Swedish scientist: Nicotine causes psychiatric disorders and epigenetic changes that are passed on to offspring – whopdidoo!

 

 

http://www.tobaksfakta.se/nikotinet-bygger-om-hjarnan/

 

New research suggests that the highly addictive substance nicotine can exacerbate psychiatric diagnoses, have effects over the generations and increase the risk of becoming addicted to alcohol.

 

Louise Adermark, University of Gothenburg, researches how nicotine affects the brain. Photo: Maj-Lis Koivisto

 

Nicotine rewires the brain

New research indicates that the very addictive substance nicotine can exacerbate psychiatric conditions, has effects over generations and increases the risk of alcohol addiction.

 

“It is extremely important to keep tobacco consumption down in society, there are many gains to be had,” says Louise Adermark, associate professor at the Department of Neuroscience and Physiology at the University of Gothenburg, who researches how nicotine affects the brain.

 

That nicotine is so addictive depends on the nicotine receptors. They are the body’s “reception centers” for nicotine and are found in many places in the body. Repeated exposure to nicotine by, for example smoking or snus, increases the number of nicotine receptors, which can affect many functions in the body.

 

Nicotine affects the body’s reward system by releasing dopamine, which is a neurotransmitter that makes us feel good and feel awake, happy and present.

 

–The reward system is important for survival. In addition to making us feel good, we need it for memory and learning, says Louise Adermark.

 

But dopamine is also a “rewire the brain” molecule. Nicotine changes the communication in the brain and affects how the tobacco user acts and thinks in the longer term.

 

– Since almost all cells in the brain’s reward system have nicotine receptors, this system changes with repeated nicotine use. This in turn makes it easy to become addicted. Not only to nicotine, but also of other substances, such as alcohol, she says.

 

Exacerbates anxiety and apprehension

 

The nicotine also affects feelings such as anxiety and apprehension. Initially, you feel better with nicotine, but in the long term the feelings of anxiety and apprehensiveness are exacerbated.

 

–There is a high proportion of smokers among people with psychiatric diagnoses. Previously cigarettes have been regarded as a kind of self-medication, but new research suggests that the nicotine may increase the risk of developing a diagnosis. Human research is supported by studies done on animals. These studies show that nicotine slowly “rebuilds” the brain, which leads to changes in how the animals behave, even when they do not have nicotine in the body, says Louise Adermark.

 

It is also not a coincidence that cigarettes and alcohol are connected. Smokers consume twice as much alcohol as non-smokers. Most alcoholics are smokers. Louise Adermark explains about animal experiments where animals were offered to choose between drinking water and drinking alcohol.

 

–When giving the animals nicotine, all animals began to drink more alcohol, she says, and says that there is a connection between the age of the nicotine debut and the abuse of alcohol and other drugs later in life.

 

Another thing that has been shown by animal testing is that the nicotine can have effects that extend over generations.

 

– Genetic studies in rats and mice indicate that nicotine changes genetics and behaviour for several generations. It may involve increased risk of asthma, increased intake of addictive substances, hyperactivity, and more. The results apply regardless of whether it is the male or female who has been exposed to nicotine, says Louise Adermark.

 

 

PLEASE FIND BELOW HER CITED WORK AT THE U OF GOTHENBURG WEBSITE – ON PUBMED ONLY 6 CITATIONS AND NONE ABOUT NICOTINE

 

2018

Progressive modulation of accumbal neurotransmission and anxiety-like behavior following protracted nicotine withdrawal
Julia Morud, Joakim Strandberg, Anna Andrén, Mia Ericson, Bo Söderpalm et al.
Neuropharmacology, Journal article 2018
Journal article

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on a web page

Complex Control of Striatal Neurotransmission by Nicotinic Acetylcholine Receptors via Excitatory Inputs onto Medium Spiny Neurons
Valentina Licheri, Oona Lagström, Amir Lotfi, X. H. Patton, Holger Wigström et al.
Journal of Neuroscience, Journal article 2018
Journal article

Read the full text
on a web page

Acute and chronic modulation of striatal endocannabinoid-mediated plasticity by nicotine.
Louise Adermark, Julia Morud Lekholm, Amir Lotfi Moghaddam, Mia Ericson, Bo Söderpalm
Addiction biology, Journal article 2018
Journal article

Read the full text
on a web page

A molecular mechanism for choosing alcohol over an alternative reward
E. Barbier, R. S. Dulman, Valentina Licheri, G. Augier, E. Domi et al.
Science, Journal article 2018
Journal article

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on a web page

2017

Minor adaptations of ethanol-induced release of taurine following chronic ethanol intake in the rat
Mia Ericson, Lisa Ulenius, Louise Adermark, Bo Söderpalm
Advances in Experimental Medicine and Biology, Springer, Conference paper 2017
Conference paper

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on a web page

Ethanol-induced taurine elevation in the rat dorsal striatum
Lisa Ulenius, Louise Adermark, Bo Söderpalm, Mia Ericson
Advances in Experimental Medicine and Biology, Journal article 2017
Journal article

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on a web page

2016

Temporal Rewiring of Striatal Circuits Initiated by Nicotine
Louise Adermark, Julia Morud, Amir Lotfi, Klara Danielsson, Lisa Ulenius et al.
Neuropsychopharmacology, Journal article 2016
Journal article

Read the full text
on a web page

Disentangling the Role of Astrocytes in Alcohol Use Disorder
Louise Adermark, M. S. Bowers
Alcoholism-Clinical and Experimental Research, Journal article 2016
Journal article

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on a web page

Nicotine produces chronic behavioral sensitization with changes in accumbal neurotransmission and increased sensitivity to re-exposure
Julia Morud, Louise Adermark, Marta Perez-Alcazar, Mia Ericson, Bo Söderpalm
Addiction Biology, Journal article 2016
Journal article

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on a web page

2015

Involvement of Inhibitory Receptors in Modulating Dopamine Signaling and Synaptic Activity Following Acute Ethanol Exposure in Striatal Subregions
Rhona B. C. Clarke, Bo Söderpalm, Amir Lotfi, Mia Ericson, Louise Adermark
Alcoholism-Clinical and Experimental Research, Journal article 2015
Journal article

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on a web page

Age-contingent influence over accumbal neurotransmission and the locomotor stimulatory response to acute and repeated administration of nicotine in Wistar rats
Louise Adermark, Julia Morud, Amir Lotfi, Susanne Jonsson, Bo Söderpalm et al.
Neuropharmacology, Journal article 2015
Journal article

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on a web page

Alterations in ethanol-induced accumbal transmission after acute and long-term zinc depletion
Julia Morud, Louise Adermark, Mia Ericson, Bo Söderpalm
Addiction Biology, Journal article 2015
Journal article

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on a web page

Astrocyte Function in Alcohol Reward and Addiction
Louise Adermark
Journal of Alcoholism & Drug Dependence , Magazine article 2015
Magazine article

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on a web page

Dopaminergic Regulation of Striatal Interneurons in Reward and Addiction: Focus on Alcohol
Rhona B. C. Clarke, Louise Adermark
Neural Plasticity, Review article 2015
Review article

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on a web page

2014

Increase in Nucleus Accumbens Dopamine Levels Following Local Ethanol Administration Is Not Mediated by Acetaldehyde
Rhona B. C. Clarke, Louise Adermark, Pei Pei Chau, Bo Söderpalm, Mia Ericson
Alcohol and Alcoholism, Journal article 2014
Journal article

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on a web page

Locus of onset and subpopulation specificity of in vivo ethanol effect in the reciprocal ventral tegmental area-nucleus accumbens circuit
J. M. Burkhardt, Louise Adermark
Neurochemistry International, Journal article 2014
Journal article

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on a web page

Brain region specific modulation of ethanol-induced depression of GABAergic neurons in the brain reward system by the nicotine receptor antagonist mecamylamine
Louise Adermark, Bo Söderpalm, J. M. Burkhardt
Alcohol, Journal article 2014
Journal article

