Thursday, April 30, 2009

Smoke Free Wisconsin’s little white lies

“I opened 8 years ago with ashtrays, and I attribute my chronic cough to secondhand smoke. I’m not in a position to take away the ashtrays – as much as I’d like to – unless there’s a law.”
Mark Keishian, Muskie’s Tavern and Grill, Wisconsin

The above quote comes from the anti-smoker website of an organization called Taverns Clearing the Air. According to the Smoke Free Wisconsin website, this group of tavern owners is willing to stand up for the right of the people of Wisconsin to breathe clean indoor air by passing a statewide law banning smoking in bars, restaurants, etc. Sounds very noble, doesn’t it?

The group has nearly 100 members comprised of tavern owners, along with some owners of restaurants, golf courses, lodges, and bowling alleys. But, judging from the comments of one of the members, the group may be more interested in protecting their bottom line than protecting their patrons from polluted indoor air.

Bob Schmidt, owner of Schmidty's, is quoted by WKBT as saying he wants to make his establishment smoke free but he fears such a policy would put him at a disadvantage. Says Schmidt: "I feel caught between a rock and hard spot because on one hand I've got friends and guests that want me to be smoke free, and on the other I have good loyal cliental that have been coming in here for 50 years that do smoke, and they're against it."

So, Schmidt wants the state legislature to pass a bill banning smoking in bars and restaurants to “level the playing field”. That way, he doesn’t have to worry about unfair competition from bars which would prefer to cater to a smoking clientele.

But, the La Crosse Tavern League (La Crosse, Wisconsin) claims there are almost 5,000 bars and taverns across the state, which don’t support a ban. This means, of course, that the “nearly 100 members” of Taverns Clearing the Air represent a very small minority in the struggle for statewide smoking bans.

Mike Brown, Vice President of the La Crosse Tavern League, owns the Logan Tavern in La Crosse. Brown believes in choice: "We don't force anybody into smoking, or not smoking. We want everyone to make their own decisions. I will be honest with you, I don't like cigarette smoke, but I'm also realistic, and I know its part of my business."

So, Smoke Free Wisconsin is promoting the “Taverns Clearing the Air” group as champions in the great anti-smoker crusade.

The truth is, if Schmidt and others in his group had the courage of their convictions, they would simply make their establishments smoke free and let the chips fall where they may. If the market for smoke free bars is there, they have nothing to fear. Instead, they choose to demand that the state intervene and ban smoking in all bars and taverns so that they suffer no economic consequences from such a decision.

Mark Keishian of Muskie’s Tavern and Grill, says: “I’m not in a position to take away the ashtrays – as much as I’d like to – unless there’s a law.”

But, he’s not exactly telling the truth. The truth is, all he has to do is remove the ashtrays from the tables in his bar and hang up a “No Smoking” sign. He doesn’t need a law to do that; it’s his right as the owner of the business.

He needs a law to prevent his smoking customers from taking their business elsewhere. He needs a law to prevent other bars and restaurants from exercising their legitimate right to cater to a smoking clientele if they deem it in their best economic interest.

Smoke Free Wisconsin, of course, as a card carrying member of the anti-smoker cult, supports the extremely small minority of bars who favour a statewide smoking ban. Their self-proclaimed mandate is to reduce or eliminate the number of venues where a smoker can light up and thereby force them to quit.

But, are you ready for the kicker?

Taverns Clearing the Air is a front group for Smoke Free Wisconsin. That’s right. Both groups share not only the same anti-smoker philosophy, but the same address and phone number; two groups of anti-smoker bigots for the price of one.

But, that’s OK. This kind of subterfuge is rampant in the Holy Church of the Anti-Smoker. After all, both groups are acting in the interest of public health. (If you buy that, we’re still selling oceanfront property in the Alberta badlands.)

Monday, April 27, 2009

E-cigs big tobacco ploy; Smoke Free Wisconsin

The electronic cigarette is under increasing attack from anti-smoker cultists who take a quit or die approach to tobacco control. The question is why?

In a recent article on their blog, Smoke Free Wisconsin declares unequivocally: “E-cigarettes: the latest ploy by Big Tobacco to hook kids”

The blog entry offers this advice: “Right now, e-cigarettes can be purchased in kiosks across the country and on the Internet. The FDA has not approved the use of e-cigarettes and there are no controls to monitor the age of purchasers. E-cigarettes are often made to look like conventional tobacco products and are marketed to kids by producing them in fruit flavors”.

