Tuesday, October 28, 2008

First the smoke police, now the fat police

It seems that smoking isn’t the only cause of preventable and premature death in Canada.

In a March 5, 2004 letter to then Minister of Finance, Ralph Goodale, CSPI asked for a funding commitment of $100 million to improve the overall health of Canadians and help reduce the incidence of avoidable disease. The letter was signed by Bill Jeffery, National Coordinator of CSPI which has offices in Ottawa and Washington.

CSPI, the Centre for Science in the Public Interest, is claiming that as many Canadians die prematurely each year from “diet and inactivity related diseases” as die from smoking. Health Canada’s most recent study estimates 37,209 (somewhere between 31,210 and 44,775) smoking related deaths in Canada each year.

Jeffery’s letter claims, among other things: “Concrete action is necessary to help reduce the $6 billion to $10 billion economic toll and 25,000 to 47,000 premature deaths attributable to diet and inactivity-related disease annually in Canada.

Sound familiar? It should. These are the same scare mongering tactics used to persuade government to impose punitive levels of taxation on tobacco and to implement draconian smoking bans on the smoking public. In fact, many of the solutions being proposed for the “obesity epidemic” appear to have been taken directly from the anti-smoker’s playbook.

For example, CSPI wants the federal government to underwrite a massive publicity campaign, “purchasing advertising space to promote nutrition, physical activity, and healthy body image messages on nationally televised TV and radio programs.” Naturally, implementation of these educational campaigns would be left to local non-profit health organizations.

They also want to impose sin taxes on unhealthful foods (high calorie, low nutrient) in much the same way as tobacco and alcohol. “In short, federal and provincial rules governing the taxation of food require immediate reform to ensure that they reflect health promotion priorities of the Government.”

Other recommendations include adjusting tax deductions for advertising so that companies promoting healthy, nutritional food are permitted greater deductions that those peddling junk food.

There are also suggestions to ban advertisements directed at children during those periods when they are most likely to be watching television. The advertising ban would apply to candy bars, breakfast cereals, soda pop, etc. They would also apply to video games, ads for television programs or anything else which might promote a sedentary lifestyle.

In the UK, even more severe measures are being considered.

The Daily Mail recently claimed school lunchboxes could soon be monitored to ensure children are eating healthy meals. If a lunch packed by a parent is thought to contain too much fat or sugar, they could be sent warning letters or have their child's meal confiscated.

A report commissioned by the British government from a think tank called the Foresight Project, has apparently suggested everything from “fat quota” ration cards for regulating individuals’ food purchases to shipping overweight teens off to government-mandated fat camps.

A few months back, the British Food Standards Agency rejected using cigarette-style health warnings on cheese, butter and whole milk. But, remember, warning labels on cigarette packages weren’t accepted immediately either.

In New York state (among others), government mandated “calorie counts” on restaurant menus has already led to class action lawsuits in the US for “misrepresenting nutritional content of menu items.” Some fast food outlets, including MacDonald’s, have been the target of lawsuits by individuals claiming fast foods were responsible for their obesity.

Obesity, like smoking, may be a legitimate health concern. But, should private business concerns be subjected to the threat of legal action over the eating habits of their clientele? No one forces an individual to eat at MacDonald’s or buy high fat or sugar rich foods at the supermarket.

Many people need help to control their weight. But, should the obese or overweight be subjected to the same kind of de-normalization and stigmatization as smokers?

Several freedom of choice groups have been warning that the war on smokers was just the first step down a slippery slope leading to the erosion of individual civil liberties. Few people paid any attention; after all, who wants to listen to a bunch of whining smokers.

But, they should. They might be the next target of the health scare professionals who approach each new health concern with fanatical zeal.

Saturday, October 25, 2008

Health Canada smoking statistics misleading?

A month or so back (September 24, 2008), I noted that Health Canada was reporting a significant decrease in smoking related deaths on their website. Smoking related deaths were reduced by roughly 21% (10,000 deaths) annually with the stroke of a pen. Health Canada was apparently responding to criticism that CPS-II data used to generate their previous estimates was “not generalizable to the entire US population.” They also observed that “direct application of a large US survey to the Canadian population may not be appropriate.

But, last week, I noticed the following claim on their website.

Overview of Health Risks of Smoking
More than 37,000 people will die prematurely this year in Canada due to tobacco use. Unless they quit, up to half of all smokers will die from their smoking, most of them before their 70th birthday and only after years of suffering a reduced quality of life.”

