August 31st, 2016

When you thought public health could go no lower - it just did

sunvaping

Except that is wrong in every way

The news coverage:

British newspapers, the main domestic vector of the anti-scientific public health dogma and baseless fear-mongering, were yesterday filled with prominently positioned garbage articles about vaping:

Not one single element of these headlines has any grounding in reality, and all are grossly misleading.  The contributory negligence or cynicism of journalists in reporting vaping health stories is now commonplace.  However, in this discussion, I would like to focus on the extraordinary negligence of the scientist behind these claims.

The quick version:

See Peter Hajek’s comment at the excellent Sense about Science:

Professor Peter Hajek, director of the Tobacco Dependence Research Unit at the Wolfson Institute of Preventive Medicine at Queen Mary University London, said:

“The study is reporting on a well-known short-term effect of nicotine – stiffening of arteries – that accompanies all types of stimulation. The same effect is generated by watching a thriller or a football match or sitting an exam. Drinking a cup of coffee actually produces a larger response of much longer duration. The key heart health risks of smoking are not caused by nicotine but by other chemicals in tobacco smoke that are not present in e-cigarette vapour.”

The facts:

  • Who’s behind it? The claim that prompted these headlines was made at a conference, the European Society of Cardiology congress in Rome, by Professor Charalambos Vlachopoulos, of the University of Athens Medical School. It is, of course, sponsored by pharma interests.  He is responsible for carefully describing the limitations of his study, yet there is no sign of caution or caveat.
  • What is it based on? It was based on a study of one particular well known acute response to nicotine exposure, written up as a letter to a journal: Vlachopoulos C, Ioakeimidis N, Abdelrasoul M, et al (2016) Electronic Cigarette Smoking Increases Aortic Stiffness and Blood Pressure in Young Smokers. J Am Coll Cardiol 67:2802–2803. [link][PDF]
  • What was the study about and should we be concerned? We should not be concerned by this. This is a study that measures an acute effect of nicotine use on the ‘stiffness’ blood vessels.  Similar effects are found with exposure to coffee, as a result of exercise and even while listening to music. Please see Mike Siegel’s amusing ridicule here: Anti-Tobacco Researcher: Cardiovascular Effects of E-Cigarettes are Nearly as Big as Smoking. Just because a stimulant causes a change to some measurable property of the body, it cannot be assumed (as they appear to have done here) that this will lead to harm.
  • Should Professor Vlachopoulos have known about caffeine causing the same effect on aortic stiffness as nicotine? Yes. He was the lead author of a study about it.

Vlachopoulos C, Hirata K, O’Rourke MF (2003) Effect of caffeine on aortic elastic properties and wave reflection. J Hypertens 21:563–70. [link]

Conclusions: Caffeine affects unfavorably aortic stiffness and enhances wave reflections. This finding has implications for the impact of caffeine consumption on cardiovascular risk.

[Improved conclusion: “This finding has (fatal) implications for (exaggerated) claims about the impact of aortic stiffness on cardiovascular risk“]

  • Is it new news? No. We already knew nicotine itself caused arterial stiffening [here] so nothing new is revealed here.
  • Does this signal that vaping has the same cardiovascular risks as smoking? No. It does not automatically follow that this stiffening effect causes cardiovascular disease in smokers or that it is a good marker for disease risk – and the study has cited nothing that establishes this link. It may be something else in cigarette smoke, rather than nicotine and rather than this particular effect (eg. like clogging of arteries). It may be that nicotine combines with something else in tobacco smoke to have a combined effect. To the extent the science is understood, it is products of combustion (like carbon monoxide) in cigarette smoke that do the damage to the cardiovascular system, with nicotine possibly having a reinforcing effect on these. See the U.S. Surgeon General on smoking and cardiovascular disease here.
  • So what do actual experts say about nicotine and vaping? Where nicotine is used separately from tobacco smoke, for example in the form of NRT or smokeless tobacco, there is no significant elevated disease risk. With these insights, Benowitz and Burbank reviewed the evidence on nicotine cardiovascular risks with e-cigarettes in mind:

Benowitz NL, Burbank AD (2016) Cardiovascular toxicity of nicotine: Implications for electronic cigarette use.  Trends Cardiovasc Med. doi: 10.1016/j.tcm.2016.03.001 [link][PDF]

Nicotine exerts pharmacologic effects that could contribute to acute cardiovascular events and accelerated atherogenesis experienced by cigarette smokers. Studies of nicotine medications and smokeless tobacco indicate that the risks of nicotine without tobacco combustion products (cigarette smoke) are low compared to cigarette smoking, but are still of concern in people with cardiovascular disease. Electronic cigarettes deliver nicotine without combustion of tobacco and appear to pose low-cardiovascular risk, at least with short-term use, in healthy users.

