May 3rd, 2016

Fighting the Vape Militia Online and Off - a reply to the speakers

California Public Health Conference

Offensive: a failed campaign mocks its critics

This session from a California tobacco control conference was circulated on Twitter and caught my eye. To me, it summarises a lot that is wrong with the anti-nicotine crusade and also with the behaviour of public servants and public health professionals in this field.  Here was my reaction on twitter, but I decided to go further…

Click to go to Twitter

Click to go to Twitter

Rather than just get annoyed on Twitter, I decided to take action in the real world and set this argument out properly, found their email addresses on the internet and wrote to the people involved in person. The memo is framed using the three themes in the tweet:

  1. Treat the public with respect
  2. Spend money wisely
  3. Learn from mistakes

Here’s the memo as sent Tuesday 3rd May 2016.

TO:
Derek Smith
Julie Lautsch
Tess Boley Cruz
Beth Olagues

I write as a former director of a well-known tobacco control organisation, a former senior civil servant and as a current advocate for tobacco harm reduction as a public health strategy. I have no competing interests with respect to any tobacco, nicotine or pharmaceutical business.

I note with some concern the theme of a seminar held during the conference: Tobacco Control, Research, and Education: Joining Forces to Address New Challenges  on October 27-29, 2015 at the Sheraton Grand Sacramento Hotel.

7B: Fighting the Vape Militia Online and Off
What happens when you produce an excellent educational campaign on e-cigarettes in your community only to have pro-vapers stampede right through the middle of it, creating a storm of negative attention and calling you names along the way? Learn from people who experienced it first-hand as we explore who the vape militia is, the tactics we use, and what you can expect from them in response to your campaign. Leave with smart strategies for planning ahead, talking points for a coordinated response, and knowing how to better prepare for negative encounters – online and off.

Speaking as someone who may even be part of this ‘militia’, I think you would be better served by understanding a little more and mocking the public a little less. Have you really understood why the “Curbit” campaign attracted the hostility it did? And have you figured why those involved feel strongly enough to ‘stampede‘ through your campaign?

I’d like to make three suggestions for a better approach in future.

1. Treat the public with respect

Maybe the public is right and you are wrong? Three of you are public servants and all of you rely on public funding for your own livelihoods. You all work in public health.  The key word here is “public”. When the public, or a subset of it, dislikes what you are doing, you should not react by dismissing them and indulging in name-calling. This is a matter of professional ethos – your responsibility, not theirs.  Something bad happened to you and your campaign, but maybe the fault was with you. You should reflect on it more carefully before you go any further with coaching others on how to fend off public criticism or, worse, to ‘fight’ them.

If you think any sort of industry is behind this, you are mistaken. Obviously, I don’t know what you believe lies behind the ‘storm of negative attention‘ you earned from the public, but if you have even the slightest suspicion that it has been orchestrated by the tobacco or vaping industry, then should abandon that idea immediately – it is completely incorrect.  If this is the case, you need to spend some time understanding social media more deeply. The effect you experienced – no doubt unpleasant – of many vape activists swarming on your campaign is known as an ’emergent behaviour’.  It arises from thousands of people sharing, liking and retweeting ideas, arguments and links that they find interesting, or, in your case, they find annoying. The best ideas, arguments and links emerge through a process of natural selection and arrive on your screens looking like a concerted onslaught. But they are not – the behaviour is emergent not co-ordinated.

You’ve been called names – get over it.  If you spend much time in a frontline role with the general public, you will find the public is highly diverse but mainly includes people who are mostly polite most of the time when they criticise others. But there will always be some who will find the asymmetry in the power relations between your well-funded mass campaign and their actual lived insights so frustrating that they will be blunt with you. You must not whine about this. You should get over it. They are the ‘public’ in ‘public health’ and you are professionally obliged to engage with them on their terms as long as they are lawful. If you would like to explore the vapers’ perspective on this conflict more deeply, I would like to recommend starting with my memo to public health: Vaping, vapers and you

2. Spend public money wisely

Did you do any due diligence on your campaign? Your dismissive approach to critics would be a little more bearable if the campaign itself had been built on proper evidential foundations, a realistic understanding of the behaviours involved, a clear justification for the desired outcomes, and a worldly assessment of the risks of unintended consequences that might be caused by your campaign – eventually leading to others dying in agony.  If you are going to spend public money, these are the things you need to do.

There is no sign that you have done any of the above.

The upfront falsehood in your campaign is fatal to your credibility.  Your campaign leads with a blatantly untruthful statement, which can only have been designed to mislead.

