Tuesday 21 April 2015

Vaping in the USA: When the lie's so big

Not a day goes by without some outrageous lie being told about e-cigarettes in the USA. America is currently in a league of its own when it comes to vaping deceit and I simply don't have time to write about it all. Many readers will already be familiar with the $75 million crusade of misinformation in California and the false portrayal of a smoker as a vaper in an attempt to con people into believing that e-cigarettes will make your lungs collapse. It is also worth reading Carl Phillips' account of the recent farce involving the FDA who were asked to make the warning labels on Swedish snus bear some relationship to reality.

It all boggles the mind and I hope someone is taking names and numbers for the inevitable reckoning in a few years time when these frauds will, I hope, be held accountable for their actions. Though far from being the most blatant attempt to mislead, this infographic from the FDA is also worth flagging up.

Amongst the most prominent lies about e-cigarettes is that (a) they don't help people quit smoking, and (b) they encourage young people to start smoking. It is no longer good enough to repeat the "we just don't know" mantra of years gone by. We have plenty of evidence—more of which was published this week—for us to know that these are lies.

An interesting question, less easily resolved, is whether e-cigarettes help to prevent smoking by getting would-be smokers to vape instead. For the fanatics, any evidence that young non-smokers experiment with e-cigarettes—which some will, of course—is evidence of a fictitious 'gateway effect' or is a terrible thing because it gets youngsters 'hooked' on nicotine (which has hastily and falsely been redefined as the scariest ingredient in cigarettes, rather awkwardly for the pharmaceutical industry).

Circumstantial evidence is all we can hope for when looking at would-be smokers because we don't know they are. We know who the smokers are, however, and we know who the vapers are, so if vaping rises sharply and smoking falls sharply there is a good a priori case for assuming that the former led to the latter.

That is exactly what has happened in the USA in the last few years and the wingnuts of 'public health' hate it because it not only scotches their gateway hypothesis but it suggests a prophylactic benefit too. The unavoidable conclusion is that high school students are vaping instead of smoking and that this is a good thing if you are concerned about public health rather than 'public health'.

How has the FDA's Center for Tobacco Products responded? By redefining e-cigarettes as tobacco products, of course, thereby pretending that nothing has really changed...

Click to enlarge, but the key point is that cigarette smoking fell dramatically between 2013 and 2014 at the same time as e-cigarette use rose dramatically. The FDA merely says that "there was no decline in overall tobacco use by students". This bare-faced lie is based on the ridiculous premise that e-cigarettes are tobacco products.

Elsewhere in the infographic, they claim that "more than 4.6 million students reported being current tobacco users". No they didn't. If they had been asked "are you a current tobacco user?" most of them would have said no because, er, they're not. The FDA finds that 2.4 million of their "current tobacco users"—ie. most of them—are actually regular or occasional users of e-cigarettes.

A decline in smoking prevalence from 15.8 per cent to 9.2 per cent in just four years would be something to cheer about if your mission was to improve the health of the nation. It's quite clear that whatever priorities the Center for Tobacco Products has—and pointless regulation seems to be the main one—the health of the nation is not amongst them.

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