes’ containers themselves, so they, not the manufacturers, set the levels of nicotine. Nicotine poisoning can result from the liquid’s accidentally coming into contact with users’ skin or ingestion by children. The United States and the United Kingdom have already seen a tremendous increase in reported nicotine poisoning, often involving children.
2. Although e-cigarettes are likely to be less toxic than conventional cigarettes, they produce more than just water vapour. They contain some cancer-causing agents, such as formaldehyde, which in some brands reach concentrations close to those of some conventional cigarettes. E-cigarettes’ impact on health has not yet been determined.
3. Finally, the use of e-cigarettes increases the level of nicotine and particulate matter (PM) in the air. There is no safe level of exposure to PM for bystanders, and the health risk multiplies with increasing concentrations.

In summary, the existing evidence shows that e-cigarette use poses serious threats to adolescents and fetuses, and increases exposure of nonsmokers and bystanders to nicotine and a number of toxicants. Nevertheless, the reduced exposure to toxicants of well regulated e-cigarettes, used by established adult smokers as a complete substitution for cigarettes, is likely to be less toxic for the smokers than conventional cigarettes or other combusted tobacco products. The amount of risk reduction, however, is unknown.

This shows how outdated the WHO is. It has been proven that nicotine in itself (without other substances in tobacco) is not very addictive. I notice they also drag the children into this, that of course will drink e-juice and die. Here's a list of other common ways for children to die: http://www.poison.org/prevent/common.asp. This is just a matter of irresponsible parents, like with all the other dangerous products we keep in our houses.

To really make this scary enough for big pharmas taste, add some second-hand vaping (which does not exist) and particulate matter (which is also a fabricated issue).

Can I be addicted to e-cigarettes?

E-cigarettes may carry a risk of addiction to nicotine and tobacco products among young people and nonsmokers. They may promote delaying of quitting smoking, or deter quitting.

As I said above, nicotine in itself is not very addictive, and even if it was, that wouldn't mean it would make you addicted to tobacco while you're at it. There is just no plausible explanation to why this should happen. Why the hell would e-cigarettes, a product designed to help people quit smoking, promote or delay quitting? The only explanation I can find for this is that the WHO simply don't count switching to e-cigs as quitting. Let's see ... how should I put this ... VAPING AND SMOKING IS NOT THE SAME THING!

Does WHO say e-cigarettes are helpful or harmful?

Sufficient evidence shows that e-cigarettes are hazardous to young people, pregnant women and people who do not use nicotine. At the same time, e-cigarettes are likely to be less toxic than cigarettes for adult smokers if product content is well regulated and if the smokers use them as a complete substitution for cigarettes. The latter would mean that e-cigarettes would have to be relatively effective as a quitting aid, which there is not yet enough evidence to prove.
For all these reasons, WHO can neither dismiss nor accept the use of e-cigarettes globally without further evidence, and regulation is necessary in the meantime both to protect the public from any potential ill effects and to ensure that these products do not contribute to the tobacco epidemic.

So, e-cigarettes are less toxic than cigarettes then? And if people start using them as complete substitutes for cigarettes you say that would mean they are relatively effective quitting aids? But you lack evidence of this happening? Well.... I'm your evidence, my colleagues are evidence, some of my friends are evidence, my wife is evidence... in fact several million people have done this. How many million people have to do this before you acknowledge it as evidence?

Can e-cigarettes help me quit smoking?

For now the evidence is inconclusive. Given the uncertainty about e-cigarettes’ safety and effectiveness as an aid to quitting, rigorous study is needed by independent research organizations that are not affiliated with the e-cigarette or tobacco industry. In coming years, a solid body of evidence is expected to be built that will allow a definitive conclusion to be drawn.
At present, no governmental agency has yet evaluated and approved an e-cigarette product for smoking cessation, although the United Kingdom’s Medicines and Healthcare Products Regulatory Agency is reviewing some products.
Before considering e-cigarettes as a potential cessation aid, smokers should be encouraged to use a combination of already approved treatments. Nevertheless, experts suggest that appropriately regulated e-cigarettes may have a role to play in supporting some smokers who have failed cessation treatment, been intolerant to it or have refused to use conventional medication.

Again... millions of people is not enough? Seriously... there must be some reason you refuse to see this right? Oh...

What products should I use to quit smoking?

