Australia is a basket case when it comes to vaping. Reading newspaper
op-eds from Down Under, you would think the country had been completely
cut off from the rest of the world. Its health establishment is so
detached from reality that all you can do is laugh at it.
So let's do that, starting with this amazing editorial
from a chap called Dr Sukhwinder Singh Sohal and a lady called Dr.
Kathryn Barnsley. The former is a medic. The latter is best known for
working for various anti-smoking pressure groups in Tasmania and
recently did a PhD in Tasmanian tobacco control.
They begin
by noticing that the prohibition of e-cigarettes in Australia has been
accompanied by a black market in e-cigarettes. This is a stupefyingly
predictable outcome of prohibition, but as far as the two doctors are
concerned, the ban would have worked fine had it not been for a shadowy
force at work…
"The advocates for unregulated e-cigarette sales, say that it is causing a black market".
It is almost certainly the industry itself which is fuelling the black market.
The tobacco industry use smuggling to open new markets. This is what they are doing with e-cigarettes.
I
don’t know why the first line is in speech marks (or why there’s a
comma in it). As far as I can see, nobody has ever said this. Nobody is
arguing for unregulated e-cigarette sales and the only countries that
have unregulated e-cigarettes are countries that have banned them.
The
claim that the tobacco industry is smuggling e-cigarettes into
Australia desperately needs a citation or some shred of evidence. It
seems rather unlikely as it would require blue chip, listed companies
who have to publish their accounts to have extensive contacts in the
criminal underworld. On the face of it, this is an unnecessarily high
risk strategy for the sake of the nickel-and-dime rewards of flogging a
few vapes in Australia when they make so much money operating in the
legal market.
In any case, most vapes are not made by the tobacco
industry. All the products shown in the tweet below by the outraged
prohibitionist Simon Chapman are made by HQD, an independent company.
The photo below comes from an article
published in May which says that over $1 million of illegal vapes have
been seized in New South Wales since the start of the year. The only
brand with any connection to ‘Big Tobacco’ is Juul (Philip Morris has a
minority stake in the company).
In
the highly unlikely event that tobacco companies were smuggling
e-cigarettes into countries that have banned them, you’d think they’d
smuggle in their own brands.
To be clear, I very much doubt that
independent vape companies are in the international smuggling game
either. We can safely assume that smugglers bring in whatever vapes they
can from wherever they can.
Big tobacco has directly
engaged in smuggling all over the world, including Asia, Europe and
Canada. In Canada, they also used it to argue for tobacco taxes to be
reduced. A University of Bath report says "Growing and diverse sources
of evidence indicate that the tobacco industry remains involved in
tobacco smuggling and that TI cigarettes account for around two-thirds
of the illicit cigarette market".
Tobacco companies
have sometimes been accused of ‘facilitating’ smuggling by selling more
cigarettes in certain countries than domestic demand requires, knowing
that they might be smuggled to other countries. I don’t really a problem
with that. The cigarettes were sold legally and what happens to them
after they leave the warehouse is not their responsibility.
Others
would say that the companies were complicit and should try harder to
control their supply chain. Whichever view you take, I don’t think
anybody is suggesting that the companies are physically smuggling
cigarettes themselves.
The big tobacco plan is to get
as many people addicted as possible, especially children and
adolescents, because the nicotine alters their brain structure, makes
them addicted, then they will clamour for vapes to be "legalised" as a
recreational drug.
This is becoming a bit of a fever dream. No country is going to legalise e-cigarettes because children
want to vape. If anything, that would make the government double down
on prohibition, as has happened in Australia. This is a terrible plan!
It’s a good job there’s absolutely no evidence for it.
As
for nicotine changing people’s brain structure, do you remember being
told this as a child in your anti-smoking class? Have you ever heard
this mentioned as a side effect of nicotine replacement therapy? No. It
is nonsense based on rodent studies. As Clive Bates, former director of
Action on Smoking and Health says:
“Over
the last 60 years, millions of adolescent nicotine users have grown up
as smokers and either continue to use nicotine or have quit. The
problem for the Surgeon General and others is that there is no sign of
any cognitive impairment in the population of former teenage smokers and
many of today’s finest adult minds were once young smokers. If a
detrimental cognitive effect of nicotine existed in the human
population, it is inconceivable that we would not already have seen
extensive evidence of it from the study of smokers, non-smokers and
ex-smokers over several decades.”
There are many
things we don't know about the health effects of e-cigarettes because it
is too early in the pandemic to ascertain.
We’re two and a half years into the pandemic. Is that early? What’s the pandemic got to do with it anyway?
