Sunday, January 30, 2011

The quit or die tactics of anti-smoker extremists

The state of New York is currently considering legislation which would ban e-cigs in that state, “until the FDA approves electronic cigarettes as a smoking cessation device.” Unfortunately, in December 2010, the U.S. Court of Appeals ruled that the FDA could not regulate e-cigarettes as drugs or devices. The ruling dictated that e-cigs must be regulated as tobacco products.

So, why do politicians and anti-smoker organizations want to deny smokers alternatives that could save lives? After all, these people claim the war on smokers is being waged to protect the public health. Shouldn't they be welcoming every opportunity to reduce the health risks associated with smoking, rather than confining their activities to the complete elimination of tobacco use in any form?

Tobacco harm reduction (THR) is a concept based on the reality that smoking is unlikely to be eliminated any time in the near future. Even the prohibition of tobacco will not eradicate smoking. Although some might quit, it would, as likely as not, simply drive tobacco use underground.

Therefore, it makes sense to reduce the harm ostensibly caused by smoking, by encouraging smokers to switch to demonstrably less hazardous tobacco products such as snus, or even alternative nicotine delivery systems such as the electronic cigarette.

Since it is the chemicals in cigarettes, formed primarily through combustion, which have been identified as the source of the health risk, reducing exposure to those chemicals would obviously reduce the health burden allegedly due to smoking. Clearly, substituting less harmful tobacco products, or electronic cigarettes, for the real thing has the potential to lessen the morbidity and mortality associated with smoking.

Yet, harm reduction is opposed by the anti-smoker crowd as vehemently as they oppose smoking. The question is why?

It's not as if there is no scientific evidence showing the potential benefits of non-combustible tobacco products like snus as compared to smoking cigarettes. The research is actually quite extensive. The problem, I would suggest, is that research into tobacco harm reduction receives little or no attention in the main stream media. And, lacking media attention, the public is largely ignorant of the fact that there are other options available if they should choose to quit smoking.

In Canada, for example, snus is not available from convenience stores or other traditional retail outlets, although you may find it in a few specialty shops dedicated to tobacco products. But, the majority of Canadians buy their cigarettes from the corner store, or when they gas up their vehicles.
In addition, advertising restrictions prevent the tobacco companies from promoting snus as a less hazardous, or safer, tobacco product.

The Canadian consumer remains oblivious to the fact that there is an alternative to the nicotine patches, gums and lozenges being promoted by the anti-smoker crowd as the only acceptable path to smoking cessation and eventual salvation.

Most Canadian consumers are likewise ignorant about the potential benefits of electronic cigarettes as an alternative to smoking.

Last fall, at a party celebrating my sister-in-law's sixtieth birthday, her brother was reflecting on the difficulty he was having in quitting. When I brought up the subject of electronic cigarettes, I was met with blank stares from everyone within earshot. No one knew what the hell I was talking about.

Health Canada had already banned the device on the grounds that they had not been proven safe. Or, to be more accurate, they banned the sale of the nicotine cartridges used with the e-cig. In Canada, nicotine may only be sold (or prescribed) in the form of patches, gums and lozenges, or the nicotine inhalers sold by the pharmaceutical industry. A very convenient law – for the drug lords.

I have suggested several times on these pages that the motivation is primarily monetary.

Governments are reluctant to give up the lucrative revenue generated by sin taxes on tobacco products. In Canada, tax revenue from tobacco exceeds 8 billion dollars annually. In the US, sin taxes on tobacco are used to balance state budgets while avoiding general tax increases or a reduction in services.

Anti-smoker organizations are anxious to deliver potential customers to their financial backers in the pharmaceutical industry. And, every smoker they can coerce into quitting represents a potential customer for the (legal) drug lords. Provided, of course, there are no other alternatives to which they might turn.

But, although the politicians and anti-smoker groups fear losing control of the nicotine market, there is yet another reason for the constant attacks on alternative methods of nicotine delivery. That is the pure vindictiveness of anti-smoker extremists such as ASH (Action on Smoking and Health) and the ANR (Americans for Non-Smokers Rights) to name but two.

For extremists such as these, the healths hazards associated with smoking are merely a convenient excuse, a subterfuge, to justify their attacks, not just on smokers, but anyone using tobacco products of any kind. And, more recently, their particular brand of vitriol is being directed at e-cig users, not because it's a tobacco product, but because it contains nicotine and it closely resembles smoking.