The problem is that there is absolutely no evidence that the e-cig has any connection to the tobacco industry or that it is being marketed to children or to hook kids on smoking, despite coming in “fruit flavours”. And, it should be noted that the NRT (nicotine replacement therapy) products (Nicorettes, the Nicorette Inhaler, etc.) offered by Pfizer and other pharmaceutical companies also come in fruit flavours and are also available to children.

Smoke Free Wisconsin is following the lead of other public health advocates, including the American Cancer Society, American Heart Association, American Lung Association and the Campaign for Tobacco-Free Kids. These groups have issued a press release commending US Senator Frank Lautenberg of New Jersey for demanding that the FDA remove e-cigarettes from the marketplace.

The press release notes that: "Makers and retailers of these products (e-cigs) have been making unproven health claims about their products, claiming that they are safer than normal cigarettes and asserting that they can help people to quit smoking. Absent scientific evidence, these claims are in blatant violation of FDA rules."

But that assertion is misleading. Visits to many different websites found no evidence that they were being touted as “smoking cessation aids.” Those sites reviewed carried a disclaimer that the e-cig was not intended for use by non-smokers, adult or otherwise, nor was it intended as a smoking cessation aid.

There are claims made on these sites that, because there is no combustion involved, the e-cig is free of the toxic compounds encountered smoking conventional cigarettes. But, this is a legitimate claim.

And there are a number of reliable experts in the field of tobacco control who support that claim.

Dr Joel Nitzkin, Chair of the Tobacco Control Task Force for the American Association of Public Health Physicians, for example, says: "...we have every reason to believe that the hazard posed by e-cigarettes would be much lower than one percent. So if we can figure that the nicotine in the e-cigarettes is basically a generic version of the same nicotine that is in prescription (NRT) products, we have every reason to believe that the hazard posed by e-cigarettes would be much lower than one percent, probably much lower than one tenth of one percent of the hazard posed by regular cigarettes."

Dr. Nitzkin notes the lack of any real research or clinical trials on the e-cig, and points out that what safety information is available is on delivery as a straight nicotine product. But, he notes clinical trials may not be possible. Any trials would require the participation of non-smokers, for example, because the outcome would be compromised by previous smoking habits if smokers were used. Such studies might never be approved. And, even if they were, they would likely take a decade or more.

So, an outright ban on the e-cig would deprive smokers of the potential harm reduction available through its use, likely in perpetuity. But if clinical trials are impossible, how could the relative safety of the e-cigs be determined?

Says Dr. Nitzkin: “Well, the first thing which I don't really see as research is quality controlled assessment by an independent lab on an ongoing basis, batch by batch, to make sure that the chemical content is not contaminated by heavy metals or cancer causing substances. They would also need to make sure that the doses are accurate as stated”.

Unfortunately, the anti-smoker cult doesn’t intend to endorse the harm reduction strategy advocated by some public health organizations and activists, because it may encourage young people to take up smoking.

But, let’s give Dr. Nitzkin the last word. “There is a danger. We don't know how much of a danger there is. Now let me put it yet another way. Cigarettes currently cause 400,000 deaths a year in the United States. If we get all those smokers to switch from regular cigarettes to e cigarettes or one of the other alternate nicotine delivery products we would reduce that death toll from 400,000 a year to less than 4,000 a year, maybe as low as 400 a year. Now, if we addicted every man, woman and child in the United States to e-cigarettes - we currently have 20% of the American population using tobacco products - and we'd multiply that by 5, so even at our worst estimates of 4,000 deaths a year you'd have 20,000 deaths a year that's still a huge reduction from 400,000 a year.”

A potential 95% reduction in deaths? So, just why is the anti-smoker cult so dead set against the e-cig.

Saturday, April 25, 2009

A cold beer and a smoke, still under attack

Those who have been paying any attention to “public health” issues of late have been predicting an assault on alcohol similar to the offensive against smoking. The telltale signs of the looming war are everywhere. And, the tactics to be used in the pending “war on alcohol” will, apparently, be the same as those used in the “war on smoking”.

From the land “down under” comes the claim by public health proponents that the alcohol industry is “behaving like big tobacco companies and using underhanded and secret strategies to protect their profits”. And, researchers from Curtin University in Perth, Australia say they have the documents to prove it.

Professor Mike Daube of the public health faculty at Curtin says the documents list strategies to deflect attention from the type of legislation most likely to damage their bottom line. Says Daube: "The measures they oppose most strongly are tax increases, controls in advertising and sponsorship, health warnings, tough policing - especially on drink driving - and good, independent mass media programs on alcohol."

But, ask yourself: wouldn’t the maker of any legal product object to having their product singled out for a special “sin” tax or other intervention meant to curb consumption of that product?

