Statistically harmless tobacco exists!

Virtually harmless tobacco

Wouldn’t that be great? A tobacco product class that through meticulous choice of minimum harm tobaccos and processed with Food Grade technology and Food Grade additives, actually turns out as a Food Grade product?

Pasta, Kimchi, Pickles, Bacon, Processed meats (including “halal” and “kosher” processed meats) are not perfect or totally harmless products, but definitely stuff you can’t, or don’t want to, go without.

What if there was a tobacco product, satisfying and attractive to smokers, no more dangerous than that, wouldn’t that be great?

Well, there is one. Well, nowadays actually 2, I would include high quality vaping products on the list too. The one I am referring to in this post has been around for over 200 years, practically unchanged. The one I am talking about was even classified under the Food Act already in 1971, 44 years ago!

What could possibly create a political and scientific environment where a product that will erase risk and harm is hidden, demonized, ostracized and even gets it’s global life saving capability severely restricted through government sanctioned activities that make future exports near impossible?

The only rational explanation I can think of is vested interests and prestige, coupled with a total case of “Regulatory Capture”.

Below please find a rather sad Christmas story of a country acting like Uncle Scrooge:

“100 years of monitored +10% snus use without serious health consequences is definitely proof of no (or unmeasurably low) harm”

The important and widely used old maxim of “no proof of harm doesn’t mean proof of no harm” can confidently be disqualified in relation to Swedish “snus”. I it however a favourite among anti-nicotine zealots globally, nowhere more so than in Sweden.

What could possibly fundamentally refute the claim that “no proof of harm doesn’t mean proof of no harm” in regards to a certain, closely measured and monitored, product?

Time, that is what. Time!

The maxim is perfectly valid on new products and chemicals entering the market.

It is not applicable however, to a product with over 100 years of monitored use history and product improvement, without any  measurable harm, because this is a different beast altogether. Especially so if the product has the capability of switching millions and millions of smokers away from lethal cigarettes.

In fact, this is an altogether benign and useful beast that should be embraced and promoted, a harm reducing beast that only Uncle Scrooges and Abolitionists would even consider trying to ban.

The information, documentation and translations linked to and explained in this post are for the purpose of giving you, the reader, an accurate account of what is and is not known about snus in Sweden. From this post  I hope you will find at least something from which to extrapolate also to vaping. I also hope that you will find some useful information that you can use to influence the “Harm Reduction” regulatory framework in your country/context.

The second purpose of this paper to clearly show that ample evidence of safety and efficacy of snus for not smoking, or instead of smoking, (and as a standalone pleasure product), has been present for an extremely long time.

The third purpose is to show that “Tobacco Control” in Sweden deliberately keeps this information from the public and from the government in order to further it’s own agenda, nationally and internationally.

The first, last and most poignant piece of evidence to establish this as fact is that for the first time in history (summer 2015): The Public Health Community and the Transnational Tobacco Industry is perfectly aligned:

Snus products must be suppressed at all costs!

Does not the fact that the cigarette industry and the Public Health communities totally agree on snus, set off about one hundred million warning klaxons sounding in total disharmony?

This going unnoticed or undiscussed is totally unacceptable and is in part responsible for millions of avoidable smoker deaths per year globally.

Potentially hundreds of millions of avoidable smoker deaths this century.

Snus in Sweden has a market share of roughly 50% of all tobacco consumed and has ZERO registered (clinical) serious adverse health effects in over 100 years.

The market share for snus was close to 90% at the start of the 20^th century and dropped to a bit over 10% daily adult male use during the extreme cigarette smoking period 1940-1980. Since the beginning of the 1970’s there has been a sharp and steady increase in snus use again, an increase that has coincided with lower smoking rates, now among the lowest in the western world.

At no point in the last century has daily snus use ever been below 10% of the adult male population in Sweden, yet there is not one single registered clinical notation of serious adverse health effects . ZIP!

Sweden is internationally recognized as a leader in Public Health work and also for excellent records keeping. This allows for high quality observational and statistical modelling, as well as excellent epidemiological study of phenomena and observations that impact individual and public health. This has been true since well before 1900, in effect more than 100 years. See translated document here Linked document 1

Tobacco and nicotine use is one of the most intensely studied harmful human habits for well over 60 years, very much so also in Sweden. It is unquestionable that smoking tobacco is very detrimental to health for all smokers and bystanders. Given the current lifespan in Sweden, lifelong  smoking has a fatality rate of approximately 50%.

This article posits that IF snus use caused any measurable and discernible serious adverse health effects in healthy human beings, then due to the weight of sheer numbers and the sex difference in usage, >90 men <10 women in Sweden, these serious adverse health effect simply could not have gone unnoticed for over a century.

This paper also posits that if the above is true, then The Kingdom of Sweden (in actual fact Swedish “Tobacco Control”) has suppressed these obvious conclusions for over 40 years, for purely ideological and political reasons, and continues to do so also in 2015.

Excellent examples from 2015 of this work continuing are 2 letters to the FDA in the USA, warning them against the dangers of snus. See letters from Swedish Public Health trying to influence the FDA here: SWEDEN PHA 2015 FDA, and here SWEDEN NBPHW 2015 FDA.

