Four poor lies presented arguing for strict e-cigarette regulation

Tom K. Grimsrud

Tore Sanner

Thought I'd share some news from the ongoing e-cigarette debate here in Norway today. Remember our friends Sanner and Grimsrud that recently published an article in the Journal of the Norwegian Medical Association, in an attempt to convince politicians and medical professionals that e-cigarettes are the devils work and needs to be regulated to death? Well, now they're apparently trying to target the public with their lies and misinformation. They've published an article in Norwegian newspaper Aftenposten's readers options section titled "Four good reasons to regulate e-cigarettes strictly" (Google translation is not that good, but you get the main points). 

There is relatively little and uncertain evidence of the usefulness of electronic cigarettes, while the indications of the potential hazards are numerous.

Yup, this is actually the ingress of their article, and it gives us a pretty good idea of what to expect from the rest of it: lies, lies, lies. They've pretty much decided to turn reality upside down and publish it as truth. I'll skip to their four "good" reasons:

1. "The use of e-cigarettes can normalize smoking and cause the decline in the proportion of smokers who quit. Many think it is worrying that users of e-cigarettes also recruited among never smokers and former smokers."

- Yeah, right... where do I start? First of all smoking is still pretty normal. Stop telling people that it's not. This is of course reality upside down. Vaping will normalize quitting, and eventually it will denormalize smoking. Then there is the fact that Sanner and Grimsruds biggest hero, Stanton Glantz, recently showed us that the quit-ratio has increased since e-cigarettes came along. Finally, their own sources (which they used in the article I mentioned in the beginning), this ASH-report to be specific, tells us that recruitment among never smokers is negligible. So, not a single true word in reason #1 there.

2. Among the never smokers that the e-cigarette appeals to, it is particularly many young people. If e-cigarettes are freely accessible, we can get a significant increase of young users with nicotine addiction and behaviour similar to smoking.

- Same lie as the first one actually. They keep saying that e-cigarettes appeal to never smokers, but again, it turns out it is not. But this one also reveals Sanner and Grimsruds real problem with vaping: behaviour similar to smoking. 

3. There is a danger of double use by enabling users to continue or just cutting down on the traditional cigarettes, and using e-cigarettes as in addition to this, believing that it is beneficial. However, only full cessation seriously reduces disease risk. Unless e-cigarettes are a step towards becoming completely tobacco free, like nicotine patches and chewable tablets are, the e-cigarette is unlikely to have any appreciable effect on disease risk.

- There are millions of people that have started out as double users before quitting completely. Some vapers might never quit completely, true, but that is not a good reason to deny people the option to try, now is it? They are trying to make it look like the e-cigarettes keeps these people smoking, which doesn't make sense at all to anyone who have tried vaping. In fact, try to google "vaping accidental quitter", and you'll find that a lot of people actually plan on double use, using e-cigs for situations where they're not able to smoke, but they end up quitting completely instead. Also, notice that Sanner and Grimsrud are recommending patches and tablets now... so maybe the nicotine isn't their problem anyway, maybe it's still that dreaded behaviour similar to smoking?

4. Although nicotine itself is not considered carcinogenic, recent studies suggest that it may contribute to cancer development and worsen the severity of cancer. Users of tobacco products such as cigarettes and smokeless tobacco have reduced efficacy of cancer treatment, and they have a poorer prognosis. Nicotine is a likely contributing factor in this picture. It may take decades before such long-term effects of e-cigarettes can be uncovered.

- So, if it turns out that nicotine promotes cancer (which I've only seen one study done on rats indicating), why on earth would that be a reason to deny everyone that do not have cancer a fantastic opportunity to quit smoking and by that avoid cancer? Makes absolutely no sense to me. I addition to that I believe this is one of the studies that Sanner and Grimsrud usually refers to when it comes to this. Have a look at how it concludes: Although nicotine might play a role, the mechanisms warrant further investigation. The study shows that users of snus (smokeless tobacco) have a moderately increased cancer-specific mortality, but keep in mind that snus is also tobacco and this study did not investigate what could have caused the increased mortality. They merely pointed out nicotine as a possibility. If you read the whole report, or just the discussion in the end, you'll see that the study has a lot of limitations. Actually it makes a lot of sense that Sanner and Grimsrud likes this study, as it contains a lot of uncertainties, unconfirmed theories and questionable conclusions... exactly what Sanner and Grimsrud wants to base their regulation scheme on.

