Boise gets it but Boston nips it

The Consumer Advocates for Smoke-free Alternatives Association, in conjunction with Jim Longden, the owner of Vapoligy (a Boise e-cigarette store) and several Boise e-cigarette users, successfully campaigned to get truthful and accurate information about e-cigarettes to the Boise City Council members, which resulted in the exclusion of e-cigarettes from ordinances which ban "smoking in bars and private clubs, near bus stops or other transit areas, on outdoor commercial patios accessible to children or on public property, at the Grove Plaza, on 8th Street from Bannock to Main streets, within 20 feet of a City of Boise-owned building and in other public locations" and "within 20 feet of the Boise Greenbelt, except in designated areas within Ann Morrison and Julia Davis parks and the Warm Springs Golf Course."


Mr. Longden was one of several who attended the Boise City Council meeting on Novemeber 1st and his experience supports CASAA's belief that e-cigarette users who show up to these meetings can make a significant impact.


"After the meeting we were able to talk with Councilman Thomson and Adam Park, who is the Communications Director for the Mayor and City Council," said Longden. "They were both very responsive and seemed genuinely interested in seeing an eCigarette perform even to the point where Mr. Park asked me to blow vapor in his face. They both seemed truly amazed at the lack of smell and the vapor dissipating almost instantly."


"This a significant victory. With a population of over 200,000 people, Boise is now the largest city in America to remove e-cigarettes from what was purported to be 'smoking' ban," said CASAA Director Gregory Conley. Other locales that have recently considered, and then rejected, bans on e-cigarette use, include Delaware County, Indiana and Alexandria, Louisiana," said CASAA Director Greg Conley.


Meanwhile, the news isn't as positive for Boston's local vapers. CASAA issued a Call to Action alert September 21st that the Boston Public Health Commission had proposed the Clean Air Works Workplace Smoking and E-Cigarette Use Restrictions Regulation, a prohibition on the use of e-cigarettes in the workplace, which was passed by the Commission on Wednesday. Although many members headed the call, it simply wasn't enough.


"Seeking to close a loophole on unregulated products like electronic cigarettes that deliver nicotine, the Boston Public Health Commission’s Board of Health today approved a proposal to treat e-cigarettes like tobacco products, including requiring retail establishments to obtain a permit to sell them, prohibiting their use in the workplace, and restricting their sale to adults only," the BPHC website stated.


The Commission's statement is confusing, because the public use of many smokeless "tobacco products," such as snus, dissolvables and chew, is not prohibited. Therefore, the inclusion of e-cigarettes in the smoking ban is, in effect, treating e-cigarettes like tobacco cigarettes, not just as a tobacco product.


The prohibition on smoking in the workplace is argued by public health officials as necessary to protect bystanders from the "known hazards" of second-hand smoke. However, there has been no such evidence that vapor exhaled by e-cigarette users poses any risk to bystanders. In fact, researchers and even the FDA have failed to find dangerous levels of any toxins or carcinogens in e-cigarettes tested, so there is no science-based reason to suspect e-cigarettes pose a significant health risk to the user, let alone to bystanders. Absent any scientific evidence of health risks, CASAA suspects e-cigarettes are being treated like tobacco cigarettes by the BPHC based solely on how they may "look" to bystanders.


"E-cigarettes are currently in use by approximately 2.5 million adults to eliminate or significantly reduce their exposure to tobacco smoke and there have been no reports of significant adverse health effects since their introduction to the U.S. over 4 years ago," said Kristin Noll-Marsh, CASAA's vice president. "The ability to use e-cigarettes [where smoking is prohibited] is a powerful incentive to get smokers to consider switching to these reduced harm alternatives. By approving this ordinance, the Boston Health Department is sending the message to smokers that they may as well keep smoking. How is that remotely in the best interest of public health? At least Boise [City Council] got it right."

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.
• A BETTER, HEALTHY BUZZ

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. 

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?

The E-cigarette bans

If YOU don't speak up for vapers, who will?? First they'll stick us back outside, then they'll charge us high taxes, limit our flavors, devices and strengths, stop online sales....you may as well still be smoking.

If you don't think these bans will affect you - THINK AGAIN! Don't think someone else will step up for you - you cannot afford to not be involved. Participate and/or donate, but join CASAA today!

Medsafe in New Zealand apparently banned cigarettes

According to a recent news story by 3 News in New Zealand, "Medsafe has ruled that nicotine for inhalation is a medicine and insists that more research needs to be done before they can be sold in New Zealand." Based on this criteria, cigarettes - which deliver nicotine (along with 4,000+ other chemicals) for inhalation - are a medicine and are banned for sale.