Sweden has long argued that “snus” is a serious Public Health problem, despite that this is demonstrably the exact opposite of the objective truth.

International experts have long since proven this and alerted Swedish authorities, but without result.

In early 2013 a group of these international experts wrote an open letter to Mrs. Maria Larsson, then Swedish Minister of Public Health, urgently urging for an evidence based and observation based investigation on snus as a vital tool against the smoking epidemic. Please read the letter in perfect english here: Linked document 4.

A similar letter, signed by a further 47 international experts was also sent one year later to Mrs Margaret Chan of the WHO. Read this letter here: Linked document 5. To the best of my knowledge Director General of the WHO, Mrs Margaret Chan, found the letter crucial to recycle immediately, probably in order to save the rain forests.

Sweden was different. In a historical first, Minister Larsson and the Cabinet of Ministers in Sweden ordered a thorough investigation with the clear objective of providing best available numbers on ill health from tobacco use, all forms of tobacco use. By logic this needed to adequately quantify the harms from snus use. Please find original and translation here:  Linked document 6. This order, and a relevant budget to perform it, was tasked to the National Board on Health and Welfare together with the Institute that awards the Nobel Prize in Medicine, The Karolinska Institute.

The problem it seems was that the same bodies who were tasked with quantifying the truth on harms from snus, are the exact same bodies with the most to lose from performing the job adequately. So they didn’t.

The resulting report was published in February 2014, the title referring only to harms from 50% of tobacco used in Sweden, cigarettes. These 50% are the same 50% that we already have almost perfect information on, namely cigarettes.

Basically the Government specifically asked for the truth on snus. Since that would be suicide for the “Quit-or-Die” movement, Tobacco Control resorted to specifically lying instead.

Bizarrely, a direct order from the Government to come clean resulted in Tobacco Control taking an even more polarized position on the issue of snus and Tobacco Harm Reduction. Digging in it’s proverbial heels to the point of arriving at a position from which it cannot ever hope to truthfully recover from, with any semblance of “grace” intact.

The “misnamed” report, published only in Swedish is called “Registry data on the harms from smoking”. This is hugely misleading as it totally omits to mention that the Registry data on the harms from snus use is ZERO. That the registry data on snus is ZERO is the only really relevant finding that should have been reported.

If you read Swedish or know someone who does, then the report in it’s entirety can be found here: Rökningens skadeverkningar

It is clear from the first page that no data on snus will be in the report. It is clear that this is in direct violation of the objective and directive from Government. There are certainly mentions of snus in the report, they are to 100%, unsubstantiated scaremongering; except for nicotine effects in pregnancy (no nicotine should be consumed during pregnancy).

Important publications from Swedish “Tobacco Control” are always published also in English and widely advertised and spread at conferences.

This report is published only in Swedish and also named in a way that I believe is intended to avoid archive searches for harms from snus. This report has never been seen again since the press conference.

The report’s findings that raised the levels of deaths from cigarettes to a whopping 12,000 per million user years however, is frequently used to argue for harsher measures on snus.

Considering the name of the report (that omits 50% of all tobacco) and the conspicuous absence of data on snus, although specifically asked for, the statistical level of serious adverse harm from 50% of tobacco use in Sweden (Snus) must be ZERO.

This has obviously been true also when Snus accounted for 90% of tobacco consumed, around 1910, as in 1910 harms would come almost exclusively from snus use.

In all likelihood the ill-health from “snus” use is slightly greater than ZERO, as with almost anything else one can come to think of. But logically so incredibly close to 0 so as to never have warranted any closer scrutiny.

Almost all forms of serious ill health that are exclusive to the female sex, even when very very rare, have been documented clinically, studied, and can be found in Swedish health records and statistics. The same is true for exclusively male ill health.

Looking at the last century it is therefore perfectly safe to say that any serious adverse health effects from snus use would have been noticeable and predominantly male, predominantly on par with prostate problems. This would certainly have been noticed, noted and studied.

Yet there is absolutely no trace in any records or databases. Nothing. The best calculation, and the only one ever to be published was by Seppo Wickholm and published in 2005. He calculates the maximum likely ill health from snus to 35 cases of cancer per million user years. Way way below detection levels. Please find a translation of the relevant bit here: Wickholm 0515 translation. If you would like to see it as it was published in 2005 in Swedish Journal of Dentistry and in the database of Karolinska Institute, then find that here: wickholm_0515

The information, or lack thereof, above is quite sufficient to make draw quite a few conclusions with a degree of certainty high enough to displace any concerns that would justify using “no proof of harm is not proof of no harm” or “the precautionary principle” in the way global experts working in “Tobacco Control” propose we continue doing.

• The available data, or lack of data, is not new, it is over 100 years old and continuous in over 10% of male population
• The available data does not support that snus/THR is completely harmless
• The available data does not support that snus/THR should ever be used by non users of tobacco/nicotine or use during pregnancy
• The available data does not support unregulated marketing, or the sales of THR products to persons under 18 years.

