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Wikipedia – encyclopaedic or idiotic?

Wikipedia

Everyone’s familiar with Wikipedia – “the encyclopedia that anyone can edit”. It sounds like a great idea, doesn’t it? A vast, sprawling reference work that everyone in the world can add their knowledge to, with administrators and fact-checking mechanisms to make sure nobody’s contaminating it with nonsense. In theory at least, it should end up containing all the open-source information in the world and be constantly checked for accuracy by thousands of dedicated users.

The trouble is that’s not exactly how it works. If the topic of an article isn’t controversial, Wikipedia is generally pretty reliable. Apart from the odd intentional vandalism or clumsy editing by a well-meaning newcomer, both of which usually get removed pretty quickly, articles about places, objects or anything else straightforward tend to be accurate and informative. I do research every day and I regularly use Wikipedia; the articles themselves give a good overview, and there’s a handy list of references at the bottom so you can dig deeper and verify facts.

Where it gets complicated is when you start dealing with any subject that’s at all controversial. That’s when special interests slither out of the woodwork, whether it’s creationists, IRA supporters or political extremists, and start gaming Wikipedia’s tortuous rules to push their point of view.

The whole idea of Wikipedia is that everyone can edit, but in practice that’s not how it works. Apart from a few basic principles the rules for resolving disagreements are made by committee, and we all know the sort of person who likes to join unpaid committees. Unsurprisingly there’s now a mass of rules, guidelines, essays and procedures that would take a lifetime to read, so of course nobody reads them. That means nobody understands them except a hard core of dedicated fanatics, and this brings us neatly to the subject of tobacco harm reduction.

Meet the Medics

I used to be a pretty active Wikipedia editor, until I got banned a couple of years ago. Officially I got banned because I was paid to edit an article, but this isn’t actually against Wikipedia’s rules. The real reason was that I upset the key people in Wikiproject Medicine, a group that’s supposedly responsible for ensuring the accuracy of medical articles on Wikipedia. Because e-cigarettes can potentially have an impact on health, WikiMed has ruled that any articles on them have to obey the stringent rules they’ve created for medical content, and who gets to decide whether they obey those rules or not? Wikiproject Medicine, of course!

This is where the problems begin, because all the leading figures in WikiMed are fanatical opponents of tobacco harm reduction. The project is led by “Doc James” – Dr James Heilman – a socially inept GP from the wilds of rural Canada. Heilman is notable for his poor grasp of logic, even poorer grasp of the English language and a stubborn inability to admit that he might ever be wrong about anything. We’re talking about a guy who thought “A cup of coffee is drug” was a winning argument. Heilman is a complete idiot.

And, like any complete idiot who finds himself in charge of a committee, he’s assembled a collection of even worse idiots to help him out. There’s a Norwegian medical student who can’t spell “cigarette” – I am not making this up – and a few other people who’ve only escaped having personality disorders because they don’t have personalities. However the worst of the lot, by a long way, is the individual known as QuackGuru.

I don’t know what, if any, medical expertise QuackGuru has. He seems to have started on Wikipedia as an opponent of “alternative medicines,” an objective that I’m fine with, but somewhere along the way he became Doc James’s most devoted follower and, just to round off his uselessness, an anti-vaping zealot. On top of that he’s terrible at actually editing. His logic and English are both even worse than Heilman’s, and he has a maddening habit of just repeating the same obviously wrong statements over and over again. He also violates Wikipedia’s rules with monotonous regularity, and although he does get the occasional short suspension – usually just from specific topics – Heilman’s influence has protected him from the permanent ban he richly deserves.

A couple of years ago, until I was banned, I and a few others fought a long battle against the WikiMed clique to try to add some semblance of reality to the article on electronic cigarettes. This is unrelentingly negative; at one point a single paper by notorious Californian aircraft mechanic Stanton Glantz was referenced more than all the other sources put together. QuackGuru was a major source of the problems on the page, blindly applying simplistic definitions of Wiki rules to exclude any references that were positive about vaping. In the end even Heilman couldn’t protect him anymore, and he was banned from editing the page for a few months, but by that time most of the pro-vaping editors had been banned or given up in disgust.