I found it a little strange that all 37,000 deaths allegedly due to smoking were “premature”. So I did a few rough calculations using the StatCan mortality tables from 2002 on which the latest Health Canada study was based. Then, I sent an e-mail to Health Canada which read in part: “I found these claims to be somewhat misleading. After a few very rough calculations, it’s quite obvious that well over 25% of these deaths occurred in the segment of the population over 80 years of age. I hardly think these deaths, which occur beyond average life expectancy, qualify as “premature”.

In addition, the claim that “most” smokers will die before their 70th birthday also tends to mislead. A quick review of the data reveals that roughly half of smoking attributable deaths from all causes occur after the age of 70, and does not support this claim."

I received a computer generated response the same day which read: “Your message has been received by the Web site administrator and is being forwarded to a subject-matter expert for consideration and a timely response.”

That was on Friday, October 17 and I haven’t yet heard from their “subject-matter expert.”

But, over the last week, I’ve had a chance to look a little closer at the data provided in the most recent study. In fact, over 31% of the smoking related deaths estimated by Health Canada occurred in the segment of the population over 80 years of age. It’s difficult to understand how Health Canada, or anyone else for that matter, could suggest that these individuals died prematurely.

For example, of the 40,000 plus Canadians who died from IHD (Ischemic Heart Disease) in 2002, over 21,000 deaths occurred after the age of 80. Yet, only the 1,400 deaths attributed to smoking were considered premature. Given that almost 20,000 non-smokers in that same age bracket died of the same disease, presumably as a result of old age, isn’t it just as likely that the smoking attributable deaths also occurred as a result of old age?

Attributing these deaths to smoking defies common sense and appears to be little more than a blatantly dishonest attempt to inflate the number of deaths associated with smoking for propaganda purposes. Claiming that deaths that occur at 80, 85 or 90 plus years of age are premature is simply bizarre.

The claim that most smokers will die before they reach the age of 70 is also suspect. Although I used a figure of 50% in my e-mail to Health Canada, a closer investigation of the data shows that over 57% of deaths attributed to smoking in 2002 occurred after the age of 70. The claim that most smokers will die before that age is simply not supported by the data provided by StatCan.

Deliberate distortion of the statistics is to be expected from the fanatical members of the anti-smoker brigade. But this type of propaganda should not be condoned from a public health body such as Health Canada.

And, while we’re on the subject of inaccurate claims, I should point out that the claim that 90% of lung cancer deaths in Canada are a result of smoking also appears to be inaccurate. The correct figure is 78% (13,401 of 17,188) for 2002. But, what’s 10 or 12 percentage points here or there?

It’s not as if anyone is going to hold them accountable for the misleading information they provide to the public.

Wednesday, October 22, 2008

SHS, anti-smoker fanatics & Orwell’s world

In his novel, 1984, George Orwell described a futuristic society dominated by a totalitarian regime. Citizens lived in total subjugation to the state. Dissenting points of view were not tolerated; even thinking that the state might be wrong became a crime.

To demonstrate the importance of language in controlling a population, Orwell invented “Newspeak”, a language of distorted meaning and comprised of simplistic dichotomies where things could only be one thing or the other, black or white, pleasant or unpleasant, good or bad.

By removing all shades of grey, only two options could be considered; that which was good (approved by the state) and that which was bad (not approved by the state). The public could not consider any alternative other than the two extremes. The possibility of compromise was removed, leaving the population no choice but to obey and accept the dictates of the state, or disobey and suffer the consequences.

By reducing everything to a simple dichotomy, even thought could be controlled. There was no need to think about anything other than the choice between the two opposites; one of which carried severe adverse consequences.

And, since only state-sanctioned thought was acceptable, people could only conclude that the state always acted in the public good; to think otherwise was a crime.

Orwell’s “Newspeak” has come to mean any attempt to distort language, usually by a government or some other authoritative body, to mean something other than the commonly accepted usage.

The word “encourage”, for instance, has very specific meanings in the English language. Most dictionaries define it as: to inspire with hope, courage, or confidence; to hearten or to give support.

So, it’s difficult not to think of Orwell’s Newspeak when you listen to the anti-smoker fanatics in public health and tobacco control declare that they want to “encourage” smokers to quit. Their attempts to de-normalize smokers, to brand them as social misfits, child abusers, etc. are not intended to encourage.

The imposition of smoking bans and punitive levels of sin taxes are meant to coerce smokers into quitting. But, the anti-smoker crowd recognizes that using that term could create a negative impression in the eyes of the public. So they use “encourage” as a euphemism to garner public support for their war on smokers. They distort the language to give it new meaning.

Coerce means to force someone to act or think in a certain way by use of pressure, threats, or intimidation; to compel; to dominate, restrain, or control forcibly. Only in the Orwellian world of the anti-smoker fanatic could force and coercion be interpreted as help or encouragement.