 

• The available data, or lack of data, is not new, it is over 100 years old and continuous in over 10% of male population
• The available data does support that THR products has been successfully used in very large numbers for no longer smoking and as standalone products without any measurable population level or individual harm
• The available data does support that large non smoking but tobacco using populations do exist without causing measurable population or individual level harm
• The data does support that instead of banning smokeless products, a product quality control and improvement strategy, is a better argument
• The available data does support that higher quit rates are possible through attractive and commercially available THR products, and will have few, if any, serious downsides
• The available data does support that blanket-banning smokeless/THR product could (but would’t) increase total numbers of individuals eventually successfully becoming tobacco-free, but at a prohibitively high cost in population level health terms, as well as individual ill-health and suffering and productivity losses
• The available data does support the idea that active support, responsible marketing, and incentivization (which has never been the case in Sweden either) and promotion for, switching from cigarettes to THR products, may have vastly better results, even than those seen in Sweden, with a documented minute risk of unwanted or negative consequences
• The available data does support the potential benefits of truthfully communicating the difference in relative risks and the risk continuum from use of different types of tobacco/nicotine products to smokers
• The available data does support that long term use of THR products differs little, if any difference at all, from long term use of NRT products that are licensed also for long term use and acknowledged to have negligible, if any, serious adverse side effects.
• The available data does support that THR product’s higher acceptance to smokers is a vital improvement over pharmaceutical alternatives, and THR products should be endorsed and supported to all smokers who have tried to quit and failed.
• The available data does support that the 6 Swedes who are smokeless with smokeless for every 1 Swede who is smokeless with NRT’s is makes “Tobacco Harm Reduction” by far the per capita best anti smoking intervention seen anywhere in the world as well as the best anti smoking intervention in absolute numbers.
• The available data does support that “Tobacco Harm Reduction” in the form of various attractive formats and formulations present the largest untapped (free for governments) anti smoking intervention globally.

For how long should we allow hidden or non available data, rule supreme over a vast body of actually available data?

When looking at the report by the Swedish Public Health authorities and the Karolinska Institute, they can with a very high level of confidence say that 100,000 new instances of smoking related disease occur every year in Sweden and almost 12,000 fatalities.

The calculations are based on actual diagnostics statistics and approximations of indirect effects using models based on best current knowledge of smoking related diseases.

Is it likely, or even possible, that given the specific orders from the government, that the report should not at least include some detailed approximation on “snus” related ill-health if there were any?

The report itself therefore constitutes proof that the harm from snus cannot be measured even after a century.

The report therefore also constitutes ample proof that Swedish snus policy is ideological and political and without any basis in scientific fact.

This directly results in thousands of entirely avoidable deaths in Sweden every year, and likely millions globally.

• Harms from snus use are so low as to make them not relevantly measurable and not warranting any attention for over a century

 

• The trend is clear: “snus” use is already replacing smoking at a 6 to 1 ratio of that of NRT’s supported by the government in Sweden

 

• There is little (and disputed) in vitro evidence and ZERO in vivo evidence for any serious adverse health effects emanating from this trend in Sweden

 

• With over 100 years of continuous +10% daily use prevalence in adult males in Sweden, this is more than sufficient “proof of no, or infinitesimally low, serious harm in healthy humans”

 

• Swedish Public Health agencies and The Karolinska Institute presented the Government with a misnamed and utterly false report indicating danger from “snus”, when the obvious conclusion is the exact opposite

 

• In 2015 they continue actively spreading this quite deadly falsification of knowledge in unsolicited letters to the FDA that you can find here: Linked document 7 and here: Linked document 8

 

• This is what the report states about snus translated, here: Linked document 9

 

It is my fairly firm belief that both the Government, the old Government (september 2014) and the Public Health bodies are fully aware of this but simply do not care.

Politics come first in Public Health, and actual Public Health is pretty far down the list. That is probably why the Swedish Government is rushing through a legislation that will lower switching from cigarettes to snus. See here: International scaremongering legislation

That they are also setting back global Tobacco Harm Reduction for at least a quarter of a century, does not even seem to have registered on their “ethics radar”. Not even a blip.

Breaking International Law does not seem to be a problem, not in Sweden and not anywhere else either: WHO stole harm reduction from the WHO FCTC

Merry Christmas and a Happy New Year 2016.

Let’s put Harm Reduction back in the FCTC in 2016, also in practice

atakan.befrits@gmail.com

Please support sos-childrensvillages.

WHO STOLE HARM REDUCTION FROM THE FCTC?

The FCTC is arguably the most comprehensive global tool against the devastating health effects of smoking and is now ratified by 180 Nation States.

This post deals with Harm Reduction, a pretty intuitive and simple concept practiced and accepted almost universally.

The FCTC (Framework Convention on Tobacco Control) belongs to the body of what is commonly referred to as International Law, in effect to a large extent binding for the ratifying states to the convention.

Is it ok to secretly and surgically remove from practice, a crucial passage found in this piece of International Law, because you don’t like it, and then just carry on as if nothing has happened. No consultations, no democracy, nothing?

Is it then ok, adding insult to injury, to accuse anyone who dares point out this totally obvious discrepancy, of being evil, murderous, unethical profiteer from children getting addicted, and in clear breach and violation of said International Law? When in fact it is the reverse that is true?

Well, that is pretty much exactly how it’s been done and is being done.