  • Even if there is no risk, why did smoking and vaping come out the same? The Greek study was designed to try to equalise nicotine exposure from smoking and vaping – 5 minutes of smoking were compared to 30 minutes of vaping. So if nicotine is causing the arterial stiffening, then the observed effect would be likely to be the same as for tobacco, as this is designed into the experiment.
  • What’s wrong with just reporting the results? He went a lot further than reporting results. In making these claims to the media, Professor Vlachopoulos highlighted an entirely predictable and already-understood effect.  His team calibrated the experiment so that the effect would be roughly the same in smokers and vapers. They then went on to falsely attribute a cardiovascular disease risk to this commonplace effect of stimulants.  He then implicitly claimed that this effect was sufficient to equate vaping cardiovascular risk to smoking cardiovascular risk. The authors carefully avoided noting any of the established literature on nicotine cardiovascular risk, including the recent paper that addresses this question explicitly in the context of e-cigarettes. Vlachopoulos then took this exercise in reckless ignorance into the media, which duly obliged with massively unscientific scare stories without the slightest critical push back.
  • Did anyone back him? Someone serious-sounding from the British Heart Foundation compounded these multiple errors in a comment to the Mirror by affirming them and adding his own non-sequitur about ‘e-cigarettes cannot be assumed risk-free’ (something that is both a nonsense concept and literally no-one credible says):

Professor Peter Weissberg, Medical Director of the British Heart Foundation and one of Britain’s most senior doctors, said: “The findings show that e-cigarettes have a similar effect to normal cigarettes on the stiffness of the main blood vessel in the body.” He said the discovery was ‘important’ and warned it ‘shows that e-cigarettes cannot be assumed to be risk free’.

  • What about his policy prescriptions? Not content with spreading junk science, Professor Vlachopoulos, then turns his hand to policy prescriptions and implications that should flow from this…

Study leader Professor Charalambos Vlachopoulos, of the University of Athens Medical School, said the UK had ‘rushed into’ its promotion of e-cigarettes, adding: ‘E-cigarettes are less harmful but they are not harmless. I wouldn’t recommend them now as a method to give up smoking.’

  • Are these ideas well-founded? Professor Vlachopoulos feels qualified to advise on smoking cessation and what he considers to be UK “promotion of e-cigarettes” – which is actually a carefully nuanced approach that he may not be fully conversant with. He has no scientific basis for making these recommendations, as above, and has  no relevant experience in smoking cessation or tobacco policy, and, of course. repeats the ‘not harmless’ non-sequitur.  In proffering this advice, one wonders what advice he would give to live smokers or vapers: should anyone who has quit using e-cigarettes return to the safety of smoking? And what of the 2.3 million UK and 8.3 million US current vapers?  Should they stop, return to smoking and start again with some other sort of smoking cessation approach? I don’t know, but I do know his baseless policy assertions received not even a cursory challenge.
  • Have tobacco control leaders put him right? Of course, tobacco control’s top fanatics are gleeful (e.g. here and here) compounding and amplifying these academic errors and jacking up the misleading hyperbole, which is now their primary function.

What is going on?

So…

  • …an academic goes to a conference casually tosses a wild exaggeration into the media that has no basis in reality or even in his actual work.
  • He creates deeply misleading headlines (with some additional contributory negligence from journalists) that are likely to divert smokers from a potentially life-saving behaviour change and create anxiety or promote relapse among vapers.
  • He promotes wider confusion about the perception of risk that rubs off on policy makers and health professionals.
  • He detracts from careful efforts to address the wide gulf in relative risk perceptions and reality we have in the UK and almost everywhere.
  • He fails to correct the story in the news or make any counter-statement to restore balance.
  • He hands propaganda lines to academic activists that will amplify its malign impact.
  • He asserts policy advice that has no foundation in either his work or anywhere else and that is beyond his professional competence.
  • Through his cavalier negligence, he has protected the cigarette trade, promoted smoking and probably caused more cases of death and disease.

I recognise that his work and this interpretation is easily dismissed by even the most elementary analysis (as above). But in terms of impact on society, this single incident, magnified to thousands of times its rightful significance in the British press, could easily outweigh and negate the entire career impact of many careful, responsible academics. It is the anti-vaxxer model of science, and it is appalling.

Accountability? I am pretty sure he will not face any reckoning or accountability or even the mildest rebuke from his peers, who will simply not see it as their responsibility or care insufficiently about the consequences, or who are too timid to engage.  On the contrary, his media ‘success’ will be high-fived by his colleagues, institution, funders, his wretched ‘learned society’ and the conference organisers/sponsors – thus ensuring it happens again and keeps happening. It’s not as if this is an isolated incident within tobacco policy or elsewhere in public health.  Here is almost the same story from June 2016: Professor Stanton Glantz makes an irresponsible and baseless claim about vaping risks.

A failing system. My view is that this is just another surface manifestation of a parasitic and malfunctioning academic public health system in which there are powerful perverse incentives to behave irresponsibly [for example, funders’ hunt for ‘impact’, conflicted sponsors, personal ego and prestige, ideology and virtue signalling, group-think and group loyalty], but with minimal checks and balances, or any accountability for the consequences.  Being a system problem, these failing needs a system response – not just isolated blogs writing the counter case. I hope there is someone out there thinking and worrying about this, because the public that is funding public health academia as both taxpayers or charitable donors is, overall, getting a really rotten deal.