Now it’s all happening again at the Heat not Burn page. Nobody in their right mind would say that an iQOS is a medical device, but WikiMed have claimed authority over it on the basis that it can have health effects. Well, so can a bunch of other things WikiMed doesn’t bother with – guns, for example, or cars. Both of these kill a lot more people every year than HnB ever will, but for some reason they’re not seen as medical subjects. Vaping and HnB are still just about niche enough that Heilman and his little bunch of cranks can take over, though, and that’s exactly what they’ve done.

Looking at the edit history for the HnB page, two names dominate the list – Doc James and, even more so, QuackGuru. For example, on 2 February there were eight edits made to the page; one by Doc James, one by a bot and six by Quack. Out of the last 50 edits, Quack as made 21 – often in rapid strings of minor edits, aimed at correcting the one before but actually making things worse with every attempt.

The Idiots’ Playground

About the only good thing about Quack’s atrocious sentence structure is that it obscures some of the terrible information in the article itself. The lead section says “There is no reliable evidence that (HnB) products are any less harmful than other cigarettes,” so I was already boiling with rage by the second line of the article – because HnB products are not cigarettes (got that yet, Vic?).

The first section in the body of the article is called “Health Effects”, and in the best WikiMed tradition it starts with an ad hominem smear attack on anyone who disagrees with Doc James – “Claims of lowered risk or health benefits for heat-not-burn tobacco products are based on industry-funded research”. Well so what? Why does it matter who funded the research? What matters is that it’s been peer-reviewed (it has) and the experimental methods and analysis have been found to be reliable (they are). Every medicine on the shelf at your local chemist’s was certified as safe thanks to “industry-funded research”, but you never hear anyone complaining about that.

Moving on, another of Quack’s trademarks starts to show up – his touching belief that “a scientist stated” is the same thing as evidence. It doesn’t matter what some Spanish doctor believes; what matters is what the research shows, and all the research on Heat not Burn shows that users are exposed to vastly lower levels of toxic substances. The first rule of toxicology is “the dose makes the poison”, so reduced exposure to toxins means less risk of harm.

The final section is titled “Regulation”, but as there are few regulations in place for HnB yet WikiMed have padded it with quotes from anti-harm reduction extremists. They even shoehorned in Stan Glantz’s lunatic suggestion that safer tobacco products be banned until tobacco companies stopped selling actual cigarettes. It seems none of these idiots have learned the lessons of Prohibition and what happens when you ban something a significant percentage of your population enjoys. As for Glantz himself, the suggestion that the safer products should be banned has to raise serious questions about his mental health.

 

Wikipedia can be a great resource, but it’s also a flawed one. The way it’s run creates immense problems for anyone who disagrees with the self-appointed cliques that dominate many areas of the site. Unfortunately tobacco harm reduction is one of those areas, so the world’s most popular encyclopaedia is also one of its most dangerous sources of anti-THR propaganda.

 

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Meet the JUUL menace

JUUL

Here at Heat not Burn UK we’re always interested in new reduced-harm tobacco products. As you’d expect we’re most interested in HnB devices, but we’re more than happy to have a look at anything else that comes on the market. One gadget we’ve wanted to take a look at for a while (but can’t, because it’s illegal in the EU) is JUUL, an ultra-compact e-cigarette that’s taken a huge share of the US market.

You might have heard of JUUL; it’s certainly been in the news enough recently. If you haven’t heard of it before, it’s a very small and sleek e-cigarette that uses unique disposable pods. The pods don’t contain standard e-liquid; instead the juice is based on nicotine salts extracted from leaf tobacco. This is supposed to give a fast nicotine hit that’s more like a cigarette than a normal e-cig. It also has a 56mg/ml nicotine content, which is why we can’t get them in the EU.

The JUUL device is tiny, slim and rectangular; the pods snap into one end and then all you have to do is take a puff. It has an automatic switch that fires the coil every time you inhale, giving an experience that’s as close to a cigarette as you can get electronically. Each pod has about as much nicotine as a pack of cigarettes and is designed to deliver 200 puffs, and the battery can be easily topped up with a USB charger.

So the JUUL is a pretty interesting little device, and it’s already picked up a hefty share of the US market – close to half of all e-cigs sold through convenience stores. That’s potentially a lot of smokers switching to a much safer alternative, so you’d expect the public health community to give it at least a cautious thumbs up, wouldn’t you? Oh wait; of course not. We all know not to expect much in the way of sense from public health types.