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on a web page

The involvement of accumbal glycine receptors in the dopamine-elevating effects of addictive drugs
Susanne Jonsson, Louise Adermark, Mia Ericson, Bo Söderpalm
Neuropharmacology, Journal article 2014
Journal article

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on a web page

2013

Rising taurine and ethanol concentrations in nucleus accumbens interact to produce the dopamine-activating effects of alcohol
Mia Ericson, Pei Pei Chau, Louise Adermark, Bo Söderpalm
Advances in Experimental Medicine and Biology, Journal article 2013
Journal article

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on a web page

Region-specific depression of striatal activity in Wistar rat by modest ethanol consumption over a ten-month period
Louise Adermark, Susanne Jonsson, Bo Söderpalm, Matts Eriksson
Alcohol, Journal article 2013
Journal article

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on a web page

2012

Changes in glycine receptor subunit expression in forebrain regions of the Wistar rat over development.
Susanne Jonsson, Julia Morud, Christopher Pickering, Louise Adermark, Mia Ericson et al.
Brain research, Journal article 2012
Journal article

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on a web page

Reduced alcohol intake and reward associated with impaired endocannabinoid signaling in mice with a deletion of the glutamate transporter GLAST.
Rose-Marie Karlsson, Louise Adermark, Anna Molander, Stephanie Perreau-Lenz, Erick Singley et al.
Neuropharmacology, Journal article 2012
Journal article

2011

Modulation of endocannabinoid-mediated long-lasting disinhibition of striatal output by cholinergic interneurons.
Louise Adermark
Neuropharmacology, Journal article 2011
Journal article

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on a web page

Intermittent ethanol consumption depresses endocannabinoid-signaling in the dorsolateral striatum of rat.
Louise Adermark, Susanne Jonsson, Mia Ericson, Bo Söderpalm
Neuropharmacology, Journal article 2011
Journal article

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on a web page

Implications for glycine receptors and astrocytes in ethanol-induced elevation of dopamine levels in the nucleus accumbens.
Louise Adermark, Rhona B. C. Clarke, Torsten Olsson, Elisabeth Hansson, Bo Söderpalm et al.
Addiction biology, Journal article 2011
Journal article

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on a web page

Subregion-Specific Modulation of Excitatory Input and Dopaminergic Output in the Striatum by Tonically Activated Glycine and GABA(A) Receptors.
Louise Adermark, Rhona B. C. Clarke, Mia Ericson, Bo Söderpalm
Frontiers in systems neuroscience, Journal article 2011
Journal article

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on a web page

Rising taurine and ethanol concentrations in nucleus accumbens interact to produce dopamine release after ethanol administration.
Mia Ericson, Pei Pei Chau, Rhona B. C. Clarke, Louise Adermark, Bo Söderpalm
Addiction biology, Journal article 2011
Journal article

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on a web page

Ethanol-induced modulation of synaptic output from the dorsolateral striatum in rat is regulated by cholinergic interneurons.
Louise Adermark, Rhona B. C. Clarke, Bo Söderpalm, Mia Ericson
Neurochemistry international, Journal article 2011
Journal article

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on a web page

2010

beta-alanine elevates dopamine levels in the rat nucleus accumbens: antagonism by strychnine.
Mia Ericson, Pei Pei Chau, Rhona B. C. Clarke, Louise Adermark, Bo Söderpalm
Amino acids, Journal article 2010
Journal article

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on a web page

2009

Lactate contributes to ammonia-mediated astroglial dysfunction during hyperammonemia.
Anna Andersson, Louise Adermark, Mikael Persson, Anna Westerlund, Torsten Olsson et al.
Neurochemical research, Journal article 2009
Journal article

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on a web page

Acute ethanol treatment prevents endocannabinoid-mediated long-lasting disinhibition of striatal output.
Rhona B. C. Clarke, Louise Adermark
Neuropharmacology, Journal article 2009
Journal article

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on a web page

Endocannabinoid-dependent plasticity at GABAergic and glutamatergic synapses in the striatum is regulated by synaptic activity.
Louise Adermark, Giuseppe Talani, David M Lovinger
The European journal of neuroscience, Journal article 2009
Journal article

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on a web page

Frequency-dependent inversion of net striatal output by endocannabinoid-dependent plasticity at different synaptic inputs.
Louise Adermark, David M Lovinger
The Journal of neuroscience : the official journal of the Society for Neuroscience, Journal article 2009
Journal article

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on a web page

2008

Electrophysiological properties and gap junction coupling of striatal astrocytes.
Louise Adermark, David M Lovinger
Neurochemistry international, Journal article 2008
Journal article

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on a web page

Neurotensin reduces glutamatergic transmission in the dorsolateral striatum via retrograde endocannabinoid signaling.
Henry H Yin, Louise Adermark, David M Lovinger
Neuropharmacology, Journal article 2008
Journal article

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on a web page

2007

Retrograde endocannabinoid signaling at striatal synapses requires a regulated postsynaptic release step.
Louise Adermark, David M Lovinger
Proceedings of the National Academy of Sciences of the United States of America, Journal article 2007
Journal article

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on a web page

Combined activation of L-type Ca2+ channels and synaptic transmission is sufficient to induce striatal long-term depression.
Louise Adermark, David M Lovinger
The Journal of neuroscience : the official journal of the Society for Neuroscience, Journal article 2007
Journal article

Read the full text
on a web page

Ethanol reverses the direction of long-term synaptic plasticity in the dorsomedial striatum.
Henry H Yin, Brian S Park, Louise Adermark, David M Lovinger
The European journal of neuroscience, Journal article 2007
Journal article

Read the full text
on a web page

2006

Ethanol effects on electrophysiological properties of astrocytes in striatal brain slices.
Louise Adermark, David M Lovinger
Neuropharmacology, Journal article 2006
Journal article

Read the full text
on a web page

2004

Ethanol acutely decreases astroglial gap junction permeability in primary cultures from defined brain regions
Louise Adermark, Torsten Olsson, Elisabeth Hansson
Neurochemistry International, Journal article 2004
Journal article

Read the full text
on a web page

2003

Ethanol-mediated effects on astroglial cells in primary culture. With a focus on acute changes in intracellular Ca2+, cell volume, actin filaments, and gap junction coupling
Louise Adermark
Doctoral thesis 2003
Doctoral thesis

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Faktaruta till DN Replik 3 januari 2019

Fakta och observationsruta med underliggande observationer kring olika typer av intressekonflikter. Ett av de allvarligaste problemen inom folkhälsoforskning och folkhälsoarbete är att motviljan mot andras intressekonflikter effektivt minskar förmågan att nyktert utvärdera egna förutfattade meningar, intressekonflikter och kognitiv dissonans inför besvärliga målkonflikter.

Normalläget är att alltid anklaga förespråkare för skademinimering för grova intressekonflikter och att vara lakejer åt den onda tobaksindustrin. Vi tänkte återgälda vänligheten enligt nedan:

“Rökning” är rökning genom förbränning och inget annat, punkt. Att författarna hänvisar till att e-cig ånga är rök 38 gånger i sin artikel medan e-cigarettånga eller liknande inte används en enda gång, är bedrägligt och missvisande.

Att inte ha med en analys av de data från CAN och Folkhälsomyndigheten som publicerades den 12 december är oärligt och ovärdigt, särskilt med tanke på den forskargärning som Arnetz och Arnetz har i sina CVn.

Att Nilsson och Wiklund väljer att gömma sig bakom andra jobbtitlar som inte klargör att de har djupa personliga och organisatoriska intressekonflikter mot skademinimering i och med både jobb och forskning och kopplingar till kärnorganisationerna som står bakom initiativet Tobacco Endgame, är anmärkningsvärt och klandervärt.

Vi är också mycket förvånad över slutsatser i artikeln som är dragits från den svenska studien i artikeln, eftersom studien indikerar att vattenpipsrökning är associerad med traditionell rökning med maffiga (raka odds) OR 7,69 och för snusanvändning OR  5,0 men för e-cig-användning är OR 1,01 vilket betyder ingen skillnad alls – det är vad författarna borde ha rapporterat, ingen skillnad alls.