58 comments to When you thought public health could go no lower – it just did

  • […] how often, and how badly vaping is portrayed in the media it should be no surprise that the public perceptions have changed. […]

  • […] in an effort to “prove” that vaping is bad for you. Most readers will remember the worst vaping article of 2016 in The Sun – though there was an altogether bizarre story drawn from an anecdotal story on Reddit which […]

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  • […] When you thought public health could go no lower – it just did On Tuesday 30th August 2016 the news media turned against Vaping all because of a study which said e-cigarettes cause 'stiffness' to blood vessels. Cue the abundance of headlines with anti-vaping messages. The team at VE counted up to 200 news articles which carried the same message 'Vaping is as bad as Smoking'. The study does show that intakes of nicotine cause aortic stiffness, but so does the intake of caffeine and even listening to music! Thankfully, Clive Bates provided a response to the news headlines with this excellent counterfactual article. Please read it and share it amongst the Vaping community but most importantly the general public because such misleading news like we witnessed this week is damaging to the positive image vaping had gained in the last year, thanks to the PHE and RCP reports. […]

  • […] how often, and how badly vaping is portrayed in the media it should be no surprise that the public perceptions have changed. […]

  • […] when you thought public health could sink no lower, it pulls it off again! This time, a couple of “tobacco control” organisations, CTFK and ENSP, […]

  • […] that study compared 30 minutes of vaping with five minutes of smoking and concluded that both can induce temporary […]

  • Properjob

    Hearteningly, a quick trawl through the comments sections of those news stories shows a healthy dose of skepticism among the responders…

  • […] The Counterfactual, Clive Bates, points out that again, the British newspapers made their headlines, with this new […]

  • […] When you thought public health could go no lower – it just did On Tuesday 30th August 2016 the news media turned against Vaping all because of a study which said e-cigarettes cause 'stiffness' to blood vessels. Cue the abundance of headlines with anti-vaping messages. The team at VE counted up to 200 news articles which carried the same message 'Vaping is as bad as Smoking'. The study does show that intakes of nicotine cause aortic stiffness, but so does the intake of caffeine and even listening to music! Thankfully, Clive Bates provided a response to the news headlines with this excellent counterfactual article. Please read it and share it amongst the Vaping community but most importantly the general public because such misleading news like we witnessed this week is damaging to the positive image vaping had gained in the last year, thanks to the PHE and RCP reports. […]

  • […] The Counterfactual, Clive Bates, points out that again, the British newspapers made their headlines, with this new […]

  • […] The Counterfactual, Clive Bates, points out that again, the British newspapers made their headlines, with this new […]

  • […] Clive Bates: When you thought public health could go no lower – it just did http://www.clivebates.com/?p=4311 Ontario Ministry of Health funded junk study authors conclude e-cigs don’t help smokers quit […]

  • DP

    Dear Mr Bates

    It is rather ironic that ‘public health professionals’ have become a threat to real health.

    It seems that the public’s health might be better served by disbanding many, if not all, of the ‘public health’ organisations and saving hugely on their taxpayer-funded costs.

    The electronic cigarette has lifted the lid on the motivations driving the people in the smoker control industry.

    DP

  • sebt

    I can’t say I’m surprised that “Vaping is as bad as fags”, given that even supermarket till receipts make you impotent.

    The contemporary world is far more dangerous than that faced by prehistoric man. Deadly dangers lurk everywhere, and whereas caveman could at least trust in his senses of hearing and smell, modern man must rely on the bravery and integrity of intrepid investigative reporters to uncover the insidious, hidden threats posed by everyday objects. Often, as in e-cigarettes, the threat is so cunningly disguised that even Scientists can’t detect it. (Probably because it was deliberately added in and obscured in the first place by other, evil Scientists, in the time they had available between their obligatory hourly 15-minute Manic-Laughter breaks).

    Luckily there are also Good Scientists, like Prof Vlachopoulos (who deserves extra credit for going against the grain of his fantastically Evil Scientist name). Let’s not quibble about silly details of methodology or scientific relevance; what makes these guys Good Scientists is that they’re brave enough to stand up for what everyone knows to be true, which is that whatever the other 99% of scientists are cooking up in their sinister, lightning-lit castles, it Just Ain’t Right. Thanks to the Good Scientists, we know that everything is in fact dangerous; that all scientists (apart from the Good Ones, obviously) are lying about it; that we can only avoid the dangers by reading the newspaper; that everyone should buy more newspapers. (Why have there been no scientific studies investigating the obvious causal link between reading newspapers and not getting cancer? It’s a conspiracy, obviously).

    So, although this story is despicable, harmful nonsense, I don’t agree that it’s a case of the Public Health faction planting, planning or promoting stories (although, as Clive has documented, they are obviously very happy about it after the fact). Newspapers follow very simple agendas: scepticism about the safety of products of science and technology could be seen as just a subtype of the general pattern “Shock Revelation: What You Thought Was X Is In Fact Y!”. All that PH had to do was to clunk a few little gears into place to connect up e-cigarettes to the powertrain of this agenda – then they could simply stand back and watch.