Strange behaviour for those ostensibly acting in the best interests of public health.

Thursday, January 27, 2011

MaineCare shouldn't pay. Let poor smokers die?

In their capacity as the new whipping boys (and girls) for everything wrong with the western world, smokers, this time in Maine, may soon be faced with yet another egregious assault on their health (and personal autonomy) by their elected representatives. And, this time smokers may literally face a life or death ultimatum; either conform to the demands of anti-smoker zealots and quit smoking or be denied medical care through the state medicaid program. Uh-huh.

Newly elected State Senator, Thomas Saviello said Friday he decided to introduce a bill to keep people receiving MaineCare from receiving benefits at the suggestion of a constituent who works in a rural health care clinic. Saviello says the unidentified female constituent is “troubled when she sees MaineCare patients who have respiratory problems and smoke heavily, because taxpayers are subsidizing treatment for illnesses that could be avoided.”

MaineCare is the state’s name for Medicaid. Funded by both state and federal money, it provides free medical and dental care to low-income residents. In 2009, it was estimated that approximately 270,000 Maine citizens were enrolled in the program, which has an annual operating budget of roughly $2.4 billion. Most of the funding is provided by the federal government, with Maine taxpayers paying roughly $1 billion.

By definition, those on the medicaid program are among the most financially disadvantaged residents in the state. Refusing MaineCare benefits to smokers could effectively deprive them of medical care in potentially life threatening situations. Is Saviello seriously proposing to jeopardize the lives of Maine residents, who obviously can't afford private health care, simply because they smoke?

In an AP article by Glenn Adams, and carried by several newspapers in Maine, Saviello claims he's "not out to punish smokers or tell them how to live their lives." Huh?

How can this deranged proposal be construed as anything but punishment for failing to conform to lifestyle behaviour deemed appropriate by anti-smoker zealots? Does the Senator realize that smoking is still a legal activity? That his plan would penalize the most vulnerable in the population for engaging in a legal activity? I wonder how many smokers voted for this morally bankrupt idiot?

This is the most cowardly, and callous, assault on smokers since Jane DeVille Almond, a British nurse and anti-smoker zealot, told a radio audience that smokers should have to quit or be denied medical procedures offered to the non-smoking public under Britain's NHS (National Health Service). When quizzed by the host of the radio program about what should be done if smokers needing heart surgery couldn't afford to pay the medical costs from their own pocket, the nurse responded: “They'll just have to die, then, won't they.”

It's unclear just how much (if any) serious consideration he's actually given to his proposal since the Senator has released no details on the bill he intends to introduce in the State Senate. But, despite the fact that his proposal is meant to reduce the costs associated with smoking related diseases, among smokers at least, Saviello acknowledges that he has no idea how much money might be saved by denying medical treatment to smokers, although he “suspects” it could be pretty significant.

I guess Maine's smokers should be thankful none of his “troubled” constituents suggested herding smokers into boxcars and shipping them off to some isolated re-education camp where they could be experimented on with Chantix and other "smoking cessation" drugs.

Saviello's proposal is just one of several pieces of anti-smoker legislation to be introduced in Maine's new legislative session.

Rep. Les Fossel wants to raise the minimum age to possess tobacco from 18 to 21, in an effort to reduce teen smoking rates. Rep. Anna Blodgett is sponsoring a bill to bar smoking in private clubs such as the Elks and the American Legion, which are apparently exempt from the current smoking ban. The lung association wants legislation to discourage youth smoking; they're lobbying for a $1.50 increase in Maine's cigarette excise tax.

Of course, this is all just idle speculation until (unless) Saviello actually comes up with a bill and introduces it formally in the legislature. So, we'll put a hold on the crucifixion . . . for now.

And, of course, there's always the possibility that the senator might change his mind. He's been known to do that. Saviello served four (two-year) terms in Maine's House of Representatives, first as a Democrat, then an independent, before being elected to the State Senate as a Republican in last November's election.

But, his political affiliation doesn't really make a lot of difference. Whether he's a 'publican, a 'dependent or one of Demuddercats, I suspect he'll still be an anti-smoker bigot.

Saturday, January 22, 2011

A world full of risk

I wasn't researching anything in particular; just catching up on some of my favourite blogs and following links I thought might be of interest. One link caught my eye, and following up on it took me to the Science Daily web site.