In a similar vein, they’ve created the illusion that secondhand smoke is either good or bad, with no middle ground acceptable. Through constant repetition of their mantra that “there is no safe level of secondhand smoke” the public is forced to choose one of only two options. Either secondhand smoke is a deadly hazard or it’s not. And, only one of those options is supported by the state.

The public is unable to look at the issue objectively because they have not been provided the information which they need to form an unbiased opinion.

The press is content to print the propaganda of the anti-smoker brigade as the uncontested, unblemished truth. And, as in Orwell’s world, the media has become just another tool by which the state controls the individual and coerces them into accepting the wisdom of the state.

It’s an effective strategy, reliant on repetitive slogans and constant reinforcement of the message, usually thru the media. But, it’s a strategy with a short shelf-life in the real world.

In Orwell’s novel, for example, it was first necessary to rewrite the dictionary and indoctrinate the populace to respond to Newspeak; an impossible task in the age of the computer. And, total control of the media was required to ensure that only messages approved by the state could be disseminated to the public; another impossible task given the power of the internet.

The anti-smoker brigade has to silence all public opposition and criticism. They must suppress or discredit the science that doesn’t support their cause and they must curb legitimate scientific debate. And, when they can’t discount the science, they denounce the source, regardless of the damage done to an individual’s reputation or career.

They can’t allow the public to see the shades of grey, or the world of black and white which they’ve created might fall apart.

Despite the claims of anti-smoker crusaders, the science surrounding the alleged hazards of exposure to secondhand smoke is unconvincing and debate within the scientific community continues. The fanatics have corrupted science to further their own agenda. Follow the links below for more information.

Warning: Anti-tobacco activism may be hazardous to epidemiologic science

Defending legitimate epidemiologic research: combating Lysenko pseudoscience

Is the tobacco control movement misrepresenting the acute cardiovascular health effects of secondhand smoke exposure

Saturday, October 18, 2008

SHS doesn’t kill as many as it used to

Physicians for a Smoke-Free Canada (PSC) is fairly diligent when it comes to putting out press releases and fact sheets. For instance, their latest initiatives include an appeal to the auditor-General to investigate the recent settlement between big tobacco and the federal government and a new fact sheet on “Recent trends in tobacco agriculture”.

It’s difficult to imagine what current trends they might be talking about since most of Canada’s tobacco farms have gone the way of the DoDo bird, thanks to groups like PSC and their allies in the anti-smoker brigade.

However, they’re somewhat less diligent when it comes to providing accurate, reliable information to the public.

For example, a fact sheet put out by PSC claims that “over 1000 (and possibly as many as 7800)” are estimated to be killed by second hand smoke each year in Canada. In addition, the fact sheet claims: “In 1996, Health Canada scientists estimated that there are approximately 350 lung cancer deaths due to smoking each year. A study conducted with Health Canada a few years earlier concluded that secondhand smoke caused approximately 2000 heart-disease deaths per year.”

This is, in fact, not only an inaccurate claim but one which seems to be deliberately distorted to inflate the deaths attributed to secondhand smoke. The most recent data from Health Canada, was published in a study entitled “Smoking-attributable mortality and expected years of life lost in Canada 2002: Conclusions for prevention and policy”, in 2007.

The latest figures from Health Canada estimate a total of 831 deaths (252 from lung cancer; 579 from ischemic heart disease) attributable to secondhand smoke. That’s roughly a third of the deaths suggested by PSC. Since the PSC fact sheet was last modified in 2001, the failure to correct the outdated and inaccurate data might be considered a simple oversight.

However, the bracketed claim that the death toll could possibly be as many as 7,800, suggests the original intention of the fact sheet was to mislead; to magnify the Canadian numbers to support their cause.

The 7,800 figure appears to have come from the California EPA: “The most exhaustive study completed to-date was conducted by the California Environmental Protection Agency. It estimated that between 4,500 and 7,800 deaths can be attributed to second-hand smoke (most from heart disease) each year.”

The numbers from California have no bearing on Canadian stats. They were used with no qualifier explaining they were applicable only to California. And, used in tandem with the claim that as many as 7,800 may have died from exposure to SHS, the California statistics might easily mislead the reader into believing the numbers were applicable to Canada.

The only reasonable rationale for using the California data in this manner was to inflate the numbers and mislead the public.

But, this is not the only fact sheet from Physicians for a Smoke-free Canada which contains outdated or inaccurate information.

In another of their fact sheets, “Estimated tobacco-caused deaths in Canada”, PSC quotes the estimated deaths from all causes as in excess of 47,000. The date on the fact sheet indicates it was revised in June 2004. The latest data from Health Canada was published in November 2007, and estimates only 37,000 deaths allegedly due to tobacco use.