    And that was easy for them to do, because e-cigarettes are easily linked (even though it’s not true) to the past behaviour of tobacco companies – a paradigmatic case of X really turning out to be Y – and, simultaneously, to the theme of things cooked up by irresponsible scientists in a lab, with no understanding of the side-effects (even though it’s not true).

    I’m certainly not saying that PH don’t ever actively try to plant or promote anti-ecig stories. This story, however, seems like an instance of something even worse: the machine PH set in motion working on its own. I can readily imagine that this scientist “freely” chose to misrepresent his research, and that the journalists concerned “freely” chose to report it without scrutiny, without any outside influence being necessary at the time.

    This is what makes (for example, it’s not the only one) what Clive reports in his previous post about the Telegraph so frustrating. As Carl says, the problem is systemic; and the worst corruption lies in the fact that the people concerned are obliged to uncomfortably pretend that they’re still practising honest science or honest journalism, when they’re obviously not. So an attempted confrontation can’t even reach the level of a clarifying debate: instead, you get adhoms, shows of wounded feelings and refusals to communicate.

    On the journalism side, you’ve got journalists having to churn out 3 times as much copy as they used to. (Owen Jones attributes this to the autocratic atmosphere of the UK press, the insane level of competition for readership, and the smashing of journalists’ and printworkers’ unions back in the 80s). So they don’t check their facts. And somewhere in the editorial chain of command, science stories end up following a simple template, well-suited to the click-generating “X Is Actually Y!” formula. There’s not nearly enough “X Is Actually Y!” going on in the world to feed this demand, so it has to be made up (or fluffed up) out of available materials. In a kind of pornification of science, every new (or rediscovered) “discovery” (which suits the agenda) is cast and reported on as a lone Galileo standing up against the establishment. Or rather as another Galileo: such is progress that there’s a scientific revolution about once a week.

    This is a confluence of deeply-rooted and well-established agendas, and it’s about far more than e-cigarettes and the PH faction (though they gladly make use of it). If science has been established in public perception as a continual, dramatic battle between heroic truthseekers (defined as those who articulate the “obvious” truth that product or practice X is horribly harmful, and that the scientific establishment have been concealing this) and a supposed majority who try to quash them, is it even possible to defuse scare stories without looking like the mediaeval Catholic Church?

    I have a feeling that, once this framing has taken place, rebuttals like Clive’s face an impossible task (which doesn’t mean that it’s not worth trying). Against the power of the drama established by scare stories, arguments about scientific relevance, methodology or the low power of single pieces of research are like popguns.

    Far better would be to prevent this kind of dreck from being published in the first place. That’s an enormous task, which extends out into politics, the media industry, and science funding mechanisms. It couldn’t fit into a blog devoted to strictly scientific rebuttals of scare stories. But I wonder whether the solution might not involve not just removing the dysfunctional role imposed on science by science reporting, leaving a putative “pure”, independent science, but replacing it with a better one (a kind of “agenda harm-reduction”!).

    There’s an interesting paper here about how the requirement to live up to unexamined standards of social relevance enters not just into researchers’ funding applications, but even into their own perceptions of their role and the work they’re doing:

    “Telling stories about science means much more than simply giving a correct
    account or an attractive presentation to convince members of the public. It is about choice, about what stories are being told and which ones are left out, and in that sense also about which kind of science we frame for which kind of society.”

  • […] regularnie blog Clive’a Batesa. Jego najnowszy wpis dotyczy świeżej histerii medialnej. Myślę, że warto się z tym zapoznać. Kolejny raz media (tym razem anglojęzyczne) rzuciły się na informacje z kongresu medycznego jak, […]

  • […] in the form of NRT or smokeless tobacco, there is no significant elevated disease risk,” wrote Clive […]

  • Norman

    Ban smoking, ban tobacco, ban ecigs and ban nicotine patches. Put the entire country on cold turkey for a month and everyone will be the better off for it. Then we can stop wasting taxpayer funds on this matter. And after the one month period, anyone still caught smoking or vaping, put them in public service sweeping streets or serving meals to the homeless and without time to waste, standing around smoking, they will learn some compassion for others instead of the selfishness they think is their right to perpetuate forever while society pays the price in their poor health for treatment and lost productivity in the workplace.

    • John walker

      “Learn some compassion for others” indeed

    • Guy Eaton

      Well if you banned smoking patches and EC would eventually not be needed! Smoking has been a state endorsed addiction through tobacco tax. Also, using your rationale you should also ban many other products including alcohol – this really would save the tax payer loads of money reducing ill health and accidents. Problem is you can’t just pick out one product you have a dislike for in a democracy. Further the ‘tax payer’ pays nothing for EC! It is a cheap consumer lead revolution that requires little State intervention and kills no one.

    • Guy Eaton

      Further you would need to ban longer than a month and work productivity would initially probably fall!!

    • vapingpoint

      Oh, I had a good laugh at your post – sardonic humour pleases me.

