Fire in the Madhouse

Existentialists challenge you to buck conventional wisdom – I am not sure about, ‘conventional,’ but Tobacco Control certainly bucks wisdom. However, there is an area of existentialism which asserts that one is anything that an individual thinks she/he is. I think that this is the principle that this collection of organisations are following. Take for example…

Nicotine is deadly and very, very bad, unless, it is, ‘my’ nicotine.

Up until very recently, nicotine was thought to be highly addictive, a dangerous poison, and some (still) argue that it is carcinogenic: This, I suppose, is understandable given its close association and cofuscation with tobacco smoking, but, for the most part, it is accepted that nicotine does not cause cancer, is not so highly addictive as once thought, and, as far as the levels contained in e cigarette liquids are concerned, is  no more toxic than dishwashing liquid (and that is only the higher concentrations).  There are studies which do indicate a theoretical connection between nicotine and cancer, but they are far from conclusive.  For those of you who wish to read more about nicotine, smoking and harm click here.

Moving back a couple of years: when e cigarettes started to become popular; when the pharmaceutical giants began to feel threatened; when governments realised the impact these infernal newcomers would have on their revenues, the Tobacco Control machine ground into action. Using the funding from Pharma and governments and using their bought politicians – and bought / deceived doctors and scientists, the nicotine scare was promoted.  (For an indication of the power and influence of the pharmaceutical industry within the UK Government see, here,)  (For a general outline of the pharmaceutical industry and its methods and influence, see here. [My own blog I am afraid])  Add to this Tobacco Control links to the media and nicotine was further demonised.  For example, “Selling a Poison by the Barrel: Liquid Nicotine for E-Cigarettes,” was the headline in the New York Times of March 23, 2014.  The paper intimates that e cigarette liquid spilt onto the skin was life-threatening.  Typical of the scare stories and dramatic headlines was, “A New Warning about E-Cigarettes and Heart Attack Risk.”   This headline was generated after Chi-Ming Hai of Brown University unveiled his findings at the American Society for Cell Biology’s annual meeting in New Orleans (2013) after publication in the journal, Vascular Pharmacology.  Headlines from single studies appear to be replicated on a huge scale, from serious medical publications all the way down the line to the tabloids. The aforementioned study generated, “ It’s Not The Smoke, It’s The Nicotine: E-Cigarettes May Damage Arteries.”  And moving into 2014, still the story persists with the headline, “E-Cigarettes: Tobacco-Free, But Your Heart May Still Be at Risk: Electronic devices still carry the dangers of nicotine.” The same study was being presented as evidence:  The repetition of headlines all over the world was not slowed by the counter arguments of some of the world’s leading experts on the topic – was not slowed by the irrefutable evidence provided over many years of snus use in Sweden, but I am afraid that the facts do not seem to matter when weighed against the power of the media and the ability of industrial giants to fund both the ‘research’ and then the subsequent, massive media campaigns. Carl V Phillips sums things up very succinctly, here.

 

But the debate over the issue of potential risk by nicotine is secondary: the objective here is to demonstrate the hypocrisy ingrained in the pharmaceutical industries’ campaign against e cigarettes, via, of course, Tobacco Control.

Who or what is Tobacco Control?

Following on from the work of Richard Doll who publicised the causal link between smoking and lung cancer in 1952, there were moves to curtail smoking but this was not wholly satisfactory.  This was followed by the creation of the World Health Organization Framework Convention on Tobacco Control or FCTC for short. This is a treaty where nations have signed up to follow certain protocols. For an overview, click here. The FCTC control and encourage most of the myriad of research, educational, publicity, medical and governmental activities to do with the ‘intended demise’ of tobacco products. This, in short, means that any organisation whose stated aims are ‘seeing an end to the use of tobacco products,’ particularly if they are influenced and / or funded by government, or, are influenced and/ or are funded by organisations who are influenced and / or funded by government.  Complicated, is it not? But it means that just about any organisation that stands in opposition to tobacco use is part of Tobacco Control. But where does this leave the pharmaceutical industry? Never forget the pharmaceutical Industry: never leave them out of the equation.

National governments provide funding, but there is a great deal more… in fact, so complex it cannot be addressed by me effectively, however, if you wish to examine the money trail, click here. Enough said that the pharmaceutical industry pumps billions upon billions into Tobacco Control. In fact, I would go as far as to say that Tobacco Control groups ARE the pharmaceutical companies: Well, maybe not, but pharma certainly appears to be the puppet master. But here is the odd one – the tobacco companies also support Tobacco Control. Here.  And, back to the pharmaceutical industry, they support cigarette smoking – that’s right…. Pfizer had the following to say about its relationship with Heartland, “Our company and its stakeholders derive significant benefits from our involvement with these organizations, which help advance our business objectives related to healthcare policy.”  You can read about heartland’s stance on smoking here. It is a right old mess, but I will leave you to work out for yourself why pharmaceutical companies support both anti-smoking and pro-smoking organisations.  Now back to nicotine.

