Monthly Archives: February 2017

**KUDOS** Good, honest, ethical and open minded KI researcher OP-ED on the diabetes issue from snus.

OP-ED :The results do signal a real effect from snus use and risk of developing diabetes

Translation by Atakan Erik Befrits of and New Nicotine Alliance Sweden, FCTC 5.3 compliant civil society NGO’s representing over 20 million successful ex-smokers, with the help of +95% harm reduced consumer nicotine products. All mistakes are my own.

OP-ED · “A single study can never give the final answer to a research question. We would still like to say that the current study is an important addition to the existing knowledge on tobacco and type 2 diabetes” Associate professor Sofia Carlsson and Professor Cecilia Magnusson conclude.

Sofia Carlsson, Associate Professor, Institute of Environmental Medicine, Karolinska Institute

Cecilia Magnusson, Professor, Department of Public Health, Karolinska Institute

As Patrik Strömer writes on SVT Opinion, there may indeed be other explanations for the findings in our study, connecting snus use and type 2 diabetes, than the snus use itself causing diabetes.

For example, we can not rule out that snus users and non-users of snus differ with respect also to other factors that contribute to an increased risk of diabetes.

At the present time there are relatively few studies of snus and type 2 diabetes, and they partly do provide different results. One explanation for different results may be that the previous studies have not been large enough to study consumers who use quite large quantities of snus, which is where we primarily find an increased risk.

Smoking is an established risk factor for diabetes, and a problem in previous studies has been to separate snus effects from smoking as dual use is common.

Our study is the largest to date on snus and the risk of type 2 diabetes. We have thus been able to examine the effect of exclusive use of snus.

We have also, insofar as possible, taken into account other risk factors for type 2 diabetes such as overweight, physical inactivity, heredity, alcohol consumption, and education level.

The results show a so-called dose-response relationship, meaning that the risk of type 2 diabetes increases with the number of cans of snus consumed per week, which reinforces the interpretation that snus is indeed behind the increase in risk.

Finally, experimental studies show that nicotine can inhibit insulin sensitivity, which means that there is a possible biological explanation for that snus can cause diabetes.

Combined, these findings make us more inclined to believe that the results do indicate that snus use does indeed affect the risk for diabetes.

A single study can never give the final answer to a research question. Every one study instead contributes a new piece to the puzzle, and slowly extends the research frontier.

We remain confident in claiming that the current study is an important addition to the existing knowledge on tobacco and type 2 diabetes.

Although we cannot prove that snus causes type 2 diabetes, we think that the public and decision makers have the right to be informed of our research findings.

Good research is characterized by humility and critical reasoning, media headlines sometimes do not reflect this adequately, and we therefore welcome these subsequent discussions.

Weaponized kafkaism from Tobaksfakta to secure funds for lobbying for more funds for lobbying for more funds for lobbying for more funds for lobbying for more funds………….

For the casual reader who is new to Swedish Tobacco Control: Tobaksfakta is a tax funded “independent” think tank lobbying organisation that also orchestrates (and shares offices with) Doctors against Tobacco, Dentistry against Tobacco, Psychologists against Tobacco, Teachers against Tobacco, Nurses against Tobacco and finally the all encompassing Professional Organisations against Tobacco. Incidentally all the above organisations co-habit with the Swedish Society of Medicine in their cushy town-house mansion in central Stockholm.

Please find below, translated for your reading pleasure, interesting and ground breaking scientific findings on how propaganda works.

____________________________ Scientific report: More knowledge increases support for stricter tobacco policy


How does knowledge enhancing information impact public perceptions?

Tobaksfakta (Tobacco Facts) – an independent think tank – measured this in method experiments presented in an article by Göran Boethius, Tobacco Fakta’s chairman and responsible for the survey.

The starting point was a measurement that was included in the annual report by the SOM Institute at Gothenburg University and was presented in June 2016. Tobacco Facts provided questions in the section on tobacco. A powerful result was that there was very strong support for smoke free outdoor environments. 66-92 percent supported non-smoking cafés, entrances, railway platforms, bus stops and balconies of apartment buildings. The share of unsure replies like “no opinion” or “neither good nor bad” accounted for low 5-17 percent scores.