      But what if we reversed your idea. Disband Tobacco Control. Lift all the bans on smoking tobacco and vaping and cancel all the taxes on Tobacco and the ones that will be imposed in the future on the vaping industry, and THEN what would happen? The government would lose the money that smokers pay them – far more than their “cost” to the government, but then they could recoup it by saving on the monies they pay Tobacco Control and the millions they pay to Smoking Cessation Services and for patches, gums etc The Hospitality Industries would flourish. Pubs would return. Communities might be healed and tourists would flood in by the millions. The economy would flourish! Those from the Tobacco Control Industries who had lost their jobs could do public service sweeping streets or serving meals to the homeless and without time to waste, persecuting smokers, they would learn some compassion for others instead of promoting dogma that they think is their right to perpetuate forever.

      Lovely thought experiment – as funny as yours!

  • […] When you thought public health could go no lower – it just did On Tuesday 30th August 2016 the news media turned against Vaping all because of a study which said e-cigarettes cause 'stiffness' to blood vessels. Cue the abundance of headlines with anti-vaping messages. The team at VE counted up to 200 news articles which carried the same message 'Vaping is as bad as Smoking'. The study does show that intakes of nicotine cause aortic stiffness, but so does the intake of caffeine and even listening to music! Thankfully, Clive Bates provided a response to the news headlines with this excellent counterfactual article. Please read it and share it amongst the Vaping community but most importantly the general public because such misleading news like we witnessed this week is damaging to the positive image vaping had gained in the last year, thanks to the PHE and RCP reports. […]

  • Mike

    As a vaper for over 4 years (having successfully quit a 34 year smoking habit), I wrote to my MP and 6 regional MEP’s back in April complaining in very strong terms about the introduction of draconian legislation on vaping to be introduced by the EU TPD. They all replied. My MP (Ken Clarke) said what a ridiculous and unwarrented piece of “legilation”it was and the MEP’s pointed out the secretive process of how the TPD was drawn up and how they were excluded from significant parts of the decision making process. Needless to say they were all powerless to actually change or veto any part of the Directive.

    One of the points I made at the time is the same point that I would make now about these lazy, sensationalist scare articles: Follow the money – it’s simply the Big Tobacco and Big Pharma lobbies hard at work again desperate to protect their market share. And they will carry on doing so by whatever means they perceive to be the most effective. Ignore them and ignore the TPD I say – which is why I’ll be ordering scores of 30ml bottles of eliquid before they’re supposedly “banned” for sale in May next year. Anyway, if Article 50 is invoked before then, presumably the TPD becomes irrelevant to the UK.

  • Mr Binkley

    Those who control the ‘governments’ around the world also control the media, all of it. Changing perceptions, altering the way we think is what the media has always done. TV was not invented to entertain us. Anyone the media promotes as opposition to our current way of living, are also controlled by those who have absolute control over the masses. The ‘controlled opposition’ also help to keep us from doing anything ourselves, because their are people out there doing it for us. For anyone interested in the controlled media, please see Clues Forum and read with an open mind.

  • John walker

    This story may well have something to do with the fact that as it stands before too long there will be a much greater range of ecigs and eliquid legally available in the UK ,than in the rather ‘puritanical’ US. Such a extreme asymmetry has obvious implications for the real world viability of the FDA’s de facto prohibition of ecigs in the US.
    I would expect that scare campaigns agaist the UKs position on ecigs, will escalate .

  • David Mullen

    This is not a fact based story,it’s old fashioned advertising !!!

  • Tim

    Whilst I share your outrage and was ranting about this myself yesterday to anyone who would listen (not many), I don’t think this is something in any way specific to vaping. It is happening all the time, in all sorts of fields, on all sorts of issues, but you are noticing it here because you are informed about vaping, and are emotionally invested in it.

    You are perhaps overestimating human beings, particularly large groups of them, who don’t all care about the same things you do. There are unfortunately precious few points for objective truth in human discourse.

    “It is not the flower dying that makes us unhappy, it is the unrealistic expectation that flowers should never die.”

    Thank you for all you write and do. It is nice that there are those who are willing and able to stand against the torrent of crap, even when it reaches their armpits.

  • Anonymous

    Load of crap … Scaremongering as normal

  • Oh no! I just fashioned a comment here and I dropped my mouse. My dog thought I was playing and leapt all over it. I don’t know if he posted my comment, or just deleted it – and he doesn’t know either!

    So I start again.

    I was saying that the press has been well-trained especially by Tobacco Control, to spread the most hair raising junk science so that the population can be re-calibrated to accept their agenda. The effects of Second Hand Smoke causing lung cancer is an example of something that has never been scientifically proven, yet it has caused the smoking bans, even in the out doors, and people believe SHS will kill them.

    People – even doctors – believe nicotine causes cancer.

    People believe smokers have black lungs.

    People believe cigarettes contain “tar”.

    “Smoking kills” is another example of hyperbole and there is no apology from the Tobacco Control perpetrators of such untrue “headlines” and they were/are perfectly happy for a tame press to repeat their mantras ad nauseum.

    I can’t see any difference with what is hapenning now with vaping.