The intent of (corporate) advertising is to make people aware of the product being sold; to influence people so that they will consume some particular product/service, or though brand identification to garner a larger share of the market for that product or service. And, advertising is legal, just as the sale of alcohol is legal.

So, why should it be surprising that the manufacturers of alcoholic beverages would object to having their marketing strategies curtailed? What’s really wrong with sponsorship of sporting or cultural events by brewers or distillers? Doesn’t the community as a whole also benefit from such sponsorship?

As long as the manufacture and sale of alcoholic beverages remains legal, why shouldn’t the manufacturers of beer or spirits be afforded the same rights and privileges as other industries?

The prohibitionists claim that the booze industry is unlike any other “normal” business; they sell a product which causes death and destruction and a host of societal ills. And, even worse they’ll tell you, they encourage children to experiment with alcohol and perhaps become regular consumers of these products as they grow older.

So, in the name of public health these products, and those who use them, must be painted as something evil; something less than “normal.” For their own good, and for the sake of the children.

These are the same tactics employed by over-zealous public health advocates in their efforts to destroy the tobacco industry and eradicate smokers. It’s a social marketing concept called de-normalization.

Social Marketing (also known as propaganda) is used to manipulate people’s thinking so that they will cease allegedly “bad” behaviour and/or engage in behaviour more acceptable to society as a whole. It’s a simple concept really; just emphasize the negative aspects of a product to create the public perception that the product itself, and those who choose to use it, is inherently bad.

Some men beat their wives after drinking therefore all men who drink are spousal abusers. Some young people may drink to excess and be inclined to violence or anti-social behaviour, therefore all young people who drink are thugs and brigands. And, according to the prohibitionists, simply taking away the demon rum which presumably drives their actions will solve the problem. More bullshit and bafflegab. It is a predilection towards violence, spousal abuse and alcohol abuse which is the problem.

There are already laws on the books to control sales to minors, drunk driving, etc. And, contrary to the claims of Mike Daube, I know of no booze company which opposes these or other reasonable public policies. But, the key word is reasonable.

Ignored by the prohibitionists and their propaganda is the fact that millions of consumers drink beer, wine and other alcoholic beverages responsibly and without adverse consequences to society or themselves.

The prohibitionists tend to deny the adverse social and economic consequences of their efforts to curtail consumption and impose a de facto form of prohibition. Their war on smokers, for example, has led to increased smuggling, decreased tax revenue and a readily available (cheap) supply of tobacco products with which young people can experiment. Unintended, but foreseeable consequences.

Tobacco growers have been forced out of business and manufacturing jobs moved offshore. And, many more jobs are affected indirectly by smoking bans and excessive taxation; the hospitality business, convenience stores, etc. Acceptable collateral damage?

The alcoholic beverages industry has a right to make valid arguments in their defense and discuss the issues among themselves. The have a right to participate in any dialogue intended to diminish their legitimacy. And, because they oppose measures designed to damage (or destroy) their perfectly lawful activities, they are being neither underhanded nor manipulative. They’re simply taking care of business.

I suspect I’m not alone when I say that I find it disconcerting that most of today’s public health issues appear to be centered on personal lifestyle choices which were once attacked primarily on moral grounds: drinking, smoking, gambling, gluttony, etc. But, the moralizing is no longer confined to the pulpit.

The high priests of public health have replaced the fire and brimstone preachers from the past. Prohibition has been resurrected as a new cult bearing the banner of public health. But, the socio-economic consequences will be the same as they were when the cult was led by the old time religious zealots.

At the end of the day, it’s just the same old bullshit and bafflegab.

Monday, April 20, 2009

Appeal to smokers; don’t buy contraband

Canadian Revenue Minister, Jean-Pierre Blackburn, announced last week that the Canadian Revenue Agency will launch an advertising campaign to combat the smuggling and sale of contraband tobacco. Blackburn plans to “tell smokers what impact smuggling has had on society."

The advertising campaign is expected to focus on the health risks (what else) of smoking contraband tobacco products. Apparently, it has come to the attention of the federal government that the manufacturers of contraband smokes do not exercise the same level of quality control as Imperial or Rothman’s. They’re concerned that Canadians who smoke contraband may be taking needless risks with their health by using a tobacco product which may not have been stored properly or may have been contaminated with foreign material.

How thoughtful of Mr. Blackburn and his federal colleagues; to be so concerned about the health and well-being of the humble smoker. But, most smokers will look at this new propagan . . . er, advertising campaign with a measure of skepticism. And who could blame them?