“E-cigarettes are harmful, like cigarettes”

That is just not true, is it?  E-cigarettes are very much less harmful than cigarettes, and that is their most relevant characteristic for consumers. The legitimate scientific arguments focus on where in the range 95% less to 99.9% less harmful. As the UK Royal College of Physicians puts it, in its report Nicotine without smoke: tobacco harm reduction

Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure. (5.5)

Can you see the difference between in the messages conveyed by these two statements? You may disagree with this expert assessment, but it is evidence-based and you certainly cannot point to any evidence that suggests the risks are remotely equivalent.

The campaign is founded on multiple misrepresentations of risk.  Your campaign literature is full of highly misleading statements about nicotine toxicity, second-hand vaping and the presence of contaminants or products of thermal decomposition in vapour. If it would help, I will give you a line-by-line assessment (you just have to ask), but the criticism boils down to the most basic idea in toxicology:

the dose makes the poison

The only reason I can think of to mention chemical names without quantifying exposure is to scare people.  But in reality, there is no reason to be scared. What matters is the exposures relative to smoking and relative to what we normally tolerate in society.  This is very well set out in several reviews, which you should digest before communicating risk with the public:

  • Burstyn I.  Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks, BMC Public Health 2014;14:18. doi:10.1186/1471-2458-14-18 [Link]
  • Farsalinos KE, Polosa R. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf 2014;5:67–86. [Link]
  • Hajek P, Etter J-F, Benowitz N, Eissenberg T, McRobbie H. Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction. 2014 Aug 31 [link

Your legitimate role is to use public money to inform, not to manipulate. If you were trying to inform Californians so they could make their own decisions in their own interests then you would not have implied smoking and vaping have equivalent harm. The effect of this is to imply to smokers that there are no health benefits from switching to vaping. So if any smokers have acted on your information and continued to smoke, you may well be ultimately responsible for their death from cancer, cardiovascular disease or emphysema. No wonder vapers reacted so forcefully to this misinformation from you – lives are at stake. Maybe you thought this message formulation would trick people into rejecting e-cigarettes? As public servants and public health professionals, it is not your job to deceive anyone. People make their own decisions and your role, if any, is to assist with that with high integrity communications.

Do you really know what you are doing? You should consider the following carefully, and what they might mean for your work.

  • What if vaping is an alternative to smoking?
  • What if users – young and older – are overwhelmingly smokers or would otherwise smoke in the absence of vaping?
  • What if the record declines in US adult smoking since 2012 are due to adults switching to vaping?
  • What if the rapid declines in youth cigarette smoking since 2012 are due to adolescent switching to vaping or never initiating smoking?
  • What if all your policies like vilifying vaping and vapers, banning vaping in public places, taxing e-liquids, banning flavours etc all just make vaping less attractive relative to smoking?
  • What if the FDA regulation you favour is so onerous that would simply wipe out most American businesses involved, protecting the cigarette trade from competition and favouring the tobacco industry in the vaping market? Do you want to be doing the dirty work for Big Tobacco?

Have you thought through any of this? Because if not, you should not be spending a cent of public money on this campaign.  And if you have, then you would not be spending a cent of public money on this campaign, because you would have concluded it was ill-advised.

I can walk you through the evidence on all of this if would help, but it is really your job as public servants to do that. To get you started, I’ll just offer you this evidence-based rejoinder to the arguments of the e-cigarette crypto-prohibitionist Matthew L. Myers of the Campaign for Tobacco Free Kids.

Your critics say you are deliberately trying to promote smoking for fiscal reasons.  Your critics point to (YouTube) California’s dire public finances, the Master Settlement Agreement funds, and irresponsible securitisation and draw an obvious conclusion: the state is trying to protect cigarette-related revenues by putting people off the alternative.  I don’t believe this theory myself. I think that ordinary ill-conceived policy and poor science is the more likely explanation. But what have you done to respond to their challenge?

3. Learn from your mistakes

Complaints are learning opportunities not a reason to mock your critics. You call them ‘negative encounters‘, I call them ‘feedback’. Just as modern governments and businesses increasingly value public complaints as an input into their improvement and innovation culture, you had a learning opportunity here.  But you don’t seem to have taken it. Here are some things to consider that might help you in future:

  • Did you make contact with any of your “vape militia” critics?
  • Did you invite them to share their insights and concerns – for example by meeting with them or asking them to write to you?
  • When they raised challenges to your campaign, did you engage to address their concerns or even to accept they had a point?
  • Did you defend the things you were saying or was the social media interaction one-way only – you hectoring and haranguing them, and then ignoring their reactions?
  • With such a hostile reaction, did you reflect on whether you had misunderstood the area you are working in (see above) and need to rethink?
  • Are you sitting in an anti-vaping echo-chamber suffering from group-think?