The “not sure” category was significantly greater on the answers to questions 2 to 5, questions that dealt with tobacco taxes, display bans in shops, plain-packs of cigarettes and a national political decision for a non-smoking society, 21-40 per cent.

Goran Boëthius formed the hypothesis that the low uncertainty figures regarding support for smoking bans in public spaces outdoors, was due to more respondents having personal experience and knowledge of tobacco smoke in outdoor environments.

– Therefore, it is easy to understand the meaning of this question. While, e.g. the issue of introducing requirements for storing packs of cigarettes out of sight in shops, provide too little information for participants in the survey to know and understand enough to really take a stand, says Göran Boethius.

– More information is needed on issues, information that improves the knowledge level in the respondents. It makes it easier to take a position, but public opinion agencies on the other hand fear that these questions are likely to be leading if they contain more information. Therefore, they must be brief.

Boëthius got the idea to study a comparison of results from two groups where one group was questioned with the briefly worded questions from the SOM survey, and the other group with fuller, informative, query formulations that provided increased knowledge of the subject. After consultation with the SOM Institute and by a grant from the Jacob Wallenberg foundation, the polling institute Novus was tasked with examining the degree to which a fuller information given in conjunction with the questions, affected the outcome of the survey. It was the four SOM issue questions not regarding outdoor environments that were tested.

The experiment showed a significant effect on the responses, when more informative formulations were presented. The question on proposed tax increase on cigarettes however, expressed very small differences in all three groups, the original SOM, Novus with, and Novus without, fuller explanatory texts.

The proportion of positive responses to increased regulation increased considerably, while the proportion of “unsure” decreased, in responses to the questions about the display bans, plain packs and a long-term strategy for phasing out tobacco from the Swedish society. They were now supported by seven out of ten, while one in ten are negative and two out of ten remain “unsure”.

– These results show how crucially important information is and knowledge is, when important public health issues are to be decided, says Göran Boethius.

– The conclusion that the politicians that we try to support should take home from this is: Politicians need to improve information to the public about why measures need to be introduced and about the benefits they will generate. 

– Our survey shows that with greater knowledge comes greater acceptance for the need to further tighten tobacco policy.

Original article in Swedish:

Original web page translated above: review A Billion Lives film before seeing it – We don’t even know if they will see it or not.