The American cancer Society had this to say about nicotine in e cigarettes, “We do know that electronic cigarettes are designed to deliver nicotine, and nicotine is addictive. This strongly suggests that e-cigarette use will lead to dependence, unless the user weans him or herself from them. Fair enough comment, I suppose, if, nicotine is ‘highly addictive.’ But look at what the same article goes on to say, “There are proven methods available to help people quit, including pure forms of inhalable nicotine as well as nasal sprays, gums, and patches.”  So, it would seem that e cigarette nicotine is addictive, BUT NRT nicotine is not. Warning! The article also contains the usual rubbish, i.e. Anti-freeze found in e cigarette:  It quotes the CDC study on youth usage – That is the one where the headline was a huge increase of young people using e cigarettes but forgot to mention a huge corresponding decrease in cigarette smoking. Well, they did mention it – a year after the headlines. Similarly we read about youth e cig usage in 2014, here. The CDC press release can be found, here.  I have added this to demonstrate how unreliable much of the criticisms about e cigarettes are.  The same applies to warnings about nicotine’s effect on the lungs and the heart. How is it possible for warnings to be issued about nicotine in e cigarettes on one hand, and claims of safety on the other when applied to their own products?  According to the opponents of e cigarettes – sorry – the pharmaceutical industry via the opponents of e cigarettes, nicotine is very, very bad, unless it is their nicotine.

Propylene glycol is harmful and very, very bad, unless it is, ‘my’ propylene glycol

This substance is used in many products and is generally considered to be safe. However regular inhalation via e cigarettes is a new phenomenon and opponents of e cigarettes, Tobacco control – sorry – the pharmaceutical industry via Tobacco Control have made it sound absolutely terrifying.  Right from the beginning the organisations and groups under the Tobacco Control umbrella have screamed (and yes, ‘screamed,’ is the operative term) that e cigarette liquid contains anti-freeze. Here they are talking about propylene glycol.  On the 22^nd July, 2009 the FDA issued a warning that e cigarettes contained antifreeze. From that point, to this day, approximately six years later, the story persists. This is despite the truth of the matter having been revealed.  

One of the most outrageous examples of the demonization of propylene glycol was when Chest Journal, the official journal of the American College of Chest Physicians, published a report entitled, “An Unexpected Consequence of Electronic Cigarette Use.”  Here, e cigarette use was blamed for causing lipoid pneumonia. This was totally rubbished as was a second similar report from Spain.

Now, I am not a scientist or doctor, in fact I have only a modest education, yet, if you look closely at the Chest report you will see that the doctors make the ‘schoolboy’ error of thinking glycerol is a lipid (and I would not have known that) but, they fail to find the real cause of the illness.  Now (again) I think I can – I am not saying this because I wish to boast, though I am feeling rather smug. I am using it to point out that the doctors did not just make one glaring mistake, they made two. I am using it to demonstrate how prejudice can blind, even an expert mind, where something can be so very obvious, but is missed.  The Chest article states, right at the beginning….

Any scientists and doctors reading this will see in an instant the potential cause for the woman’s condition – I had to work my way through them.  I wish they had put, ‘albuterol metered dose inhaler,’ at the beginning of the list. Here, on investigation I came across one of the ingredients… oleic acid… a lipid.  So how did these doctors make a silly mistake in classifying glycerol as a lipid and on top of that, fail to see the real cause (if it was such)?

It happened because they were so blinded by their prejudice they failed to see what even a rank novice, worse, someone with no scientific training whatsoever could see. The article ends with the comment that the woman’s condition cleared after withdrawal from e cigarettes, but, would her inhaler not have been withdrawn as well?  It appears to me that the woman’s recovery was down more to good luck than anything else.

Nonetheless, the story hit the headlines

It would therefore seem that medically approved devices with propylene glycol can result in lipoid pneumonia but they are ok,however, e cigarettes which contain propylene glycol are not… unless… they are medically approved e cigarettes or similar. For example, the new Voke produced by a tobacco company and making its way, so far with success, through the MHRA maze of regulation, and, the existing NRT spray.

Using devices where one looks like smoking is setting a bad example and very, very bad unless it is, ‘my’ device one is using.

I am tempted just to write, ‘ha-ha, ha-ha, ha…,’ here but I will go one better.  It would appear that Tobacco Control, sorry, the pharmaceutical industry through Tobacco Control, have not got the intuition / common sense of primary school children. A recent, albeit, small study was conducted in New Zealand where young children were asked what they thought when they were shown e cigarettes being used. At first they confused the devices with smoking, but many did note differences such as the fact that they were not being lit up before use and that they were being placed in the users pockets in between puffs. The net result of the study was that when the youngsters understood what the devices were and why they were being used, they thought that e cigarettes were a good thing: “they should normalise quitting behaviour.”

I have mentioned the Voke which is soon to be presented as a medical device and, in all honesty it cannot be mistaken for a tobacco cigarette. This is the Voke

As you can see, it is nothing like a real cigarette.Here, on the other hand, is an e cigarette of the kind the regulators and Tobacco Control, sorry, the pharmaceutical industry through Tobacco Control, will see an end to. You will note the similarities of the device and a tobacco cigarette.