Bengt Arnetz publika CV visar framgångsrikt att han varit involverad i forskning och projekt som säkerställt minst 71 miljoner dollar i olika forskningsanslag sedan 1990, inklusive ett 8,5 miljoner dollar i anslag från Vetenskapsrådet och som matchades med 8,5 miljoner dollar från Uppsala universitet för perioden 2008-2017. Väl inom tidsramen för aktuella intressekonflikter. Självklart påstår vi inte styrning eller oegentligheter på något vis, men samtidigt biter de flesta vettiga människor ogärna den uppsättning händer som föder en. Kanske särskilt inte efter avsevärd del i en dryg halv miljard kronor i totala anslag….

Folkhälsomyndighetens forskningsanslag som nämns i artikeln var på 525 000 $ (SEK 4,069,988 enl redovisning hos Folkhälsomyndigheten) och involverade alla fyra författarna och flera universitet. Anslaget var avsedd till att mäta förekomsten av, samt utveckla skolbaserade interventionsprogram mot, vattenpipsanvändning. Vi kan inte hitta de skolbaserade interventionsprogrammen mot ökad användning av vattenpipa som var en av de två delarna i projektet. Vi ifrågasätter dessutom syftet med och om det är etiskt att turbotrimma en del av gjord forskning och återanvända på detta sätt. Artikeln i originalpublicerades redan i september 2016, men har som gubben i lådan fått nytt liv genom att återpubliceras 2018 och nu även i pappersform, med nytt syfte och kopplat till en tveksam debattartikel i samband med lobbyarbetet för att trixa igenom och försvara lagstiftning som både skapar och dödar rökare.

Nilsson och Wiklund får utöver jobb och forskargärningar sägas vara mycket tätt knutna till organisationer som under lång tid erhållit minst 6 miljoner kronor om året för att bedriva sin verksamhet som ”fristående” civilsamhälleorganisationer – under 2018 har stödet närmat sig 10 miljoner kronor – inte vad man normalt tycker indikerar varken fristående eller civilsamhälle i någon egentlig mening. Återigen, vi påstår inte någon som helst finansiell intressekonflikt, men finansering för opinionsbildning kan onekligen skapa ganska kraftiga incitament till intellektuella intressekonflikter.

Svenska Myndigheter och Organisationer, amerikanska universitetsvärlden samt Karolinska institutet, Uppsala Universitet och Umeå Universitet är väl kända för en extremt normativ och negativ inställning till skademinimering inom tobak, som resulterar i kraftigt snedvriden och anslagsstyrd och forskningsansats med tydligt politiskt gynnsamma resultat^8,9.

Artikel 5.3 i den globala WHO: s ramkonvention om tobakskontroll syftar till att motverka negativ eller förhalande inblandning från tobaksindustrins i arbetet för att eliminera tobaksrelaterade sjukdomar, dödsfall och samhällskostnader. Självklart står vi fullt ut bakom den principen. Samtidigt måste alla positiva och potentiellt positiva utvecklingar välkomnas och utvärderas på egna meriter oavsett ursprung.

Artikel 1(d) i ramkonventionen blev kirurgiskt felöversatt till svenska⁶2004 på ett sätt som var avsett att eliminera snus från alla diskussioner kring skademinimering i Sverige. Den kirurgiska svenska felöversättningen har med hjälp av felinformation om snus exporterats till i princip hela världen som den korrekta ”tolkningen” och tillåter moralism att styra över vetenskap och pragmatism även global. Det är en folkhälsokatastrof av tidigare ej skådat slag att sabotera möjligheten att rädda upp till 7 miljoner liv om året och i samma veva spara upp till 2 biljoner dollar om året som kan användas till annat – Sverige bär huvudansvaret för detta efter 45 år av snus-idioti och vinklad forskning som fortsätter med ominskad kraft 2019.

PS: Charlotta Pisinger från Danmark publicerade en anti-e-cig artikel i Berlingske Tidende⁷den 27 december som har ett fascinerande likartad ansats och språkbruk som denna debattartikel, nästan för lik för att vara en fullständig slump. Till det kan nämnas att även hon har precis återpublicerat en återanvänd och turbotrimmad studie som publicerades 2014 och bemöttes med mycket kraftig kritik redan då. Kunskapsläget kring e-cigaretter i Skandinavien 2014 jämfört med 2018 kan med fördel jämföras med kyrkans läror om världsalltet före Copernicus jämfört med perioden strax efter Kepler – det finns en hel del kvar att lära. 

* https://skepticalscience.com/docs/Debunking_Handbook_Swedish.pdf

1 https://nnasweden.org/blog/198-graphs-showing-smoking-and-e-cig-in-swedish-youth-2014-2018

2 Tobacco Harm Reduction

3 https://befrits.wordpress.com/2019/01/01/january-1-2019-the-holy-mother-of-all-ethical-train-wrecks-swedish-parliament-december-2018/

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129320/

5 https://www.folkhalsomyndigheten.se/contentassets/9b0c23490ceb401ba3d0a094a567f6cb/vaccination-av-barn-det-svenska-vaccinationsprogrammet-2008-126-9.pdf

6 https://befrits.files.wordpress.com/2019/01/Ove-Bring-PDF-Ramkonventionen-om-tobakskontroll.pdf.pdf

7 https://www.berlingske.dk/laesere/kampen-om-den-afhängig-nikotinforbruger

8 https://openarchive.ki.se/xmlui/bitstream/handle/10616/46371/Thesis_Lukasz_Antoniewicz.pdf

9 http://uu.diva-portal.org/smash/get/diva2:1191340/FULLTEXT01.pdf

 

JANUARY 1, 2019 – The holy mother of all ethical train wrecks – Swedish Parliament – December 2018

The above clear mistranslation to Swedish in 2004 was deliberate and surgical. It effectively got rid of the snus issue as harm reduction - what it also did was get rid of harm reduction period and that is what Sweden has been exporting since 2005. Vera da Costa and Bloomberg simply could not have done what they are doing - had Sweden gone the honest route and started talking candidly about snus already 13 years ago. Not a chance in hell. Sadly this is proof that Nobel Prize Sweden has a huge mountain of responsibility for the global situation. We always want to be a "Moral Superpower", sure I get that, but at the cost of perhaps hundreds of millions of premature deaths? Wow!

 

Faktaruta till Replik i DN: Fact box on COI in DN article 22 December

Dear all,

I am currently active on multiple levels trying to provide truthful content and relevant commentary on the situation in Sweden. I am over time growing more and more confident that my 2012 analysis holds. An analysis that Sweden has successfully delayed acceptance and universal application of Tobacco Harm Reduction, by almost half a century. With the current trajectory the WHO and many with her calculate total premature loss of life due to smoking (and totally unnecessarily toxic Smokeless formulations) will be a billion people or thereabouts this century. Delaying Harm reduction in tobacco by 30 years pre FCTC, materially negatively impacting how the FCTC was formulated and subsequently applied, and a further 20 years post FCTC anti THR – is probably a world record that will be very very difficult for anyone to beat. Why anyone would want to try to do so eludes me, but then again there are definitely moves to have overweight parents declared unfit, and so on and so forth.

Originally first published results:

Letter to Government

Graph tweet

Ove Bring PDF Ramkonventionen om tobakskontroll.pdf – This PM by Sweden’s most respected International Law and Treaty Law jurist is acknowledged as valid (but action refused due to clash with policy) by Ministry of Foreign Affairs and the Public Health Agency and National Board on Health and Welfare and finally the Ministry of Health and Social Affairs.

Swedish Parliament on December 12th, 2018 enacted a massive expansion of our smoke free laws and doubly bizarrely included vaping in all existing and new smoke free areas. This was done despite crystal clear and irrefutable data showing that the already record low smoking in Sweden dropped again, like a sinking rock, with the introduction of vaping.