Curiously, this is not actually the case. While cigarettes, which deliver nicotine for inhalation and are clearly hazardous to public health, remain legal to sell, e-cigarettes containing just nicotine and no toxic levels of any chemicals are banned for sale there.

"It's a start but there's a way to go before, really, there's going to be enough information for us to know about how safe these products are and how effective they are," said Dr. Stewart Jessamine about e-cigarettes.

Dr. Stewart seems to have forgotten that smoking "is the leading cause of preventable death in New Zealand, accounting for around 4300 to 4600 deaths per year." These 4600 smokers obviously could not or would not quit using Medsafe-approved "nicotine medicine" products and will continue to smoke, so why is Medsafe not fast-tracking the research and approval of a product which contains just 3 low-risk main ingredients: nicotine, propylene glycol and food flavoring? A product which has been on the market - world-wide - for several years without any reported serious adverse affects or deaths? How "safe and effective" do they need to be proven to try to prevent those 4300 to 4600 annual smoking-related deaths? How long is "a way to go" to get the information they need? One year? Two years? Or rather just 4600 more deaths? Just 9200 more deaths?

The good news from the article is the study being done by Dr. Chris Bullen at Auckland University, which will hopefully contribute to the reversal of not only Medsafe's e-cigarette policy, but other irresponsible e-cigarette sale bans currently in place around the world.

“We are going to recruit 650 people in New Zealand for this trial, so we think at the end of this study, the evidence will suggest one way or the other, do they help people quit smoking,” said Bullen.

The news piece also included little-publicized information about New Zealand anti-smoking campaigner Dr. Murray Laugesen, who has completed his own tests on e-cigarettes and is convinced that they cause less harm than traditional cigarettes.

"All around the emmissions score for e-cigarettes is about less than 1% of what it is for...an ordinary cigarette," Laugesen said.

Hundreds of thousands of e-cigarette users are reporting success switching from using hazardous traditional cigarettes to e-cigarettes without serious adverse events. Even if they only worked for half of New Zealand's smokers or had only 50% of the health risks of smoking, that could mean 2300 prevented smoking-related deaths a year or more. E-cigarettes can't possibly be any less effective than Chantix (Champix,) with a failure rate of 86% after 12 months nor more dangerous, with hundreds of Chantix-related suicides, murders and heart attacks reported; in the nearly identical time period e-cigarettes have also been on the market with no reports of serious adverse events. In spite of the increasingly obvious unknowns of Chantix, Medsafe continues to endorse its use, while banning another product which has shown no evidence of safety issues.

Luckily, in the U.S., the FDA was stopped short (by court order) of being able to follow in Medsafe's footsteps and treat e-cigarettes as a nicotine medicine, rather than what they really are - a much, much safer alternative to smoking for people who cannot or will not quit using "nicotine as medicine." As a result (and in spite of numerous ANTZ and FDA scare tactics) hundreds of thousands of U.S. smokers have access to a much safer product and are now smoke-free. CASAA is working to keep it that way.

Safe sex vs. Safe tobacco

In the 1980's, public health groups began campaigning for "safe" sex. These campaigns promoted the use of condoms to reduce exposure to HIV and AIDS and continue to be used today to promote reduced exposure to other dangerous and debilitating sexually transmitted diseases (STD).

Rarely are the public health benefits of reducing health risks via "safe" sex questioned, even though "safe" sex is a misnomer. A 2001 NIH panel of experts examined dozens of studies and found that proper and consistent condom use reduced the incidence of STDs by 18% to 92%, depending upon the disease in question. At best case, that still leaves an 8% health risk for "safe" sex practices. For the human papilloma virus (HPV) - which has been linked to cervical cancer, the fifth most deadly cancer in the world for women - the harm reduction is even less. 

In reality, condoms contribute to "safer" sex, but do not cause sex to be 100% safe. This does not stop public health groups from promoting "safe" sex to the public and the majority of us agree that it's better to be safer, even if it's not 100% safe. Millions are still spent promoting safe sex practices, even though STDs rarely result in death. In fact, it's reported that 80% of those infected with STDs are asymptomatic and not even aware that they are infected. The CDC reports that around 18,000 people with AIDS and approximately 4,000 women with cervical cancer die annually.