First, government launched an initiative to save us from the clutches of the evil tobacco companies. To do that, they followed the advice of the anti-smoker cult and raised tobacco taxes to an obscene level; making them unaffordable to many Canadians. Now, they’re going to try and convince smokers that they should buy only over-priced, government approved tobacco; for their own good, of course.

It will be a hard sell, because it’s not really about public health any more. It’s about the money.

Think about it. Try insinuating a little bit of common sense into the equation. Governments at the federal and provincial level are losing vast amounts of revenue to sales of contraband. A black market they themselves created with misguided public policy.

And it’s not just the government losing money. Tobacco companies complain about a corresponding decrease in the sales of legal tobacco products. Corner stores, reliant on sales of cigarettes and other tobacco products have also seen declines in income. Tobacco farmers have already been devastated; production facilities have moved offshore. Bars and hospitality venues are losing income as smokers do more entertaining at home to avoid smoking bans.

Have our already short-sighted politicians been wearing blinders? How could they ignore the potential adverse consequences of their heavy handed approach to tobacco control? Were they so hell bent on persecuting smokers that they couldn’t see the social and economic impact of their draconian bans and obscene levels of taxation?

You’ll no doubt see and hear about these issues in the pending ad campaign from Revenue Canada. But, there will be no admission from government that they are in large measure responsible for the situation with an unnecessary, misguided war on smokers.

Instead, smokers will be blamed for failing to comply with the outrageous dictates of governments which have chosen to isolate smokers and designate them as second class citizens. The trade in contraband, they’ll tell you, is controlled by criminals. And, those smokers who support the illicit trade by buying untaxed tobacco are, by extension, also criminals.

In Quebec, Bloc Québécois public safety critic, Serge Ménard, is already demanding that smokers be targeted for their “crimes”. Ménard claims contraband can be controlled by simply arresting smokers and seizing their vehicles as they leave First Nations territory with untaxed tobacco.

Of course, that will merely worsen the situation, straining relations with Canada’s First Nations and attracting an even more ruthless criminal element, not to mention the political fallout from turning otherwise law abiding citizens into criminals.

Ménard’s suggestion is not a reasoned response. New methods of distribution will develop quickly. As long as the market remains so lucrative, contraband activity will continue to escalate to the point where it is impossible to control.

Hypocritical governments, while proclaiming smoking a health risk on one hand, rake in billions in tax revenue with the other. If they really want to resolve the contraband issue, they have to do away with the hypocrisy and bring a little reason and common sense into tobacco control legislation.

But, they won’t be able to do anything concrete while their singular source of information is the anti-smoker
lobby. Maybe they should invite smokers into the dialogue. After all, we are the biggest stakeholders.

Thursday, April 16, 2009

Do cigarette displays corrupt kids?

In May, 2008, the Ontario government amended the Smoke Free Ontario Act to ban “point of sale” tobacco advertising in convenience stores, gas stations and other retail outlets across the province. Retail store owners were forced to hide all cigarettes and other tobacco products from public view, lest underage youth be tempted to buy and try the fiendish cigarettes.

The “power walls” of tobacco displays, as they were called, were thought to influence the smoking habits of teenagers. The anti-smoker cult believed our young people were being led astray by all the pretty packaging with their grotesque pictures of diseased lungs and sinister health warnings.

Cult leaders persuaded gullible politicians that the power walls were a serious threat to the health and welfare of our most impressionable citizens and they were duly banned. And, the only lasting health threat was the threat to the economic health of the retail store owners.

So, it’s interesting to watch the current debate in Scotland, land of my birth, on a similar initiative to banish in-store advertising of tobacco products. It’s actually quite amusing to see the anti-smoker brigade across the pond using the same bullshit and bafflegab used by the anti-smoker contingent here in Canada in their efforts to pass similar legislation.

It is not in the least amusing to realize that politicians around the world seem susceptible to the ravings of the anti-smoker crowd; so easily baffled by the bullshit.

Some MSPs (Members of the Scottish Parliament) have claimed that teenage smoking prevalence rates fell after the display of tobacco products was made illegal in Canada. They claim a ban on power walls was responsible for a decline of 32% in youth smoking “between the introduction of the tobacco display ban in Canada in 2002 and 2007”. The politicians accept this claim, and repeat it, because these “facts” were provided by bona fide members of the anti-smoker cult.

And, that sounds pretty impressive; a 32% decline in smoking prevalence among Canadian teens in only five years.

But, wait a minute. Ontario, Canada’s most populous province (roughly 40% of the population) only approved their ban on power walls in May, 2008, not 2002. Quebec, the second most populous province followed Ontario. In fact, bans on in-store tobacco displays were implemented in only three provinces and one territory between 2002 and 2007.