Dear All,

Under this link you can find a commentary on A Billion Lives from biggest ”independent” heavily tax funded think-tank Tobaksfakta. Published today on Saturday February 4th 2017. Tobaksfakta also run and control several other groups, namely: Doctors against tobacco, Psychologists against tobacco, Dental care against tobacco, Teachers against tobacco, Professional organisations against tobacco.
Wouldn’t it have been more appropriate if they came and saw the film and wrote a film review after?
OK translation below
Comments to the film A Billion Lives – about e-cigarettes and Public Health
Are e-cigarettes a panacea for global epidemic of tobacco-related deaths? A panacea unfortunately held back by an unholy alliance of governments, the pharmaceutical industry and the tobacco industry (and even supported by public health workers)?
These claims are made by filmmaker Aaron Biebert in the documentary a Billion Lives. It premiered last year and tours continent by continent in a campaign-like shape, with the support of the e-cigarette industry. On 7 February it will screen in Stockholm. The screenings are marketed by a number of vape companies Filmvisningarna marknadsförs av ett antal e-cigarettföretag..
Stopped by conspiracy?
Film director Aaron Biebert runs a media company in Milwaukee, United States. He has previously produced music videos, commercials and short films for social media. A Billion Lives is his first feature leangth film. It tells how the suffering and death follows in the tracks of tobacco smoking all over the world and how the tobacco industry in the longest attempted to conceal the devastating effects of smoking. One billion people are at risk of dying from smoking in this century, says Aaron Biebert. But he has a prescription for the majority of all these lives (A Billion Lives) will be saved – namely, to encourage e-cigarette smoking.
That not everyone is as convinced as he is that e-cigarettes are a side-effect free panacea against the tobacco epidemic, Aaron Biebert describes as a result of a conspiracy. He believes that the various economic and political interests have joined together to prevent e-cigarette suceeding. This he argues is behind and causing heavy requirements for legislation on e-cigarettes and that they are even banned in some countries.
What does the tobacco prevention professional say?
In Sweden, the government is currently working out a proposal for a new special law on e-cigarettes, as a result of new EU Tobacco Products Directive where EU country regulation of e-cigarettes is taken. Tobaksfakta and other tobacco prevention organizations welcome the regulation of e-cigarettes.
But why the need for such legislation, however, should we not do anything to unreservedly support the e-cigarette use if it is true that it is so good for public health as A Billion Lives claim? To answer this we ask Barbro Holm Ivarsson, Chairman of Psychologists against Tobacco who is closely following and reporting on the development of knowledge concerning e-cigarettes:
– There are many reasons to have precise control over these new products.
Among other things, many studies show that the risk increases that teenagers start smoking conventional cigarettes if they are experimenting with e-cigarettes. And e-cigarettes are becoming increasingly popular among young people – about 30 percent have ever used them.
– The E-cigarette is not a safe product, the customer does not know what it contains and it can explode and cause injury or fire. Nicotine in high concentrations may be fatal if a child ingests it. We also know that the e-cigarette vapor contains harmful and even carcinogenic substances, but not how the long-term impact on health will be.
– Therefore, there needs to be child-resistant packaging, limits on nicotine concentration in e-liquid, 18-year limit, ban candy flavors and packaging that look like toys, advertising bans – including exposure ban in stores, ingredients lists, directions for use, warnings and license requirements for dealers, and quality assurance of product. Finally, the vapor that e-cigarettes also emits are harmful to bystanders and the product must be urgently prohibited in all non-smoking environments.
Barbro Holm Ivarsson also emphasizes that no one yet can say for sure what the net effect of e-cigarettes will be. Does the product really help more smokers to quit than the number that will be attracted, when taken into account that
1) Smokers postpone quitting smoking indefinitely when they are lulled into security when replacing a part of cigarettes to e-cigarettes,
2) young people who would not otherwise have started to smoke regular cigarettes, do it after having started with e-cigarettes,
3) Former adults smokers and never-smokers tempted to start with e-cigarettes, and then transferred to conventional cigarettes, and
4) e-cigarettes make nicotine consumption and smoking more cool and popular again?
What does the addiction researcher say?
An addiction researcher who followed the e-cigarette research for a long time is Fred Nyberg, senior professor of biological addiction research at Uppsala University. He confirms that there is not yet enough research evidence to be able to say anything for certain about the health advantages and disadvantages of e-cigarettes.
– In terms of how well they can help tobacco smokers to reduce their health risks are research results so far contradictory. My conclusion is still that it inveterate smokers are better off to switch to e-cigarettes than to continue with regular cigarettes. But there are more categories than inveterate smokers who meets e-cigarettes, says Fred Nyberg.
– The ones I’m most concerned about are those who haven’t started smoking at all, especially those who are under 20 years. Nicotine is addictive and especially young people are vulnerable to these effects. The nicotine in e-cigarettes triggers the reward system and the risk  becoming a gateway to both tobacco use and other addictive drugs.
– In addition, the e-cigarette even begun to be used to cannabinoid drugs and stimulants because you get a much faster effect of the drug if you smoke or inhale it. Developments in the drug field is fast and I am convinced that soon you will find many more illegal substances to put in e-cigarettes.
Another aspect is, says Fred Nyberg, that nicotine can have adverse effects on the fetus, and he believes that pregnant women should not use e-cigarettes. Along with uncertainty about the potential risks of hazardous substances in the steam, making all the listed factors he recommends a restrictive regulatory approach.
– We must have control of this and wait for more research. It took 40 years for us to learn lessons about the dangers of smoking tobacco. Let us not make the same mistake again.
Erik Atakan Befrits
INNCO Steering Group
+46 764 156046
+90 531 5942910