JUULmania

I’m not going to say that anti-JUUL hysteria has reached the level of the “Satanic Panic” in the 1980s, a frenzy of moral outrage about Satanic ritual abuse that saw dozens of nursery owners and employees arrested on suspicion of ritually sacrificing the children who had been entrusted to their care. It’s heading in that direction fast, though. There are daily articles from the USA, and they all follow a very similar – and totally ridiculous – theme.

According to the media, “Juuling” is an epidemic of nicotine use that’s threatening to turn the youth of America into addicts, zombies and probably communists. Schools are panicking at the thought of their students sneaking a puff in class, and nobody’s stopping to look at the actual evidence.

The panic seems to be caused by the design of the device itself. It’s very small, which the media usually translate into “easily hidden,” and thanks to its low power/high nicotine delivery mode, it doesn’t produce a lot of visible vapour. Although I’ve never tried one it seems like it would be the perfect stealth device, so I suppose it would be possible for kids to have a sly drag in class. What I’m not so sure about is why this is somehow worse than them smoking a crumpled Lambert & Butler behind the bike sheds at lunchtime.

What is JUUL anyway?

In any article on JUUL it’s obligatory to mention that “it looks like a USB stick”. It doesn’t, really; it’s longer and slimmer, and has a mouthpiece at one end – USB sticks don’t tend to have those, in my fairly broad experience of the things. Still, it’s small and oblong, so that’s close enough for the media and their public health puppet masters. Cue much hilarity.

In a classic case of over-reaction, one school district in Pennsylvania has banned real USB sticks from all its schools, apparently believing that this will stop students using an e-cig that vaguely resembles one. Officials from the district were falling over themselves to talk about how important this move was in preventing the JUUL epidemic; fortunately one maverick journalist asked them how many students in the district had actually been caught using a JUUL.

One.

That’s right; the school brought in a totally disproportionate ban, and splashed the story all over the media, because they caught one student with a JUUL. I’d say this was ridiculous, if it wasn’t pathetic. Or maybe it’s both. The point is, hardly any US high school students are using JUUL. Far more are using normal e-cigs, mostly basic vape pens, and almost all teens who vape are former smokers!

 

First do no harm

The whole point these clowns are missing with their moral panic is that the product they’re panicking about was specifically designed to help people who already smoke to move to a safer alternative. They should be grateful for this; thanks to JUUL and other e-cigs, teen smoking in the USA is at its lowest rate in a century. Kids who weren’t attracted to smoking aren’t going to be attracted to vaping, either: they’re not going to buy a JUUL. The target market is adults who smoke, and it’s worth pointing out that any kids who do get their hands on a JUUL are violating the company’s strict prohibition on sales to under-21s.

What worries us at Heat not Burn UK is that the same panic that’s grown up around JUUL is likely to spread to products like iQOS when the FDA finally gets round to allowing them onto the US market. I can predict the headlines already; they’re going to focus on the fact that all the leading HnB devices are produced by tobacco companies, and throw in some wild speculation about students putting spliffs in them instead of Heets (a few articles about JUUL claimed students were mixing drugs into the liquid, despite the pod design making this impossible).

I fully support people’s right to smoke if they want to, but there’s no denying that it isn’t the healthiest habit. Smokers should have a choice of safer and effective recreational nicotine products to move to if they choose. JUUL is one of those products; iQOS, Glo and the iBuddy are others. If harm reduction advocates start supporting some products but not others, instead of combining forces against the common enemy, we’ll be picked off one by one.

iQOS and 100 HEETS £49

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Surprise result for PMI in New Zealand iQOS case

iQOS case

If you follow the news on heated tobacco products you’ll probably have noticed that Heat not Burn hasn’t been having an easy ride in every market. Despite the spectacular success of iQOS in Japan, where it’s now taken over more than 15% of the cigarette market in just two years, some governments have decided they’d rather keep collecting cigarette taxes than give smokers the option of switching to a lower-risk product.

One recent example of this was New Zealand. Although the country has been making some (uneven) progress towards legalising vaping, the Ministry of Health seems to have taken a strong dislike to iQOS. Philip Morris International started selling the iQOS device, and the Heets for it, in early 2017; the ministry’s response was take them to court for violating a law that was originally intended to ban chewing tobacco.