WHO STOLE HARM REDUCTION FROM THE FCTC? (elegant pun right?)

Below is the only and global legal definition of “Tobacco Contr0l” as defined in the very onset in the FCTC treaty text, and thus is International Law:

“tobacco control” means a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke;

CHALLENGE!!!

Open the below document, it is the official 10-year celebratory leaflet honoring the first 10 years of the Tobacco Conventions existence. I dare you: find one single hint, not to mention actual mention, of Harm Reduction as a viable strategy to improve the health of tobacco users.

FCTC anniversary leaflet where is Harm Reduction?

Since I simply cannot believe anyone would even consider NOT wanting to reduce harm and risk to people who are obese, climb mountains, race cars, refuse to exercise, drink too much or whatever else one might think of; therefore I must clearly be mistaken.

Why would harm from tobacco be any less worthy to try and minimize?

Please point out my mistake to me, so I can get peace of mind before the holidays.

If you can’t then I will be just as happy for your help in finding whoever stole Harm Reduction from the FCTC, so that we may put it back where it belongs.

Either way, please share this information as wide and far as you can.

99,999% of the share of the world’s population, who have even heard of the Tobacco Convention, have absolutely no clue or suspicion that Harm Reduction is a perfectly valid and clearly stated strategy to combat disease and death from tobacco.

Just as valid as reducing supply and demand

*Season’s Greetings to All*

Atakan Erik Befrits

Open letter in the Norwegian Medical Association Journal December 2015

(Credit to MD PhD H O leira – document available online and translation by Atakan Befrits – any mistakes or misunderstandings shall be the responsibility of the translator alone – original here http://tidsskriftet.no/article/3429260)

Dec 8th 2015, Journal of the Norwegian Medical Association

Håkon Olov Leira, Postdoctoral Fellow, Norwegian University of Science and Technology, Trondheim Norway.

E-cigarettes are a good alternative to regular cigarettes, they can save many years of life lost and lost years of health, respectively. Sadly the Health Minister and central health communities want to restrict access.

I daily treat patients with severe smoking-related illness, provide advice on smoking cessation and reduction of cigarette consumption, and have been thrilled at the possibility of now being able to offer yet another means of smoke reduction, the e-cigarette. My impression from my own practice is that e-cigarettes and smokeless tobacco are more attractive for experienced smokers than patches and nicotine gum.

I wonder why there is such significant resistance from our Minister of Health, Public Health Agency and my experienced colleagues, to the idea of legalizing e-cigarettes. As recently as this summer the discussions in this journal portrayed e-cigarettes almost as a stimulus/equivalent to continued smoking (1, 2). The fight against tobacco is in this discussion turned into a fight against all nicotine, where we run the real risk of winning the battle but losing the war.

Years of life lost
Smoking causes heart attacks and strokes and is the main cause of lung cancer. In addition, smoking is a major cause of cancer of the mouth, pharynx, esophagus, stomach, pancreas and urinary tract. The Health Directorate (in Norway) estimates that smoking causes 8,000 deaths and 150 000 to 180 000 lost QALYs (Quality Adjusted Life Years) each year and that the social costs of smoking are up to 80 billion per year (3, 4). 4-5 billion cigarettes are smoked in Norway every year. That means every smoked cigarette corresponds to ca. 15 lost quality adjusted life minutes and consequently, an average a smoker has lost one quality-adjusted life year after just 6-7 years of smoking.

In an article in NRK Freedom in August 2014 the president of the Medical Association and director of the Institute of Public Health stated that we should phase out tobacco smoking by 2035 (5). In a follow-up article in Bergens Tidende, the Health Minister Høie is quoted as saying that he envisions that with active policy measures the smoking epidemic will be over by 2050 (6). If we multiply 150,000 lost QALYs and 8000 deaths per year with the NMA / NIPH 20 years or the health minister’s 35 years of waiting, it equates to roughly 150 000 to 200 000 deaths and 3 million to 4 million lost QALYs in the process.

E-cigarettes are just a little bit not Harmless
To put it very bluntly: It is the smoking of tobacco is dangerous, much less so tobacco itself. Tobacco is not entirely harmless, but cancer occurs primarily when organic material is heated to 700 ° C in cigarette and pulled into the lungs (7). Although tobacco has been in use for 500 years in Europe, lung cancer was a very rare form of cancer before the invention of the cigarette manufacturing machines in the late 1800s (8).

We now have excellent cigarette replacement products like gum, snus and e-cigarettes that all are virtually harmless compared to smoking. If available these alternatives should satisfy most needs except to roll your own cigarette or fill your briar pipe. So if we are not going to ban tobacco just yet, isn’t it time to immediately do everything we can to reduce actual smoking? Every cigarette counts.

Advice to the Minister of Health
E-cigarettes contain controllable chemical substances and can be made to, in principle, not contain any harmful substances beyond nicotine. Today, e-cigarettes are banned from being sold in this country and therefore unregulated. We risk leaving many to their own devices who may import dangerous products from rogue manufacturers. We should rather do as England did, who after a review of current research will allow e-cigarettes next year (9) (both as consumer product and as licensed cessation method).