A full billion people, of whom the vast majority are and are increasingly going to be, in Low and Middle Income Countries desperately trying to lift their broader standard of living, will this century be trudging down a long and arduous and expensive road to premature death from smoking, a road that is lined with disease, loss of income and loss of productivity. How much of this would have, or at least could have, been avoided by Sweden simply calling a spade a spade?

Snus was added to smoking as a fully legitimate TC target as a last ditch effort in circa 1993 under the guise of the “Gateway theory” in order to avoid the accumulating and overwhelming evidence that snus was in fact probably not even legitimate as a blip on the public health radar at all. That the Gateway theory for snus has been totally eviscerated and proven to go clearly and massively in the opposite direction, didn’t hinder the argument to be successfully being applied to e-cig. Unless we do something about the false basic premise here, this argument will usable again and again and again – always backed by cited bullshit on “Peer reviewed” record from Sweden and regurgitated in the form of citations abroad. Add to this a thorough understanding from anti-THR science, that is analogous to Pharaonic Egypt. If you plant the Nile plains with only Pharao’s seed and the ensuing yearly inundation is all Pharao’s water down to the last drop – then the entire crop is going to be Pharao’s crop.  

Sweden has achieved a large part of becoming the global leader of “western standard” economies in terms of low smoking through 30 years of intense public information campaigning, true. Sweden also achieved a large(r) part of becoming the global leader of “western standard” economies in terms of low smoking through almost 40 years of having +98%-99,6% harm reduced snus as the most commonly used assisted method for no longer smoking in men and now fast increasing also with women – this happended despite our government and public health bodies and even the Institute awarding the Nobel Prize in Medicine, doing their absolute damndest to stop it.

Sweden was just about to achieve the next to last large part of becoming the ultra stellar  global leader of “western standard” economies in terms of low smoking by wide adoption of e-cigarette experimentation getting the whole population under 5% daily smoking, and moving steadily toward unimaginably (ludicrous, to use a Musky term) low smoking rates in youth – along with Iceland and Norway. Norway has almost no youth daily smoking thanks to snus use instead – something they argue in European Court of Justice is nothing less than a full blown epidemic (epidemic of lower smoking would be more correct – but that runs into problems with the Siracusa principles). Iceland does not have snus and is incredibly proud and boastful of huge success despite snus being banned since 1995. Useful information here though is that Iceland’s government tobacco company has seen 400% growth in sales of “traditional coarse nasal snuff – Neftobakk – since 1995. Interesting to note here is that all the tobacco for this **unregistered and unmeasured government produced traditional product** that is not in any statistics, is that all the tobacco is high grade snus tobacco purchased from Swedish Match and the consumers mix the end product with a bit of water. What do you get then? Snus! QED.

Back to the new round of train wreck ethical travesty in Sweden. The data was in. The data was crystal. The Government had it months ago and if they didn’t, then it was because the Public Health bodies kept it from them – I don’t know which it is and I don’t know which would be the greater scandal?

The data is irrefutable and solidly disqualifies policy in any other direction that the one suggested by the data. Unless of course Sweden was willing to bet the total credibility capital of the entire Swedish Public Health establishment and the red-green hued political parties in Government and what is left of a tattered Nobel Prize reputation – that just like in Asterix, the sky was about to fall on our heads. (This could very well have happened! According to many, who to a man and woman disagree with a postmodern relativist view on policy based evidence making, the level of public health science acumen in Tobacco Control could very well mean authors choosing to cite Goscinny R., Uderzo A., Miraculix, Broccoli A., et al. to an article on “Skyfall theory’s important role in substantiating the nicotine gateway theory” and hoping the reviewers (are there reviewers?) would let it slide with a chuckle. Clearly though with the premise that the evidence cannot emerge until later but will do so with 102.5% certainty and thus absolutely valid for policy and legislation. Note here please that “later” (but not 102.5%) is something up for periodic review and renewal every ten years or so… Sublimely elegant really.

Solution to this monumental conundrum: Pass the law before the data is out! But of course not before the data is out because that would be unethical. Hmmm, how does one achieve this logical double Salkov of disingenuity?

The March 2018 law bill was silently and fast as hell de-moth-balled and “sprung” on and through parliament in the shortest time recorded in peace-time Sweden. This happened  despite Sweden standing without a legitimate new government at the moment and in the middle of the biggest Parliamentary cluster waltz in modern history. (The EU initially stopped the bill in June 2018 because we refused to remove flavour markings on snus – The Horror – How was it then that the EU did not protest this time, after all the offending bit was still in the bill package!?)

The bill in its final format was released to the public on Friday December 7th, debated in Parliament on Tuesday December 11th (you have to click the link and see a report of the travesty with me and Bengt Wiberg from #EU4Snus) and finally voted on in the afternoon of  Wednesday December 12th. Nothing too bad about snus happened as the centre and right are waking up to snus and coffee and beginning to realise what is going on (The liberals are not included here – aren’t liberalism and extreme fascist tendencies sort of mutually excluding political leanings – I always thought so – Silly me!).

Reds, greens, Mussolini liberals and Christian Democrats sealed the fate of vaping as we know it. We (they!) enacted a widely expanded smoke free law framework, even to the extent of banning publicans from choosing to have a small portion of their outside service area reserved for smokers. All vaping was magically included in this and it still passed, and herein lies the royally screwed up skullduggery boo-boo in all its gory glory.

The Parliamentary vote was on the 12th, same day as the data-sets on the biggest collection of tobacco use data ever in Sweden were released. This was the first major one since 2016 and the biggest one ever in Sweden.

 

DATASETS FOR ABOVE AND BELOW: Collection CAN+PHA 2018 december 13

I think most of readers of this piece will agree that had these graphs been verified and placed before each MP before the vote – the smoke free laws would not have included vaping/e-cig?

The data was published the same night – basically available first thing in the morning of the 12th. The below two graphs are the only two representations we have seen so far superimposing the three different datasets on each other to give a more whole overview (the originals were tabulated differently and from separate sources, for extra obfuscation).

To this date we believe we are the only ones who have made the effort to collate and graphically represent the data in a useful format (useful is here in the sense of positively useful as based on hard facts and with relevant context – lying through your teeth by obfuscating what the data means and ripping it totally out of context is of course very useful too, depending on your ambitions, but hardly honest).

A completely different picture can be viewed at Psychologists Against Tobacco, a founding member of the Tobacco Endgame – Smokefree Sweden 2025 initiative here. (Swedish only, sorry, if you want a translated version then please send emails to Atakan.befrits@gmail.com – If I get more than 5 mails I’ll reallocate time to get it done, along with a peptic ulcer from piteous impotent frustration and rage)

There was a barrage of media and press in the morning of the 12th, the day of the vote. The entire focus was on that the “ever tried e-cig” among youth was up by 70% since 2014 – Ergo the only possible action was the widest possible bans and deterrents to youth e-cig experimentation – any parliamentarian not getting that and voting along those lines would automatically be in gross dereliction of duty to protect innocent youth and must obviously be a Big Tobacco lackey (100% certain Harakiri end of said political career).

The collated and tabulated data from the two major surveys in 2018 can be found in excel format to fiddle with, validate and/or critique here: Collection CAN+PHA 2018 December 13 . As you can see from date in the filename, it took us laymen a bit longer to play catch-up than what was absolutely necessary, in order to ensure each voting member of Parliament had at least been provided with the hard facts in politician friendly format.

Again, sublimely elegant and very well played.

We did send a call to reason already on Monday the 10th though after having read the bill published Friday. We sent in vain hopes that we could create change or a space to breathe. Here I am going to give a big hand to the Sweden Democrats for being fast on the ball and having a good grasp of 1+1=2. The SweDems changed the wording during their debate slot on the Tuesday to include a clear reference to that e-cig should immediately or later be regulated in an entirely separate framework from the smoke-free laws, as the evidence dictates. Basically the entire centre+right (not the Mussolini Liberal Party) are clearly seeing the light and want to decouple snus from tobacco, as tobacco is understood by the Swedish uniquely mistranslated FCTC. A correctly translated FCTC would have eliminated this whole problem entirely and would have shaved 13 years of the half century of delayed acceptance of Harm Reduction in Tobacco (THR). A lot of the politicians individually see cautious reason for optimism also with e-cig (HnB) as harm reduction but so far only the Sweden Democrats seem convinced enough to speak up.