The Science Daily piece was titled “Being Overweight Just As Risky To Health As Being A Smoker”.

According to the article “Obese adolescents have the same risk of premature death in adulthood as people who smoke more than 10 cigarettes a day, while those who are overweight have the same risk as less heavy smokers, according to research published on the British Medical Journal website.” Uh-huh.

Apparently, being overweight at the age of 18 increases the risk of premature death by just over a third, while being obese more than doubles the risk. The gist of the article was that, unless you wanted to kick the bucket prematurely (what, exactly, does premature mean, I wonder), you'd better sign up for a membership at Jenny Craig's.

Then, just as I was prepared to move along, I spotted another link to an article titled: “Be Overweight And Live Longer, German Study Suggests.” Since this article appeared to contradict the one I'd just finished reading, I had to check it out.

The second article noted: “Contrary to what was previously assumed, being overweight is not increasing the overall death rate in the German population. Matthias Lenz of the Faculty of Mathematics, Computer Science, and Natural Sciences of the University of Hamburg and his co-authors present these and other results in the current issue of Deutsches Ă„rtzeblatt International.”

The German Study claims that being overweight does not increase death rates (premature or otherwise), although obesity does increase them by 20%. Fortunately, the study also notes that, as people grow older, obesity makes less and less difference.

Since I'm only 8 or 10 pounds overweight, the apparent contradictions in these two studies don't really bother me. I'm getting too old to die young, at any rate. And besides, I'm already destined to die of a smoking related disease.

So, I think I'll believe the German study. That way, I can have the occasional beer without worrying that I'll pack on the pounds and die prematurely. It's nice to have a choice in these matters.

But, the subject matter seems to be of great importance to some young people. For example, another article on the same website is entitled: “Reducing Suicidal Behaviors Among Adolescents.”

This one, by Inas Rashad, an assistant professor of economics at Georgia State University, claims that adolescent girls who perceive themselves as too fat are more likely to commit Hari-Kiri than girls who are, in fact, overweight. “Although studies have shown a link between obesity, depressive disorders and suicidal behaviors, Rashad and Dhaval Dave of Bentley University, analyze these indicators in conjunction with an individual's perception of their weight.”

The article notes: “The study revealed that body dissatisfaction had a strong impact on all suicidal behaviors for girls and was generally insignificant for males.”

Another article on the same topic, “Teens Who Think They’re Overweight More Likely To Try Suicide”, tends to agree. Well, almost.

Monica Swahn, Ph.D.,lead author of the second study, noted that: “Our findings show that both perceived and actual overweight increase risk for suicide attempt.” The only discrepancy is that the Swahn study concluded that the “association was as strong for boys as for girls, contrary to what the researchers had originally expected.”

So, being overweight may, or may not, shorten your life. But, just thinking you're overweight might cause you to jump off a tall building or throw yourself in front of a subway train. Interesting.

Apparently, there are risks every where. It's enough to make a man want to lock the doors, park his ass in his favourite armchair and let the rest of the world go by.

But, then again, that might not be such a good idea. There's another study on the Science Daily site which claims: “More Time Spent Sitting Linked to Higher Risk of Death; Risk Found to Be Independent of Physical Activity Level”. Uh-huh. A study which claims too much sitting can kill you.

Researchers “found that more leisure time spent sitting was associated with higher risk of mortality, particularly in women. Women who reported more than six hours per day of sitting were 37 percent more likely to die during the time period studied than those who sat fewer than 3 hours a day. Men who sat more than 6 hours a day were 18 percent more likely to die than those who sat fewer than 3 hours per day. The association remained virtually unchanged after adjusting for physical activity level. Associations were stronger for cardiovascular disease mortality than for cancer mortality.”

Now, there's a potential confounder I'll bet the EPA and the US Surgeon General never took into consideration in their secondhand smoke studies. Imagine. The excess mortality among spouses being attributed to secondhand smoke exposure may have been due to an excess of female couch potatoes in the cohort exposed to secondhand smoke.

Ain't science grand?

Monday, January 17, 2011

Smoking statistics and 18 holes of golf

“Numbers don't lie.”

