What? Patience dear reader and bear with me.
This week the MPs on the House of Commons Select Committee on Science and Technology released their favourable report on e-cigarettes. UK Channel 4 News brought together Deborah Arnott, Director of Action on Smoking and Health and Professor Martin McKee from the London School of Hygiene and Tropical Medicine.
Now looking at that line-up, the average viewer would expect the campaigner to rail against the report, accuse MPs of being ‘nobbled’ by Big Tobacco and generally attack any idea that e-cigarettes could by any measure be described as ‘a good thing’. Whereas the expectation would be that the academic would be the sane voice of balanced, evidence-based reason.
Not a bit of it. Deborah called the report ‘balanced’ (which it is) and corralled all the other evidence from the whole alphabet soup of August medical bodies in support of tobacco harm reduction including PHE, RCP, BMA and the NHS. All the Prof could muster in response was mainly the evidence-free world of the WHO and something called PATH which most viewers would think was a reference to invigorating country walks. A key point he made was that e-cigs don’t help people to quit – which Deborah robustly kicked into touch. Those who think like the Prof will only give the slightest ground to tobacco harm reduction if, and only if, the errant smoker switches to e-cigs as a very rapid exit strategy from nicotine consumption altogether. But surely there must be other reasons why a smoker might want to switch? Let’s see now. How about NOT DYING?
The BBC did include the MPs’ report in its headline news round-up, but also set it against the study from some university which demonstrated that if you subject poor unsuspecting cells to 24 hours of continuous nicotine chemical warfare, they won’t feel very well at the end of it thus proving conclusively that vaping is bad for you. Comparison with cigarette smoke? No. Anything even vaguely resembling a real-world situation? No.
And this kind of one-off flawed study will be trotted out along with similar bad science and set against proper evidence reviews as if they were equally valid. Hence, the bullshit asymmetry principle coined by Karl Lund from the Norwegian Institute of Health which basically says that the effort required to redress the balance against bullshit takes way more effort than was expended on producing bullshit in the first place.
And because of all the media-friendly bad news bullshit, the risk perception of e-cigarettes over cigarettes just seems to get worse. A recent poll from the US polling agency Rasmussen revealed that only 20% of American adults think smoking e-cigarettes is safer than smoking cigarettes. Thirteen percent think e-cigarettes are less safe than traditional ones, while 50% think the health risk is about the same from both. Another 17% are not sure. This is the result of official bullshit at its most damaging and morally repugnant.
Just as worrying though was the way the question was framed; “Is smoking electronic cigarettes more safe or less safe than smoking traditional cigarettes, or is the health risk about the same?" Firstly, vaping produces no smoke and secondly who ever said that either vaping, let alone smoking, was ‘safe’? It’s almost as if the question was framed deliberately to confuse. Did somebody pay to get the ‘right’ result?
What can be done? Clearly just citing the evidence-base isn’t enough when one study of nicotine-addled mice from Dogbreath University can sideswipe considered multi-study reviews. But the example of medicinal cannabis in the UK may be instructive. For years, there have been campaigns, reports, articles and TV programmes urging that people be allowed to use cannabis for medicinal purposes while the state has spent thousands of pounds of tax-payers money prosecuting otherwise law-abiding citizens for growing, supplying and using cannabis to alleviate distressing symptoms. All moves to get a change in the law have fallen on official deaf ears. And then this year, two cases of young people in desperate need of cannabis oil to deal with horrendous seizures captured the public attention and suddenly ‘what to do about medicinal cannabis’ landed right into the Prime Minister’s lap. The Chief Medical Officer produced what seemed like an instant evidence review and a special group of experts convened. The rules and regs will be changed. How much difference it makes remains to be seen, but drug policy was turned on a penny by the fact that this always highly controversial issue passed the critical three-pronged stress test - the scientific, the political and the public (both the popular press and social media).
Could the same happen with safer nicotine products in countries where they are banned or at least very hard to obtain? What if a campaign was started by the families of those who have lost a loved one through lung cancer or who have relatives struggling to give up cigarettes? Could they be mobilised to put pressure on politicians and start say ‘#ustoo’? First of course, they would have to be convinced that safer nicotine products can make a difference to the health of those they cherish. But there are plenty of tobacco harm reductionists; academics, doctors and consumers who would be only too happy to oblige.