According to the news the Norwegian government may come to allow a tasteless version of E-cigarettes next year, but these will unfortunately not appeal to the group who need it the most (10). Similar are already legally sold as as drugs, but without success,

My advice to the Minister of Health is therefore: Allow quality assured e-cigarettes and liquids with flavors and regulate emissions. Strongly encourage smokers to replace cigarettes with snus, e-cigarettes or nicotine pharmaceuticals. And finally: increase taxes on tobacco smoke and lower taxes on replacement products.

The goal for the health authorities should not be a tobacco-free society by 2050, but a cigarette and smoke free society much earlier than that.

Litteratur

1.	Sanner T, Grimsrud TK. E-sigaretter – til skade eller nytte? Tidsskr Nor Legeforen 2015; 135: 959 – 61. [PubMed]
2.	Folkehelseinstituttet. Bruk av e-sigaretter er ikke risikofritt. www.fhi.no/artikler/?id=114662(5.11.2015).
3.	Helsedirektoratet. Statistikk om røyking, bruk av snus og e-sigaretter.https://helsedirektoratet.no/folkehelse/tobakk-royk-og-snus/statistikk-om-royking-bruk-av-snus-og-e-sigaretter (10.9.2015).
4.	Helsedirektoratet. Samfunnsøkonomiske kostnader av røyking – En vurdering av metodikk og kostnadenes størrelsesorden.https://helsedirektoratet.no/Sider/Samfunns%C3%B8konomiske-kostnader-av-r%C3%B8yking-%E2%80%93-En-vurdering-av-metodikk-og-kostnadenes-st%C3%B8rrelsesorden.aspx (17.10.2015).
5.	Fem skritt for folkehelsen. Ytring. www.nrk.no/ytring/fem-skritt-for-folkehelsen-1.11881025(9.2.2015).
6.	Dyregrov S. Legeforeningen vil utfase salg av tobakk innen 2035. Bergens Tidende 6.10.2014. www.bt.no/sprek/Legeforeningen-vil-utfase-salg-av-tobakk-innen-2035–3206990.html (9.2.2015).
7.	Chemistry and toxicology of cigarette smoke and biomarkers of exposure and harm. I: How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention, 2010.
8.	Adler I. Primary malignant growths of the lung and bronchi: a pathologic and clinical study. London: Longmans, Green and Company, 1912.
9.	Choices NHS. Some types of e-cigarettes to be regulated as medicines.www.nhs.uk/news/2013/06June/Pages/e-cigarettes-and-vaping.aspx
10.	NTB. Regjeringen vil behandle e-sigaretter som vanlig røyk.www.dn.no/nyheter/politikkSamfunn/2015/10/26/1320/regjeringen-vil-behandle-esigaretter-som-vanlig-ryk (5.11.2015).

Mottatt 17.10. 2015, første revisjon innsendt 20.11. 2015, godkjent 25.11. 2015. Redaktør: Martine Rostadmo.

Message to @pmarca Dec. 10th

Dear Mr @pmarca,

Glad to have you here! Thank you for kindly following the link!

As promised the message to you was taken down after 3 hours, it was intended for your private viewing and I will be more than pleased to send it to you.

As a final result of the message my goal is to put you in touch with @chris_lager of GP Bullhound in San Francisco for a 45 minute meeting that you will not regret.

You can always reach me on @AtakanBefrits, atakan.befrits@gmail.com or on 0046 764 156046.

 

Something is rotten in the (Tobacco Control) state of Sweden

Sweden is set to sabotage global efforts at Tobacco Harm Reduction by ELEVATING health warnings on snus, despite no evidence to support this. By senselessly following the EU TPD2 to the letter, even though there is no legal requirement to do so as snus has a derogation from the EU TPD2.

At the same time and in the same law:

Sweden is set to protect flavors and flavor information on snus to Swedish and Norwegian consumers, in violation of the EU TPD with reference to a derogation from legal requirement to follow EU TPD2 on snus.

Friday December 6th 2015 the government (The council of ministers make collective decisions by the way) published a proposal on legal implementation of the EU Tobacco Products Directive in to Swedish law before the dead-line on May 16th 2016.

In a Bizarre twist, tucked away in more mundane texts on smoking, is a quite real recommendation to RAISE the level of health warning on Swedish “snus” and this will imminently become law unless changed.

This is utterly bizarre and counterintuitive as “The Swedish Experience” with snus, so evidently and clearly shows “snus” to be part of the solution, not part of the problem.

Snus will, according to the new law, have it’s warning label ELEVATED from today’s warning. This will be enacted despite overwhelming evidence suggesting an even more moderated warning, a warning that actually promotes switching from cigarettes to snus, if quitting entirely seems too difficult (which seems to be the case for the majority of smokers).

The warning will be changed from “may cause harm” (which is an overstatement already) to “causes harm” (Which is a totally outrageous and erroneous overstatement and quite quite deadly). This will happen  without any further shred of remotely credible evidence having been presented, compared to the evidence already present when the EU ruled in 2001 that the current warning was quite sufficient.

Make no mistake about this: This new law on snus will have exactly ZERO effect here in Sweden where ZERO people die from using snus. It will however have devastating effects for the health of smokers and users of toxic smokeless formulations in THE 193 OTHER recognized countries in the world.

