US Surgeon General: World’s Most Dangerous Man?

Having only had a few hours notice that the US Surgeon General would be releasing his “first” report on the subject of e-cigarettes, it should come as no surprise how quickly the news has spread that “e-cigs are bad mmmkay”. Clive Bates eloquently put together three separate posts, two before the report and one after. Each delving deep into the minutiae of the US position on e-cigarettes.

The major issue with the release of this report is how easily it will be taken as gospel by a number of tobacco controllers and public health busybodies. Already Simon Chapman has gleefully tweeted:

Which doesn’t link to the report, but rather his mate Stanton Glantz’ analysis of it – which needless to say, is full of self-indulgence (seeing as Glantz was in fact a reviewer of the report) – and claiming that a total of 150 “experts” reviewed it. Actually the number of actual reviewers was only sixty-four, including two from the Campaign for Tobacco-Free Kids. There were seven report editors, seven contributing editors, twenty-three contributing authors, and twenty-six “other” contributors. Adding editors, authors and contributors together is only 127.

I thought being a “scientist” meant you could math? If you add the seven other acknowledgements, it’s only 134. Still far short of the “Reviewed by 150 experts” figure. Still, this isn’t a Simon Chapman bashing session, for once.

The opening statements included in the report from Sylvia Burwell, Thomas Frieden and the Surgeon General himself naturally reflect the tone of the report and it is, quite frankly, the worst piece of drivel I’ve had the misfortune to read.

Comments such as:

and

Commentary from two individuals that are hardly objective when it comes to e-cigarettes specifically, and harm reduction generally.

If you truly care about the young people of the nation then you’d spend more time researching how to make these products better instead of wasting taxpayer cash on scaring the public into believing that e-cigs are just as harmful (or more harmful) than combustible tobacco. But then, this is a deliberate crusade against a disruptive technology that can have a major beneficial impact for millions of people.

As noted by Dr Christopher Russell:

It is clear from the report that there is an emphasis on the harms (potential or otherwise) of e-cigarettes rather than the benefits that can be gained.

The thing is, this “astounding increase” doesn’t have any context. This is, plain and simple, a sound-bite for the media to pick up and echo.

Data from the CDC shows that, yes while e-cigarette use has risen other actual tobacco product use has fallen. But showing information like this alongside combustible tobacco simply reinforces the ideal that e-cigarettes are a tobacco product. Whether you agree with that sentiment is beside the point, it adds to the misconception that the products are bad – after all, the US spends an awful lot of taxpayer dollars telling anyone and everyone that tobacco is a bad thing. (hint: it’s an enjoyable, legal product)

The US also likes to admonish anyone that uses any of the products shown in the graph as “hopelessly addicted” but data from the Monitoring the Future Survey belies that claim:

Experimentation is by far the most common reason why teens use e-cigarettes with tiny number claiming they are “addicted”. If nicotine is such an addictive chemical as is widely (and incorrectly) believed then surely that tiny 0.8-1.3 figure would be much larger? There is already solid data on nicotine within NRT that can, if used correctly, handily debunk such a myth. Some NRT users do indeed continue long past the end of their “course” and those figures are likely to be around the same level – 0.8 – 1.3%.

Meanwhile, the headlines generated in response to this report are only going to further skew public perceptions of the product – look for the next survey data point when the public are asked how harmful they think e-cigarettes are, guarantee there’ll be a jump in “as harmful” and “more harmful”. Which, of course, is the whole point of this exercise isn’t it?

Nowhere in the report is there any understanding of why people choose to vape, nor why they choose to smoke. It is grossly underestimating consumer forces and the market in general. But of course, the US don’t like e-cigarettes. They have a comfy number with the MSA and the various “public health” bodies (yes CfTFK I’m looking at you) that a disruptive product to that arrangement is immediately and irreversibly seen as a “public health threat”.

The only threat to the health of the US public right now is from those out to “save” it.

This now means that the UK is truly isolated in its view on e-cigarettes. Does that mean that our establishment will cave in to the mounting pressure from the US and the WHO?

Time will tell.