Alice in TobaccoLand.

aliceintobaccoland

According to Wikipedia, Tobacco control “is a field of international public health science, policy and practice dedicated to addressing tobacco use and thereby reducing the morbidity and mortality it causes”.

Let me break that down.

Public health science.  It also says practice.

Dedicated to addressing tobacco use via public health science, policy and practice.

Thereby reducing morbidity and mortality it causes.

It says mortality, not morality.

If the morality on vaping products doesn’t cease, the mortalities will continue.


Down the rabbit hole.

There are hundreds of organizations dedicated to addressing tobacco use. Those organizations are normally funded, among other things, by tobacco use. The Master Settlement Agreement, taxes, government grants and funding by pharmaceuticals trying convincing researchers to see “their side” so the FDA will trust & approve it are all part of the bigger picture. Don’t want any of them chasing us down the rabbit hole now, do we?

Let us have some tea, shall we?

 aliceintobaccolandtea

Tobacco control for the cessation world, involves “approved methods”, counseling, quit lines & other mythical suggestions in tobacco-land such as the always encouraging “quit or die”, you’re not trying hard enough… as smokers travel down the stop smoking hole…

Along come vaping products. Contested? Hot topic? Absolutely. Proof? Yep. Doubts? As far as your fingers can tweet or read in the media in the U.S.A..

It seems simple, really. Less tobacco use by smokers with an alternative in ANY way possible by anyone in the public health field, or by organizations like the Heart, Lung or Cancer associations…would be immediately and swiftly encouraged……well – that, my readers seems to be a fairy tale.

On to “Alice”.


To be balanced there has been some tweeting of vaping products as an alternative. I can’t possibly search for them all, but DID get a “maybe” here in 2015.


Here, in 2014, there was “waiting on evidence”.


Smokers falling a long way seem to always land in a hall with many locked doors….and a table appears… with concoctions and promises of cures to the smoker trying to stop with “try me” and “use as directed” and “FDA approved”. What do they feel, those trying so hard?

Shame.

Without success, a smoker is shamed regardless of the method chosen. (That is Tobacco Control training 101, is it not?)  Shamed, by everyone and their brother – who have been taught that forEVER.

Frustration.

Despite the EFFORT to cease tobacco use, the tobacco plant has nicotine. The cigarette has -how many other- chemicals that also MAKE tobacco addictive by design. Nicotine itself is not addictive, but the world doesn’t know – because they’ve been taught that as well… so they offer nicotine “replacement” therapies. (Love that word “therapy”).

Disillusion.

After multiple attempts for various reasons – be it poor health, children, mortality sinking in, whatever the personal decision was to try -the quit attempt fails or is aborted and the tobacco control machine turns to spin cycle. Round & round the smoker goes, falling down the rabbit hole.


We don’t know enough -about- long term effects. We know enough despite our own government’s challenge of regulations – we’ve stopped smoking -many accidentally- in a way NO other product or advice has come close to succeeding with on our journey down the hole. We communicate with each other via twitter, facebook and more. Learning daily. Empowered, making an impact.

As for long term effects? Well – we’re not smoking – if it were EXACTLY the same risk – I certainly wouldn’t have a blog.


Know enough, Alice. Make a commitment. Part of the perils of knowing enough is learning as much as you can, without bias and being able to relay that knowledge to others seeking information.

Speaking fluently with truth and conviction, will come naturally.


Long term:

agent

What is your definition of a long term study?

Supportive & hopeful methods are applied here.

BUT


The Pool of Tears

“Alice swims through her own tears and meets a mouse, who is swimming as well. She tries to make small talk with him in elementary French –  but her opening gambit “Où est ma chatte?” (“Where is my cat?”) offends the mouse and he tries to escape her.”

That’s the thing about Alice. Clarity. I’m still not sure how clear she is. I need some more tea!


RUTH


Pig and Pepper

“The Cheshire Cat appears in a tree, directing her to the March Hare’s house. He disappears, but his grin remains behind to float on its own in the air, prompting Alice to remark that she has often seen a cat without a grin but never a grin without a cat.”

 A Mad Tea-Party

“Alice becomes a guest at a “mad” tea party along with the March Hare, the Hatter, and a very tired Dormouse who falls asleep frequently, only to be violently woken up moments later by the March Hare and the Hatter. The characters give Alice many riddles and stories…”

   I cannot tell.


 Yes. That’s where a consumer could choose an alternative to tobacco.


Not sure about you, but the ‘real world’ is where we are using #e-cigarettes instead of tobacco.