This will without any doubt seriously negatively affect some 1.3 BILLION tobacco using people who are not lucky enough to live in Sweden or Norway where snus is commonplace and the trivially low risk is a well known fact in the general population. 

Swedish Tobacco Control Science and Public Health bodies have had an extra full 14 years since 2001 to firmly establish harms from snus, had there been any.

In a report from 2014 by the NBHW (Swedish National Board of Health and Welfare) it is obvious that exactly ZERO such evidence has been found. Not in the 14 years and also not in the well studied entire century preceding 2001. In the entire period between 1901-2001 there is not one single clinical mention of serious adverse health from snus use whatsoever. None.

When the government in 2013 gave the order for this report to be prepared it was perfectly clear that both major tobacco products used in Sweden (cigarettes and snus with 49%/49% share of the total market) should be thoroughly reviewed and data presented. As there simply is no data do be found on serious harm from snus use, the NBHW simply changed the name of the report to imply that only smoking data was ever asked for.

The honest and scientifically correct reply from the NBHW would have been: With over 100 years of observation and a very thorough investigation in to the matter of snus, the actual serious harms found among the 1 million snus users in Sweden is so close to ZERO, that any residual harm cannot be meaningfully measured from a Public Health perspective.

 

There is also not one single mention of the word snus in Sweden’s most prominent medical journal between 1904-1995, but of course several hundred studies and articles on the devastating harms from smoking. In the very early 1900’s snus sales in Sweden was 7000 tons and again 7000 tons in the 2000’s. Serious harms from snus going unnoticed in a country like Sweden, for well over a century and with some +75  million user years, is simply not even a theoretical possibility.

The Rest of the Story:

The Government in Sweden instead intends to group practically harmless snus (totally banned in the rest of the EU) together with highly toxic Asian smokeless products like Khaini, Gutka, Pan-Masala, betel quid, areca nut and more (all allowed in the EU, in a further bizarre Brussels twist from a decade ago) and regulate them equally.

Peculiarly enough, and further adding to the bizarre and total lack of logical reasoning, flavor markings on snus and characterizing flavors in snus, will be allowed also in the future.

Specifically the EU TPD banning of flavor markings on tobacco products is with the intent of keeping all tobacco products as unattractive as possible to young people. In this respect however, Sweden instead chose to invoke the “unique status for self regulation” and derogation achieved in the EU accession that snus has, as legal grounds for keeping flavors and flavor markings.

I am baffled as to why Sweden did not chose the same legal route for the much more logical and Public Health safeguarding action, and keep the lower level warning? (or better: easing it in to a positive Tobacco Harm Reduction message, while warning young people, to avoid unintended uptake consequences)

It makes infinitely more sense for smokeless tobacco products like snus (that fill all the criteria in the Swedish Food Act), to keep the uniquely Swedish moderated warning labels. It would also make infinitely more sense to subject ONLY products NOT meeting these standards to the warning mandated in the EU Tobacco Products Directive. This would act to effectively help in directing tobacco users to the least harmful alternatives available, and informing on which is what.

This route of regulation is even more baffling due to this gloriously simple fact: The products in question will/would never be legally sold in the EU anyway. They are specifically and discriminatorily BANNED, period!

For a better and more comprehensive legal explanation to the discriminatory and product specific targeting of snus by the EU, please follow this link to open source book excerpt with an excellent analysis: Legal discussion

On a final note. What then, might the lead author of the world’s most comprehensive study on Smokeless Tobacco globally have to say on the matter of snus? Link to very comprehensive and globally recognized study:Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries By Dr Kamran Siddiqi, University of York et. al.

Please find quote from an email to me dated August 28th 2015, published with author Dr Kamran Siddiqi’s kind permission:

“I am also a supporter of harm reduction strategies in tobacco control. The challenge with smokeless tobacco is the spectrum. At one end (Swedish snus) is more or less harmless and can be used as harm reduction substitute while on the other hand the products used in Asia and Africa have very high TSNA and are extremely harmful.”

Dr Kamran Siddiqi

If the above is true (it is), then why would anyone who cares about health want consumers to believe that Food Grade Smokeless Tobacco (suns) is no better than cancer causing Asian and African products, and little better than continued smoking?

Tobacco Control Sweden, you know this, and yet you applaud this proposed new law for elevated warnings on snus, why?

Exchance vape for snus and Pötschke-Langer for Tobksfakta/Folkhälsomyndigheten/Socialstyrelsen/Karolinska Institutet/Gabriel Wikström

Credit Norbert Zillatron

Vapemail from Germany

December 1, 2015Advocacy, International, Politicsvapersinpower

Envy for the Enlightened Isles

A guest post from Norbert Zillatron

German vapers — at least those few that care about it — envy the UK for the open acknowledgement of PHE et al. Sure, we know that it’s far from perfect and a lot of the lot still can’t see vaping as anything but an improved kind of NRT. But that’s much better than what we have in Germany.

Vapers and Politics

It’s pretty much like everywhere else. The vast majority don’t care at all. They just found something they like and they buy it. They don’t bother with forums or additional information. As long as they’ll get their usual products.
Then there is the minuscule percentage who visit forums and social network groups or watch vaping videos on youtube. To most of them politics is far away and of no concern. They just want to enjoy their hobby.