On the other hand, the CDC and other health groups report that "tobacco use" (or more specifically, smoking) causes 440,000 deaths annually in the U.S. (including the highly debated second hand smoke deaths.)  Compared to smoking deaths, mouth cancer, the main health warning for smokeless tobacco use, contributes to only 8,000 deaths annually. However, according to the National Cancer Institute, researchers have been unable to determine how many of those deaths are actually caused by smokeless tobacco use. Based on one 1981 study of female chew users in the southern U.S., the NCI reports that "users of smokeless tobacco are at four times the risk of developing oral cancer than non-users." More recent research shows that smoking actually causes twice the risk of oral cancers (compared to smokeless) and factors such as alcohol abuse and dual use of smoking and smokeless seem to have reduced the link to oral cancer caused by smokeless use alone even further. In fact, the scientific research overwhelmingly shows evidence that smokeless tobacco carries very little to no health risks, at or less than 1% compared to never-users.

In spite of knowledge of this widely known research and the ready acceptance of harm reduction practices for less lethal STDs, public health officials refuse to acknowledge the obvious potential health benefits of promoting harm reduction in the form of smokeless tobacco products. In fact, they go out of their way to convince the public (and smokers) that smokeless products are just as deadly as smoking. While condoms, with a contribution of lowering health risks 18% - 92%, are required by the FDA to inform the public that condoms reduce the risk of STDs, smokeless tobacco products are required to display health warnings such as "This product is not a safe alternative to smoking," or "This product causes oral cancer." Rather than informing smokers that switching to smokeless tobacco would reduce their health risks by 99% or greater, the FDA actually prohibits smokeless tobacco companies from informing the public and forces them to misrepresent the comparative risks, causing the 440,000 people who die from smoking annually to believe that they may as well keep smoking.

Additionally, public health groups continue to lobby legislators to limit or outright ban and/or apply unwarranted "sin taxes" to smokeless products such as snus, lozenges, sticks and strips, claiming "no safe tobacco use" and over unfounded concerns that children and smokers will flock to these less deadly products rather than eschew tobacco products altogether. The concern about youth use is particularly comical, considering that banning these smokeless products would leave no competition for cigarettes, leading curious and reckless youths to smoking tobacco instead of using smokeless and increasing their health risks by 99%. Taxing these products to make them just as expensive as cigarettes also removes further incentive for current smokers - who have no intention of quitting tobacco - to switch to smokeless alternatives.

This insane double standard of approving and encouraging harm reduction for less lethal practices and denying them for tobacco must end. The "abstinence only" approach has resulted in smoking quit rates stagnating at 20% and public health efforts to stop smokeless use as an alternative could result in that percentage increasing again as smokeless products are made less available and more expensive for smokers who have already switched. Not only must the "quit or die" approach be rethought, but public health must stop misleading the public about the health risks and start encouraging inveterate smokers to switch. If they can call an 8% health risk "safe" when it comes to sex, then a less than 1% health risk from smokeless tobacco IS a "safe alternative to smoking." The great dream (lie) of total tobacco abstinence must end. Based on the scientific evidence, the time for tobacco harm reduction must be allowed its turn.

Concerned groups such as the Consumer Advocates for Smoke-free Alternatives Association (CASAA) and TobaccoHarmReduction.org are working to promote "safer" tobacco use. For more information on Tobacco Harm Reduction please visit casaa.org.

American Lung Association continues to misrepresent smokeless risks

The ALA posted an article titled "Is There an Easy Way to Quit?" on it's web site today, which is filled with typically deceptive ANTZ tactics.

Making statements such as  smokeless tobacco has "28 cancer-causing agents" and "increases the risk of developing cancer" and that e-cigarettes contain "cancer-causing agents and toxic chemicals" found in anti-freeze is not only leaving out key information, it relies upon questionable "science" and sensationalism to deceive the reader.

Smokeless Tobacco
Smokeless tobacco includes chewing tobacco, snuff, snus and some other new products. Some people think that using smokeless tobacco is a safe alternative to smoking but that’s not the case. Smokeless tobacco has 28 cancer-causing agents and it increases the risk of developing cancer in the mouth, gums, and pancreas. The amount of nicotine that is absorbed from smokeless tobacco is 3 to 4 times the amount delivered by a cigarette.

The key information left out here is that many products we consume contain "cancer-causing agents." The question is, "How much?" Hot dogs can contain "cancer-causing agents." Whole milk can contain "cancer causing agents." Potato chips and french fries can contain "cancer-causing agents."

Yet we consider these foods to be "safe," because although the "agents" are present, the risk of actually getting cancer from them is extremely low.

While there is a "risk" of developing cancer in the mouth and gums from some smokeless tobacco, the risk is extremely small - somewhere between 0% to 4% - and smokeless snus studies have not shown any increased risk of oral or other cancers. The very few studies linking smokeless tobacco to a very low risk of pancreatic cancer have contradicted themselves, so the link remains inconclusive as to whether or not there is an actual risk at all.