I include below the letter that we did manage to get off to Parliament, Parties, Agencies and the Prime Ministry on the Friday (fast and not very good – we are a very small outfit here and did not get very much help from the pros. They are experts on snus and don’t have the requisite knowledge of vaping, vaping science or the global ping-pong game of cherry-picked science bouncing back and forth between the nicotine delivery technologies and always backed up and corroborated by someone somewhere. The general feeling was that we should be incredibly grateful that a majority of political parties are slowly changing their views on snus, so we must all be nice little boy and girl (and them) experts and show gratitude and encouragement….

Note here again: While we show gratitude for the snus kindness that has zero effect on policy in India, this latest outing is an Op-ed in Dagens Nyheter 22 December against e-cig by 2 veteran hard core ANTZ from UMEÅ U. Co-sponsored by a very credible husband and wife hit-crew from Michigan State U. Both originating from Sweden and both still on the UU (Uppsala University) faculty pages. I don’t know them and haven’t heard of them before so I will presume they are honest and diligent and professional, but they do seem to be Glans fans and that is never a good sign.

Prime Minister’s Office

Head of Legal

Ministry of Foreign Affairs

Head of Legal

Ministry of Health and Social Affairs

Head of Legal

 

2018.12.10

 

CC sent to Left Party, Greens, Social Democrats, Centre Party, Liberals, Moderates, Christian Democrats, Sweden Democrats

Open letter to Swedish Governmental offices and Agencies and political parties regarding “harm reduction” in relation to the proposed new Tobacco Law.

To whom it may concern,

We are representatives of a global network of scientists, professionals and 36 civil society advocacy organisations from 34 countries. We, together with numerous national governments, represent a globally increasing movement in recognition and acceptance that “harm reduction” is clearly mandated in the original FCTC (Framework Convention on Tobacco Control). Harm reduction also in tobacco is clearly a human right and that is enshrined in the rights to health and autonomy.

Enacting the proposed law may have the negative effect that 35 CSO-NGOs together with the global harm reduced nicotine user community will advise their members to disregard Sweden as a travel destination because of the increased anti harm reduction regulations and possible legal consequences. The proposed law in its current format is unnecessarily damaging to public health, individual health and to the goal of ending cigarette smoking and smoking related disease. The proposed law is a Human Rights to Health violation.

We are writing to your respective offices and to the media in some urgency as new circumstances have come to our attention. These are very positive circumstances and present a unique opportunity to instead implement prospective new knowledge that will not be available until 2020.

In our view these very recent circumstances clearly and urgently indicate that any legal decisions that affect snus and/or electronic nicotine delivery systems are wholly inappropriate to enact at the current time. ​We therefore respectfully ask that the proposed law be voted down, withdrawn or redrafted, as the scientific validity of harm reduction via snus and electronic nicotine delivery systems are not adequately reflected in the proposed law.

 

1.​  ​We have received information that a project has been initiated within Swedish Agency SBU (Swedish Agency for Health Technology Assessment and Assessment of Social Services) to evaluate and assess snus (and e-cig) in relation to smoking and the results are expected no earlier than 2020. This project carries tremendous global value in that adequate and useful quantitative relative risk estimates between Swedish Snus and Smoking have so far to the best of our understanding never been produced or communicated, Nationally or Internationally. Snus is not harmless and should not be communicated as harmless. Nor should there be any misunderstandings regarding that nicotine use should best be avoided in entirety, but if not entirely then at least especially in and before pregnancy and preferably when there is cardiovascular disease present ​unless it is likely that the alternative is continued smoking​. These facts are already known and almost universally agreed, therefore what remains to urgently quantify is the relative difference in risk between snus use and smoking to otherwise healthy and non-pregnant adults, and this announced project within SBU is therefore of immense global value.

2.​  ​It has also come to our attention that a new tobacco law for Sweden was agreed by the Social Committee in Parliament on Thursday December 6th and published online on Friday December 7t​ h​. These steps taken in preparation for a parliamentary debate on December 11t​ h​, with a planned Yay/Nay voting session on December 12t​ h​. In effect this means that the final version was made available to the public​[1]​on December 7t​ h​, and the voting session is less than three full weekdays from that day.

3.​  ​We have received information that there is an initiative underway, with support from the Ministry of Foreign Affairs Treaty office, to correct an obvious mistranslation in Article 1(d) in the Swedish version of the FCTC (Framework Convention on Tobacco Control).

4.​  ​The clearly mistranslated portion has changed the meaning of “harm reduction” as understood, expressed, and intended in 1(d) in the original as a requirement, to instead becoming a de facto ban of “harm reduction” in Sweden. The most obvious effects of this are found in science and policy regarding snus and the international (mis)information enabled by the error. A correction of the Swedish FCTC text, to accurately reflect the true meaning and intent of “harm reduction” as expressed in the treaty and preparatory materials would be a very welcome step forward and have tremendous potential value in the fight against tobacco related disease. We believe a correction would have a positive impact on willingness and ability to affordably achieve UN Agenda 2030 SDG goal 3 targets, also in Low and Middle Income Countries (LMIC) globally, where soon 75% of global smoking takes place.

There is every likelihood that prospective and retrospective results from assessments by SBU in 2020, and a correction in the Swedish translation of the FCTC, can considerably improve and expand the available toolbox that the global health community and public health communities use in “Tobacco Control” work as per the requirements and intentions enshrined in the FCTC.

We therefore respectfully urge political representatives of the Kingdom of Sweden, and her governmental bodies and agencies – to postpone any proposed legislation that negatively affects the ability to exercise and utilize an appreciation of the relative risks of different products– at least until such a time as the two crucial issues in this letter have been thoroughly examined and resolved.

With our great respect for Sweden and her role in promoting health, equity and Human Rights.

 

Atakan Erik Befrits

NNA Sweden (New Nicotine Alliance Sweden)
INNCO (International Network of Nicotine Consumer Organisations)ab@nnasweden.org
+46 764 156046

 

 

 

Pro-Vapeo Mexico publishes open response to train wreck anti-THR Television adverts by MoH (Translated)

The spot of the Ministry of Health

Irresponsible disinformation about electronic cigarettes

The Ministry of Health continues to broadcast an alarmist spot on radio and TV
about electronic cigarettes (1). The narrator, Dr. Angélica Ocampo Ocampo, who is a psychologist and director of the smoking cessation clinic of the General Hospital, warns that “the electronic cigarette affects those around us” and adds that “the nicotine that comes out of vapor kills, generates cancer and heart attacks and heart disease exactly like smoking tobacco.”

The intention of the spot is not to inform but to instill fear in the population. The Ministry of Health has never provided evidence to support this content. Furthermore, the MoH fails to comply with its ethical duty to provide the population with information on health issues that is based on the scientific evidence, namely (see references on the back of the sheet):

• It is grossly untrue that the use of electronic cigarettes is “exactly the same” as smoking tobacco. The electronic cigarette represents for the user a 95% reduction of the damage that causes smoking (see reports from the Royal College of Physicians of the United Kingdom (2) and Public Health England (3).

 

• Nicotine is not carcinogenic or causes heart attacks once dissociated from the smoke from tobacco. There is 30 years of epidemiological (snus) evidence that shows this (4)( 5).

 

• Nicotine “coming out of the vapor exhaled” does not affect people in the environment. The user’s body absorbs more than 94% of the nicotine inhaled (6), so the exhaled concentrations of this substance (and other pollutants) are truly
  minimal (3) and they disperse quickly. Environmental vapor is nothing like environmental or second hand tobacco smoke.