According to the Ministry of Health, PMI were in breach of Section 29 of the Smoke-free Environments Act. This bans the import, sale or advertising of any tobacco product intended “for chewing, or for any other oral use (other than smoking)”, and technically Heets do come under it – they’re not smoked, because the tobacco doesn’t burn, but they are meant for oral use. However, the law was written in 1990 when HnB didn’t seem to have any future, and PMI have been arguing that it was never intended to apply to products like Heets. They only come under the law because of a technicality, and the company’s position was that it made no sense to use the Smoke-free Act to ban the product.

A lost cause?

The case finally came to trial on 5 March, and following three days of claims and evidence most people assumed that the judgement would go in favour of the Ministry of Health. It’s been a long time since a tobacco company actually won a case brought by a health organisation, after all. iQOS doesn’t benefit from the increasing support for e-cigarettes, either; it’s different enough that many people – even some vaping advocates – still think it’s basically a cigarette.

Well, some people were in for a big surprise. In fact I confess I was one of them. When the judgement was released on Tuesday my jaw hit the floor just as hard as everyone else’s.

Because PMI won the case.

That’s right; the District Court at Wellington rejected a charge laid by its own government’s health department, and awarded victory to a tobacco company. This now means that PMI can carry on selling Heets in New Zealand – and potentially makes iQOS the most accessible product for any Kiwi smoker who wants to move to a safer option.

The previous government had pledged to legalise nicotine e-liquids, but the Labour-Green coalition that replaced it has been dragging its feet on the issue. That means vapers in New Zealand have to import their own liquid from abroad. This can be an expensive and complicated process, and it’s likely to deter many smokers from trying to switch. With Heets once more legally on sale they now have HnB as an easier option.

So what happened?

It’s not clear why the Ministry of Health decided to go after Heets, but when they did they chose to use a technical legal argument based on the strict wording of the law. The Smoke-free Environments Act makes clear references to “any tobacco product” intended for “chewing, or any other oral use (other than smoking).” A Heet is certainly a tobacco product; processed tobacco is the main ingredient in the filling. It’s also intended for oral use – the vapour it produces is inhaled through the mouth – and, because there’s no combustion involved, it’s obviously not smoking.

It’s worth taking a moment to think about that. The health ministry wanted to ban a new, reduced-risk tobacco product because it isn’t smoking. If the Heet was just a new brand of cigarette that would have been fine with New Zealand’s government; their problem was that it wasn’t a cigarette, but something specifically designed to be much safer.

Luckily, PMI’s defence team weren’t shy about pointing that out. They reminded the court that the section of the law was written specifically to ban chewing tobacco, which is linked to mouth cancer – not to suppress a product designed to remove almost all the harm of smoking. The defence also brought a strong expert witness who explained just how safe HnB is compared to smoking. The health ministry tried to claim that this was irrelevant, but the judge disagreed.

The exact tool the judge used to demolish the case was a legal rule called Ejusdem Generis. This says that if particular words describe a class of thing, then any general words that follow it are confined to the same class of thing. So, where the law starts off by mentioning “chewing” then says “or for any other oral use”, it still only means chewing. Based on that the court agreed with PMI and threw out the case; in the process they rebuked the Ministry of Health, telling them that trying to ban a safer product was the exact opposite of what the law was trying to achieve.

 

So what does this mean for heated tobacco products? It’s actually hard to overstate what good news it is. Obviously it’s good for smokers in New Zealand, who once again have iQOS available as an alternative to cigarettes. The big impact, though, is the precedent it sets. Other health ministries who might be thinking about banning Heets will now have to look at this case and consider the possibility that, if they try it, they might just lose.

Health organisations don’t lose often; that’s a sad fact about the nanny state times we live in. This result is going to send shockwaves rippling around the world. A tobacco company has actually won, using the argument that their product is going to help public health and should be protected from misguided laws. Let’s hope the message gets across in other countries too; smokers need more options, not more knee-jerk bans.

iQOS and 100 HEETS £49

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California study claims iQOS risks – but is this good science?

iQOS risks

Im my last post I mentioned that there would be some good news about Glo being released today. What I didn’t know at the time was that some bad news about iQOS was also scheduled for release. Luckily the ever-resourceful Dick Puddlecote tipped me off that it was coming. He wasn’t the only one who knew about the paper, either; Philip Morris International have obviously got hold of an advance copy in plenty of time to have a look at it and compare its conclusions to their own science.