 I’m as authentic as they come. Lorien is also. I troll her more than I troll you. 🙂

Ahhh…. nicotine. That’s another of my blogs.


  Potential? Huh. Safer but too early to be so blithely reassuring?


 See – told you Lorien is authentic. Genuine & approved.


 Which are you, proponent or opponent?


Alice, involved in a paper with C. Gartner:

Dueling letters: which one would you sign?


In 2014, DO INDEED was capitalized for emphasis. I appreciate that.


Advice from a Caterpillar

I appreciate the fact that “Alice” is willing to engage with most on twitter. As you know, most of her colleagues will block and never engage.

Simon Chapman and Stan GlANTZ are two examples of (legaleeze: may, might, could) conniving denying monkeys. (Haven’t blogged Capewell or McKee yet.)

Everyone tweets something they regret at one time or another. We’re all human  -except the jury isn’t in on @Entropy72 yet.

This is where I was actually shocked at you. I know from another – personal experience when a professional diagnosis became a lawsuit to a “commoner”. Thing is, we’re professionals just like you. All walks of life, including mental health.

 You took your well deserved lumps.

Then you did it again…….

I couldn’t tell if you were joking on this one any more than I can tell your true position on less harm with vaping products.

So off we go to the final chapter of Alice In TobaccoLand…


Alice’s Evidence

The Queen shouts her familiar “Off with her head!” but Alice is unafraid, calling them out as just a pack of cards, just as they start to swarm over her.

You engage with anecdotal vapers quaintly without making a statement. Teetering on a picket fence without committing. Rocking back and forth. A dangerous line of indecision. I strongly suggest focusing your eyes on the ball. Less tobacco use for the public. I imagine the implications of a “well respected by her peers” professional like yourself facing one of two possibilities.

  1. You’ll be ostracized by them by merely stating the emperor has no cloths. (Think of the thousands of twitter friends you’ll gain!)
  2.  You’ll empower them to take the stand with you, realizing the potential of millions of smokers very lives hang in the frustrating and disillusioned balance.

Either way, you can’t win, I suppose. Indignant irreverence for your own chosen profession, recognizing the “public” in public health and the public it intends to serve -at least at face value- is unacceptable.

You yourself are a Professor, a nurse, an environmental activist. The Editor of BMJ Tobacco Control Journal. You cannot convince me you’re set on sitting in the middle in a rocking chair on a fence. Being pragmatic  <–(funny that link mentions a unicorn) is “real-world application”.

I am the real world. This is not a guessing game, and lives are at stake. TAKE your eyes “OFF the ball” of tobacco for a moment. Vaping products are being regulated, restricted, taxed & banned as if – tobacco control’s livelihood – is at stake. Rather than being accepted as one way to become the end game, it is the ball they have become.

Speak to colleagues – some who are active tobacco control members around the world, all who have professional titles. They aren’t some rogue set of flunkies, they are your counterparts. Colleagues. Each are aiming for the same goal. Tobacco harm reduction. Here, at M.O.V.E..

Once you’ve done so, you can decide which this is. Real harm reduction, where you can join other members of M.O.V.E. and take a stand publicly against the fire and brimstone establishment  – who don’t like to be tested….

Or grab a match… pick your poison… and let the cards fall where they may.

cards


I invited you to the A Billion Lives premier, you respectfully declined.  (I was serious.)

I KNOW they’re going to be in California, I hope you go. Take Glantz with you.


Finally, If I’ve offended you in any way, shape or form, good.

Check Clive’s “Memo to public health grandees: vaping, vapers and you

for reference.

You shouldn’t be offended, though. Did you see what I wrote about Simple Simon Chimpmanzee?

.

I hope you don’t block me and we’ll continue learning from each other.

It is about health, after all.


Speaking of health, this one’s fresh off the Dick Puddlecoat press:

Desperately Seeking Dictatorship.


Ruth Malone:

Via Tobacco Control BMJ

Via UCSF


Update 10/22/16:

Ruth has written this

“Yet, e-cigarettes and the burgeoning list of other non-combustible tobacco and nicotine products could represent potential leverage for accomplishing what once seemed unthinkable: phasing out combustible cigarettes, the single most deadly consumer product ever marketed.”

 

That is in full here:

The Race to a Tobacco Endgame

 


health

FIGHT:

THESE are national consumer and industry organizations in the United States who keep US informed.


August8th.org

A BILLION LIVES

E-cigarette Research is HERE.

MORE e-cigarette research is also HERE.

If you are a Medical Professional  go HERE.

More to come.

Keep ON #Vaping On.

Kevin