Tuesday 25 September 2012

That Tipp-Ex report

Clive Bates has some strong words to say about the alleged public health community's scientific jiggery-pokery on snus. Readers of The Art of Suppression will recall the 'Tipp-Ex report'—the document published by the European Network for Smoking and Tobacco Prevention which systematically downplayed the importance of snus in bringing about Sweden's rock-bottom smoking rates. Such was the scramble to uphold the scientifically insupportable ban on the product that the text was changed even after the report had been published. Last week the Swedish newspaper Aftonbladet published a photo of one of the doctored pages.


The original text (which can still be read when the text is held up to the light) made the truthful claim that smokeless tobacco has been found to increase the risk of oral cancer in America but that no strong evidence exists for users of smokeless tobacco (oral snuff) in Sweden. This is crucial because chewing tobacco in the USA is fundamentally different from Swedish snus—it has a fraction of the carcinogens, is cured differently, is in a bag and is used in a different fashion.

The sentence was changed from “An increased frequency of cancer in the oral cavity has been seen among snuff users in North America, but not unequivocally in Sweden” to “An increased frequency of cancer in the oral cavity has been seen among snuff users.” This is only the most blatant of the many changes made to this document. As Bates says...

Campaigning by so-called health groups to ban much less hazardous alternatives to smoking is dangerous, unethical, lazy with facts and utterly without regard for the people they are supposedly trying to help – see my detailed post Death by regulation. But they go to a whole new level of awfulness – evil maybe – when it is done with deliberate deception and falsification. When that happens, it becomes something much darker – in fact as bad, and as deadly, as the worst excesses of tobacco industry PR. And that is what happened – they used Tipp-ex to erase inconvenient truths in a report intended to inform science based policy on alternatives to smoking.

It is with real dismay that we have to confront the deliberate falsification of a scientific assessment of smokeless tobacco by a European ‘health’ group, the European Network on Smoking Prevention, as it was known at the time. The use of Tipp-Ex is only the absurd symbolic tip of the iceberg of deliberate knowing rejection of evidence...

I’m disgusted with these people. While you consider what has happened here, just imagine the tsunami of righteous outrage there would be if a tobacco company or those of us who support the widespread introduction of much less hazardous alternative to smoking had done similar.

Bates is, of course, in no way associated with said tobacco companies. He is Deborah Arnott's predecessor at ASH (UK) and has no reason to speak out against the anti-smoking lobby other than a sincere concern for public health. Although I greatly respect him for burning his bridges with the tobacco control lobby on a point of principle, I do not agree with him on every issue, far from it. I don't accept that the UK smoking ban was a proportionate response to the feeble evidence on secondhand smoke, for example, and I reject the whole concept of health being public in the first place.

I support the re-legalisation of snus because individuals have a right to consume any such product, especially one which is vastly less dangerous than the one they are currently consuming. Re-legalisation will almost certainly reduce rates of smoking, lung cancer and heart disease at the population level, and that is a very good thing, but that is not really my business and it is not yours either. However, the distinction between the philosophies of individual sovereignty and public health are almost irrelevant in the case of snus since re-legalisation will clearly benefit both.

Early signs of what will be contained in the forthcoming Tobacco Products Directive strongly suggest that a pro-pharmaceutical/neo-prohibition line will be toed. In May, the European Network for Smoking and Tobacco Prevention—who wrote the dodgy dossier above—wrote a letter dismissing the role of tobacco harm reduction in EU policy which is nothing more than a compilation of non-sequiturs. I copy it here from Clive's blog:

Promoting snus will not solve Europe’s tobacco problems

The arguments promoting snus put forward in the letter from Lars Ramström of the Institute for Tobacco Studies in Stockholm (“Cut out the smoke, reduce the risks”, 3-9 May) are all well known. That does not make them more valid. [Nor does it make them invalid. Why not address them?]

Tobacco control specialists in the EU do not consider another tobacco product as the solution to the smoking disaster [Many of them do. Will you address their evidence and arguments?]. The World Health Organization’s (WHO) framework convention on tobacco control (FCTC), ratified by 175 countries worldwide, including all EU member states, contains the broad strategy needed for a continuous reduction of cigarette smoking. An increased use of smokeless tobacco of any kind is not a part of that strategy. [Why not? To state the obvious, smokeless tobacco use is not a cigarette and is not smoked.]

What is included in the FCTC, however, is the fight against tobacco-industry interference on public-health policy [even if the tobacco industry has developed a product which has reduced the smoking rate more effectively than anything else?]. The importance of this fight is demonstrated by the WHO in choosing this topic as the theme for this year’s World No Tobacco Day on 31 May. On this day, the Swedish government should be shamed for its support of the snus manufacturers’ struggle to lift the ban on snus sales in the EU [Really?! You want to "shame" one of your member states—the one with the lowest smoking rate on the continent?]. If Sweden truly respected the FCTC it would not pursue this route, nor would it continue to fight constructive proposals in line with the FCTC in the upcoming EU tobacco-product directive. [This is really just a childish war between the zealous "tobacco control specialists" and the snus manufacturers, isn't it?] 

Francis Grogna Secretary-general, European Network for Smoking and Tobacco Prevention (ENSP) Brussels

One graphic shows how twisted the mentality of this little clique is (click to enlarge)...



It has been obvious for a very long time that these people care no more about health than they do about liberty. The shame is on them.





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