Actually, as a long-time advocate for vaping, this all looks very familiar to me. I mentioned in my last post that tobacco control is increasingly rejecting science, and this new paper is an excellent example of that. I was going to say it’s terrible science, but that’s too kind – it isn’t science at all. In fact PMI’s response completely demolishes it. Unfortunately the media won’t pay any attention to that. They’ll report the bad news, and ignore the response because it comes from an Evil Big Tobacco Company. So I’m going to do what I can to get the message out – and hopefully, in the process, show just how low tobacco control “science” has fallen.

The usual suspects?

The new study has been published by the University of California, Riverside – and that’s something else I’m familiar with as a vaping advocate. The UC system is excellent in many ways, and includes several world-class universities, but it also harbours a nest of virulently prejudiced anti-nicotine loons. The most notorious, of course, is Stanton Glantz, but there are others. So when I looked at the authors of the new paper and saw the name Prue Talbot, I wasn’t at all surprised. Talbot is a professor of cell biology at Riverside – so, unlike Glantz, she does at least have some actual qualifications – and she’s also a fanatical opponent of any form of tobacco harm reduction. Her obsession with the subject started with e-cigs, but now she seems to have transferred it to heated tobacco. And the quality of her science is as bad as ever.

Talbot and her team have come up with the argument that iQOS isn’t really a Heat not Burn device. They’re claiming that it burns tobacco and other parts of the Heet, creating toxic substances in the process, and that the way people use it actually increases their exposure to nicotine and harmful chemicals. The thing is, they aren’t the first people to investigate this, and their results are wildly different to what previous researchers found.

There were four main claims in Talbot’s paper, adding up to the conclusion that iQOS exposes users to serious toxins. They are:

  • Despite PMI’s claims, iQOS does burn tobacco
  • The device runs hot enough to melt part of the filter, releasing toxic fumes
  • The time limit on an iQOS session makes users puff more often, increasing their exposure to toxins
  • Not cleaning the iQOS increases the temperature when it’s heated

These are obviously worrying claims, if they’re true – but are they? The hazards identified by Talbot and her team haven’t been spotted by anyone else, and it’s not like Talbot was the first person to look. PMI did a lot of research into safety before iQOS went on the market, and while it’s easy to dismiss that as industry research, PMI have a big incentive to do rigorous research. They’ve invested a lot of money in moving to less harmful products, after all. If it turned out that those products hadn’t been properly researched, and there were risks people weren’t being told about, their whole strategy would collapse. On top of that, PMI know that if they do the research themselves a lot of people will attack it, so they’ve been using independent labs for most of the work.

For obvious reasons, that research has already looked at all the issues Talbot claims to have found. PMI have looked at each of them, and compared them with their own research. The results don’t look good for Talbot.

Does iQOS burn tobacco?

According to Talbot, the tobacco in a Heet is charred when the iQOS heats up. That, she says, leads to a process called pyrolysis, which creates toxins. Her team decided this after looking at a used Heet under a stereomicroscope – but a stereomicroscope isn’t powerful enough to detect pyrolysis. I have one at home; they’re designed for looking at insects, coins and electronic components. If the tobacco really was charred, like she claims, a stereomicroscope could detect that, but is charring possible in an iQOS?

No, it isn’t. The heating blade in an iQOS never gets hotter than 350°C, and that temperature was chosen for a reason. In a cigarette the tobacco burns at a temperature of at least 800°C, and there’s no way an iQOS will ever get anywhere close to that. PMI deliberately selected a temperature that was hot enough to create a vapour from the tobacco, but not hot enough to burn or char it.

I’ve dissected used Heets myself, and looked at them under both a stereomicroscope and a high-powered biological microscope. I didn’t see any signs of burning or charring; what I did see was some discolouration around where the blade had been. PMI say this is torrefaction, a kind of mild thermal decomposition that takes place around 300-350°C.

PMI also cited Public Health England, the UK Committee on Toxicity and the Netherlands National Institute for Health and Environment, all of which confirm from their own research that iQOS does not burn tobacco – and Talbot is wrong.

Are the filters melting?

Talbot claims that the PLA roll inside a Heet, which is there to let the vapour cool before being inhaled, gets hot enough to melt and release a highly toxic chemical called formaldehyde cyanohydrin.