The three provinces, Saskatchewan, Manitoba and Prince Edward Island are among the least populated in Canada. And, the population of the newly formed territory of Nunavut could be seated comfortably in the Sky Dome although a few might have to sit on the infield grass.

So, why the misleading suggestion that there was a country wide ban in effect between 2002 and 2007? Why the claim that the ban on power walls was responsible for the decline in smoking prevalence among Canada’s young people? It simply isn’t true.

And, what about the alleged decline of 32% in smoking prevalence. Could that figure possibly have been plucked from the posterior of the first anti-smoker cultist caught bending over?

Well, actually, no. The 32% seems to be an honest number. Health Canada estimated a decline in youth smoking from 22% to 15% (a decline of roughly 32%) between 2002 and 2007. The deception was in the inference that there was a nationwide ban on power walls in effect during that period, and that it contributed to the alleged decline in youth smoking.

It is not even remotely possible that the country wide decline in smoking prevalence could be attributed to a ban on tobacco display advertising in the least populated regions of Canada. To suggest otherwise is to ignore reality. That’s nothing new; anti-smokers frequently distort the facts.

Unfortunately for politicians (and the public), the anti-smoker cult has little more than a nodding acquaintance with the truth. They know that the truth will not sustain their efforts to de-normalize smokers.

So they lie. And that’s the truth.

Monday, April 13, 2009

Quit smoking? Or just quit smoking contraband?

A funny thing happened on the way to a smoke free Canada. Well, it’s not so funny really, particularly if you’re an adherent of the Holy Church of the Anti-smoker. The cultists are not smiling these days. Instead, they’re whining and crying and wringing their hands about “contraband” tobacco. Again. Or, perhaps that should be “still”.

Several articles appeared last week about the rise in smuggling and sales of untaxed tobacco. It’s an issue that has been in the news more and more frequently as the problem of contraband tobacco continues to grow.

The anti-smoker cult is despondent because Canada’s smokers have failed to submit meekly to government imposed sanctions (euphemistically referred to as taxes). After all, the penalties were levied for the smokers own good. Smokers, according to the cultists, should be thankful for the blessing bestowed on them and either pay the punishing taxes or give up the wicked weed as demanded by their betters.

The stated purpose of tobacco taxation imposed by governments in Canada is to force smokers to quit. Ottawa, and provincial governments across the country, have hiked tobacco taxes to usurious levels, ostensibly to curb smoking (and raise revenue). In effect, the government demands smokers pay what amounts to legalized extortion or surrender their right to use a legal product.

But, legal tobacco, through taxation, has been priced out of reach of all but well off Canadians. For those at the lower end of the socio-economic ladder, the ever increasing level of punitive taxation has created a de facto model of prohibition. Tobacco itself is still legal, but many people simply can’t afford to buy it legally. And, they’re unwilling to quit.

The effect is the same as if the government had introduced outright prohibition on tobacco and tobacco products. And, it has neither curbed smoking nor increased revenue, much to the chagrin of the anti-smoker cult. Instead, it has created a growing black market, making cigarettes cheaper for many consumers, especially young people. Rather than increasing revenue, the government has seen revenue decline. And, policing the problem has strained law enforcement budgets to the max.

A Halifax Herald article last week claimed a 1.6 billion dollar loss in government revenue due to contraband sales of untaxed tobacco.

But, by defining taxation as the foremost weapon in their unholy crusade against smokers, the cultists (and the politicians) ignored the lessons learned during the US Prohibition of alcohol from 1920 to 1933. If there’s a market for a product, someone will fill it, legally or otherwise.

And contrary to what you may read in the press, the trade in contraband tobacco was not created by Canada’s First Nations or tobacco consumers, but rather by this misguided public policy which provides the huge financial incentive to both the supplier and consumer of illegal tobacco products. Governments, at the insistence of their cronies in the anti-smoker cult, have created that market by raising tobacco taxes to a level that many smokers simply can’t afford, or refuse to pay.

Consider this; the government makes three times as much on a pack of smokes than the manufacturers, wholesalers and retailers combined. And still, the cult pressures government to raise taxes even further. They continue to ignore the adverse consequences of an ill-advised policy that is doing more harm than good.

Instead of forcing smokers to quit, the ever-increasing levels of tobacco taxation have forced smokers to modify their spending habits rather than their smoking habits. They have been forced to find alternative, cheaper sources of supply. And it’s a growing concern, not just in Canada, but worldwide. Knock-offs of popular brands are being manufactured in South America, China and Europe and are readily available at a fraction of the price of the real thing.