PSC is, arguably, one of the more reputable members of the anti-smoker brigade. They have a responsibility to ensure that the information they are presenting to the public is accurate, reliable and up to date.

They have had almost a year to correct the outdated, exaggerated information on their website. The fact they haven’t done so is suggestive of one of two things; either a total lack of concern for the facts or a deliberate attempt to deceive.

We’ll know which if and when we get a response to our e-mail.

Tuesday, October 14, 2008

Power to the puff, smok'em if you can find'em

According to an October 8 press release, Imperial Tobacco is upset that Prime Minister Stephen Harper didn’t include the issue of illegal tobacco as a priority item in the Conservative's political platform for today’s federal election.

The press release notes that Canadian governments are losing over $2 billion dollars in tax revenues, “which is especially relevant in these troubled economic times”. It’s nice to see the folks at Imperial are so concerned about the loss of tax revenue extorted from their (former) customers.

Sounding more like a member of the anti-smoker brigade than a nasty old tobacco company executive, Benjamin Kemball, President and CEO of Imperial, said: "Failure of government to prioritize the issue of illegal tobacco sales is driving a highly regulated, heavily taxed, tobacco market to an illegal, unregulated and untaxed free-for-all.”

Loosely translated, that means the sale of cheap contraband is cutting into Imperial’s market share and adversely affecting their bottom line.

Of course, Imperial would like us to believe that their concern is for Canada's youth who can now buy contraband smokes at rock bottom prices without the hassle of going through legal retail outlets. But, their real concern is that hundreds of thousands of adult smokers can, and do, take advantage of the same everyday low prices.

Echoing the sentiments of anti-smoker crusaders, their press release notes that “For the last three years, after more than 40 years of steady decline, national smoking rates have remained the same.” Uh-huh. Imperial Tobacco is concerned that there aren’t enough smokers quitting. What the hell are these people trying to sell us?

Do they think no one noticed that while their customer base has been gradually declining, tobacco company profits have been steadily increasing?

The day after their first press release, they issued a second (Oct 9, 2008) to announce the results of a “study”, commissioned by Imperial, which found that “the vast majority of Canadians think the illegal tobacco trade is a problem in Canada that the federal government and the Royal Canadian Mounted Police should address.

The vast majority of Canadians, in this case, would be the fanatics in the anti-smoker brigade, greedy governments concerned about the billions being lost in sin taxes, Canada’s non-smokers and maybe a few disgruntled smokers who can’t find anyone from whom to buy the cut rate smokes.

Most smokers don’t see a problem. They see an opportunity to avoid the usurious costs of buying and using legal product. A pack a day smoker can easily save $50 per week by buying contraband. That’s a lot of money to a pensioner or a minimum wage earner.

In lock step with anti-smoker crusaders, the Imperial study notes that: “Illegal tobacco products do not comply with Canada's tobacco regulations. Furthermore, illegal tobacco trade erodes the respect Canadians have toward public order and undermines tobacco control initiatives put in place by governments.”

Hello! Is there anyone over there at Imperial Tobacco who hasn’t undergone a frontal lobotomy?

Respect for public order is not being eroded by those supplying Canadian smokers with contraband. It has been diminished by a de-normalization campaign deliberately designed to denigrate and demean smokers.

Respect for public order has been battered by the outright discrimination of smokers in the areas of housing, employment and medical care.

Does the “vast majority” really expect Canada’s five million smokers to maintain any respect for public order when they’ve been forced into the street to consume a legal product, when their governments demand ever increasing levels of extortion in the form of sin taxes, when they’re branded as child abusers and worse, when seniors and the infirm, among the most vulnerable in society, are left to die in the cold because they smoke?

The problem didn’t start with the people supplying contraband. It started with tobacco control initiatives meant to control smokers, not tobacco. Initiatives implemented by governments under pressure from the anti-smoker cranks and fanatics and meant to force smokers to quit. Force! Not encourage, not help, not educate; but to force smokers to quit.

So, apparently, now we have Imperial Tobacco joining forces with anti-smoker crusaders to demand that the federal government put an end to the sale of contraband smokes to protect their bottom line.

But, maybe they really do want smokers to quit, or at least quit smoking.

With the price of cigarettes kept artificially high by sinful sin taxes, and no cheap contraband available, some smokers would be forced to give up the dreadful smoking habit. With a few tax breaks, Imperial could corner the market for alternative nicotine delivery systems with their new line of snus (sounds like moose). Maybe they plan on sharing a display counter with nicotine gum and nicotine lozenges.