Pro-Vapeo Mexico deeply regrets that:

• The Ministry of Health is causing serious social damage by demonizing the
  electronic cigarette and falsely equate it with the tobacco cigarette. How many millions of smokers will continue to smoke because of fear of consuming nicotine through a medium that eliminates 95% of the risk to your health? Nicotine itself may be addictive but it is not the main cause of health damage from smoking.

 

• The Ministry of Health has failed miserably in the fight against smoking.
  As an institution still in the charge of Dr. José Narro Robles, he must be held accountable to the public. According to official data (ENCODAT 2016-2017 7) in Mexico, more is smoked now than in 2011 (17.6% of the population between 12 and 65 years of age smoked in 2016 but 17.0% smoked in 2011).

 

Pro-Vapeo Mexico hopes that the Secretary of Health in the new administration can correct the failure of the previous administration. A worthy example to follow is the case of the United Kingdom, whose Ministry of Health has adopted as an integral part of its official public health policy (8), the use of electronic cigarettes, which has contributed to a great breakthrough in the fight against smoking: the proportion of smokers in the adult population decreased at further and greatly accelerated rates (from 20.2% to 15.1%) in the same period as smoking in Mexico increased 2011-2016 (9).

There is no reason why a similar Public health success can not be achieved also in Mexico.

Original below:

References to support below

REFERENCIAS.

1 Enlace del spot https://www.youtube.com/watch?v=irx9s15tUlc&feature=youtu.be

2 Nicotine without smoke: Tobacco harm reduction”. Informe del Royal College of Physicians RCP, 2016. Enlace. Versión en

2 Nicotine without smoke: Tobacco harm reduction”. Informe del Royal College of Physicians RCP, 2016. Enlace. Versión en español: pulsar aquí. Versión resumida en español: pulsar aquí.

3 A McNeill, L S Brose, R Calder, L Bauld, D Robson. “Evidence review of e-cigarettes and heated tobacco products 2018. A report commissioned by Public Health England”. Informe completo PDF, Resumen extenso, Resumen Breve, Nota de Prensa

4 https://cancer-code-europe.iarc.fr/index.php/en/ecac-12-ways/tobacco/199-nicotine-cause-cancer

5 Benowitz NL, Fraiman JB, Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends Cardiovasc Med. 2016 Aug;26(6):515-23. doi: 10.1016/j.tcm.2016.03.001. Epub 2016 Mar 10

6 St Helen G, Havel C, Dempsey DA, Jacob P, Benowitz NL. Nicotine delivery, retention, and pharmacokinetics from various electronic cigarettes. Addiction. 2016;111(3):535-44; Bush D, Goniewicz ML. A pilot study on nicotine residues in houses of electronic cigarette users, tobacco smokers, and non-users of nicotine-containing products. Int J Drug Policy. 2015;26(6):609-11

7 Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco (ENCODAT 2016-2017). Ver páginas 65-66.

https://drive.google.com/file/d/1Iktptvdu2nsrSpMBMT4FdqBIk8gikz7q/view

8 Towards a Smoke-free Generation: A Tobacco Control Plan for England. Department of Health. Descarga

9 Office for National Statistics, Adult smoking habits in the UK: 2017. Enlace

Pro-Vapeo México, A.C.

https://www.provapeo.org.mx facebook/provapeomexicoac

___________________________________________________________________________________________

Pro-Vapeo México A.C. es una asociación civil que no persigue fines de lucro. La formamos consumidores informados

de productos que suministran nicotina sin combustión de por medio, por lo cual son sustancialmente menos dañinos que el cigarro tradicional. Promovemos la estrategia de Reducción de Daños por el Tabaquismo que consiste en dar a conocer a los fumadores adultos, y a la sociedad mexicana en general, los beneficios a la salud por la sustitución del hábito de fumar por el consumo de estos productos. Nuestra asociación civil comparte los principios, y es miembro activo, de la Red Internacional de Organizaciones de Consumidores de Nicotina (INNCO, por sus siglas en inglés).

Pro-Vapeo México, A.C. no tiene dependencia ni vínculos financieros con la industria tabacalera y/o las industrias que fabrican y venden cigarros electrónicos, ni con la industria farmacéutica, ni con las burocracias de la salud.

RCP 2007 Report

RCP 2007 Harm reduction in nicotine addiction

Sweden flipping things and killing people again: “Experts omitted studies showing that snus is dangerous”. Did we now?

Dear all,

Please find a very respectable looking article this morning. Rife in ad-homing some of the best people we have in our field and generally touting obviously coached narratives, in one of Sweden’s most respectable newspapers this morning. It is a bit of a read but at the bottom you will also find my reply to the article translated. Word document of translated article and my reply translated: Translation SvD October 10 2018

By Lovis Kojo, Vendela Wikström Today October 10, in Svenska Dagbladet 06.00 (updated) original article below

https://www.svd.se/experter-valde-bort-studier-som-visar-att-snus-ar-farligt

Experts omitted studies showing that snus is dangerous

Swedish tobacco policy is based on false information about snus, the manufacturers mean. To spread the true image, they started the Snus Commission. But SvD’s review shows that several studies selected by the Commission contain shortcomings. Others have been completely omitted.

– There is no disease burden associated with snus. End of story, says the Snus Commission’s chairman Anders Milton, former chairman of the Swedish Medical Association.

Chief physician Gunilla Bolinder criticizes the Snus Commission. “It sounds like it’s a health organization and that it’s the government that has set it up. But the Snus Commission is the snus industry top to bottom, “she says.

Chief physician Gunilla Bolinder criticizes the Snus Commission. “It sounds like it’s a health organization that it’s the government that has set it up. But the Snus Commission is the snus industry top to bottom, “she says. Photo: Allis Nettréus, Isabell Höjman / TT

Just over two years ago, the then Public Health Minister Gabriel Wikström received a letter with sharp criticism against the work on the new tobacco law. The bill meant stricter regulation of tobacco, including Swedish snus. The letter to the minister stated that the investigation was based on false perceptions of snus and that the proposed measures would adversely affect public health. The government was invited to address the factual evidence attached: a report entitled “The health effects of snus”.

The sender was the Snus Commission. The Snus Commission released its first report just over two months after the proposal for a new law was published. When the Snus Commission was formed, Anders Milton, former chairman and CEO of the Swedish Medical Association, was contacted by the PR agency JKL. This agency has previously had the world-leading tobacco company Philip Morris as a client.

“The snus manufacturers wanted to make the discussion about snus more evidence-based, and JKL asked if I could lead a group for achieving that. I replied that I can do that if they do not preview or influence what we write or who I choose to work with, says Milton.

The Snus Commission also has three more members, including tobacco researcher Karl-Olov Fagerström.

That tobacco industry recruits doctors and researchers is nothing new. When the health effects of smoking became known in the 1950s, Philip Morris employed researchers who were tasked with creating uncertainty about the harmfulness of smoking.

The Snus Commission produces its own reports, but that it is financed by Snustillverkarföreningen, which represents the snus companies, Milton doesn’t see as a barrier (COI) to the fact that he, as a physician, can present factual reports on behalf of it.

– They do not see what we write until the reports are published. So that they would have affected us is completely ruled out. The state also finances the National Board of Health and Welfare through the Public Health Agency, which works against tobacco, he says.

Gunilla Bolinderis a senior doctor who has been praised by the World Health Organization, WHO, for her work against snus. Her research shows several possible health risks with snus consumption. She warns against the image of the snus as a harmless product. That Milton as a high-profile doctor spreads that image worries her.

“That he suddenly stands up as an expert for the Snus Commission, even to the extent of being a chairman, surprises me greatly,” she says.

Bolinder also believes that the name “Snus Commission” is misleading.

“It sounds like it’s a health organization that it’s the government that has ordered it. But the Snus Commission is the snus industry straight up and down.