By raising taxes to such absurd levels, they have created a multi-billion dollar industry. They have fashioned an illicit trade in a legal product. At a time when a sagging economy has mandated governments around the world to engage in deficit financing, they insist on maintaining prohibitive levels of taxation and increasing the potential profit level for dealers in contraband.

But, the really scary part is that the government is either too stupid or too greedy to understand that high tobacco taxes and smoking bans have long since become counter-productive. Canadian smokers (like a growing number of smokers around the world) have begun to realize that they have become the targets of undemocratic, discriminatory government censure. And, with no voice in the legislative procedure, tax avoidance becomes their only means of fighting back.

Non-governmental groups can ignore the adverse consequences of a punitive taxation policy; government cannot.

Politicians should remember that five million Canadians continue to use tobacco products. For governments to expect them to pay through the nose for the dubious pleasure of being relegated to second class citizenship is nothing short of insane.

Wednesday, April 8, 2009

Quit smoking with Chantix says UW course

An article by the Associated Press notes that: “In a drastic proposal for limiting drug company influence on doctors and patient care, a group of prominent physicians says medical associations and their leaders should reject almost all industry funding.”

I’ve written a couple of posts over the past year about the growing influence of the pharmaceutical industry on medical research and unreported conflict of interest by some medical professionals. But a Milwaukee, Wisconsin newspaper points out just how pervasive the practice has become.

The Journal-Sentinnel reported that “drug companies have largely taken over the field of doctor education, in part by bankrolling physician education courses at medical schools.” The drug industry spent $1.2 billion on such courses in 2006 according to the Journal of the American Medical Association, funding more than half of all such courses.

"Drug companies have essentially hijacked the highest level of medical education we have in this country," said Daniel Carlat, an associate clinical professor of psychiatry at Tufts University Medical School.

Journalists Susanne Rust and John Fauber found that, among other things, an online doctor education course offered at the University of Wisconsin (UW) recommended the use of the smoking cessation drug Chantix (sold in Canada as Champix). The drug has been linked to serious side effects, including suicidal ideation, and may have contributed to 3,325 serious injuries and 112 deaths in the U.S. Both the US FDA and Health Canada have issued advisories concerning the drug.

But mention of the side effects wasn’t evident in the online course materials.

Drug companies like Pfizer, spend about $13 million a year to fund UW medical education courses, with the university receiving over $3 million of that money. The remainder of the funding goes to private firms that develop the course material.

Courses funded by the pharmaceutical industry are offered free at UW, making them attractive to physicians required to earn continuing medical education credits.

In addition to recommending Chantix, the course promotes a reliance on pharmaceutical aids as the only reliable means to smoking cessation, despite having a very dismal long term success rate of roughly 2%. No consideration is given to simply quitting “cold turkey”, despite considerable evidence that it is a far more successful method than nicotine replacement therapy.

Dr. Michael Siegel of Boston University School of Public Health, took the course even though he’s an expert in the field of tobacco control. Apparently, he wanted to get a feel for the course material for an article which appeared on his blog.

Says Siegel: “I discovered that the course relies heavily upon and frequently cites as documentation, the recommendations of an NIH (National Institute of Health) expert panel on smoking cessation. However, nowhere is it disclosed that the chair of the panel and eight of its members had financial conflicts of interest by virtue of their financial ties to Big Pharma”.

In fact, the only source of information and guidance for the course appears to be from the guidelines established by the expert panel, which may have been heavily influenced by the financial connection of numerous members of the panel with the pharmaceutical industry.

But, if drug company influence on doctors, and in turn on patient care, is so pervasive, how can the public fully trust in the treatment being proscribed by their physicians?

If the writers of treatment guidelines can be influenced by financial ties with the drug industry to recommend a certain course of treatment, or prescribe a certain medication, the biggest winners are likely be the drug companies.

And, if doctors' continuing education classes are based on treatment guidelines, quite possibly biased by financial conflict of interest, how can even doctors be assured they are giving their patients the best medical advice available?

Dr. Steven Nissen, one of 11 co-authors of the proposal to limit drug company influence, and a former president of the American College of Cardiology noted that: "It has not always been flattering to see how physicians' relationships to industry appear to have colored their judgment in matters of public health."

The proposal is not expected to go far. Said one doctor; “it's unlikely to be fully adopted by large medical groups which depend on industry funding for many activities”. Uh-huh.

The truth is the pharmaceutical industry, in large measure, has funded the research that has defined the tobacco “problem”. They have funded the research and developed the drugs meant to resolve the problem. They have heavily funded the anti-smoker movement, whose activities promote smoking cessation and the need for drug company products.