Shit. No wonder their press releases read as if they were written by Gar Mahood of the Non-Smokers Rights Association.

Saturday, October 11, 2008

A smoker's home - a public place?

An October 4, 2008 article in the Toronto Star advises that: “Landlords and tenants are joining movement to get smokers to butt-out in their homes.”

What they mean, of course, is that landlords and tenants are being pressured to adopt “no smoking” clauses in their leasing and rental agreements in an effort to force smokers to quit. In this case the pressure is apparently coming from the Non-Smokers Rights Association (NSRA).

The author of the piece, Jennifer Brown, uses a 53-unit, four-storey housing complex to make her point that practically everyone in Ontario is demanding smoke-free housing. Says Ms. Brown: “And since it opened in July 2006, the building on Cummer Ave. in North York has had no problem with vacancies.

She goes on: “In fact, the building of about 150 tenants, which offers three, two and one-bedroom apartments, has a waiting list. It is home to families, seniors and single people with mixed incomes.”

I suspect that’s actually a truthful claim. It’s just not the whole truth.

The fact is that all non-profit housing complexes, housing co-operatives and other forms of social housing in the city of Toronto have extensive waiting lists, whether they are smoke-free or not. In most cases the waiting lists are very long because these types of housing are heavily reliant on government subsidy. Filling vacancies is seldom a concern in this sector of the housing market.

The article notes that the 2007 Canadian Tobacco Use Monitoring Survey shows ”that about 75 per cent of all Canadian households, including smokers who reside in those households, no longer smoke inside the homes.” That sounds impressive until you realize that only 20% of Canadians over the age of 15 are smokers. When you understand that the vast majority of the 75% who have made their homes smoke-free are non-smokers, it’s a lot less impressive; and much more suggestive of personal bias against smokers.

The article quotes Pippa Beck, of the NSRA, who chairs the Canadian Smoke-Free Housing Group: "It's not a huge shift to formalize what most people are already doing."

Ms. Beck conveniently ignores the fact that Canada has over five million smokers and that they are just as entitled to a decent place to live as non-smokers. Under the current situation, some smokers have chosen to make their homes smoke-free. Formalizing “what most people are doing” removes the right to choose. It translates to dictating what people can do in the privacy of their own home.

Also ignored is the fact that there’s a world of difference between single family homes and multi-unit dwellings.

A smoker in a single family home can create a smoking zone in a garage or workshop, for example. Smokers living in multi-unit buildings have no such option. This is especially true in the example used in the Star article where the entire property is smoke-free. The only option is to leave the property entirely.

Ever mindful of the need to avoid any appearance that smokers are being discriminated against, the article notes: “However, a smoke-free housing policy does not prevent smokers from renting accommodation. Just as smokers are asked to step outside public places and workplaces for a cigarette, a smoke-free housing policy requires them to do the same.” Uh-huh.

Forgotten is the fact that a person’s housing is not a public place. It’s a private dwelling, whether it’s a single family unit or a high rise apartment building. It’s a private home. And, no one should be permitted to dictate what an individual may or may not do in the privacy of his/her home, provided the activity in which they are engaging is legal.

Says Ms. Brown in her article: “Smokers can live in smoke-free multi-unit dwellings as long as they follow the rules like everyone else.” Uh-huh. That’s very considerate of her. Follow the Rules made by anti-smokers which intrude on the autonomy and privacy of smokers or else. And, if they don’t do as they’re told? Chuck them out?

To convince landlords that it’s in their best business interests to include smoke-free clauses in their lease and agreements, the NSRA Smoking and Health Action Foundation claims that landlords report that it typically costs two-to-three times as much to turn over a unit where heavy smoking has occurred as it does for a non-smoking unit.

That’s a report I’d like to read; assuming one exists. The NSRA has been known to bend the truth somewhat in their efforts to de-normalize and demean smokers.

But, in my talks with landlords, it has been suggested that the factors contributing most to the cost of refurbishing a unit to rental condition are excessive wear and tear, often due to neglect. Were the floors and carpets cleaned on a regular basis, for example? Were appliances cleaned regularly? Were maintenance issues reported to management promptly, or were they allowed to deteriorate to unacceptable levels? What time frames are we talking about; one year, two years, five years?

All of these issues can be more significant factors in the cost of refurbishing a unit than smoking.

In fact, to the best of my knowledge, the issue of additional cost to maintain or refurbish rental units occupied by smokers has not been raised until recently. It didn’t become an issue until it was raised by the NSRA and other members of the anti-smoker brigade.

Jennifer Brown’s article in the Star runs to roughly 1,000 words. Anyone reading this biased, lopsided piece of journalism is left to believe that there is only one side to the story. Only information supportive of the views of the NSRA position was quoted. No other point of view was presented.