For adults, WHO recommends licensed forms of nicotine replacement therapy (NRT): a therapeutic nicotine-delivery device produced under strict medical regulations for completely quitting smoking, with clear instructions on dosage, duration and methods of use. NRT (such as nicotine gum and the nicotine patch) delivers nicotine through skin or the lining of the mouth, and at lower levels and a much slower rate than smoking, which involves inhaling nicotine into the lung.
While the nicotine in e-cigarettes does not pose additional health risks for adult smokers, the evidence for the devices’ effectiveness as a method of quitting is limited and requires further research.

....you rather want people to quit by using the NRTs that your friends in Big Pharma makes and earns a lot of money by selling, even if they don't work? But don't these also contain the same nicotine that will get you addicted to tobacco? You can't explain? Well I don't blame you...

Does using e-cigarettes harm other people?

No studies currently link the exhaled aerosol from e-cigarettes to specific diseases, but it contains nicotine and particulate matter (PM): the tiny particles to which some toxicants are attached. In addition, when a user exhales this aerosol into indoor air, the background level of PM and nicotine rises.
The inhalation of nicotine by nonsmokers, adolescents and pregnant women not only leads to addiction but has also been linked to some cardiovascular problems in adults. In addition, fetal and adolescent nicotine exposure can have long-term consequences for brain development.
WHO has long maintained that there is no safe level of PM, so levels should be minimized as far as possible, regardless of their source.

Ugh... see above... 

Is e-cigarette use a gateway to smoking for young people?

As young people account for a growing proportion of e-cigarette users, antitobacco experts are concerned that e-cigarette use can serve as a gateway for them to nicotine addiction and ultimately smoking. The literature shows that experimentation with e-cigarettes among adolescents doubled in 2008–2012. One of the presumed reasons for this can be the great variety of flavours of e-cigarettes (up to 8000 are available), including flavours like those of fruit, candy and alcoholic drinks. These could entice young people to experiment with e-cigarettes and then become addicted to nicotine.

The gateway theory seems to be one hell of a floater. No matter how many times we flush it down the toilet it keeps on coming back. Further up we established that WHO needs millions of people to do something to call it evidence for it happening regularly. Well... they haven't found a single smoker that started out vaping. Not one... zero. Nada! Until they do, you can safely dismiss this last paragraph as pure and utter bullshit, by the logic of the WHO. The gateway theory, if valid would in fact be very easy to prove... you just have to show that people start vaping and move on to smoking tobacco. Easy as that. So why can't you? Cause it's just not happening!

COP-6: Caviar and Champagne for the pharmaceutical industry

Apparently the WHO couldn't afford to stop the Ebola outbreak (http://goo.gl/SS1jc7), but they seem to have no problem hosting a £1.6 million party in Moscow for their friends in the pharmaceutical industry. While Ebola was (and still is) ravaging West-Africa, the delegates attending COP-6 was eating caviar and drinking champagne in Moscow: http://goo.gl/AYv1kC. And while the media and the public was thrown out and the doors were shut behind them to make sure the decision making wouldn't be affected by outsiders, Big Pharmas lobbyists were allowed to stay: http://goo.gl/w2C39t.

I asked before the weekend what happened to the FCA behind those closed doors. I think Dick Puddlecote pretty much sums this up in his excellent post on the subject:

With all those dissenters out of the way; with the hall packed with pharma lobbyists and security forcibly silencing any flies in the ointment, I suppose it made it quite easy for the FCA's original recommendation on e-cigs - for caution and a postponement of recommendations pending further study - to be steamrollered out in favour of encouraging wholesale bans.

I highly recommend reading the whole post. I also recommend reading Christopher Snowdon's post "Health über alles". There is so much wrong with the way the WHO and public health is handling the situation right now, and I think Snowdon's post gives some great insights when it comes to why things are the way they are.



photo credit: geishaboy500 via photopin cc

COP-6: What happened to FCA behind those closed doors?

This photo was taken on the 13th.
The next day the media was thrown out. 

On Saturday we got the final wording on the decision on ENDS from COP-6. On Clive Bates' blog you can see Professor Gerry Stimson's reaction to this, as well as follow the evolution of this statement (have a look at the bottom of the post on Clive's blog). I don't see the need to elaborate to much on what I think of decision from COP-6, as I've written a good deal about this earlier when WHO's report on ENDS prior to COP-6 was published, and I also agree fully what professor Stimson writes in his post.