Comments on the political development are usually along the lines “They can’t do that!”, “Just relax, it won’t be so bad!”, “Then I’ll buy in China.”, “My stockpile will last for years”.

Just a few vapers bother to really read what the bansturbators concoct and are often ridiculed as worrywarts. Including all those who only occasionally bother we are just a few dozens. We’re gonna see who’s right. I hope we worrywarts are wrong. But I’m afraid we’re still too optimistic.

Mass Media, Politicians, and Experts

This is where we German vapers are mired up to our necks in bovine excrement. There is one and only one ultimate “Expert” all mass media and politicians refer to: The Oracle of Heidelberg, Martina Pötschke-Langer. She’s the head of the WHO collaborators that have infested the German Center for Cancer Research (DKFZ). Dick Puddlecote has some strong words about her in “Meet Mendacious Martina”

Credit: hope from the German Vapers Forum – ERF

When German mass media couldn’t simply ignore the Public Health England revolution, all articles about it were also brimming with her dire warnings about unknown hypothetical dangers that PHE might have failed to take into consideration. Her choice of words implies that all scientists supporting this report were clueless idiots. But she always is very careful to avoid any direct insult. It’s all in the mind of the reader.

Of course she pounced on the nutty letter in the Lancet and regurgitated it in many words, suggesting that the PHE report was corrupted by a BigTobacco and BigVapor conspiracy and thus is totally useless. That was the last headlines we heard about it. Chapter closed, evidence dismissed.

Even worse than this constant one-sided public propaganda is the way politicians of all parties keep bowing and scraping to her supposed wisdom. Any facts and arguments are countered with links to her dogmatic pamphlets. And–for the illusion of multiple sources–to the BfR, The Federal Institute for Risk assessment. Two birds of a feather. They often refer to each other’s opinion in argumentative incest.

Don’t let her innocent looks and displayed motherly concern fool you! She knows exactly what she’s doing and her propagandistic skills may even be sharper than those of the undisputed master from Germany’s darkest history. She studiously avoids telling any outright lie. She’s very apt at presenting the most absurd “theories” and visions of doom so that they sound like scientifically proven facts and real concerns. And of course she never forgets to rhetorically abuse “The Chiiiiildren”.

Professor Bernd Mayer from Austria commented on one of her pamphlets: “New Madness in Electronic Cigarette Policy …”. That was a year ago. Now she regurgitated the same “ideas” in a comment on the planned German implementation of the Tobacco tax Protection Directive.

She’s so successful in distorting reality that recently the German Minister for Youth, Family, etc. (Manuela Schwesig) said as one part of the justification for the proposed restrictive amendment of the youth protection laws: “Electronic cigarettes are just as harmful as smoking.”

That is exactly the impression this propaganda is supposed to generate. And it obviously works.

You can’t find any politician or prominent figure in the health business who dares contradict her. Behind this deceiving image mix of Mother Teresa and Buddha hides a nuclear-powered sledge hammer. Ready to vanquish any opposition. When the German vapers organisation (IG-ED) satirically presented her with an honor membership for all her help in getting vaping into the media, her immediate and only reaction was a very nasty letter from her shysters.

We (the IG-ED) were invited twice to speak at the Tobacco Control Conference she hosts. I think the first time she thought we would be the comical element on the panel. Besides the alibi “enemy” from the vendors association. That we would be like puppies overwhelmed by all the greatness. Tough luck. A lot of the audience had questions our speaker could answer far more competently than she or any of her cronies. The second time we were apparently invited as a tame enemy. Only we weren’t tame. We had tried long enough to reason with her. So it wasn’t quite unexpected that we didn’t get another invitation this year. But we were a bit surprised when an official representative of the IG-ED tried to register as regular audience and got a rejection notice signed by her personally. Telling us, that she doesn’t want to see the “ecigs lobby” there. Yes, truth can be painful. Avoidance is an easy way out. And it’s also a way to prevent exposure of her flimsy house of cards to a torrent of scientifically solid facts. In front of an impressionable audience who came looking for real information.

Credit: hope from the German Vapers Forum – ERF

Recently she tried to prohibit a vape shop from using a quote made years ago. When she still did concede that “vaping of course is much, much less harmful than smoking”, she sued them for abuse of the trademark “DKFZ”. Fortunately she lost.

She will demolish any institution or person who gets in her way. By insinuating incompetence and possible corruption from the tobacco lobby. Never crossing the line of liability. If that isn’t enough deterrent, she also can rely on the power of the WHO to threaten even with UN sanctions.

And her pals from the BfR are just as bad. Professor Mayer wrote them an open letter criticising the junk science they published. They responded with a letter to his University suggesting his dismissal.

Implementation of the Tobacco tax Protection Directive

Lately we were able to have a peek at the plans of the German ministry. They don’t just want to do the TPD, dog’s breakfast that it already is. First they also want to skip any distinction between nicotine containing and nicotine free devices and liquids. And then they have a rather long list of prohibited flavours. Most most of their bans they simply copied from the ban list for tobacco products. And this list contains — besides a lot of chemicals of which I have no idea what flavours would be affected by their prohibition — all forms of menthol and one wholly outrageous category: “Substances which might create the impression they might be healthy”. Among those already in the list: Peppermint and woodruff. And they also include the right to expand this list without consulting the parliament (like in the infamous EU “delegated acts”).