In public health offices, university departments, tobacco control conferences and the closed and introverted world of tobacco control it is quite easy to acquire a profound misunderstanding of the real world and believe everyone else shares your view.  Maybe your views about vaping just didn’t survive their first contact with reality. That’s something to learn from and not a reason to sneer at the people who took you down.

I would very much like to see sound public health thinking return to California, and I would be delighted to follow up this memo with a Skype call at your convenience. Please let me know if you would like to proceed with that.

This matter is of interest more broadly, so I have made this memo publicly available. I look forward to hearing from you, and will, of course, respect any request for confidentiality.

Yours sincerely

Clive Bates
Counterfactual
London

I’ll keep readers posted on any replies, though of course respect any request for confidentiality.

26 comments to Fighting the Vape Militia Online and Off – a reply to the speakers

  • Anonymous

    I quit a 20 year smoking habit with an ecig. In three days I was totally off the tobacco and never looked back. Something else happened also. In my enthusiastic research into these products, a stark reality set in about the concerted force of governmental and agency effort to discount, lie and obfuscate these products and technology. It’s been a similar, natural progression with myself and many vapers experience. I thank you Mr Clive Bates for having a grounded perspective on the technology and the dire shortcomings of the US tobacco policies. Always look forward to you thoughts and perspective. Fine work here again.

  • I’ve wanted to contact them but am buried in work and family (and anti-56, and Billion LIves)
    and I think the group that would have the largest stake in not throwing away their credibility would be the Immunization Branch:
    http://www.cdph.ca.gov/programs/immunize/Pages/default.aspx

    A lot of vaccines are not 100% effective (Whooping cough is 80% at BEST) and we have had whooping cough deaths in infants too young to vaccinate because the “herd immunity” has dropped too low. Why add vapers (many of whom are young parents) to the list of people that don’t believe anything the CADPH says?

  • Julio

    Thanks for good article, Clive. Myself personally quit smoke and start vaping and feels a lot better on health. I can run don’t cough, my wife won’t angry on me because I don’t smell bad. Pros, pros, pros.

  • I know quite a few people who have started vaping to quit smoking cigarettes, and they say it’s been a huge help for them. Many of them have gotten to the point where they smoke liquids with little or no nicotine at all. Thanks for sharing this!

  • […] Clive Bates: Fighting the Vape Militia Online and Off – a reply to the speakers http://www.clivebates.com/?p=3996 […]

  • Zac S.

    Amazing! I emailed, wrote on Facebook, Twitter, Instagram many, many times asking the simplest questions… Never once getting a response. I cited medical and scientific studies negating the information they were posting to the public and never once received a response. When they claimed vaping kills, I asked for one instance. I do believe that this boils down to loss of revenue for the state of California, specifically MSA funds. The borrowed against it to stave off bankruptcy and now find themselves in crisis mode..and after reading more negative responses and seeing them “fight” against the vaping community justifies my line of thinking. They are scrambling to keep their jobs while being utterly clueless as to what exactly they are “fighting” against. Thank you sir for a well thought out response. Let’s see what-if anything-they have to say in response. I’ll bet on black, radio silence.

  • Anthony

    Clive great article… Congrats and thank you from a long time vapor…

    My only fear is thatbitbwontbmatter because the anti-vaping campaigns are more prevalent in the media thus garner more public attention that the pro-vaping campaings…

    Also, it’s sad to say, but stupidity and misinformation is the way of the world and the US in todays age. The “immediate self gradification” mindset of American people will harm any pro-vaping truths because most Americans see and believe what they see on TV because it is immediate (even though usualy false) information… it’s information in which is presented so concretely that people often do not feel the need or want to research the subject further to discover if what they were just told is bullshit or not. “It was on the news or in the paper so it must be true because journalists don’t lie and they research these things before they print them” is the prevalent way of thinking…

    The only way to get the American public ton listen is to get the truth put out there on some major network news report or major political talk show, either satirical or otherwise (John Stewart or JON Oliver come first to mind) or some national program where a debate can issue and the truths can finally bury the lies….

  • Clive Bates

    Several commenters are asking variations on: will these Curbit staffers pay attention? The answer is ‘probably not’ – the ignorance and arrogance are strong there. But you never know, there might be someone else in California Public Health who actually does useful work and wonders why resources flow to these people. Or a budget office. Or state politicians. There might be journalists wondering why this is controversial, and there might be smokers or vapers feeling bullied, who want to push back. There might be senior officials in California State wondering why the quality of policy-making is so poor and looking for a case=study. There might be vapers who write similar letters or ask their congressional representatives to do the same….

    It’s kind of in the nature of social media that you don’t know who is reading and what they will do with the information and idea you publish. Occasionally it may change something by routes you never of thought of and that you didn’t know had happened.

