October 21st, 2020

Twenty reasons to be sceptical about rules lowering nicotine levels in cigarettes - and what to do instead

Well, that rather depends on how you ask the question

To mark the annual US Food Drug and Law Institute Tobacco and Nicotine Products Regulation and Policy Conference (21-23 Oct), where FDA traditionally gives an update on its plans for nicotine regulation, I thought it worth noting that the centrepiece of its comprehensive strategy for nicotine seems to have disappeared.   This would be a proposed rule lowering nicotine levels in cigarettes with a view to making them sub-addictive – persuading adults to quit and adolescents to never start.  The trouble is that consumers, markets, producers, and criminal networks have a way of thwarting such bold measures.

Not in the work plan. The US Federal government periodically sets out its overall regulatory programme (the “Unified Agenda“).  For Spring 2020, the Health and Human Services / FDA list (here) continues to show the absence of effort on rule-making that would reduce nicotine concentrations in cigarettes to sub-addictive levels. This disappeared from the list last year.

The centrepiece of a comprehensive strategy. In July 2017, this measure was announced as the centrepiece of FDA’s strategy for tobacco/nicotine – a multi-year roadmap.  It seems to have run out of road in less than three years, perhaps reaching a dead end with the departure of Scott Gottlieb – its most visible backer (speech, July 2017). It caused quite an earthquake at the time and precipitated a sell-off in tobacco stocks that they have not so far recovered from.

I have always been sceptical about this measure.   Here are twenty reasons to be sceptical. >> read the full post

October 21st, 2020

Response to the extremely poor European Commission SCHEER preliminary opinion on e-cigarettes

….and another thing.

 

Further to my 30 Sept blog: European Commission SCHEER scientific opinion on e-cigarettes – a guide for policymakers.

I have made a short submission to the consultation on the European Commission SCHEER Committee preliminary opinion on e-cigarettes.  You can respond to the consultation on this very poor scientific assessment here, where you can find all relevant documentation.  The closing date is just before midnight CET, Monday 26 October 2020. All contributions are helpful, but keep it polite, objective and on the subject – the science of e-cigarettes – and most importantly, in your own words.

In my view, the problems with the report are too serious and fundamental to justify a line-by-line and paper-by-paper incremental review.  I set out the fundamental problems on my 30 September blog:  European Commission SCHEER scientific opinion on e-cigarettes – a guide for policymakers.  So rather than pretend that this dreadful report can be easily fixed with a few more references and some different takes on the evidence, I have reiterated the main themes of that blog in the “Summary” box of the consultation submission form and provided the blog as a link and upload.  I’ve no idea whether they will give this the slightest attention, but they should, because I’ll back when they’ve done the final report.

Update 26 Oct 2020. It’s the closing date and I’ve made an additional submission.

Here’s my response: >> read the full post

October 14th, 2020

Australia's anti-vaping activists and bureaucrats working together to harass citizens and protect the cigarette trade

I remember back when I was Director of Action on Smoking and Health in the UK (1997-2003), we used to glance across hemispheres and admire what they were doing on tobacco in Australia. Australia’s anti-smoking coalition was engaged in a feisty battle for genuine public health, defending the little guy from predatory tobacco companies. At that time, it was the David of the story taking on the giant.

No longer.

What a pitiful spectacle they make now.  Now they are the predatory giants, harassing and bullying the little guy.

Thousands of ordinary Australians want a better and longer life by switching from smoking to vaping but an unaccountable cadre of public health activists, apparently with unshakable convictions untempered by evidence, humility or empathy, believes the government should use its powers to obstruct them.  On what basis? And how have they managed to get the Minister for Health to go along with their weird and dogmatic opposition to pro-health innovation and progress that is working well elsewhere?

In June, Australia’s Minister for Health, the Hon. Greg Hunt MP announced new measures to make access to vaping products even more difficult in Australia: Prescription Nicotine Based Vaping. This is an astonishingly poor act of policymaking and this blog takes a hard look at his proposals.

I am pleased there is to be a Senate inquiry into Tobacco Harm Reduction – this blog is my initial take on how Australian policymakers, consumers and businesses should navigate these issues – it’s quite long so please dip in.

>> read the full post

September 30th, 2020

European Commission SCHEER scientific opinion on e-cigarettes - a guide for policymakers

“C’mon… we’ll never get away with that

Introduction

The SCHEER opinion on e-cigarettes

On 23 September 2020, the European Commissions’ Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) provided its Preliminary Opinion on Electronic Cigarettes (context & abstract, preliminary report PDF).  This opinion is important because it is one input to the report on the implementation of the EU Tobacco Products Directive 2014/40/EC, under Article 28 of the Directive.  This review should complete by 20 May 2021, and it may form the basis for a further revision of the Tobacco Products Directive.  The Committee’s mandate (Request for Scientific Opinion) sets out its terms of reference.

Consultation

The preliminary scientific opinion is open for consultation responses until 26 October 2020. The consultation system is here: Public consultation on electronic cigarettes and looks designed to deter responses to the extent possible. ETHRA, European Tobacco Harm Reduction Advocates, provides guidance on responding here.  However, that is not the only way to respond to it, though responding directly is important.  Another way is to approach the people who are intended to make sense of and use the opinion – policymakers in EU member states and European Commission, politicians in the EU legislature, and stakeholders in the political policymaking process. This post is for them.

This post

In this post, I discuss why the SCHEER preliminary opinion offers no useful analysis or relevant insights to policymakers. It is not that the committee has not reviewed a lot of literature: it has. It stems from a more fundamental problem: a failure to frame the scientific knowledge in a way that will assist policymakers in considering what, if anything, to do next.  Though policymakers should be the primary audience, the report also provides little of value to other communities of interest – smokers, vapers, parents, public health or medical practitioners, or businesses.

It starts with reproducing the report abstract and then groups my advice to appropriately sceptical policymakers under ten headings. >> read the full post

July 23rd, 2020

Canada takes a wrong turn after a flawed paper induces moral panic about youth vaping and smoking

Canada takes a wrong turn after a flawed paper induces moral panic

Summary

In June 2019, an influential and well-respected research group published a paper in the BMJ showing both a sharp rise in youth vaping in Canada between 2017 and 2018 – mirroring the rise in the United States.  But the truly shocking finding was that there had also been a sharp rise in youth smoking (not seen in the United States).

Starting from well before publication, the paper had a strong negative influence on Canada’s approach to tobacco harm reduction, causing a reversal from a promising and insightful pro-public health approach to making ad hoc responses to a mounting moral panic.  Yet it turns out the smoking figures were wrong – a consequence of a flawed weighting procedure.

By July 2020, a correction had been issued in the BMJ noting that with revised weighting, smoking had, in fact, fallen.  But, absurdly, the correction was buried in a statistical supplement and the published paper still states, inaccurately, that youth smoking increased in its results and conclusion.  The discussion section of the paper continues to discuss an increase in smoking that never happened. Given the political salience of this paper, a proper correction or retraction and resubmission is essential.

In this blog post, I unpick what happened and when. I finish with thoughts on lessons for researchers using this type of research to promote regulatory policies. >> read the full post