If I had a nickle for every time I heard (or read) that claim over my lifetime, I'd be able to play a damn sight more golf in my retirement than I currently do - in my dreams. Although the claim has a ring of truth, and many people will nod in agreement, it can easily be proven to be untrue.

But, since I don't really know how often I've heard someone make the claim that numbers don't lie, I'd have to calculate (or assume) the number of times I've heard the phrase. So, let's assume that I heard the “Numbers don't lie” claim once a day, on average, every day since I was five years old. Uh-huh. That's an unrealistic assumption, but it will serve to illustrate my point.

So, that's five cents a day for every day over the past 62 years. (365 X .05 X 62) or $1,130.50. That's not a lot of money.

Now, if I go out golfing on a sunny summer morning, I'd likely spend $40.00 (a conservative estimate) for green fees; another $20 to rent a golf cart, and yet another $15 for a few drinks or a bite to eat at the 19th hole.

We'll ignore minor costs, like the replacement cost for balls lost in various water hazards, or those lost in the deep woods on the occasional hook. And, then there's the balls lost when those perfect tee shots inexplicably disappear from the middle of the fairway. We'll also ignore the cost of a new three-iron every time I wrap the old one around a tree because I couldn't break 90; which is roughly 75% of the time. That is to say that I fail to break 90 some 75% of the time, not that I wrap my three-iron around a tree every time I fail to break 90.

At any rate, I expect to spend about $75 every time I go out to play. So, if I've saved roughly $1,130 in nickles and if I spend an average of $75 when I play; and, if I live to average life expectancy, then I might be able to afford an extra day of golf a year over the remainder of my lifetime. That's a lot of “ifs” and it doesn't add up to a lot more golf.

And, what if my basic assumptions were wrong? For example, what if I only heard that phrase every second day. Then my nickle a day savings would be reduced by half and I would only be able to afford an extra game every second year during my retirement. That's not even worth the effort of searching my pockets for a nickle every time someone claimed that numbers don't lie and stuffing it into a piggy-bank for 62 years.

And, what would happen if inflation drove the cost of a game of golf up to $90 a day. Obviously, I would be able to afford even less time on the golf course. That might do wonders for my blood pressure, but it would do little to improve my golf game.

In addition, there's always the possibility that some unexpected event might also affect my calculations. For example, if I had gone out to play a game of golf to celebrate my retirement and gotten run over by a bus load of Moose Lodge members arriving for their annual tournament. Then I would have derived absolutely no benefit from all those nickles I'd squirreled away every time someone claimed that “Numbers don't lie.”

I know what you're thinking. Just where in hell is he going with this little analogy?

The point is that if I take into consideration all the factors which might affect my calculations, the whole exercise can be seen for the absurdity it is.

And, the same holds true, I suspect, for the statistics bandied about by the anti-smoker zealots. Estimated numbers lacking adequate quantification. Deliberately ignoring confounding variables in their analysis and interpretation of data. Throw in a fistful of ifs, mights and maybes. And then pass the results off on an unsuspecting public as honest science. All of which is likely the reason we see such a lack of consistency in the results of the many secondhand smoke studies that have been conducted over the years.

Now it seems they don't even want to go through the motions of conducting (or exploiting) fraudulent scientific studies to mislead the masses. Instead, they want the politicians to ignore the science and pass legislation based on popularity polls conducted by anti-smoker fanatics.

From the Montreal Gazette: "A new study is urging lawmakers not to let science get in the way of sound policy when it comes to laws on children's exposure to second-hand smoke in cars. Smoking in cars carrying children should be banned whether or not science can prove exactly how risky it is, according to an article penned by Ray Pawson of the University of Leeds and published in the Canadian Medical Association Journal."

Science should not get in the way of sound policy? What the hell does that mean?

In pushing for a ban on smoking in cars carrying children in seven Canadian provinces, the anti-smoker fanatics emphasized, repeatedly, the claim that smoking in a car is 23 times more toxic than smoking at home; a statement that has been disproved.

Now, caught in a lie, the anti-smokers zealots want policymakers to ignore the science. Apparently, the science should only be considered if it favours the anti-smoker crusade.

Said Rob Cunningham, of the Canadian Cancer Society. "This issue has unstoppable momentum. These laws have enormous public support and they have been easily adopted with all party support in provincial legislatures."

Of course, most anti-smoking laws enjoy public support only because of the fear-mongering bullshit and bafflegab disseminated by the fanatics with the sole intention of misleading the public and influencing gullible politicians.