And, drug industry dollars are influencing medical treatment guidelines, continuing education courses for doctors and therefore, indirectly, the course of treatment being recommended to patients.

They do none of these things for the good of humanity. Like the tobacco companies before them, they expect a return on their investment.

Saturday, April 4, 2009

Quitting smoking with NRT, 1.6% success rate

The tobacco industry has been roundly condemned for alleged unethical research conduct for decades. As the association between smoking and lung cancer began making news back in the fifties, some tobacco companies conducted their own research which showed contradictory results. Shame on those nasty tobacco companies, the money grubbing bastards.

They sponsored scientific conferences and published their studies in medical journals. And, it was not uncommon for members of the medical profession to lend their support to one particular brand of cigarettes or another. Shame on those nasty doctors, the money grubbing bastards.

That’s all changed now. Nowadays, it’s more likely to be the pharmaceutical industry that’s fudging the facts on the “scientific” evidence. And, the drug companies can put more spin on a study than a Nolan Ryan fastball. Shame on those nasty drug companies, the money grubbing bastards.

And, shame on the anti-smoker cult for promoting useless interventions on behalf of their puppet masters in the pharmaceutical industry.

Every anti-smoker group in the country is pushing smoking cessation drugs and nicotine replacement therapy; Physicians for a Smokefree Canada, the Canadian Lung Association, the Non-Smokers Rights Association, etc. Doctors push the product on patients and even government health agencies like the Ontario Ministry of Health Propagan . . . er, Promotion endorse the use of the stuff.

And, it’s not just in Canada. It’s a worldwide phenomena, with drug company shills in the anti-smoker brigade pushing pharmaceutical nicotine from Montreal to Madagascar; Toronto to Timbuktu.

Wouldn’t it be funny if the stuff turned out to be as useless as teats on a bull? Do you think anybody would be embarrassed? No? OK, so you’re right. They know no shame.

Now, the anti-smoker cult is quick to tell us that the vast majority of smokers really want to quit. Unfortunately, they are often less than honest in the information they provide to the public. And, I’ve read some of their studies and their math often leaves something to be desired . . . like a sixth grade education.

But, I have no doubt that there are, indeed, many smokers who would like to quit. Some might want to quit for health reasons; others may be growing weary of the de-normalization campaign of the anti-smoker cult and the social exclusion it represents. Smoking is banned in most social settings, and in most workplaces. Even smoking outdoors is becoming a hassle.

In fact, smoking bans are interfering with more and more aspects of a smoker’s life. So, it’s not surprising that some would rather switch than fight and start waving the white flag.

However, human nature dictates that we look for the easiest, least painful means of accomplishing any goal, including any decision to quit smoking. So, those smokers become easy targets for the marketing strategies of the pharmaceutical industry and their sales representative in the anti-smoker brigade.

But, just how effective is nicotine replacement therapy in accomplishing the objective?

Well, according to one study, it isn’t. Effective that is. Well, OK, it’s more effective than sugar pills or gummy bears, but . . . OK, OK. So, it wasn’t tested against gummy bears, but you get the point, right?

The study was called: “Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis”. Hasn’t that got a nice ring to it? Very . . .er, scientific.

The study reviewed several trials which enrolled a total of 2,767 smokers given either nicotine replacement therapy for 6 to18 months or a placebo.

The percentage of smokers who managed to stay off cigarettes for six months with nicotine replacement therapy (NRT) was 6.75%, compared to 3.28% for those given a placebo. Uh-huh. 3.28% managed to quit using a sugar pill. (I wonder how many heroin addicts could give up their habit using a placebo.)

The percentage still not smoking at final follow-up after one year was 1.6% for the NRT group, compared to 0.4% for the placebo group.

From this, the authors of the study conclude: “Available trials indicate that nicotine replacement therapy is an effective intervention in achieving sustained smoking abstinence for smokers who have no intention or are unable to attempt an abrupt quit. Most of the evidence, however, comes from trials with regular behavioural support and monitoring and it is unclear whether using nicotine replacement therapy without regular contact would be as effective.”

Hmmm. Does that mean nicotine replacement therapy would be even less effective without “behavioural support and monitoring”? Might the placebo have actually out-performed NRT?

Just how hard were the authors of this study laughing when they wrote the part that says “nicotine replacement therapy is an effective intervention?” Was it a little chuckle, a rumbling guffaw or were they actually rolling on the floor laughing their asses off? Shame on the money grubbing bastards..