To me the whole COP-6 was a farce, with the WHO closing the doors completely, making sure they avoid any critical voices raised as they made their decisions. The event wasn't streamed, not much info got out on the internet during the event, and the WHO threw out the public, the media and even the Interpol (http://goo.gl/ddLfGC)... and all principles of transparency along with them. One has to start wondering what the WHO is hiding? How on earth are we supposed to trust the WHO when they do this, with just some lame excuse that there might be representatives from the tobacco industry observing? So what, they are not making the decisions, only observing, right? So what they are signalling by this is that their decision making will be affected by the tobacco lobby just being there? Then they are clearly not the right people for the job they're set to do if you ask me.

Margaret Chan on COP-6

It doesn't make it better that their Director-General, Margaret Chan, misleads the public to believe that she's using all her time to fight Ebola, when she in fact is in Moscow (http://goo.gl/WCxfa1) delivering opening remarks at COP-6, at expense of a speech about the Ebola pandemic. And her reasoning for this makes it even worse: “I can’t be a single-issue director-general. I don’t want people to think I spend all of my time on Ebola.” Ehm... say what? Is this for real? This is the leader of UN's health agency, WHO, faced with one of the biggest health emergencies of this century, and she DOESN'T want people to think she's spending all her time on it? Now, even if she was only in Moscow for the opening remarks and maybe some photos, I think this show a total lack of judgement and common sense, and I don't see how we can trust an organization that makes such priorities.

So, back to the topic: What did actually happen behind those closed doors in Moscow last week? Especially, what happened to the FCA? Before the meeting they published a statement on ENDS that showed their position was in sharp contrast to WHO and their report. From their own bulletin from day 2 of COP-6 (http://goo.gl/hU3awS) you can also see that this position was presented there. But now... they're urging governments to implement the ridiculous guidelines mentioned at the top of this post as soon as possible (http://goo.gl/yqaocd). To be fair, they don't mention ENDS in that last statement at all, but they are not excluding them either: "Decisions made this week in Moscow will save hundreds of millions of lives if governments work to implement them immediately." So, what are they saying now then? "Forget what we said last time, the WHO was right and those principles we suggested earlier (http://goo.gl/oUX8sK)... that was just something we said, but we don't see any reason to make a fuzz about the WHO flushing them down the drain."

So, what do I think happened behind the closed doors in Moscow? I'm not really sure to be honest, but I am certain that from WHO's point of view it was the right thing to do. A picture of Margaret Chan beating the FCA with a baseball bat before surgically removing their balls keeps popping up in my head.

FCA COP-6 brief on e-cigarettes, is it good enough?

The Sixth session of the Conference of the Parties to the WHO FCTC, also known as COP-6 is going to be held next week (from the 13th to the 18th of October) in Moscow. I guess most of you noticed that WHO published their report and position on e-cigarettes (or ENDS as they like to call it) a little while ago, a report that to me looks like it's designed by Big Tobacco and backed up by Big Pharma to make sure e-cigarettes pose a health problem. You can read my comments on the report here.

On October the 7th the Framework Convention Alliance (FCA) published it's brief on e-cigarettes prior to the COP-6, and yesterday Clive Bates did an excellent review of their paperwork: http://www.clivebates.com/?p=2448. As Clive says, the FCA position on e-cigarettes is in sharp contrast to WHO. I'm happy to see that the FCA recognizes that there could be negative unintended consequences from over-regulation just as there could be from under-regulation, something the WHO doesn't seem to understand at all. To me this very sentence shows that they are actually seeing e-cigarettes as part of a possible solution, not the problem, as opposed to the WHO who only sees e-cigarettes as a problem (or at least so it seems from their report). 

The FCA also recommends agreeing on direction setting principles prior to any policy making, and suggest 7 such principles: 

1. The global burden of death and disease from tobacco is primarily caused by smoking.  
2. While quitting tobacco use is paramount, quitting nicotine use altogether is the best option.
3. For those unable to quit tobacco, switching to alternative sources of nicotine that are less harmful can reduce, often very substantially, the harm smoking causes to the individual. 
4. The benefits of such an approach would be maximised if uptake were limited to existing smokers who are unable to quit. 
5. The risks of such an approach would be minimised by taking measures to limit uptake by never-smokers, in particular amongst young people, to protect non-users, and to discourage long-term dual use.
6. There could be negative unintended consequences from over-regulation just as there could be from under-regulation. 
7. The involvement of tobacco companies in the production and marketing of e-cigarettes is a matter of particular concern as there is an irreconcilable conflict of interest between those profiting from the sale of tobacco and public health.