Shit. The temperature's below zero and there's about three inches of snow on the ground. I can't even work out my frustration on the golf course.

Thursday, January 13, 2011

Is the US Surgeon General a liar?

Anti-smoking activist Michael Siegel announced the winner of his 2010 Tobacco Control “Lie of the Year” award in December . This year's recipient, the Office of the United States Surgeon General, was announced with little fanfare and no press coverage via an article on Siegel's blog, Tobacco Analysis.

According to Siegel's article: “The Surgeon General's office takes the award for disseminating widely throughout the media the blatant lie that even brief exposure to secondhand smoke can cause cardiovascular disease and that inhaling even the smallest amount of tobacco smoke causes cancer.”

Of course, if the office of the SG is disseminating a lie, then US Surgeon General Regina Benjamin is a liar.

Last week, Siegel noted that the ANR (Americans for Non-smokers Rights) was claiming that "there are virtually no health disparities between active and passive smoking." In other words, the risk of heart disease associated with secondhand smoke is the same as the risk from active smoking. The ANR was a runner-up in Siegel's Tobacco Control Lie of the Year Contest.

According to Siegel, “These false claims are damaging because they undermine decades of public education about the hazards of active smoking. They represent a lie that is every bit as false as anything the tobacco industry has fraudulently asserted in the historical annals of tobacco industry lies and deception.”

In October, 2009, a “committee of experts” from the US Institute of Medicine, in a study sponsored by the CDC, claimed: “Smoking bans reduce the risk of heart attacks associated with secondhand smoke.”

The committee concluded that: “Although there is no direct evidence that a relatively brief exposure to secondhand smoke could precipitate a heart attack, the committee found the indirect evidence compelling. Data on particulate matter in smoke from other pollution sources suggest that a relatively brief exposure to such substances can initiate a heart attack, and particulate matter is a major component of secondhand smoke.”

Dr. Siegel headlined his blog entry: “Institute of Medicine report's conclusions on smoking ban effects are defied by its own assertions; study conclusions, press release severely biased.”

According to Siegel, “ . . . the report draws conclusions that are essentially meaningless from an epidemiologic and clinical perspective. What the report does is take important questions and distort them so much that the answers no longer have any meaning.” That sounds very much like a lie.

Some very interesting remarks. The Office of the Surgeon General is guilty of a blatant lie; remarks made by the ANR represent a lie as big as any made by the tobacco industry; an IOM report distorts the science beyond all meaning.

Now, if those accusations were being bandied about by some insignificant blogger like the Old Rambler, then the main stream media would perhaps be justified in their failure to comment on the rather dubious honour Siegel bestowed on the Surgeon General and Americans for Non-smoker's Rights.

But, the accusation didn't originate with some lowly blogger expressing his opinion and exercising his right to freedom of speech. The allegations of dishonesty come from a medical doctor and a staunch anti-smoking advocate; a professor on the faculty of Boston University School of Public Health. And, charges that the Surgeon General and the ANR are playing fast and loose with the truth and deliberately deceiving the public is not something that should be taken lightly.

Yet, the main stream media ignore the lies and misrepresentations of fact.

In his latest blog entry, Siegel points out more dishonesty from the anti-smoker zealots. This time it's ASH (Action on Smoking and Health) which is claiming that electronic cigarettes are deadly “due to the nicotine, propylene glycol, carcinogens, and other toxins delivered to the user. ASH also implies that the electronic vapor can be deadly to non-users.”

After explaining why those claims are dishonest, Siegel notes: “I do not criticize ASH for promoting a ban on vaping on airplanes. However, I strongly criticize ASH for supporting such a ban by lying to its constituents and by grossly distorting the science.”

Do any of these anti-smoker zealots tell the truth?

In closing his article, Siegel notes: “Coming on the heels of my revelations that a large number of other prominent, national anti-smoking organizations are lying to the public (including the FDA, Surgeon General's office, and Americans for Nonsmokers' Rights), this story makes it compellingly clear that the scientific integrity of the anti-smoking movement is imploding.” Uh-huh.

All those lies, and, still not a peep from the main stream media. A compelling argument could be made that the media is complicit in the deception(s) being perpetrated by the anti-smoker fanatics and the dehumanization of those who choose to smoke.