PMI say that they’ve tested the aerosol from iQOS with advanced techniques, including gas and liquid chromatography, and found no trace of formaldehyde cyanohydrin. They also said that the chemical is found in conventional cigarettes.

Finally, PMI pointed out that PLA is made from corn starch, and is a very safe product. When the PLA filter in a Heet is exposed to the heated vapour it doesn’t melt; it hardens, and it doesn’t release any toxic chemicals. In fact that’s exactly why the material was chosen.

Do users puff more rapidly?

Talbot thinks – and it’s just speculation; she has no evidence for it – that because iQOS switches off after six minutes, users will puff faster and expose themselves to more toxins. What this suggests is that Talbot doesn’t understand how iQOS – or cigarettes, for that matter – works.

Firstly, a smoker who’s used to smoking a cigarette in five or six minutes isn’t going to feel rushed with an iQOS. They can puff at their usual speed, with no worries about running out of time. Secondly, iQOS shuts down after six minutes or 14 puffs. It doesn’t matter how fast you chuff away at it; you’re not going to get any more than 14 inhales. On this point Talbot isn’t even wrong; she’s just making things up.

Does not cleaning the iQOS make it run hotter?

Talbot’s final claim was that iQOS, if not properly cleaned after every session – and she said that PMI’s recommended cleaning routine doesn’t work – collects residue that makes it run hotter and generate more toxic chemicals. Again, PMI point out that she obviously doesn’t know how it works. The temperature of iQOS is electronically controlled and cannot go above 350°C. Again, Talbot seems to be making things up.

 

Nobody at PMI is pretending that there are no toxic substances in iQOS aerosol. That would be ridiculous; there are toxic substances in fresh air. However, all the research except Talbot’s has found that the levels of toxic substances are close to two orders of magnitude lower than what’s found in cigarette smoke. As the product is aimed at smokers, that’s the comparison that should be made.

Overall this looks like the same kind of sloppy, biased research vapers have been used to for a long time. It’s even by one of the same researchers who produced a lot of that sloppy, biased research. The aim of Talbot’s paper isn’t to increase the sum of scientific knowledge; it’s to give tobacco controllers ammunition to bash iQOS and the people who make it. There’s likely to be a lot more of this in the future, so all Heat not Burn enthusiasts need to start activating their bullshit detectors now.

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Tobacco control is becoming a doomsday cult that eats its own children

Tobacco control

Another week, another anti-nicotine conference. This time it was Cape Town’s turn to host the World Conference on Tobacco or Health, a three-day extravaganza of propaganda and hate funded by NRT manufacturer Pfizer. This conference has been running since 1967 and, until the mid-1980s, it was reasonably good at sticking to proper science. Then the prohibitionists started to take over, and since then it’s become increasingly hysterical and extreme. Its activities lost touch with the health effects of tobacco long ago, replaced by an obsession with regulating people’s lifestyles. This year’s event showcased that perfectly, plumbing new depths of ideological nutbaggery even by tobacco control standards.

The most newsworthy thing about the event was the very public blackballing of Derek Yach. This came as a surprise to many; after all, Dr Yach isn’t exactly famous as a friend of the tobacco industry. In fact he was one of the key figures behind the WHO’s Framework Convention on Tobacco Control, when he worked for that organisation as its director for non-communicable disease. The FCTC sets up strict rules for how governments and other organisations are allowed to work with the tobacco industry.

Working together?

However, Yach is also a realist. He knows that hundreds of millions of people actually like tobacco and nicotine, so the chances of them ever going away are roughly zero. The only way smoking is going to disappear is if people are given safer ways of enjoying tobacco and nicotine; that, of course, is what Heat not Burn is all about.

To advance his more realistic agenda, last year Yach agreed to head the new Foundation for a Smoke Free World. The goal of this organisation is to accelerate the process of eliminating smoking globally, so you would expect the people at WCTOH to approve of it. FSFW has already secured close to a billion dollars of funding over the next twelve years, which should make a huge difference to research and education about smoking and safer alternatives.

Unfortunately – from the point of view of the tobacco control industry, anyway – that billion dollars in funding comes from Philip Morris. It’s coming quite openly and without any strings attached, of course; FSFW’s rulebook says quite clearly that the organisation has total control over how funds are spent. PMI can’t tell Yach what to spend the money on or what any research it pays for has to find.