So, there you have it. Four poor lies presented arguing for strict e-cigarette regulations. Luckily both this last article in Aftenposten and the one from Journal of the Norwegian Medical Association have been heavily criticized in the comments section. Not only by the vaping community, but also by medical professionals and scientists who have done studies on nicotine themselves. Sanner and Grimsruds pretty weak attempts to defend themselves have also been answered and it seems like they've given up on it. It's also worth noting that these articles are published by the authors themselves in sections where the readers can express their opinions, which indicates that the publications themselves probably haven't found their articles newsworthy. It's a shame however that this isn't made clearer, especially in the last case where the target audience is the public who tends to read the headlines and possibly the ingress.  
 

Make 2015 the year vapers when won the media war!

Before I took a short break from blogging during Christmas I kind of concluded that 2014 had been a year with a lot of ups and downs for vapers. The media published horror stories, claiming that vaping is more harmful than smoking cigarettes or that vaping would cause a new generation of nicotine addicts, and then the next week they published hallelujah-stories claiming that vaping could save millions of lives. Yesterday the Ashtray blog published a pretty amusing post on this topic: E-Cigs Cause (Media) Schizophrenia: A Case Study. As James points at the end of his post the media is of course not really as schizophrenic as they appear at times, they are just doing what they can to get as many readers as possible:

The Daily Mail isn’t really schizophrenic, it simply takes stories from both sides, and twists and manipulates them to ensure they sell the most papers.

I think this is one of the most important facts we, as vapers who want to continue fighting for our case, have to remember this year. Hopefully, we will be able to make some changes in 2015, but I believe some things will be the same... and will never change:

• The media will write their stories to get readers and in this way earn more money. 
• Big Tobacco and Big Pharma will continue their lobbying in 2015 for the same reason, to earn money, or maybe in their case, to avoid loosing money. 
• Then there is Glantz and his fellow prohibitionists. These guys did not care much about facts and truth in 2014 and I have no hopes that this will change in 2015. As Steve K pointed out recently, New year, same prohibitionists. 

Working to stop Big Pharma or Big Tobacco or to trying to turn the prohibitionists around will pretty much be a waste of time and energy. Luckily, these are not the guys that will decide what regulations e-cigarettes will be subject to in the end. The politicians will. And politicians need support from the public to be able to stay in charge. I don't believe that e-cigarette regulations are the most important case for most politicians. Most of them probably knows very little about it, and do not care too much either. There are other, more important cases on their minds. So if the general public has a positive attitude towards vaping, chances are these politicians will have that too, just because it will give them some goodwill.

We have to remember that most people are not smokers or vapers. Most people's knowledge of the subject and their attitude towards vaping is based on what the media writes about it. Actually, from my experience, most people's attitude is based on the headlines alone. I don't have the exact percentage of non-smokers in the world today, but I don't think I'm wrong if I say it's somewhere around 70% and 80%, most of them with little knowledge of vaping other than what they read in the papers or see on their TV-screens.

For these reasons I think vapers and vaping advocates need to focus on getting the truth out in the media this year. This will affect the general public's, and the politician's, attitude towards vaping in a positive way. If we can "win" the media war in 2015, chances are that vaping will be allowed to continue saving millions of lives.

So my advice for 2015 is, if you want to help out and make a difference in this case, don't just educate yourself on vaping, but try to educate the media as well. Write a couple of emails to the local newspaper, give them some tips on the research I'm sure you've read about. Who knows... if they get enough emails, maybe they will write a story about it. And maybe some bigger newspapers or news agencies will pick up on it and the snowball will start rolling, hopefully knocking down some prohibitionists on it's way. Make 2015 they year when vapers won the media war!

My comments on CDC Director Frieden's explanation to what he hates with e-cigarettes

I just finished reading this article in the Los Angeles Times where CDC (Centers for Disease Control and Prevention) Director Tom Frieden explains what he hates about electronic cigarettes, and I just can't resist the urge to comment on it. I know I'm a bit late but what the hell. How this man got this job is beyond my understanding.

“I’ve treated so many adults who are desperate -- desperate -- to get off tobacco. They all started as kids,” Frieden said. “I see the industry getting another generation of our kids addicted. To me, as a physician, when 1.78 million of our high school kids have tried an e-cigarette and a lot of them are using them regularly … that’s like watching someone harm hundreds of thousands of children.”

When the anti-e-cigarette movement is out of arguments, this is what they turn to. Think about the children. And Frieden even wants us to think about 1.78 million of them. Of course with no reference to any evidence whatsoever. To be honest I'm a bit surprised he didn't mention puppies and kittens while he was at it. Now dr. Frieden - how many patients have you treated that was desperate -- desperate -- to get off e-cigarettes? Well at least he kind of confirms that e-cigarettes gets these people off tobacco. Then he adds:

“people have a misconception that the tobacco epidemic is a thing of the past. Tobacco still kills more Americans than any other cause. It still kills more than 1,000 people a day. As a doctor, I can tell you it kills them in really unpleasant ways -- gasping for breath with emphysema, with cancer, with heart disease.” 

