“Lovejoy’s Law”

Or, when used by health advocates against the use of e cigarettes, the twisted nature of the cry, “Think about the children.”

In 1996 Helen Lovejoy, a character in the TV programme, ‘The Simpsons,’ pleaded, “Won’t someone please think of the children!” This has become known as Lovejoy’s Law.  This is a plea which has been made repeatedly, not just in the TV programme, but by individuals and organisations opposed to the development and public use of e cigarettes.

There are two purposes for the use of the plea, ‘think about, or, what about the children.’ One is legitimate for use in reasoned debate – the other is not. It is legitimate to use the question to draw attention to the plight of children:  It is not legitimate to use it to detract from logical argument and where it becomes an appeal to emotion.  So when Anti-Smoking organisations and health bodies take up the cry, “Think about the children.” How exactly is it being used? Is it part of a reasoned debate on the topic of e cigarettes, or is it an appeal to emotion – a logical fallacy?

The history of the appeal goes back, back before the popularity of e cigarettes had been established, in fact, before the opponents of e cigarettes had even heard of them, and, ironically, to a time where they were wishing that they did exist. That is correct: The very same people who object to vaporisers now, when they were dreaming as if they were something out of science fiction, had once placed them at the top of their wish lists.[i]

In October 2008, Action on Smoking and Health, produced a document called, “BEYOND Smoking Kills.” It was funded by The British Heart Foundation and Cancer Research UK. It was endorsed by a mass of health organisations and charities, and by many local authorities.  It is, however, the sub-title I find interesting: “PROTECTING CHILDREN, REDUCING INEQUALITIES.”

This is where they, and we, I am afraid, get into a bit of a muddle. You see, based on conventional wisdom – based on what was truly believed to be the dangers of smoking cigarettes (and second hand smoke)[ii] by ‘those in the know,’ to demand that we, ‘think about the children,’ was legitimate, rational and logical. However the same document advocates… as a future means to protect the children… the e cigarette… but not in so many words.  So, if, now, the e cigarette is a threat and we must, ‘think about the children’ in the face of this threat, how can it be that the people advocating this were, at that time, praying for the very thing that has been developed to fit their criteria[iii],… the e cigarette… as a means of protecting the children?[iv]

So the e cigarette was a means of protecting children then, and is a threat to them now? Hardly!

In fact, what we have is the same argument being presented in favour of two very different scenarios. The problem is that it just does not seem like two different scenarios.

And this is the crux of the matter. This is why I have presented to you what is contained in the document, “Beyond Smoking Kills.”  The appeal, “think of the children,” was based on a genuine desire to save countless lives where young people were being attracted to a deadly habit. However, when applied to e cigarettes the same does not hold true.

Children are not being ‘attracted’ and the activity is not ‘deadly.’ There is no evidence to suggest that children, who are never-users of cigarettes, are taking up and using e cigarettes. We have to be careful with statements like this, for two reasons. There is an important difference between the terms, ‘using,’ and, ‘trying,’ and that never-users of tobacco cigarettes, may, in the future, begin to use e cigarettes.  I wish to deal with these separately.

That there is a difference between, ‘using,’ and ‘trying:’ to see the importance of making a definition between the two words, look at an early CDC report which confused the two. On the 5^th of September 2013, the Centres for Disease Control & Prevention (CDC) issued a press release. The headline and sub-heading screamed, “E-cigarette use more than doubles among U.S. middle and high school students from 2011-2012. More than 75 percent of youth users smoke conventional cigarettes too.”[v]  (You will note that I used the word, ‘screamed’ here. It is an emotive term, and, as previously stated, emotion is a powerful tool when trying to convince someone about something – the question you have to ask is, ‘is the use of the device justified?)

Well, in the case of this headline, I think I can justify the use of the word, ‘screamed.’ The first reason is that this press release was taken up world-wide by the press. The story was a dominant one. Newspapers, television and radio all over the world featured it. But it was the emotion which carried the story, not the substance. The report itself did nothing to support the headline. As Carl V. Phillips stated, “The biggest lie is that they report nothing about use.[vi]  All the reported statistics are about trying the products.” There is a great deal more wrong with the headline but the confusion between, ‘using,’ and, ‘trying,’ is my main concern here. Enough to say that e cigarette use had not doubled as the headlines claimed, but the news was out, and it was believed. The emotive message had carried the day.

That young people who have never smoked but who might, in the future, take up e cigarette use is not really a concern either. I would argue that it is to be expected. It is just common sense. It is common sense to expect that among the young people who might be attracted to smoking cigarettes, some will prefer the safer option – but this does not mean that they will go on to smoke tobacco. In fact, why would they? If they enjoy the experience of using e cigarettes, why move over to something which is less enjoyable, and a damn sight more dangerous, and, if they do not enjoy the experience, why try something worse? But the public, generally speaking, cannot see this – they are blinded by emotion: the e cigarette in many minds IS smoking; IS evil; IS dangerous. That e cigarettes might be replacing tobacco smoking actually does seem to be the present trend, though be careful, just because one set of figures is rising does not necessarily mean that this is the reason for the fall in the other – but it looks that way.