    Unfortunately, the T C template is being copied by others. The press also spreads the ideas of the sugar antis, obesity antis, the booze antis, and other lifestyle misbehaviours with “scientific” stories leaked to them by the antis.

    The symbiosis of the do-gooders with the press is disgusting. But more disgusting is the practise of do-gooders forcing their agendas on countries by infiltrating public health and feeding off public funding to do so.

    I have no objection to anyone setting up their own “charity” – whatever its aim. But it needs to be supported by private funding.

    The fact that Nato’s World Health Organisation got involved with Tobaco Control in the first place should have been questioned right at the beginning. It has squandered billions on “Lifestyle” legislation and the fact that it is happy for countries (even the poorest of them) to do the same in an effort to conform to The Tobacco Control Directive is repulsive to me. Whether any “directive” was promoting world co-operation on – say – birth control, or whether we should eat sadwiches instead of soup, and to turn into such a juggernaut in doing so, is something every sane person should question – no, fear.

    The answer is to disband the whole of Tobacco Control and not allow such power to any “group” in the future. That way no such a groteque thing could ever occur again. Tobacco Control have built themselves up into a most evil bunch.

    Am I the only one that sees that?

    Anyway, thank you for caring Clive.

    My dog is going to post this comment now, he says. :-) And apologises if he’s already posted one!

    • “It is, of course, sponsored by pharma interests.”

      Of course. The media story is a simple damage control effort by Big Pharma. The E-cigs have been depressing pharma’s market share for four years, not only NRT’s and smoking cessation products, but also the markets of pharma’s monopoly products, like antidepressants and other presciption drugs.

      What we are witnessing is the turn of a huge business supercycle. A turn in which old products & methods eventually will fall and new products & methods will rise. Nothing can stop that turn – it is the way of universal and human activity and development. But the owners of the old products & methods will by all means try to postpone it. However eventually they will always loose.

  • Jon Ingall

    What we really need now is for a proper public statement- printed media, telly and radio- from at least one of the big guns. PHE, RCP or even ASH (won’t hold my breath though).
    This situation is an absolute travesty which will, in no uncertain terms, damage the overall public health by deterring those who might have switched from tobacco to vaping.
    It’s all well and good putting things straight on Twitter, and via (excellent) pieces such as this- but the problem is that the takedowns and debunkings NEVER make the press. They just aren’t interested, as long as they shift papers.
    I (as many of us are) am almost at my wits’ end with this nonsense now. The general public believe almost everything they’re told, and trying to fight back is, to say the least, an uphill struggle.
    Us vapers now cop more abuse and flak from the public than smokers do. Just yesterday I was pilloried for vaping by a smoker- he wouldn’t even listen to my thoughts, to him I was still a smoker. I gave up after a tirade of abuse was hurled at me, despite my remaining calm and dignified.

    This HAS to stop. We need a public statement, and a big one at that.
    Clive, your work is excellent. Paul Barnes, John Summers, Lorien Jollye, Dave Dorn, Dick Puddlecote- to name just a few- are all tireless, excellent advocates.
    But their messages are wasted unless the general public get to see them.

    And that is a situation I find very depressing. How do we move forward now? We need some very high-level intervention, and fast.

    I don’t wish to be pessimistic, but it seems that every time we seem to be getting somewhere, someone comes along and kicks the ladder out from underneath us.
    And the fact that this is (most likely) sanctioned by those who SHOULD be protecting our health, not their own pockets, is utterly sickening.

    • Guy Eaton

      I agree with this. A public statement is needed – fundament research by PHE & RCP seems to have been ignored as is a report from NCSCT synthesising all good research to date. Also, there is currently a Government strategy to inform the public & Parliament of evidenced based information that vaping is far less risky.

  • […] The news coverage British newspapers, the main domestic vector of the public health community’s anti-scientific dogma and baseless fear-mongering, were yesterday filled with prominently posit…  […]

  • Clive,

    Obviously your outrage is warranted. But perhaps it is a bit, well, naive. You describe “contributory negligence” by journalists. But theirs is clearly a/the primary crime. People recite all sorts of lies and Dunning-Kruger shit to the press every day. That does not make that ok, but it does mean it is a state of nature. It is the journos’ error in putting their reputations and megaphones behind falsehoods. Even worse than not examining the facts in a particular case is not even making any effort, in their careers, to figure out who to believe. Believing a random medic from a third-world medical school who is just reporting on silly toxicology experiments is just stupid in the first place.

    Of course, when the do that for someone whose politics go the other way on this issue, the same people who condemn this will praise that. So, yes, this is about the fact that tribalism rules in public health, not science.

    As for the comparison to the work of other academics in public health, if you exclude those who are actually doing fieldwork in underserved places, I would estimate that to be a net negative on average anyway.

    More important, however, is getting too excited about one Tuesday’s newspapers. How many headlines ran about the doom that Brexit would cause? Or the panacea? Is anyone still influenced by one particular one of those? I find it hard to imagine that there are many people whose opinions will be changed (as opposed to their preferred beliefs just being reinforced) by this by next Tuesday.