Oh, yeah, one of the study authors, Paul Aveyard, admits to receiving compensation from the Swedish drug company (McNeil) which sponsored the initial trials used in their report. But, conflicts of interest, whether real or perceived, are par for the course these days. Although the claim that NRT is an effective intervention does suggest some bias might be present.

I wonder if Health Canada will make the makers put a disclaimer on their packaging. You know, something simple, like: “Warning: This product is totally useless 98% of the time.”

Yeah, you’re right. It’ll never happen. You pay your money and you take your chances, folks.

PS You can read more about the study on Dr. Michael Siegel’s blog, Tobacco Analysis.

Wednesday, April 1, 2009

health canada to rescue big pharma from e-cig

Health Canada has just jumped in (with both feet) on the e-cig controversy, advising Canadians against purchase or use of the product. According to Health Canada, “these products may pose health risks and have not been fully evaluated for safety, quality and efficacy by Health Canada”. (I wonder if Champix was “fully evaluated for safety, quality and efficacy”)

But, while Health Canada goes on at great length about the possible hazards of nicotine addiction in their press release, they note that pharmaceutical nicotine is sanctioned for sale here in the Great White North. Says the press release: “While no electronic smoking product has yet been authorized for sale in Canada, Health Canada has authorized the sale of a number of smoking cessation aids, including nicotine gum, nicotine patches, nicotine inhaler, and nicotine lozenges”.

Health Canada’s endorsement of alternate nicotine delivery systems sold by the drug industry, while discouraging use of the e-cig, appears to be a direct attempt to influence the market place and deprive smokers of a satisfactory alternative to smoking. Their energetic promotion of pharmaceutical nicotine is problematic and should be of concern to all Canadians.

And, the timing of the news release, less than a week before the launch of a major television advertising campaign for the Nicorette Inhaler in Canada, should have Canadians concerned about the role of Health Canada as a marketing agent for the big drug companies.

The e-cig has been on the market for several years, yet Health Canada chose to raise no safety concerns until the e-cig started making news in the mainstream media. Celebrities using the e-cig, such as Leonardo DiCaprio, have been cropping up in the news and have threatened to increase the popularity of the new nicotine delivery device.

Health Canada has a legitimate role to play in the health and safety of Canadians. Unfortunately, their latest press release looks more like a campaign to protect the interests of the pharmaceutical industry. And, I’ve noted several times on these pages the propensity of the anti-smoker cult (The Canadian Cancer Society, Physicians for a Smokefree Canada, etc.) to promote pharmaceutical nicotine.

The safety issue provides a handy smokescreen for anti-smoker efforts to promote the profits of their puppet masters in the drug industry.

Murray Laugesen, a former medical officer in New Zealand, tested the first electronic cigarette in 2004. The result was a paper by Laugesen, along with others at Health New Zealand, entitled: “How safe is an e-cigarette? The results of independent chemical and microbiological analysis”.

According to Laugesen, who is also an anti-smoking activist with ASH (Action on Smoking and Health) New Zealand: “no cause of serious concern has been found." This doesn’t mean the e-cig is completely safe, or that further study is unnecessary. But, Health Canada has had ample time to evaluate this product for “safety, quality and efficacy”.

Not surprisingly. most members of the anti-smoker cult have been critical of the e-cig. Unlike the patch or the inhaler, the e-cig looks like a cigarette and provides the user with most of the trappings of the real thing. There’s even simulated smoke.

And that, apparently, is what has the anti-smoker cult in an uproar. It looks like people are smoking and that is simply unacceptable to the cultists. And, there’s also the fact that the e-cig is not geared specifically to smoking cessation. It is meant to be used as a safer substitute for smoking tobacco, although it can be used as an aid for smoking cessation.

According to Pfizer, the drug company which makes the competing Nicorette Inhaler, mimicking the hand to mouth ritual involved in smoking reinforces smoking cessation. At the launch of the inhaler in 2004, they claimed: “the Nicorette Inhaler is the only smoking cessation product to wean smokers from both the primary reinforcement (nicotine) and the secondary reinforcement (hand-to-mouth).

In a survey, 41 per cent of smokers said that one of the reasons their last quit attempt failed was because they missed the hand-to-mouth gratification they've come to depend on after years of smoking”.

Hmmm . . . 41% of smokers? Or 41% of smokers who tried to quit and who were surveyed (not all smokers actually do want to quit, contrary to myths created by the anti-smoker crowd).

But many might consider reducing tobacco consumption through use of the e-cig, if they’re given the opportunity. Unfortunately, it looks like the anti-smoker brigade will be using every means available to prevent that from happening.

Champix, on the other hand . . .