But, that’s typical of the press when it comes to the issue of secondhand smoke. They can’t have the public believing there might be another side to the story. The public might get wise to the fact that the science behind the alleged hazards of secondhand smoke is neither clear nor unequivocal.

Their job, apparently, is to act as a cheerleading section for anti-smoker crusaders like the NSRA.

Wednesday, October 8, 2008

Quit smoking - permanently

Chantix is a smoking cessation drug manufactured by Pfizer, the world’s biggest drug manufacturer. Launched in August 2006, and available by prescription only, it has been touted as the most effective drug of its kind on the market. Over 6 million people have been prescribed Chantix in the US, with sales totaling $883 million in 2007.

The main ingredient of the drug is varenicline tartrate which works by blocking nicotine receptors to the brain and reducing the pleasure which comes from smoking..

But in February, less than two years after giving the drug approval, the US Food and Drug Administration (FDA) issued an alert suggesting that serious neuropsychiatric symptoms had occurred in patients taking Chantix. Causing the most concern was the prospect the drug contributed to suicidal ideation in some users, which may have been responsible for a number of suicides and attempted suicides.

Pfizer responded by strengthening its Chantix labeling to include stronger warnings about neuropsychiatric symptoms. In May, it revised the warning again, advising physicians to discontinue Chantix immediately if patients become agitated, depressed or suicidal.

In June, Health Canada warned that Chantix, sold in Canada as Champix, had caused “unusual feelings of agitation, depressed mood, hostility, changes in behavior or impulsive or disturbing thoughts, such as ideas of self-harm or of harming others, in some users.” Health Canada noted that in the year following its approval, 226 Canadian cases of adverse neuropsychiatric events had been reported in patients taking the anti-smoking medication.

And, in addition to warnings from health authorities in both Canada and the US, the US Federal Aviation Administration (FAA) banned pilots and air traffic controllers from using the drug. It has also been banned for use by commercial drivers.

In June, Pfizer began a massive public relations campaign to combat growing concerns that their smoking cessation pills were dangerous because of links to suicides, seizures, and traffic accidents.

Shannon Pettypiece, in an article on Bloomberg.com, quotes company spokesman Ray Kerins: “When there is confusion in the marketplace related to one of our products we want to make sure the right information is out there. We can't lose sight of the benefit of this product; the public health benefit is clear.''

The health benefit Kerins is talking about is the alleged effectiveness of the drug in getting people to quit smoking. However, some experts on smoking cessation have suggested that the benefits of drugs, including Chantix, are over-stated. And, rival drug company GlaxoSmithKline, claims Chantix is no better at helping patients quit smoking than their products which include Nicoderm and Nicorettes.

The first lawsuit against Pfizer alleging adverse reactions to Chantix was launched in July 2008. Now there are several hundred, with a thousand or more cases being investigated.

Yet, despite the openly stated public health concerns of the US FDA, Health Canada and others, and multiple pending lawsuits, the drug has been allowed to remain on the market and is being widely advertised on television in the US.

And, allegations that the drug may be hazardous to a user’s health might also prove embarrassing to some supporters of the drug.

In May of 2008, a panel of experts, convened by the Agency for Healthcare Research and Quality (AHRQ), made a recommendation to physicians across the US that every patient wanting to quit should be advised to use smoking cessation products such as Nicoderm, Nicorettes, etc.

Also among the drugs recommended by the panel in their Clinical Practices Guideline was Chantix.

What may be even more embarrassing is that Dr. Michael Fiore, the chair of the panel, was believed to have a substantial, undeclared conflict of interest and had received a good deal of money from the pharmaceutical industry, most notably GlaxoSmithKline. Eight other members of the panel had similar conflicts which were apparently reported.

It is the drug companies which stand to benefit most from the sales of nicotine replacement and smoking cessation drugs recommended by the panel of experts. Although many experts consider “cold turkey” to be the most effective means of giving up smoking, the majority of anti-smoker organizations recommend smoking cessation drugs or nicotine replacement therapy.

The pharmaceutical industry, including the Robert Wood Johnson Foundation, is the biggest financial supporter of the anti-smoker crusade. In fact, funding for the Clinical Practices Guideline, which recommended Chantix and other smoking cessation drugs, apparently came from the Robert Wood Johnson Foundation.

So, the drug companies fund the activities of the antismoker crusaders. The anti-smoker fanatics lobby governments to impose draconian smoking bans and extortion levels of taxation on smokers to force them to quit. Then, they pitch the benefits of smoking cessation drugs which profit the drug companies which funded them in the first place.