And what should we make of this comment in the Oneida Daily Dispatch. “New York State tobacco control advocates . . . are descending on Albany to educate New York leaders about the important role tobacco use prevention and cessation have in preventing youth initiation and reducing healthcare costs.”

For politicians in any jurisdiction to be “educated” by the lying bastards in tobacco control . . . now, that's a scary thought.

Wednesday, January 5, 2011

Health warnings on Twinkies?

Back in September, 2010, Canada's federal health authority, Health Canada, advised its provincial counterparts of its intention to postpone the introduction of new regulations requiring tobacco companies to display new graphic warnings on cigarette packs. Health Canada spent an estimated 3.6 million taxpayer dollars on studies and focus groups over the last six years or so, analyzing the potential benefits of larger, more grotesque warning labels on smoking prevalence rates.

In addition to new graphics, the cigarette packs were to include a proposed toll-free smoking cessation help line.

Anti-smoker zealots were, of course, outraged at the delay and began a public campaign to persuade politicians to implement the new warnings immediately. They claim bigger, more gruesome warnings will cause at least some smokers to think twice about their habit and perhaps quit.

According to Gar Mahood, Executive Director of the Non-Smokers Rights Association, “the renewed and improved warnings will, over time, prevent tens of thousands of tobacco deaths." Uh-huh.

Rob Cunningham, of the Canadian Cancer Society, echoed similar sentiments. "Implementation of the new, larger package warnings will be an important achievement, and will reduce cancer and other tobacco-related diseases in Canada.”

And, Physicians for a Smoke-free Canada claim: “Large health warnings also reduce the attractiveness of cigarette packages and help create an environment where smoking is less acceptable.”

The health warnings currently used in Canada were introduced in 2001 and were ostensibly designed to inform the public about the harmful effects of smoking, such as an increased risk for lung cancer and heart disease, as well as the alleged hazards of secondhand smoke. But, in fact, that has never been their real function.

The graphic images were actually meant to “encourage” smokers to quit by providing a constant reminder of the alleged health hazards of smoking. But, most smokers have become desensitized to the warning labels. So, the anti-smoker zealots have been pushing Health Canada to force tobacco companies to display larger, more shocking images on their cigarette packaging in the hope that the negative imagery might persuade a few more smokers to give up the habit.

A group of eight anti-smoker organizations, hinting that the government had caved in to pressure from the tobacco industry, sent a letter to Canada's Health Minister Leona Aglukkaq, pointing out that Health Canada's own research shows larger graphics could cause some smokers to quit. “The research commissioned by your department shows clearly that the larger the warning, the greater the positive impact it will have on its intended target audiences.”

But . . .

Hamish Marshall, in an article in the National Post, questions the research used to support the anti-smoker contention that larger warning labels will have a significant impact on smoking prevalence. In fact, Marshall states unequivocally that the Health Canada research is “deeply flawed.”

Marshall is identified in the Post article as the chief research officer of Abingdon Research, and notes that previously he was responsible for government research in the Prime Minister's Office. One must assume he has some expertise in conducting polls and surveys.

Marshall contends that, to avoid something called "social desirability bias" , “good researchers ask their questions in ways designed to obscure the point of view of the client, providing an environment where the respondent feels safe offering "unpopular" opinions.”

However, says Marshall: “The Health Canada studies are a master lesson in doing just the opposite. They seemed to be trying to introduce as much social desirability bias as possible into their results. “ Ouch.

In other words, the surveys were manipulated to solicit answers favourable to the proposed policy of incorporating larger health warnings on cigarette packs. Having already made up their mind that new health warnings should be larger and more pornographic, Health Canada commissioned the study so they could claim public support for the new health warnings.

After pointing out many of the flaws he sees in the research, Marshall concludes his article with a little advice to Health Minister Leona Aglukkaq : “Rather than listening to her bureaucrats' advice, the Health Minister would be well advised to do some research of her own: a full investigation into the research practices of Health Canada. “ Uh-huh.

Unfortunately, that advice will fall on deaf ears.

And, I wonder . . .

Since the government has assumed the right to dictate graphic design of cigarette packaging for the tobacco companies, when will they legislate graphic warnings on Cola? Twinkies? Shotgun shells? And, just how in hell will they convince the black market to display the new warnings on the 50% of cigarette sales in Ontario estimated to be contraband?