The Snus Commission’s report “The Betrayal of The Smokers” says that snus is the most effective way to quit smoking. The conclusion is motivated by a survey conducted by the Commission using Ipsos research, where in principle all former smokers who used snus to abandon the cigarettes state that they are still smokeless, but snusers, after five years. But snus is no smoking cessation product, but a transition to another just as serious nicotine addiction, Bolinder claims.

“We do not believe that we are saving Europe as a whole by giving the smokers snus instead of cigarettes. This way of trying to introduce an industry that you still know has unhealthy effects, we in the medical professions don’t think is very attractive.”

At the same time that research has shown that snus use during pregnancy affects the heart rate of the fetus and brain development, and can cause premature birth and induce preeclampsia, the snus industry is investing in more women to start using snus. The Snus Commission advises against snus use while pregnant, but at the same time, it claims that the proportion of women who smoke would decrease if more of them perceived snus as less dangerous.

“It may be very hard for a pregnant mom to stop using snus. She will become batshit crazy from abstinence if she is very nicotine addicted. Then you have a hellish experience in front of yourself when you feel very guilty for using snus” says Bolinder.

In the report “The Health Effects of Snus”, the Commission writes that it reviewed all relevant research on snus from the last 25 years. When we ask Milton about why some studies have been left out, he states there were no more relevant ones. A study may have shortcomings in methodology and design, or the researcher has made incorrect conclusions, he explains.

But when we examine the studies chosen by the Commission, many of them are criticized by other tobacco researchers for containing the above shortcomings, or cite other research that does. One of those studies was made by Lars Ramström, an experienced tobacco researcher who titles himself as a doctor – despite not having a doctorate. (PhD / MD confusion here) NOTE for correction, SvD corrected the text later on the publication date to include the following passage also: When we contact Ramström to ask about the name of his doctoral thesis, we were informed that there is no doctoral thesis as such, he was awarded the doctorate for his work for the WHO in the 1970’s.

Many of the studies that the Commission uses are also either sponsored by the snus industry or referring to studies that are. One researcher cited has performed studies when an employee of Swedish Match. – There is hardly any research available Swedish snus in this area. So you have to look at what’s available, and if what is written is reasonable or not, “says Anders Milton.

We find that a study by two Swedish tobacco researchers such as Milton refers to when he writes that snus does not cause cancer in the mouth and throat, afterwards, have later been reviewed in Tobacco Control, an international journal that examines the consequences of tobacco use.

Scott Tomar, who conducted the review, is a senior dentist, doctor and researcher in Florida focusing on tobacco and oral health. He discovered that the researchers to the study had erroneous conclusions from the data. While the results showed a significantly increased risk of oral cavity for people who use snus – the researchers concluded the opposite.

“What incentives can researchers have to reduce the discovery that smokers who never smoked were almost five times more likely than non-users to develop head and neck cancer, exclude that from the abstract and use a very confusing analysis to dispel a relationship?” “ Is it possible for research funding from the Swedish tobacco industry could play a role?” “Shortly after the publication of this report, the scientist became spokesman and researcher for Swedish Match.” “Maybe it’s a coincidence?” says Scott Tomar.

Another study by the Swedish oral and maxillofacial surgeon Jan Hirsch shows 16 cases where elderly men who used snus for many years suffered from cancer under the lip. this is not included in the Commission’s report. According to Milton, this is because it was not included in the medical journal The Lancet’s summary of research on snus, the one used by the Commission.

“There is no disease burden associated with snus. End of story. This is certain. You may think that’s too bad, but it is what it is.”

In February 2017, a report covering five studies with 54,500 snus users received a great deal of media attention. It showed that the risk of type 2 diabetes increases by 40 percent if you use five cans per week and 70 percent if one can per day.

On its website, the Commission comments on the report. The commission comments that the authors of the studies did not find any connection between snus and diabetes in their previous research. The Commission also highlights that high BMI adds a significantly greater risk for diabetes, than heavy snus use. The conclusion of the research – that using a can of snus per day could equal the risk increase for type 2 diabetes as smoking a pack of cigarettes per day, is not mentioned by the Commission.

The Commission’s reports are extensively used in the snus industry’s public perception work, and have all been sent to athe members of Parliament. The reports have been highlighted in media, and Milton has also talked about the Commission’s work to the Norwegian Parliament.

The goal is obvious, he means; “The public must be informed that snus is not dangerous.”

“The only thing we say is this: say it like it is. If the Swedish authorities had been truthful, then there would never have been any reason to give me this assignment. It’s that simple,” says Milton.

The new tobacco law was scheduled to be processed after the election. (Nope, it was scheduled for before summer recess but EU went apeshit as the snus parts were too soft – translator’s comment)

Members of the Snus Commission:

 Anders Milton, Chairman of the Snuskommission. Formerly Chairman and then CEO of the Swedish Medical Association. Has also served as Chairman of SACO and in the Swedish Red Cross

Christina Bellander, journalist, former EVP for MTG AB and responsible for business development on TV4. Board member of, among others, New Wave Group AB, Mittmedia AB, Knowledge Sweden Education Sweden AB and Sveriges Utbildningsradio AB.

Karl-olof fagerström, lecturer and researcher about tobacco and nicotine. He has also founded a company that sells smoking cessation products, and he joined Nicorette. 

Göran Johnsson, former chairman of IF Metall, former member of the Social Democrats Executive Committee, former member of Volvo Group Executive Board and former chairman of SVT.

 

My reply this morning to the authors of the article

 

Good morning!

Oh boy, I was surprised at reading this article on the subway home from leaving child at school. Oh boy! Oh boy! Oh boy!

I even read the title wrong first. I read the title as it probably should be:

Experts omitted studies that show that snus is not dangerous

(Bolinder, Giljam, Galanti, Larzon, Glantz, Chaloupka, Gupta, Sinha, Malone, Antoniewics – etc.).

Much of the Swedish research is derived from a giant health cohort that was made in 1971-1994, the so-called construction worker cohort. Foreign researchers have sued Karolinska to demand access to the raw data in order to reproduce studies and compare results. KI has refused, and Higher Administrative Court ultimately awarded a researcher the right to extract the material, but at the same time also awarded the Karolinska Institute the right to deliver the material in a format completely unusable for the purpose. This cohort is also often called “the revolving door cohort” because the (100% anti-harm reduction in tobacco) researchers that do get accesses the material includes or excludes parts of the cohort a little depending on what results they want to show.

I attach two scientific articles by Hirsch that might be interesting for you to check again. For example the one with 16 patients with cancer at the snus location, you might want to check with Hirsch how many years it took them to collect the 16 cases among Sweden’s approximately one million snus users? The article further states quite clearly that these are basically all cases throughout all of Sweden during the collection period.

Over time, the Swedish calculations is that smokers die (of smoking) a rate of about 1.2% per year. During the period 2010-2012 the figure from the Swedish National Board of Health and Welfare was 11,881 per year in Sweden’s approximately 1 million smokers (Registry data on the harmful effects of tobacco smoke, Socialstyrelsen, 2014).

Let’s pretend that all Hirsch cases were reported as new cases in just one year, then we decide that these are all from precisely just those people who used or began using snus around 1960 and were still alive in the early 2000’s – then that gives 16 cases of cancer caused by snus among the 375,000 snus users who used snus but did not smoke ca 1960.

This gives 16 / 375,000 = 0.0000426 which means0.0024%.

Thus, in this extreme worst case, 1 person gets a cancer in the mouth from snus for every 500 people who die of smoking. (per year)

Then lets add another site of cancer that cannot be attributed directly, but still given the same weight – then we have 2 who get cancer for every 500 who die of smoking. (also per year)

Then lets add also Diabetes with the same weight, and we’ve suddenly got 3 total among the snus users who get seriously ill from snus for every 500 who die of smoking. (per year again)

We mustn’t forget heart disease and cardiovascular death, lets put it at twice the weight as for the other diseases (nicotine !!), we then end up with 5 cases of very serious disease from snus for every 500 people who die of smoking. One in a hundred then. (also per year, again)

About 0.5% -2% risk from using snus compared with smoking is what Swedish and international researchers who are not ideologically controlled claim today and have claimed since 1973. That is as far back we can follow the track of discussing snus in terms of harm reduction in Sweden, as that is when we saw serious exodus among men from cigarettes to snus, 50-100 times less dangerous snus.