And, the ones paying the price are the tobacco farmers who lose their farms; workers in the tobacco and hospitality industry who lose their jobs; and, of course, smokers.

And, quite possibly, those forced to use drugs like Chantix. There ought to be a law.

Visit the PharmaGossip blog

Sunday, October 5, 2008

SHS, suspect science & a complacent press

Throughout history there have been periods where fear, born of ignorance, clouded the judgment of normally rational, tolerant men and women. And, more often than not on such occasions, there were individuals ready to exploit that fear, often with fanatical zeal, to further their own interests.

The McCarthy era back in the fifties is one example of a modern day witch hunt. An irrational fear of communism, fueled by political opportunists, led to the persecution of alleged communist sympathizers. The threat posed by those accused was often non-existent or greatly exaggerated; the evidence, at best, inconclusive or dubious

No one was burned at the stake. But, the lives of many were irrevocably changed as victims of the anti-communist crusade suffered loss of employment, destruction of their reputation, and even imprisonment.

Another example of a modern day witch hunt is the war on smokers.

Anti-smoker crusaders, by associating secondhand smoke with dread diseases such as lung cancer, have created a climate of fear using flimsy, inconclusive, and possibly manufactured, evidence. Their crusade has turned into a campaign to harass and persecute smokers. Many activists have used public health as a vehicle to enhance their personal power, prestige and financial well-being.

Science has been distorted to ridiculous levels, with more and more outlandish “scientific” studies being released on a regular basis. Two recent studies deserve special mention for their attempts to heighten the level of anxiety parents already feel for their children.

Dr. Krassi Rumchev is the author of a study published in the June issue of Indoor Air. The study concludes that even smoking outside the home poses a major health risk to children. Rumchev claims, “they (smokers) still breathed out smoke that contaminated the air enough to cause damage. They also brought particles inside on their body and clothes

Rumchev is telling the public that breathing on children after smoking a cigarette adversely affects their health.

But, Dr. Michael Siegel, an anti-smoking advocate at Boston University, believes the study is flawed. And, except in the most extreme situations, he doesn’t think smoker’s breath represents a health hazard to children. “No, I don't believe that it represents a serious health hazard to nonsmokers or to children.

Dr. Siegel noted on his blog: “the study in question actually provides no evidence that smoking outside the home is not adequate to protect children from substantial exposure to tobacco smoke inside the home.”

But, in their article reporting the study, the HeraldSun (Australia), claimed: “Smoking outside does not stop children being exposed to high levels of dangerous tobacco chemicals, research shows.”

Clearly, the article was intended to present the conclusions of the flawed study as fact.

In another article, published in The Calgary Herald, Jennifer O'Loughlin, a professor at the University of Montreal, is quoted as saying: “Increased exposure to second-hand smoke, both in cars and homes, was associated with an increased likelihood of children reporting nicotine dependence symptoms -- even though these kids had never put a cigarette in their mouths."

The basis of those claims was a study headed by O'Loughlin, an epidemiologist, in which they asked a group of 1488 kids aged between 10 and 12 years of age to fill out a questionnaire. The questions included “the number of persons who smoke inside the home, number of days exposed to SHS in a motor vehicle in the past week, number of parents, siblings, and friends who smoke, and ND (nicotine dependency) symptoms.”

According to the study, “Sixty-nine of 1488 never-smokers (5%) reported one or more ND symptoms.”

It goes on, “exposure to SHS in a motor vehicle was independently associated with ND symptoms (OR, 95% CI = 1.2, 1.0–1.4).

The conclusion reached by the study: “SHS exposure in motor vehicles may be associated with ND symptoms among young never-smokers. If replicated, this finding provides support for interventions that promote non-smoking in motor vehicles.”

But, even to the untrained eye, there are serious credibility problems with this study.

For instance, the relative risk (OR) is given as 1.2 with a confidence interval of 1.0 to 1.4 making the OR statistically insignificant since it includes the baseline (1). Secondly, the abstract makes no reference to a control group against which these numbers could be compared. It appears to be little more than a poll of 10 to 12 year olds.

But, most significantly, the study draws its conclusions, not on any evidence of actual nicotine dependence, but on observations by 10, 11 and 12 year olds as to whether they were experiencing symptoms. What symptoms? Depression, anxiety, trouble concentrating? Couldn’t these same symptoms be caused by any number of factors, such as dealing with schoolyard bullies or poor self-image?

But, it doesn't matter that these studies are seriously flawed; all that matters to the anti-smoker crusaders is that the public believe secondhand smoke is jeopardizing children’s health. For this, they have been able to rely on the power of the press to relay their message to the public. And, these studies are, almost without exception, reported in the press as unambiguous and incontrovertible, without a single dissenting voice.