Yet the ALA reports these as established facts and make it sound as though the health risks are great.

Once again the ALA has ignored scientific evidence and used inflammatory language to make something sound worse than it is by reporting the statement made by the FDA rather than the scientific evidence from the actual FDA testing.

e-Cigarettes
There is no scientific evidence establishing the safety of e-cigarettes. The FDA has found that these products contain cancer-causing agents and toxic chemicals, including the ingredients found in anti-freeze. While some distributors directly or indirectly market e-cigarettes for smoking cessation, there is no scientific evidence that demonstrates these products are safe or effective at helping smokers quit.

By this time, anyone who has bothered to read the actual FDA test results knows the truth vs. the spin put out by the FDA. The "cancer-causing agents" discovered in the e-cigarette cartridges tested were found in only one out of the 18 tested, were not found in the actual vapor that is inhaled and were at levels so low they were comparable to the levels of "cancer-causing agents" found in the FDA-approved nicotine patch.

Yet the ALA reports this as though e-cigarettes have been proven to cause cancer and hides the fact that the same levels of "cancer-causing agents" are found in the nicotine patch - which they endorse.

The inflammatory language used to describe the non-toxic amount of diethylene glycol detected (again in just one cartridge and not in the vapor) as "ingredients found in anti-freeze" is pure sensationalism. Diethylene glycol is also found in other FDA-approved products at non-toxic levels. Because the amount found in the one e-cigarette cartridge is so small and not in the actual vapor to which the user is exposed, the user would have to drink the contents of a few thousand cartridges per day in order to reach toxic levels.

Yet the ALA reports the presence of "ingredients found in anti-freeze" as though e-cigarettes have been shown to be just as poisonous as anti-freeze.

So let's see why using the products and methods endorsed by the ALA isn’t a good way to quit:

Nicotine Replacement Products (NRT)
NRTs includes nicotine gum, nicotine patches, nicotine lozenges and nicotine inhalers. Some people think that using NRT is a safe alternative to smoking but that’s not the case. NRT has cancer-causing agents and it increases the risk of developing oral cancer. The amount of nicotine that is absorbed from NRT is much lower than the amount delivered by a cigarette, which may contribute to a failure rate as high as 95%, greatly increasing the risk of relapse to deadly smoking. Nicotine is highly addictive and because these nicotine products are available over the counter to both adults and youth, they are easily abused, contributing to sustained addiction rather than cessation.


Chantix (Varenicline)
There is no scientific evidence establishing the long-term safety or effectiveness of varenicline. The FDA did not review varenicline for the usual 10 month period and it had not been tested in those under 18 years; those with mental illness or pregnant women and therefore is not recommended for use by these groups. The FDA has received reports of "suicidal acts and ideation, psychosis, and hostility or aggression, including homicidal ideation, were the most prominent psychiatric side effects. Multiple reports suggested that varenicline may be related to the loss of glycemic control and new onset of diabetes, heart rhythm disturbances, skin reactions, vision disturbances, seizures, abnormal muscle spasms and other movement disorders."


While some claim varenicline is "safe and effective," only 4.3% more smokers had still quit after one year compared with placebo and over 200 deaths have been linked to varenicline since its release to the public. France's government health insurance no longer subsidizes varenicline prescriptions due to questions about its safety. Canada and Australia have received more than 1,800 reports of adverse events related to varenicline as of May 2010. The number of adverse events associated with varenicline outnumber any other medication monitored by ISMP and more than twice as many deaths have been linked to varenicline than with any other medication currently on the U.S. market.

Really, American Lung Association? Compare all of that to zero reports of serious adverse events linked to e-cigarette use since they were introduced to Europe in 2004 and the U.S. in 2006.

The ALA claims that "Becoming smokefree is anything but simple, yet some folks will try almost anything that promises to a quicker, easier way to quit smoking. You can’t wave a magic wand and suddenly be done with the process of quitting." Yet millions of smokers world-wide, most of whom have tried and failed with the ALA's "safe and effective" methods, are calling e-cigarettes a "miracle" and the "easiest" method they've ever used to remain smoke-free. Sweden, where smokeless snus use is most common, boasts the lowest smoking rates in the E.U. without increased adverse health effects vs. never-smokers.

Any "fact" can be spun to appear to support an agenda. The difference is whether or not the "facts" are based on scientific evidence or if they are based upon junk science and made to sound reliable. Can you tell the difference?