I think that one of the better arguments that I have come across is contained in Kristin Knoll-Marsh’s blog which compares the emotion surrounding young peoples’ use of e cigarettes to the furores over sex education and use of condoms. As she states, “They also wring their hands over youth use, worrying loudly that kids will try e-cigarettes and then move on to the more risky behaviour of smoking. (Like anti-safe sex folks argued kids learning about safe sex would lead to more un-safe sex, leaving many people scratching their heads with that logic.) However, after 10 years on the market and increased use by (mostly smoking) youth being widely reported, CDC statistics show that youth smoking continues to decline significantly: Worrying over increased youth use of e-cigarettes while smoking rates are declining is akin to worrying about more teens having sex using condoms while STD and unwanted pregnancy rates are declining.”[vii] (Highlight mine)

But, as it used to be the case with the issues surrounding young people with regard to sex, so it is the case now with the young and e cigarette use.

The users of the phrase, ‘think about the children,’ when applied to smoking, and then to vaping, have found themselves lost in an ethical maze. Happily some are beginning to find their way out. Some of the major anti-smoking organisations and charities are now speaking out against the imposition of banning use in public places[viii]

But we must, ‘think about the children.’ Well, when thinking about children, is it not an idea to see what they think, or do you see them as mindless, naïve and in need of guidance for every step they take? This image of children certainly does not show in a recent New Zealand study which looked at the perceptions of Maori junior school pupils with regard to e cigarettes.[ix] The result of this small but very important study, demonstrates that far from seeing e cigarettes as something that could act as a gateway to smoking, they were seen as the opposite. It was recognised by the little ones (and they were little and not older children)that e cigarettes were being used as an escape from smoking – where does this leave the argument that e cigarette users should be hidden from sight to protect the children?

It is always a temptation in the face of the, ‘think about the children,’ demand to respond by arguing that e cigarettes do not present the children with any threat, however, there is actually no need to do this. As stated at the beginning, there are only two reasons for using the phrase; one is a genuine desire to protect the children from a threat, and the other is to cover up the fact that a threat does not exist. I hope you can see the problem here – if a threat does not exist, how you establish something which is not there? This being the case, one is forced to discuss the alleged danger. All the opponents of e cigarettes have to do is exactly what we have witnessed them doing right from the start, produce a string of unfounded claims, irrespective of the fact that they are not evidenced and use the media to publicise it. A newspaper does not need evidence, just someone to say something… but the damage is done.

The tiny apology, months after the initial publication of the story, does not undo the damage. Here, the readers of the original article have not seen the apology and are convinced that e cigarettes do harm, and added to this they feel the heavy weight of responsibility to protect the vulnerable little ones in our society from this danger. There is no debate now. Any argument to say that e cigarettes do not present danger must not be tolerated, and the ‘evil’ advocates for e cigarette use must be silenced. We must, ‘think about the children.’

Whenever you hear or read, we must, ‘think about the children,’ ask yourself, why this demand is being made. Is it genuine, or is it an attempt to cover the fact that no real danger or threat exists and that the ‘children’ argument is being used as an emotive red herring?

[i] The harm of tobacco can be reduced by helping smokers to quit, reducing exposure to secondhand smoke

and preventing people from starting smoking in the first place. For heavily addicted smokers who are

currently unable or unwilling to quit, there is also the possibility of switching to pure nicotine products (which,

like the current medicinal products on the market, contain only nicotine and not other tobacco derivatives).As smoking is responsible for half the difference in deaths across socio-economic groups, tobacco control also has a major role to play in reducing health and social inequalities. These aims are profoundly inter-linked. Children who live with parents who smoke will breathe cleaner air, and be less likely to become smokers themselves, if their parents quit or switch to pure nicotine products. Poor families will also benefit from the financial savings of quitting.

http://www.ash.org.uk/beyondsmokingkills

[ii] For those who do not agree with the argument that second hand smoke presents a danger, do you see how powerful the emotive argument becomes? The same will hold true for those who do believe in the danger from second hand smoke. My wording casts doubt on this and I would ask you to think about your response when you read it.

[iii] A commercial nicotine products designed for long-term use as a replacement for smoking. http://www.ash.org.uk/beyondsmokingkills Chapter 8.

[iv] Smoking prevalence is declining but not fast enough. Too few people successfully quit every year and too many people start smoking. New ways of driving down smoking prevalence are needed. Smokers are addicted to nicotine but are harmed by the tar and toxins in tobacco smoke. It is therefore possible for smokers who are currently unable or unwilling to quit to satisfy their nicotine craving at much lower risk by switching to pure nicotine products (which, like the current medicinal products on the market, contain only nicotine and not other tobacco derivatives). Although these products are not 100% safe, they are many orders of magnitude safer than smoking. Given the higher levels of addiction among the most disadvantaged smokers, the promotion of wider access to pure nicotine products as an alternative to smoking is an important means of tackling health inequalities.