    They haven’t replied, but I have more to say to them.

  • I am eagerly awaiting a response from those in California as this is my home state. I have lost all hope in any public official or servent here in CA. It would be nice to see atleast one step forward with integrity and sit down to hear both sides.

  • Thank you Clive. I believe both sides needed this.

  • Nukeum

    Clive,

    Thank you so much for your perspective on this, very succinct and to the point. Will the CADPH take it to heart, will the ANTI_VAPING Militia really listen when there is so much evidence that is Pro Vaping, as stated ion your memo above they didn’t look at science before launching that campaign, I highly doubt that anything will transpire from this, I await their reply to this, as a former smoker 2 1/2 packs per day for over 30 years, I am smoke free for the last 4, thank you for calling them out.

  • Gil Benitez

    As a former 40+ year smoker who is going smokefree now 5+ years thanks to vaping, I applaud your efforts to bring some common sense to the debate. Unfortunately, I don’t think it will be successful. After the MSA, the states sold government bonds anticipating the windfall of cash they would receive from big tobacco. That amount has been lessened now by billions of dollars due to people quitting smoking. The money has been spent and I don’t think there is any way of recouping it unless they tax e-cigs and related products like tobacco products which I believe would kill the industry “or” they get more people smoking again, health be damned. It comes down to greed or common sense and I’m sure most of know which side the politicians fall on that subject.

  • […] Fighting the Vape Militia Online and Off – a reply to the speakers  […]

  • Chris Erickson

    Thank you for such an eloquent, logical, and organized communication. You speak so well for the millions of people who need to leave the dangers of smoking behind.

  • Tache

    Clive,

    Thanks once again for a factual, balanced and appropriate response to politics. I know it might seem at times that you are whispering into a storm, but I take heart from the apparent change of “temperature” lately in the media. There are far more neutral (and some times even positive!) pieces about vaping. The releases by Public Health England (which I’m sure you and some of your colleagues had an impact on) and the recent release by the British College of Physicians and Surgeons, appear to have had a great influence on turning the tide.

    Please take heart and don’t stop. You are making a difference and I thank you.

    A forty year, two pack a day ex-smoker, current vaper – three years completely smoke free.

  • A+ Mr Clive Bates. Such a well delivered lesson and Kudos to you for including the voice or smokers and vapers. Awesome letter. Have a grand evening.

  • strayan

    Anxiety about the remaining uncertainties of ecigs has turned pathological for this lot.

    Their behaviour is consistent with people experiencing persecutory delusions.

    • That might possibly be true; many of “this lot” were negatively affected by pharmaceutical “stop smoking drugs” like Chantix, and were able to quit smoking by using tobacco harm reduction products to successfully quit smoking cigarettes. Perhaps those same lot fear the damage that could be done by prohibition of such life-empowering technology. The science is present.

  • I have always fantasized about taking my complains about CADPH to the vaccination department. They’re DESPERATELY trying to stop the outbreaks of measles and whooping cough in California (that includes one at my grandson’s daycare that resulted in him having to go through 3 rounds of needless antibiotics or else my daughter would have had to quit her job.) I’d think it would bother someone what the ANTZ among them are doing to their credibility.

  • G. Karl Snae

    An excellent letter to the Californians, but doubt they read it, but surely dislike if read but maybe learn something in a strange way ;-). But that’s not the most important really, because so many others read it and enjoy and surely learn from it and admire your tone in your letter and use it towards similar types on another occasion they confront. I will surely make use of your text when needed. Thank you.

  • Irish Lass

    Clive, as always, you put these dangerous people to shame.

    I hope they will actually READ your memo and that, having done so, they will actually THINK about what they are doing. But I fear that they will do neither, given their contempt for all those (even scientists) who do not share their point of view.

    At least there are now some sensible public health voices telling the truth about vaping in the UK. Would that they had done so before the e-cigarette section of the TPD got voted through by the EU Parliament.

    But even here the Tobacco Controllers still cannot accept the evidence that e-cigarettes are safer than tobacco cigarettes. What hope in the US, where it seems that all of the public health establishment is following Tobacco Control like sheep?

  • Louise Ross

    A joy to read, Clive, as always

  • Bob Pearson

    Excellent Clive, very nicely put.

    I often think, when reading some of the anti vaping rhetoric, then seeing your measured responses, that common sense must surely prevail, that there will be a lowering of the veils and the world will be a better place.

    Sadly, so far, that seems to be fantasy, but I still live in hope.

    Please keep up the great work that you do.

  • […] This session from a California tobacco control conference was circulated on Twitter and caught my eye. To me, it summarises a lot that is wrong with the anti-nicotine crusade and also with the beha…  […]

  • Guy Eaton

    Brilliant!

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