    Of course there will be no accountability. There is no accountability for anything dishonest in public health. There are only litmus tests for political correctness. A few people in the field, like Linda Bauld who already commented, have a different view of political correctness than the mainstream, but it is still all about politics and not science. I have seen her endorse plenty of junk science when it suited her politics. (Nothing unique about her in all of this, so not singling out. She just happens to have a comment above.)

    • Clive Bates

      I don’t think it was naive… I made it clear I was not focussing on the journalism this time. But I agree this is a major part of the problem and driven by the new incentive structure that journalists face now that on-line impact is a major pre-occupation of their owners. It’s just that I’ve done a couple of posts on that recently – Credulous or cynical? Science journalists played yet again by e-cigarette pseudoscience and spin and Telegraph science editor Sarah Knapton puts the record straight. Not really..

      I don’t think the problem is one day of newspaper headlines, but a malevolent and malfunctioning system that keeps creating them without any apparent restraint or accountability. As you would usually say, the critique is ‘meta’. But I think specific instances of that are a more accessible way of discussing it that as an abstract system.

      • Ok, I should not have said “naive” — sorry. I know quite well that you are one of the least naive people I know. What I was going for was something like “what you write kind of implies that it would be possible for institutions to get evil or Dunning-Kruger-ized people in their midst to stop saying stupid things to the press, and that it makes sense to try to leverage the issue there”. I would say there is no chance of that. Recall the forays into criticizing people like that where you and I have discussed/debated the attempt. With the exception of more or less only the two of us, the criticisms are precious kid-glove bickering about petty details and dramatics that reminds me of a Victorian lady fanning herself and passing out. Why? Because those within the institution do not want to criticize the core problems — their careers are built on perpetuating those problems.

        Yes, there is a malevolent and malfunctioning system. But suggesting there are any checks within that system is pretty hopeless.

        Fighting the behavior of the press is a steep climb too, of course. But at least they are violating the norms of their profession that most of their peers uphold, whereas the anti-THR pontificators in public health are not violating any norms (there are none) and are simply acting their role.

        • Clive Bates

          I totally agree it’s a tough climb all round. I think it will have to come from people who want a modern pragmatic and self-aware version of public health that actually works and isn’t just a Trojan Horse for anti-capitalist crackpot authoritarianism.

          There are some things that would help – post-publication peer review, open peer review for example if done at scale and routinely. E.g. see the PubMed Commons reviews of this.

          Also, at least one academic has written to him asking him to correct the misleading statements in te press, and others have made critical statements. That is something rather than nothing – but it needs to emerge as a routine way of challenging negligent work and words.

          I don’t agree that you can dismiss all people in that field – many care deeply and do good work, and find this deeply frustrating. But challenge within the discipline is just not a cultural norm, unless it’s bullying ‘enforcers’ making sure everyone subscribes to their dogma.

    • I’ve reached the point where, although I believe we need a post-peer-review system (call it “collegiate review, something where a panel of PAID and CREDITED experimental-design and statistics experts review something after peer-review but before publication and have some power to approve or rebut…long story) and I believe the press should be more-aggressive in seeking truth, the bottom line is this is OUR fault…we advocates. Because the press no longer has the money to go out and look for stories, they get ALL their stories from press releases or police scanners. And pro-THR advocates issue few if any press releases. When I bring this up, I’m told they would be ignored. Well, duh. I’m sure that 99% of press releases are ignored. But the act of ignoring them is still a choice. If we don’t issue them, then that choice doesn’t even exist, and the people who would have to choose to ignore us will not have a memory of ignoring, say, 100+ press releases a year. We are not knocking on the door and we wonder why nobody answers? Let’s get some cumulative history building in that space.

      • Steven Raith

        The pro THR press releases do go out (note how ECITA regularly get quotes in these days, too), but there’s no adclick money in good news.

        It’s really that simple. The rebuttals to this sort of shoddy research need to come from the top – PHE, ASH (fat chance..), RCP, RSPH et al, who have real weight, and who need to be very clear on these matters.

        When you, me, or even Clive or Carl rebutt this stuff, you’ll quite often see ad-homs and general ignorance as we ‘aren’t important’ or we’re biased, etc – despite the rather obvious notion that if these things are dangerous, we’re the ones with something to lose as we’re the users, and so have an interest in getting accurate information on the risks.

        If PHE come out and say “Er, yeah, this is disingenuous twaddle and we’ll be speaking to our counterparts in Greece and IPSO about this obvious misinterpretation of the facts” then that’s a different story entirely.

        Problem is, support from the top is hard to find – I did see in the Times today a list of comments from PHE, RSPH, ASH about this study, but it was a small boxout fairly deep in the paper.

        What it needed was a front page challenge from the Times to the Sun to put up or shut up – which of course, would never happen as that’s Just Not How It Works.

        That said, like DD, I’m tired (not just because of the recent shenanigans – I’m currently living in BnBs while trying to move to Leeds from Scarborough whilst working full time…) and so don’t worry about reading too much into this post. Just add it to the list of the times where I’ve been vaguely constructively shitposting, as is my norm. :-)

        Steven R

        • There need to be a LOT of THR organizations issuing press releases, and if necessary, we could have half of them be bad news, by issuing releases talking about scientific fraud.