“Looks like smoking” – are they nuts?

 

 

 

Toasters are very, very bad and must be banned unless the toast is produced without first heating the bread.

One of the main selling points of the Voke is that it operates without heating. In the advertising blurb this is emphasised. It is no coincidence that some (very bad) studies and articles have been appearing lately arguing that formaldehyde and metals have been found in e cigarette vapour.

A report was published in the New England Journal of Medicine claiming that, at high temperatures, more formaldehyde was produced by e cigarettes that from conventional tobacco cigarettes. And, once again the media latched on and the news was spread around the globe.  There were, however, a number of weaknesses and these were highlighted by Dr. Konstantinos Farsalinos. Here.  Without going into the detail (the link is there for you) no one in their right mind would use an e cigarette at the temperatures suggested in the original study.

 

This is the equivalent of what the researchers produced and vapers would no more use e cigarettes at the temperatures needed to produce the toxins discovered any more than you would eat burnt bread like this. But the results of studies like this, and I include inaccurate conclusions and fear inducing tabloid style headlines as, ‘results,’ are part of the case being made against e cigarettes and vaping.

Products of an established level of safety are not safe and very, very bad because they are not proven to be such:  The medical product is of a proven level of safety, because we say so.

Medicalised devices are approved in the UK by the MHRA. Many countries have similar organisations to control medical products. The claim is that licencing by the MHRA ensures safety – does it really. On the other hand e cigarettes have been adequately demonstrated to be 95% – 99% safer than conventional cigarettes. They are nearly always used by cigarette smokers looking for a safer alternative.

Virtually every single study conducted by world experts either establishes a relative level of safety or fails to establish any real danger. I have not come across anything which would prevent me from vaping and I have read a great deal over the last two or three years.

I would go as far as to say that the MHRA cannot be trusted any further than the FDA and CDC in the US on their commentary about e cigarettes.  The pharmaceutical industries’ hold on government is just too great: their pockets are just too deep; history demonstrates a catalogue of errors and sometimes even deliberate deception by pharma in order to sidestep the regulation supposedly supervised by regulatory bodies – indeed these organisations designed to protect us have been subjected to so much ‘creep,’ I do not consider them to be anything more than extensions of the pharmaceutical industry itself.

A 1914 UK Government Select Committee had this to say,

“After careful consideration of the evidence laid before them your Committee find: That there is a large and increasing sale in this country of patent and proprietary remedies and appliances and of medicated wines. That these remedies are of a widely differing characters, comprising genuine scientific preparations;  unobjectionable remedies for simple ailments; and many secret remedies making grossly exaggerated claims of efficacy… That this last-mentioned class of remedies contains none which spring from therapeutical or medical knowledge, but that they are put upon the market by ignorant persons, and in many cases by cunning swindlers who exploit for their own profit the apparently invincible credulity of the public.  That this constitutes a grave and widespread public evil…”

And nothing much has changed.

The 2014 UK Government Select Committee has this to say,

“These problems … reflect its (Pharma’s) influence. People have been taking ineffective and harmful medicines for centuries. However, there is reason to fear that the industry has positively nurtured anxieties about ill-health. The fundamental problem, it is alleged, is that the industry is increasingly dominated by pressure from its investors and the influence of its marketing force and advertising agencies rather than its scientists. The industry is hugely influential, affecting every aspect of the medical world, including prescribers, patients, academics, the media, and even the institutions designed to regulate it. Its influence in Parliament is extensive.”

For a humorous overview of pharma high jinks, click here.

And when a regulatory organisation claims ‘safety,’ is it really: This from the US. “The FDA buries evidence of fraud in medical trials.” Here

Or how about, “The extent of industry influence over drug regulation, at the expense of other interested parties suggests that the current system could be more robust.” ‘Suggests … could be?’    Well, it is The Lancet after all. Here

Then we have, “Institutional Corruption and the Pharmaceutical Policy.” This from Marc A. Rodwin Professor of Law, Suffolk University Law School: Here.

There is so much more but I think the above is enough to establish that, ‘safe,’ from the MHRA or other regulatory organisations does not actually mean, ‘safe.’

 

A tobacco product is a medical product when something which is not a medical product has to be considered a tobacco product, (Not too sure which one, or both, or none, is very, very bad, but, in the spirit of the madhouse, who cares!) but if the product is not a medical product, OR, a tobacco product it must be very, very bad, because it is neither, OR, it is very, very good. (For much the same reason)

I am still trying to work out what I mean by this. It has to do with early attempts to maintain that e cigarettes were medical products with the subsequent legal challenges and the realisation that they could not be classified thus, then the claim that they are tobacco products which they are patently not, and now the production of a tobacco product, which it is patently not, where the MHRA are classifying it as a medical product – see what I mean?

Anyway, it is a consumer product. Simple really!

A pharmaceutical company is still a pharmaceutical company even when it is a tobacco company, or is it the other way round?

A little dig at pharmaceutical companies which have interests in tobacco companies and vice versa.

 

ANYWAY

 

Would someone call the emergency services, there is a fire in the madhouse.