Please ask Gunilla Bolinder how many times less dangerous snus is compared to smoking – her best guess. If she answers that we do not know, because there is not enough research on that – then the relevant question could be: Why is that research missing?

My name is Atakan Befrits and I represent INNCO, a global association of civil society organizations that do not receive industrial money and, of course, have no chance of getting a cent from Public Health Agencies. We represent 30 million who quit smoking with “unauthorized methods” (like vaping and snus etc.) and also represent the right to accurate relative risk information for the around 1.4 billion in the world who still use the most dangerous ways of consuming tobacco and nicotine. We managed to gather 17 organizations in Geneva last week when the WHO and the Framework Convention held their global meeting on tobacco strategies (WHO FCTC COP8).

Our central function (INNCO Secretariat) was rejected as an observer to the meeting, despite having fought in many countries, including Sweden for 7 weeks, to ensure that civil society would not be excluded. The Swedish Ministry of Social Affairs answered me 4 minutes after close of business in the afternoon the day before the meeting (after 7 weeks) that they absolutely wanted civil society out.

We (INNCO) were available just outside the meeting venue on 9 occasions during the week but not a single employee or delegate dared / wanted to come and talk to us.

You name Milton and Ramström in rather ad-hom and derogatory terms (Ramström has also been given prize by the WHO for his tobacco work, did you know that?) – but no names about the researcher Scott Tomar refers to. Can you tell me who they would be?

Best regards

Atakan Befrits

Brev till webbredaktionen på SvD idag om snus och snusforskning

God morgon!

 

Oj vad jag blev förvånad på tunnelbanan hem från att ha lämnat på skolan. Oj! Oj! Oj!

 

Jag läste till och med rubriken fel först. Jag läste rubriken som den nog egentligen borde vara:Experter valde bort studier som visar att snus inte är farligt

(Bolinder, Giljam, Galanti, Larzon, Glantz, Chaloupka, Gupta, Sinha, Malone, Antoniewics – mfl mfl).

 

Mycket av den svenska forskningen härrör sig ur en jättehälsoinsamling som gjordes 1971-1994, den sk. bygghälsokohorten. Utländska forskare har stämt Karolinska för att kräva tillgång till det grundläggande datamaterialet för att kunna reproducera studier och jämföra resultaten. Det har inte KI gått med på och Kammarrätten gav till slut forskaren rätt att få ut materialet men gav samtidigt KI rätten att göra materialet oanvändbart för syftet. Den här kohorten kallas ofta för ”the revolving door cohort” för att de (100% anti-skademinimering inom tobak) som får tillgång till materialet inkluderar eller exkluderar delar av kohorten lite beroende på vad man vill visa.

 

Jag sänder med två vetenskapliga artiklar av Hirsch som kanske är intressanta att kolla igen. Den med 16 patienter med cancer vid snusplaceringen, ni borde kanske kolla med Hirsch under hur många år de samlade in de 16 fallen bland Sveriges ca en miljon snusare? Artikeln anger dessutom ganska klart att det rör sig om i princip samtliga fall i hela Sverige under den insamlingsperioden.

 

Över tid är den svenska beräkningen att rökare dör (av rökningen) en takt av ca 1,2% om året. Under perioden 2010-2012 var siffran från Socialstyrelsen 11,881 om året av sveriges ca 1 miljon rökare (Registeruppgifter om tobaksrökningens skadeverkningar, Socialstyrelsen, 2014).

 

Om vi skojs skull skulle låtsas att alla Hirschs fall rapporterades in som nya fall under bara ett år, och så tar vi som bas (nämnare) att det just är de personerna som snusade ca 1960 och fortfarande var i livet – så ger det 16 fall av cancer orsakat av snus hos 375,000 snusare som snusade men inte rökte ca 1960.

 

16/375,000 = 0,0000426 vilket innebär 0,0024%.

 

I detta extrema (worst case) exempel får alltså 1 person cancer i munnen av snus för varje 500 personer som dör av rökning. (per år)

 

Om vi sen lägger på annan cancer som inte går att härleda direkt, men med samma vikt – så har vi 2 som får cancer för varje 500 som dör av rökning. (också per år)

 

Om vi sen lägger på Diabetes med samma vikt så har vi vips 3 som blir allvarligt sjuka av snus för varje 500 som dör av rökning. (per år igen)

 

Om vi sen lägger på Hjärtsjukdom och hjärtkärldöd med dubbelt så hög vikt (nikotinet!!) som för de andra sjukdomarna så är vi uppe i 5 fall av mycket allvarlig sjukdom av snus för varje 500 personer som dör av rökning. En på hundra alltså. (också per år, igen)

 

Ungefär 0,5%-2% risk av snus jämfört med rökning är vad svenska och internationella forskare som inte är ideologiskt styrda hävdar idag och har hävdat sedan 1973. Så långt tillbaka kan vi följa spåret i Sverige för då började svenska män byta farliga cigaretter mot 50-100 gånger mindre farligt snus.

 

Kolla med Gunilla hur många gånger mindre farligt snus är jämfört med rökning – hennes bästa gissning. Om hon svarar att det vet man inte, för det saknas forskning på det – så är väl en relevant fråga i så fall: Varför saknas den forskningen då?

 

Jag heter Atakan Befrits och representerar INNCO, en global sammanslutning av civilsamhälleorganisationer som inte tar emot industripengar och som självklart inte har en chans att få ett korvöre av Folkhälsomyndigheten. Vi representerar 30 miljoner som slutat röka med ”icke godkända metoder” och representerar även rätten till korrekt information om relativa risker för de ca 1.4 miljarder i världen som fortfarande använder de absolut farligaste sätten att bruka tobak och nikotin. Vi lyckades samla 17 organisationer i Geneve förra veckan när WHO och ramkonventionen hade sitt globala möte om tobaksstrategier (WHO FCTC COP8).

 

Vår centralfunktion blev inte insläppt som observatör till mötet, trots att vi legat på Sverige i 7 veckor för att säkerställa att civilsamhället inte skulle stängas ute. Socialdepartementet svarade mig 4 minuter över 5 på eftermiddagen dagen innan mötet (efter 7 veckor alltså) att de absolut ville ha något civilsamhälle där som skulle visa att det faktiskt handlar om människor.

 

Vi fanns tillgängliga precis utanför möteslokalerna vid 9 tillfällen under veckan men inte en enda anställd eller delegat vågade/ville komma och prata med oss.

 

Ni namnger Milton och Ramström i tämligen nedsättande ordalag (Ramström är också prisad av WHO för sitt tobaksarbete, visste ni det?) – men inga namn om den/de forskare som Scott Tomar hänvisar till. Kan ni tala om för mig vilka de skulle vara?

 

Visste ni förresten att en annan KI forskare – Seppo Wickholm – 2005 i tandläkartidningen beräknade total cancerincidens till 35 per miljon snusare och år. Alltså 1 fall av snus cancer (hela kroppen) per 337 dödsfall av rökning per år. Seppo blev raskt medicinsk direktör för Nicorette tuggummi o har mig veterligen varit det sedan dess……

 

Hör gärna av er om ni vill ha en annan bild att balansera med, global expertis från vilken kontinent ni vill finns att tillgå – som kommer säga att Sverige inte beter sig hederligt i denna fråga och det skadar folkhälsan globalt.

 

Med vänlig hälsning

Atakan

 

Best regards

Erik Atakan Befrits
COO INNCO Secretariat
NNA Sweden Chairman
ab@innco.org
http://www.innco.org
http://www.nnasweden.org

+46 764 156046
+90 531 5942910

INNCO.org and NNA Sweden raise no Issues

with WHO-FCTC or article 5.3 and are

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