The headline of the September 30 Calgary Herald article by Charlie Fidelman, for example, read: “Smoking parents can hook kids on nicotine,” despite the fact that “Researchers did not make a direct link between cause and effect.”

The press, by failing to publish any opposing point of view, has been derelict in their duty to inform the public. In fact, the press has become little more than a cheering section for anti-smoker fanatics in their attempts to de-normalize smokers.

The failure of the press to present balanced, unbiased coverage of these studies has contributed significantly to the fear and ignorance which drives this particular modern day witch hunt.

Anti-smoking activist Dr. Michael Siegel comments on the second of these studies on his blog, saying: “This is an example of biased and shoddy science. Unfortunately, this is what tobacco control research is gradually deteriorating into.”

Thursday, October 2, 2008

Will generic packaging eliminate smokers?

A pair of anti-smoker activists is gleefully contemplating the imminent demise of the global tobacco industry. Simon Chapman, a professor of public health, and Becky Freeman, a doctoral student in tobacco control, have suggested that the industry is about to meet its Waterloo.

The cape-less crusaders, from the University of Sydney in Australia, believe that generic packaging of cigarettes will turn smokers off and inevitably “kill the industry”. The strategy is to pass legislation to require that all cigarette packs be identical, except for the brand name printed in non-descript, standard font on the box. No colours or logos will be permitted, just the brand name and the standard health warning.

The argument used by Chapman and Freeman to support generic packaging legislation is that since prescription dugs come in plain packaging, tobacco products should be sold in a similar fashion. They ignore the fact that nicotine based drugs (gum, lozenges, etc.), designed to compete with tobacco, are sold “over the counter”. And, these nicotine replacement products are sold from in store displays designed for maximum appeal and located to provide maximum exposure to the consumer.

The also fail to take into consideration the massive “direct to consumer” advertising of many prescription medications. Even the reportedly deadly Chantix, a smoking cessation drug, despite hundred of lawsuits filed against its manufacturer over the adverse effects of the drug, is advertised openly on television and in the print media.

Chapman and Freeman point to research by Professor Melanie Wakefield, from the Cancer Council Victoria, which shows that smokers rated similar dull, generic boxes as less attractive and popular than current packs. Apparently, the 813 smokers who participated in the study also thought that those who would smoke them were “much less stylish, outgoing and mature than smokers of the original pack.” Uh-huh.

Here in Ontario, cigarettes are already hidden from view. Smokers have to ask for the brand by name. They’re not allowed to see or touch the pack until they’ve paid for it. The article points out that Australia is currently considering legislation similar to that used in Ontario.

But, it’s highly unlikely the smoking public will give a rat’s ass about whether the cigarettes come in a black and white pack, any more than they will about the compulsory and grotesque health warnings.

Maybe the fanatics have forgotten that it’s the cigarettes that people smoke, not the packaging. Are these anti-smoker control freaks really that divorced from reality. Don’t they know the best selling brands in Canada come in plain, unadorned plastic bags?

This whole charade is becoming laughable.

How long do they think it will be before some budding entrepreneur starts producing sleeves for cigarette packages? Just slip off that offensive black and white sleeve with its ridiculous pictures of blackened lungs and slip the remainder of the pack into something a little more appropriate.

How about a picture of the majestic Rockies with an aging smoker in a black cowboy hat smoking a generic cigarette in the foreground? Or, a picture of beautiful Ingonish in Cape Breton, with its white sand beach and a bikini clad babe lighting up as the sun sets in the west.

Or, alternatively, you could print out self-adhesive labels to cover the offensive packaging. For example, labels depicting the smoker’s favourite leisure activity; baseball, soccer, hockey; golf, etc. Hell, with inexpensive graphics software and a decent printer, you could personalize your own stickers.

You could even print your own warning labels. Something like: “Don’t tell me to butt out; I have a license to carry.” Or, how about: ‘Telling this smoker to butt out could be hazardous to your health.” Or, this one: “Yes, smokers are suicidal and may be homicidal. So, keep your opinion to yourself.”

But, you don’t even have to get fancy. Cheap plastic cigarette cases are available for a couple of bucks. Or, will the anti-smoker brigade try and have them banned too?

The Chapman/Freeman article in the Sydney Morning Herald (Australia) opens with the statement: “The global tobacco industry's annual conference features a special session on what many are seeing as its Armageddon: plain, generic packaging.”

These people are dreaming in technicolour. No matter how unattractive they make the packaging, adult smokers will continue to buy the product. And, the more unappealing you make the package, the more tempting it will become to rebellious teens.

As I recall, marijuana already comes in plain packaging.