Clive comments on each of these principles, and I agree with most of his comments, so I'm just going to recommend reading his post. I especially like Clive's comments on number 4, where he disagrees with the FCA, and say that "this sounds reasonable but it is not true". The point here is that non-smokers taking up vaping could actually be doing so instead of taking up smoking. Clive points to Scandinavia and says that part of the reason for low smoking initiation rates here is that Snus initiation has displaced smoking. This is exactly the same theory that I've written about earlier, the firewall theory. E-cigarettes work as a firewall towards cigarette smoking, both for ex-smokers hindering a relapse, and for non-smokers, often youth that would otherwise have experimented with cigarettes smoking.

Now I said I agree with most of Clives comments. When it comes to the last principle Clive says that Big Tobacco's involvement "should be problematic only if their involvement results in more smoking." Although I don't actually disagree with that statement I think Clive gives Big Tobacco more credit than they deserve: "It is very far from clear that the companies have incentives to protect smoking". In my opinion, seeing how they have navigated and lobbied so far it's not that far from clear. Their latest warning labels on their e-cigs are a good example. However, as Clive says, it is problematic to deny a harm reduction product as a matter of principle just because it's made by Big Tobacco. But I do understand FCA's concern.

The FCA's brief on e-cigarettes are miles better than the WHO's, but I also ask myself the same question that Clive does: Is it good enough? I'm sitting here with a feeling that FCA is holding back a bit to avoid colliding to hard with the WHO, and I'm a bit afraid that we'll end up with something in the middle, which in my opinion isn't good enough. To quote Clive once again:

Think what could be achieved if this alliance embraced the concept of tobacco harm reduction, and ran hard with it – becoming the experts and authorities on managing the risks and unintended consequences in their own countries and, if appropriate, in the FCTC.

Two important critiques of the WHO report that you should read

Since the WHO published their report on e-cigarettes last month it has been criticized by a lot of people. Many of the critics point out the fact that WHO focuses on every little trace of harmful substances found in e-cigarettes and cherry-picking scientific reports that supports this. They fail completely to compare the potential risk of using e-cigarettes to the risk of smoking cigarettes, and they haven't even looked at the potential positive effects of e-cigarettes.

I want to highlight a couple of very well written and thought through critiques that pinpoints the errors made in the WHO report and the consequences they have on public health:

• Earlier this month Ann McNeill and others (among them our dear Dr. Farsalinos) published their critique in Addiction Journal: http://goo.gl/3kqBR3
• On Sunday, Clive Bates published his critique: http://goo.gl/qwuyDk. Remember the WHO tried to shut him up not long ago? I'm happy to see they failed.

I highly recommend reading both of them, as they explain very well why the WHO report does more harm than good. I don't really see the need for me to comment any further on those, but I noticed that the McNeill critique was responded to by one of Dr. Glantz's friends, David W Bareham. The response was published by Glantz here: http://goo.gl/8LZ5e8. What I found very interesting was Dr. Farsalinos comments on this response, published here: http://goo.gl/5GJszv. Now I realize I've given you guys a lot to read, but trust me, it's worth it. If you don't have the time to read it all, go straight for the last couple paragraphs in the comments by Farsalinos. It makes a couple of very good points:

• He points out that the possible negative effects of vaping is highlighted without even taking the positive effects into consideration. If this was done with other smoking cessation medications they wouldn't sell much of it.

"Would any smoker ever try an oral smoking cessation medication if the only information provided would be that they can cause seizures, depression and suicidal ideation?", Farsalinos asks.

• Vaping is not compared to smoking, like it should be, but to not smoking:    

"Of course we continue our research efforts because we need to learn more about e-cigarettes. Of course we are concerned about some issues, such as e-liquid composition (despite the lack of combustion and the absence of cured tobacco) and temperature of e-cigarette use (despite being almost 5 times lower than smoking), not because e-cigarettes may be more harmful than smoking but because we want to find ways to make e-cigarettes even less harmful than they currently are."