          And of course, we’ll not get as much coverage and we need the top guys to do things, but I really think the press should have to work 10 times harder to ignore us than they presently have to work.

          (They’ll still ignore us, but maybe they’ll moan about it in the lunchroom where other journalists can overhear.)

          There are journalists out there who are completely unaware there’s another side to this: https://grrattitude.org/2016/06/11/is-it-time-to-wake-up-the-press/

        • Steven,

          “Problem is, support from the top is hard to find” I disagree — but only in the sense that this is an understatement. I would contended that you NEVER find support from those quarters (I would not call them “the top” of anything!) in the form that would matter.

          My underlying point was that to the extent that any of them speak up on any of this, they never say “the system that produces claims like this is fatally flawed and it should be realized that….” or even “this particularguy is full of shit and no one should listen to him”. This is a classic case of those in power versus the public that lacks power: Sure some of those in power might move the needle a little bit in favor of the people compared to their fellows, quibbling around the edges about details. But ultimately they are happy and comfortable with the system, and will not say anything to really challenge it because it works for them. The only ideas or people they will attack aggressively are those that threaten their cozy arrangement. (cue references to Brexit, Trump, Corbyn, Bernie Sanders, etc.)

  • Steven Raith

    Here’s an irony of sorts.

    Forty years ago, when there was little public scrutiny of research (acedemic or industry), Big Tobacco basically owned the press in terms of getting it’s misinformation out there – and lets face it, it lied so hard it’s pants could be used as an industrial blast furnace and there was little way for public health to counter it, as they could simply outspend them, had better PR, etc.

    Fast forward to today, we have greater access to research than ever – the public can see more research, more quickly, and can openly critique it in a manner that it has ever been able to before.

    But now, the misinformation and pants-on-fire is being pushed by irresponsible researchers desperate for attention and research grants. They have the ears of the press, and because they are ‘Public Health’, they get uncritical press coverage, rather like big Tobacco used to back in the day – not because of money, bribery, etc, but because they’re public health, how can they be wrong?

    Quite easily, as this demonstrates.

    There’s some quote about fighting monsters that I’m sure is relevant here but the exact wording escapes me….

    Steven R

  • Fundamentally, the Peer Review system is being compromised in the era of “publish or perish” – and with the current debate surrounding the benefits or risks of e-cigarettes, there is a gamut of ‘research’ being published weekly, if not daily.

    Most of such papers, and I refer to several I’ve seen recently including the infamous “unicorn” study are prime examples of how the peer review system – particularly within the tobacco control / public health spheres – is broken.

    The sad thing is, many of these papers garner a lot of media attention, most of it negative, which only serves to influence the harm perceptions of the public at large. The headlines are the hook and they stick, so when a paper – like the Sun or any other paper – boldly splashes across the front page “Vaping as bad as fags” the damage is done in five words.

    Damage that, sadly, is nigh on impossible to reverse by the consumer advocates like me – we either get accused of being “addicts needing our fix” or, in some extreme cases, thoroughly abused.

    Sadly, rebutting such poor journalism is difficult, and countering the actual research is even harder for those of us without access.

    • Sarah

      Spot on Paul.

      It doesn’t matter what 100 vapers say, or even a 1000, we will always be dismissed. If the academic world fails to root out and expose these charlatans for what they are a great many people will suffer the consequences of their misinformation campaign.

      And they wonder why we get angry..

  • Linda Bauld

    I do think there is someone somewhere worrying about this. This includes funders as well as researchers and others. The problem is that funders operate largely within a domestic (national) sphere in public health and the international environment (beyond a few countries) is overwhelmingly opposed to tobacco harm reduction. That is not the full story but it is part of it.

    It’s like the scenario of the little Dutch boy and the dyke: http://www.pantheon.org/articles/l/little_dutch_boy.html

    Basically we need more fingers. Mine are getting quite tired, as I am sure yours are too.

    Linda

    • We’ve been sticking fingers in the dyke for ages – it needs the folks with the tools to effect a permanent patch to come along. In my view, that needs (in the UK) to be the Department of Health. They need (again in my view) to publicly and loudly state that the ecig provisions in the TPD are a whole load of hooey, remove every last drop of TPD inspired legislation from the TRPR, make a big song and dance about it, and then publicly humiliate these disingenuous so-called researchers who are scaring the bejaysus out of folks, and, at the same time, get some kind of class action against the editors and journalists who write and publish this kind of crap.
      And yes, my fingers are tired – I’m just about out of the strength reserves to keep fighting at the rate we’ve had to, and while these disingenuous tosspots reap financial rewards, my bank manager looks at me funny these days.
      David

      • David, Clive, Linda,

        As I said at the Global Forum on Nicotine this year, until someone is brought to book for their malfeasance this won’t stop. For the UK at least Public Health England, the Dept of Health and the Crown Prosecution Service should be having a little chat…

        Does it set a worrying precedent if they do? I suppose yes, but no more worrying than the precedent being set by those malign individuals infesting Public Health organisations & charities.

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