Currently pure nicotine products are not attractive to smokers as direct replacements for cigarettes as they do not mimic the speed and intensity of nicotine intake that a cigarette provides. Regulation difficulties inhibit the development of more efficient and effective pure nicotine products. As a result, the most toxic nicotine products – cigarettes – are barely regulated while the safest products – medicinal nicotine – are highly regulated.

If they are to compete with tobacco products, pure nicotine products must be sold on equal terms or better: pricing should favour pure nicotine products over tobacco. Public education is also needed as many smokers (and health professionals) have a poor understanding of the relative safety of pure nicotine products including nicotine replacement therapy.

Recommendations

➣ Develop a strategy and an appropriate regulatory structure to improve the acceptability, attractiveness and accessibility of pure nicotine products for use as an alternative to smoking for those who are currently unable or unwilling to quit.

➣ Encourage commercial development of pure nicotine products designed for long-term use as a replacement for smoking.

➣ Develop a communications strategy to counter public misunderstanding of the health impacts of nicotine. This should promote nicotine replacement therapy for quitting and encourage the longer-term use of pure nicotine products as alternatives to tobacco.

➣ Tax pure nicotine products at the lowest rate of VAT.

➣ Evaluate the cost-effectiveness of providing pure nicotine products free on prescription to smokers for as long as they are unable or unwilling to quit.

➣ Increase investment in research into the long-term impacts of nicotine.

http://www.ash.org.uk/beyondsmokingkills Chapter 8.

[v] http://www.cdc.gov/media/releases/2013/p0905-ecigarette-use.html

[vi]The headline of the press release manages to fit in one lie and two misleading claims, “E-cigarette use more than doubles among U.S. middle and high school students from 2011-2012″.  The biggest lie is that they report nothing about use.  All the reported statistics are about trying the products, perhaps only once, which is obviously not the same thing (and CDC knows this).  Some statistics reported are for “ever having tried” and the others are “tried at least once in the last 30 days”.  They misidentify anyone who has tried in the last month as a current user, which is a rather blatant lie.  (Of course, some of those who tried recently may well actually be users, but there is nothing in the report that lets us conclude that even one single student is actually an e-cigarette user.)

The second sneaky lie was listing “middle school” ahead of “high school” even though the results for the former are trivial.  But it is scarier to imply that this is mostly about 12-year-olds and not 18-year-old high school students, isn’t it? http://antithrlies.com/2013/09/07/cdc-lies-about-kids-using-e-cigarettes/

[vii] http://wivapers.blogspot.co.uk/2014/12/are-e-cigarettes-are-new-condom.html

[viii] ASH recognises that whilst efforts to help people stop smoking should remain a priority, many smokers either do not wish to stop quit or find it very hard to do so because of their addiction to nicotine. For this group, nicotine containing products which have been properly regulated to ensure product safety, quality and efficacy should be available as an alternative to tobacco.

Most of the diseases associated with smoking are caused by inhaling smoke which contains thousands of toxic chemicals. By contrast, nicotine is relatively safe. Electronic cigarettes, which deliver nicotine without the harmful toxins found in tobacco smoke, are a safer alternative to smoking.

In addition, electronic cigarettes reduce secondhand smoke exposure in places where smoking is allowed since they do not produce smoke. Nonetheless, nicotine is an addictive substance, electronic cigarettes currently available are highly variable in terms of delivery of nicotine and product quality, and smokers are uncertain about the effectiveness of the product. There are concerns, as yet unsupported by evidence, that these products may provide a gateway into smoking for children and young people. The regulation of these products, in particular with respect to their advertising, promotion and sponsorship needs to be undertaken with these factors in mind.

In the UK smokefree legislation exists to protect the public from the demonstrable harms of secondhand smoke. ASH does not consider it appropriate for electronic cigarettes to be subject to this legislation, but that it should be for organisations to determine on a voluntary basis how these products should be used on their premises

http://www.ash.org.uk/files/documents/ASH_715.pdf

[ix]Methods

Two structured focus groups and twelve individual interviews were conducted with twenty Māori and Pacific children (6–10 years old) in low socioeconomic areas in Auckland, New Zealand. Children viewed short video clips on an iPad that demonstrated an actor smoking a tobacco cigarette, sucking a lollipop or using an electronic cigarette or a nicotine inhaler.

Results

Children did not recognise the inhaler or electronic cigarette. Some children did however notice anomalies in the ‘smoking’ behaviour. Once told about the products the children were mostly positive about the potential of the inhaler and electronic cigarette to assist smokers to quit. Negative perceptions were expressed, including views about the ill health effects associated with continued nicotine intake and the smoker’s inability to quit.

Conclusions

In a context unfamiliar with electronic cigarettes or nicotine inhalers, such as New Zealand, children may misperceive use of these products as smoking. Once these products are more common and the purpose of them is known, seeing people use them should normalise quitting behaviour, something the children were very supportive of.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874641/