Monday, November 28, 2011

Chew/snus alternatives free from scrutiny given to e-cigarettes

The FDA has gone after e-cigarettes because it decided that the claims that e-cigarettes were safer than smoking were unproven and that the products were actually unapproved drug delivery systems designed for smoking cessation. Arguments that e-cigarettes are actually safer alternatives to smoking (rather than a treatment) have fallen on deaf ears.

Ironically, another "alternative" to tobacco - tobacco and nicotine-free chew/snus products - have seemingly been free to make similar claims about their products without any clinical trials or FDA scrutiny. Compare the claims made on the web site for a product called "Nip the Grip":
  • Is NiP really safe? Yes. NiP the ENERGY DIP is made with natural sea sponge that is infused with Vitamin B-12, Caffeine, and natural flavorings which are all FDA approved ingredients.
  • NiP is a safe and healthy, natural alternative to smokeless tobacco. It has been specially developed for times of nicotine cravings and your need for increased mental and physical focus.
  • NiP is a unique, safe alternative to smokeless tobacco. NiP is designed to help people break away from the powerful grip of nicotine addiction.
  • Nip is safe, healthy and a great way to cope with the intense physical cravings of nicotine while achieving more ENERGY and enjoying the same oral gratification as a dip of tobacco.
And this is just one product's claims. I found several chew/snus alternatives including Absolut Snus (coffee based), Jake's Mint Chew (mint leaf-based in mint, cinnamon, licorice or cherry flavors), Chattahoochee Herbal Snuff (made with soy and glycerin in wintergreen, cherry, mint, whiskey, tobacco and "spitfire" flavors), and Root 100 (ginseng-based in candy and fruit flavors such as apple, cinnamon, peppermint and tangerine) all making similar claims on their web sites.

So, where is the FDA questioning the safety and efficacy of these products claiming to help you beat your nicotine addiction? Why is it legal for some of them to simply put the standard disclaimer
"These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease," (others don't even bother with the disclaimer) when that is clearly what they state the product is for on their web sites? Where is the demand for clinical trials and peer-reviewed research?

Where are the public health groups questioning the long-term effects of having these products in your mouth? Why are they not objecting to the fact that these products "look like" tobacco products and counter their denormalization campaign against tobacco? Why are the ANTZ not claiming that these fruit and candy flavors are encouraging kids to pretend to chew and that they may be a gateway to using "real" chew? How about the fact that it's sold right along side chewing tobacco in convenience stores?

Now, obviously I don't think any of those things should happen - anymore than they should for e-cigarettes. I don't want to see any alternative taken away from people who want it. It's the double standard that bothers me. 

According to this CNN report on mint snuff, dentists endorse and even hand out the tobacco-free products:

(Note the deceptive and misleading statement made by the reporter at the end. She continues the myth that nicotine and addiction is the greatest health risk by stating, "If you think dipping snuff is better than smoking, you're wrong. Chewing tobacco is highly addictive and exposes the body to levels of nicotine equal to those of cigarettes.")

And there it is: the nicotine. These other products are virtually identical in purpose to e-cigarettes, but they do not contain the nicotine. Which begs another question - then why the objection to nicotine-free e-cigarettes? They just "look like" smoking as these products "look like" chewing tobacco. And what about the addictive qualities of the caffeine in some of these chew replacements?

That is what it really comes down to - the vilification of nicotine and the belief that any "addiction" - no matter how low health risks - is the true evil.
 It's truly not about health - it's about social acceptance. 

Wednesday, November 16, 2011

Fat people - welcome to our world

In a recent Time Magazine online article, "Let’s Stop Being Passive About Fighting Obesity: It's time to embrace the same tactics that worked against smoking," public health writer Shannon Brownlee drew comparisons between smoking and obesity, calling for public health (and the public) to start treating fat people like smokers. I responded in the comments, but felt it was worth posting here, as well:

The author says, "The war on smoking worked because it made smoking shameful and the public health measures needed to fight it permissible."

In fact, the war on smoking was most successful from 1950 (when the link to lung cancer was found) through the 1980's - when public health focused on education and information, not the "shaming" of smokers. The smoking rate dropped dramatically from 44% to 26% (from 1950 to 1990.) The greatest advances in the mid to late 1980's - nicotine gum approved by the FDA, first city bans smoking in restaurants in 1987, nicotine compared to heroin (without any actual studies to support it), had very little impact in the following decade. The research on second-hand smoke came out in the 1990's, which was gleefully used to change a war against the negative health effects of smoking (to HELP smokers improve their health) into a war AGAINST smokers. The smoking rate at that time was 25%. Since the war on smoking turned from education and encouragement to a war on smokers and making smoking "shameful," the smoking rate has decreased only 5% in those 20 years (1990 to present) and has even ticked back up from 19% to 20% in the past couple of years.

The war on smoking worked for 40 years because it focused on education, developing tools for smokers to quit (finding them safer alternatives) and helping get smokers access to those tools. It relied on sound science and a true dedication to improving public health by empowering people - not controlling human behavior.

Since the late 1980's, public health has turned from trying to help smokers to battling "Big Evil Tobacco" - regardless of the health effects. The discovery that nicotine is addictive turned nicotine and addiction into the evil of smoking, rather than the health effects of inhaling toxic smoke. The science shows that not all tobacco use is equally hazardous - modern smokeless tobacco and e-cigarettes have been shown to be 99% safer than smoking, but since the anti-tobacco groups want everyone to quit, they feel justified in letting smokers think they may as well smoke, so they don't just switch to safer options. The insistence on absolute abstinence from all nicotine use, even if it has extremely low health risks, angering smokers and tobacco users by treating them as less than human, applying punitive charges, taxes and policies to smokers - all while isolating them and ostracizing them - has created a backlash.

Additionally, using junk science to justify these actions (claiming taxes, graphic labels, bans and nicotine products work, when real scientific research proves they don't or claiming smokeless products like snus, dissolvable tobacco or e-cigarettes are just as dangerous as smoking when they are 99% less of a health risk) has created distrust and animosity of public health groups. Not to mention revelations that tobacco taxes - having been raised over 2,000% in some places since 1990, because proponents claimed for every 10% taxes were raised overall smoking rates would fall 4% (yet the smoking rate has only fallen 5% overall in the same time period) - are being relied upon to balance state budgets and pay tobacco control executive salaries, which seems to be a huge conflict of interest in actually wanting to END smoking.

Is this really the model you want to apply to fighting obesity?