There are many things we do know
about the health effects of e-cigarettes, none of which are mentioned
in the article. Crucially, we know that they do not emit smoke. We know
that they do not emit carbon monoxide. We know that the Royal College of Physicians
- amongst others - concluded that the long-term health risks are
“unlikely to exceed 5% of those associated with smoked tobacco products,
and may well be substantially lower than this figure”. We know that the
lifetime cancer risks are estimated to be less than one per cent of that associated with smoking.
And we know that e-cigarettes have been around for over a decade
without a single recorded death being attributed to a conventional,
regulated vape device.
However, e-cigarettes
will likely cause head, neck and oral cancers, cardiovascular disease,
strokes, pediatric injury, and are likely to exacerbate COVID-19
respiratory symptoms.
This is quite a series of
assertions coming from people who have just said they don’t know much
about the health effects of e-cigarettes. It falls under the category of
‘asserted without evidence and can be dismissed without evidence’.
Indeed,
in a recently published study, we confirmed that electronic cigarette
condensates increase the expression of SARS-CoV-2 (COVID-19) receptor on
human lung cells.
In
Australia, e-cigarettes can be prescribed by a doctor and dispensed by a
chemist, for people who are interested in quitting smoking.
Indeed that is the only way Australians can get hold of them, but it is too much for Drs Sohal and Barnsley.
Unsurprisingly
few doctors will do this, as there are many other drugs, proven to be
relatively safe, and which have been approved by the TGA, and services
available to help people quit.
Furthermore, the evidence on successful quitting using e-cigarettes is very thin.
If
this evidence base is ‘very thin’, how should the evidence base for the
claim that vaping causes head cancer and pediatric injury be described?
Microscopic? Invisible?
One 2022 study concluded,
"The use of e-cigarettes as a therapeutic intervention for smoking
cessation may lead to permanent nicotine dependence."
E-cigarettes
are not designed to wean people off nicotine. They exist to give people
a much less harmful way of consuming nicotine. If you don’t know that,
perhaps you should keep your opinion of tobacco harm reduction to
yourselves?
Doctors prefer evidence.
And as patients, we prefer doctors who follow evidence-based medicine. Not quacks who have been "bought" by industry".
Who
are these mercenary shysters? We should be told. Alas, the authors do
not name names, presumably for fear of successful litigation.
Numerous
researchers agree that the development of electronic cigarette-related
illnesses will outweigh any short-term benefits, but the evidence for
short-term benefit is lacking. Of utmost importance, we amongst an array
of other scientists have repeatedly shown electronic nicotine delivery
devices to be toxic and in no regard a "safer" option for smoking
tobacco.
It is a shame that these ‘numerous
researchers’ are not identified because it would be interesting to see
their work. Looking at the thin publication CV of Kathryn Barnsley, I
can see no studies showing that e-cigs are toxic. Dr Sohal has
co-authored a number of journal articles about e-cigarettes but these are mostly glorified opinion pieces containing no original research and a good deal of scaremongering. I’m not aware of any study by anyone showing that e-cigs are as dangerous as combustible cigarettes. Even anti-vaping headbangers like Martin McKee and Stanton Glantz acknowledge that vaping is at least somewhat safer than smoking.
Tobacco
manufacturers can lawfully insert anything they choose, however toxic,
in their products and the same applies to electronic cigarette
manufacturers.
No it doesn’t. Here is a non-exhaustive list of some of the ingredients that cannot be put in e-cigarettes in the UK, for example: Diacetyl
Pentane 2,3 dione
Diethylene glycol
Ethylene glycol
Formaldehyde
Acetaldehyde
Acrolein
Metals, including cadmium, chromium, iron, lead, mercury and nickel
Preservatives liable to release formaldehyde.
vitamins
or other additives that create the impression that a tobacco product
has a health benefit or presents reduced health risks;
caffeine or taurine or other additives and stimulant compounds that are associated with energy and vitality;
additives having colouring properties for emissions;
Substances classified as carcinogenic, mutagenic or reprotoxic (CMR categories 1 and 2)
Substances classified with specific target organ toxicity for the respiratory tract (STOT category 1)
The
sensible thing for Australian regulators to do would be to legalise
e-cigarettes and produce a similar list, rather than tolerate Aussie
vapers inhaling whatever the people who run the black market give them.
We do not believe that substantial evidence exists for electronic cigarettes to be used as a tool for smoking cessation.
In fairness, it has already established that you don’t know what you’re talking about and that your opinions are worthless.
The risks of electronic cigarettes are far too great for them to be deemed safe to be prescribed by medical professionals.
Let’s leave that the judgement of medical professionals, shall we? Even in Australia, some of them must know more than you.
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