•  The last one speaks for itself I guess: 

In fact, our position concerning e-cigarettes is identical to the recommendation of the American Heart Association (AHA): “If a patient has failed initial treatment, has been intolerant to or refuses to use conventional smoking cessation medication, and wishes to use e-cigarettes to aid quitting, it is reasonable to support the attempt”. What AHA and other scientific associations fail (or avoid) to admit is that this group represents the majority of smokers.

As I said, I highly recommend reading the articles and comments mentioned above. If you're a fast reader and still hunger for more, I'm going to go ahead and recommend reading my own article about this from late last month (http://goo.gl/qE8FNC) if you haven't read it yet.

WHO attempts to censor Clive Bates

As I wrote yesterday, the WHO report released on Monday has been massively criticized this week. As usual Clive Bates delivered one of the most thought through and well written criticisms (http://www.clivebates.com/?p=2350) and posted a letter he wrote to the WHO in response to a public statement made by one of their representatives (http://www.clivebates.com/?p=2355). The WHO has responded to this by threatening to sue him for using a parody of their logo. Please read Carl Philips' post on the topic here: http://goo.gl/rLVcdM. This comes on top of their twitter messages that Dr. Farsalinos commented on here: http://goo.gl/NJYQ9f.

This is the logo that the WHO didn't like

This is the kind of behaviour you typically see in people all out of arguments. They've put themselves in a position where they actually know they are wrong, but are reluctant to admit their mistake cause they are afraid to loose their authority... or they have financial reasons not to admit it. They are all out of arguments so their only option is to spread lies and try to crush the opposition with all means available not caring about the mess they leave behind. My wrecking ball analogy from yesterday seems even more relevant today.

In my honest opinion the WHO are not doing their job very well at the moment. I think Carl Philips says what we're all thinking right now:

If the WHO is so defenseless against criticism that this is the only way they can respond to it, perhaps it is time to replace them with people and an organization that are more suited to their role.

The WHO report: Tearing down the firewall

Two days ago WHO released their dreaded report on E-cigarettes. There is a lot of problems with this report, and although WHOs position is not as bad as it once was there is still a lot of problems like many others have already pointed out:

• The Ashtray Blog has a great article on the topic here: http://goo.gl/mMREwS
• Read Clive Bates' comments here: http://goo.gl/Ztd0JA
• Dr. Farsalinos is as usual spot on in his critisism pointing out that the WHO apparently ignores the health of smokers: http://goo.gl/7hFT1I

The WHO was also active on twitter trying to spread their propaganda after the report was released, something that I think made Dr. Farsalinos (and a lot of others) quite pissed off: http://goo.gl/NJYQ9f.

Notice the snake in WHO's logo?

On Monday I introduced a counterpart to the gateway theory; "the firewall theory". To me it sounds much more plausible that e-cigarettes act as a firewall stopping people who otherwise would have started smoking cigarettes from doing so, rather than a gateway into the deadly habit. Non-tobacco flavours are the bricks of this firewall, innovative technology that distances vaping from smoking is the mortar and it is reinforced by huge health benefits for the users and people around them.

This theory should be like music in the WHOs ears. They are looking at something that not only could be a gateway out of tobacco addiction but could also make a lot less people start smoking. But instead they are doing their best to tear down this wall. They seem completely reluctant to acknowledge that the facts don't fit their precious gateway theory, so they they are now trying to change the facts by banning non-tobacco flavours, banning use in public spaces and trying to convince the public that the health benefits are not there. All of these will make vaping more similar to smoking. Think about it: If kids could only get hold of tobacco flavours, would this make it more or less likely that they switch to cigarettes? If you have to go outside to the smoking areas standing alongside smokers to be able to vape, would more or less vapers switch the wrong way? If all e-cigarettes looks like cigarettes and performs poorly, would that be good or bad for public health?

To me it looks like the WHO report is designed by Big Tobacco and backed up by Big Pharma to make sure e-cigarettes pose a health problem. All of the proposed regulations will make e-cigarettes more dangerous and the gateway theory more plausible. Because the big problem for Big Tobacco and Big Pharma today is that e-cigarettes work, and innovation will make them work even better, building an increasingly higher wall between them and their customers' money. So they've invested in a wrecking ball called WHO to tear down that wall.