What on earth does that have to do with e-cigarettes? We all know cigarettes kills people in rather nasty ways, but why should that make one hate e-cigarettes? Again, he feels the need to mention he's a doctor, to give people the impression he knows what he's talking about. Some probably fall for that too and it is such statements that will keep your patients gasping for breath with emphysema and dying from cancer or heart disease, dr. Frieden.

I'm glad the journalist felt the same way that I did about the statement above and asked the obvious question next:

"What does that have to do with e-cigarettes?"
"E-cigarettes are a tobacco product," Frieden answers.

Oh really? By what logic? That the nicotine can be extracted from tobacco? That would also make nicotine gum and patches tobacco products. But maybe it's because it looks like you are smoking tobacco when you use them? By that logic however you also have to assume that electric cars are oil-products that lets out just as much CO2 as a regular car, right? I mean in some cases you can't really see the difference. Actually, when I think more about it, e-cigarettes does have something to do with this; they have the potential to shorten dr. Frieden's line of emphysema, cancer and heart disease patients. Maybe that's his problem?

Then there is the five reasons Frieden rattled off to why e-cigarettes are as dangerous as tobacco cigarettes:

--“If they get another generation of kids more hooked on nicotine and more likely to smoke cigarettes, that’s more harm than good”
--“If they get smokers who would have quit to keep smoking instead of quitting, more harm than good.
--“If they get ex-smokers who have been off nicotine to go back on nicotine and then back to cigarettes, more harm than good.
--“If they get people who want to quit smoking and would have taken medicines to think e-cigarettes are going to help, but they don’t, more harm than good.
--“If they re-glamorize smoking, it’s more harm than good.”

This makes it pretty obvious that Frieden actually has no reason to hate e-cigarettes, but has decided to do it anyway. And these are just a list of reasons he wish he had, that's why he put "if" in front of them. Well here is why I hate dr. Frieden and why he is as dangerous as a mass murderer:
-- "If he buys a machine gun and kills a bunch of people, he would do more harm than good".
Actually I've got another, more plausible one as well:
-- "If he takes advantage of his position to make sure smokers are deprived of a healthier alternative and hence keep on smoking, he would to more harm than good"

Just for good measure, Frieden threw in two more problems with e-cigarettes: People who use them can expose kids, teens and pregnant women to nicotine via secondhand smoke; and enterprising smokers can put marijuana or hallucinogens in an e-cigarette “tank.”

First of all there is no smoke involved in vaping. This just shows ignorant and uneducated this man is. Then there is a bunch of ways to consume marijuana and hallucinogens. Do you hate ovens since it can be used to bake hash cookies? And by the way Frieden, you missed another opportunity to throw in puppies and kittens. Stay focused please.

Frieden acknowledged that “stick to stick, they’re almost certainly less toxic than cigarettes" and that many people have quit smoking tobacco cigarettes with the help of e-cigarettes. However, he said, “the plural of anecdote is not data.”

So the fact that millions of people have quit with the help of e-cigarettes are just funny anecdotes and not data? If you ask everyone who quit smoking how they did it, the means they used are just irrelevant then? This argument just crumbles under it's own weight.

“If the e-cigarette companies want to market these to help people quit, then do the clinical trials and apply to the FDA,” he said, in a reference to the Food and Drug Administration. “But they don’t want to do that. They want to market them widely.”

Another example of how little common sense this man shows/has. This has nothing to do with whether or not e-cigarette companies want to apply to the FDA or not, it has to do with what they can afford and how long it would take to get a new product to the market. I would like to believe that Frieden understands this in his position, but based on his statements, sadly I don't.

“The challenge that the FDA has is that they will be challenged by the tobacco industry, as they have been at every step of the way,” he said. The federal agency “tried to regulate e-cigarettes earlier, and they lost to the tobacco industry. … So the FDA has to balance moving quickly with moving in a way that’s going to be able to survive the tobacco industry’s highly paid legal challenge.” 

You think the tobacco industry's lawyers will fight regulations that will effectively wipe out all their competition? The FDA's challenge is to balance between moving quickly and moving in a way that will convince the general public that their regulations are reasonable. And the tobacco industry will applaud every successful step the FDA takes in this direction.

Since I started this blog, I've read tons of articles about, and interviews of, anti-e-cigarette advocates, but never before have I come across any that managed to reel off this many contradictions and this much, excuse my language, bullshit in so few words.