But that’s just the first draft. Now it will have to pass through both “houses”. They probably will enter some modifications. But not necessarily for the better.

When MPs are asked about their position on ecigs their answers — if any — invariably refer to the pamphlets of the Oracle and her buddies in the BfR. And she keeps on lobbying massively for banning any flavours except tobacco. And also to make them as unappealing as possible by banning coloured devices. To “Save The Chiiildren!” of course. Those who are already “protected” from buying them anyway.

Petitions in Limbo

Similar to the petition to the UK government to refuse article 20, or to the US government to put the FDA in their place, we also have petitions to our government. My first attempt to get a petition published was rejected after 2 weeks. About six weeks ago I submitted a reworked version, where I eliminated all the causes given for the rejection. Its aim is to get a voice in as many parliamentary consultations as possible. At about the same time another vaper submitted his petition, similar to the UK petition it suggests that the german parliament refuses to implement article 20.

Both petitions are still in limbo. Neither publication nor rejection. Nothing.

Should they be published we would have 4 weeks to collect 50.000 signatures. Lucky for us, German petitions are more like the US petitions and unlike the UK version anybody all over the world may sign it. If we reach the goal we would have the chance to present our case personally.

But as time passes the suspicion is growing that somebody wants to delay us, so that even a successful petition would be essentially useless.

Expectations

Some people still have confidence in the competence of the MPs. That they would listen and apply common sense. But I’m afraid this is just wishful thinking. I think the only ones motivated to change anything will be those devoted to prohibitionism. And the greedy ones. There are bound to be some that would like to follow the Finnish proposal. The vast majority of MPs just won’t care and sign anything their “experts” suggest. And those “experts” faithfully repeat the dogmata from Heidelberg.

I would love to be proven too pessimistic.

Maybe I’ll move to the UK.

To the Enlightened Isles,

where science still can prevail.

By Norbert Zillatron

Note –  All images are; created by, copyrighted to and used by permission of Hope. German Vapers Forum. 2015. http://www.e-rauchen-forum.de/thread-67084.html

Replies to Braillon and Trégouët

Answer to question from Monsieur Braillon on source data for smoking trend lines in Norway when snus became widely available in 2000 and then vaping products around 2010:

Certainly Sir,

https://www.ssb.no/en/royk

This is the website of the Norwegian statistical institute.

Also please be advised that in Norway it is absolutely illegal (as in Sweden) to inform users that the full Tobacco Harm Reduction potential (of the snus product or vaping product) is only realized if one quits cigarettes 100%.

For further information the Norwegian Institute for research on tobacco, drugs and alcohol is a good place. www.sirus.no

In Sweden the Public Health agencies were in 2013 ordered by the government to provide best available numbers on total harm and ill health from smoking and from snus.

The report they submitted is titled “Registry Data on Ill health from smoking tobacco”. In effect meaning that the Registry Data available on snus was ZERO.

In 1900 7,000 tonnes of snus was consumed in Sweden giving an approximate 1 million exclusive users in a 4.5 million population. In 2000 again about 7,000 tonnes of snus was consumed in Sweden giving an approximate 1 million users in a 9.5 million population.

Never in 100 years was snus use ever below 10% daily adult male exclusive use, yet there is ZERO Registry Data on ill health.

Snus is not harmless, but the harm is below relevant measurement criteria and “lost” in the general “noise”.

Considering that there is no doubt whatsoever that Calvados is a clear cause of ill-health, I think this is a pretty strong case for responsible Government promotion of Tobacco Harm Reduction.

Granted Sir, there are no long term data on vaping. But the EU in it’s infinite wisdom chose to ban snus while allowing definitely cancer causing Indian Khaini smokeless tobacco and I haven’t heard any signs of banning or imposing toxicant level thresholds for Calvados??

Idiocy I say, idiocy!

Kind regards

Atakan Befrits

 

Answer to Monsieur Trégouët on that smoking in France is actually rising and that this would be a good case AGAINST “Tobacco Harm Reduction”

Sir,

I would interpret your belief as a very good reason FOR “Tobacco Harm Reduction” products, not against them.

To the best of my research findings there are some 400 million more smokers compared to when Sweden and WHO started working seriously against the transnational cigarette companies in 1970.

It is my impression that daily smoking among french is declining, but very slowly. Am I wrong?

The war on nicotine is not proving any more effective than the war on drugs or the war on alcohol (prohibition).

Do you, Sir, have source data for your belief that the proportion of adult smokers in France have gone up? And data supporting that this in some way is connected to vaping, in France?

Kind regards

Atakan Befrits

(My graph is from the Government Statistical Institute in Norway, I just added the trendlines where snus was introduced in 2000 and vaping started to become popular around 2008-2010)

Waiting, waiting, waiting, still waiting! Anytime now, anytime now anytime now! I am third generation gravedigger and still waiting. Waiting, waiting, waiting……………………………………………………