That’s not good enough for the tobacco controllers, of course. Instead of being pleased that so much money is available to reduce smoking, they’re just furious about where it came from – and they seem to be even more furious at Yach for having it when they don’t. Being tobacco controllers they’ve vented their fury in a typically childish way. Last Wednesday, on the first day of the conference, they held a session on FSFW and let rip with every cliché they could think of.

Dick Puddlecote went through the session in some detail on his blog here, here and here, and it’s not impressive; just the usual collection of dishonest rubbish we expect when tobacco controllers are confronted with something they don’t like. Yach is enough of an expert that he could easily have countered all the allegations made against him – if he was there.

He wasn’t there, of course. Even though the conference was held in his native South Africa, Yach didn’t attend. Neither did anyone else from FSFW – because they were declared personae non grata and publicly informed through the conference website that they weren’t welcome and wouldn’t be allowed in.

This is pretty astonishing, to be honest. If Yach’s colleagues weren’t happy with who controlled his funding, they could have discussed it with him at the conference. Instead, they chose to openly turn on one of the most respected people in their profession and ban his entire organisation from a major event. This, as the saying goes, is nothing to do with health. The people who decided to ban Yach are nothing more than quasi-religious zealots, so consumed with hatred of the tobacco industry that they can’t even admit the possibility of it doing anything positive.

Not about health – or truth

The banning of Derek Yach wasn’t the only case of demented spite at WCTOH; several vaping advocates who were there reported being abused by delegates or ejected from sessions. As bad as it was, though, we can write that off as just what you’d expect from the sort of unpleasant people who’re attracted to a career in telling the rest of us how to live. What’s really worrying is the increasingly open hostility to science shown by tobacco controllers.

One of the stars of the conference was Robyn Koval, the CEO of the anti-tobacco group Truth Initiative (which is entirely funded by tobacco industry money). Koval was described as a “visionary” by some WCTOH delegates, but in fact she’s just a marketing executive with no scientific or medical background – and it shows.

Among Koval’s great ideas were to “refuse to legitimise scientific dialogue”, because “any engagement on a scientific level is a win (for FSFW).” There’s no other way to say it: This is appalling. FSFW is pro-harm reduction; most of the science it’s looking at doing is aimed at making safer products available. Why don’t tobacco controllers want to know how safe these new products are?

We know the answer to that one; it’s because every effective harm reduction product on the market is made by what these demented zealots call “the tobacco industry”. They’re still saying that about e-cigs, despite it being obvious for years that most of the market has nothing to do with tobacco companies. Imagine how angry they must be now that HnB is growing in popularity, because those products really are made by the dreaded Big Tobacco.

And so what? Who cares? iQOS has already helped millions of people to quit smoking; Blu, when it becomes widely available, will help millions more. It doesn’t matter that these products are made by companies that also make cigarettes – they still do what they’re supposed to do (and you can find out for yourself by buying an iQOS today).

People who want iQOS banned because it’s made by PMI are saying that they’d rather smokers continue to smoke – and die – than be helped by a tobacco company. This is a fanatical, fundamentalist position. It has strong echoes of the religious concept of original sin, and it’s certainly nothing to do with science.

Science works. It’s the best method we have for examining the world and answering questions about it. There’s already science that shows HnB is much safer than smoking, and more is in the pipeline – some very interesting research on Glo will be released tomorrow. Tobacco controllers hate that, which is why they’re turning their backs on science, expelling heretics like Derek Yach and retreating into the echo chamber of their destructive cult. That’s the sort of people who’re criticising Heat not Burn; my advice is that you treat them the same way you’d treat any other loony cultist.

Ignore them.

iQOS and 100 HEETS £49

 

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Japan Tobacco are releasing a new heat not burn device

Japan Tobacco

Look at all these rumours, surrounding me every day

It looks like Japan Tobacco are going to be releasing a new Heat Not Burn product later this year, if news reports are to be believed. Japan Tobacco is one of the world’s leading tobacco companies, producing famous cigarette and hand rolling tobacco brands including Camel, Silk Cut, Winston, Old Holborn and Amber Leaf. Seeing global cigarette sales on a downward trajectory throughout most of the developed world they have announced that they will be bringing out a new Heat Not Burn device.

Japan Tobacco must be really concerned at the success of the iQOS in their home territory, where it has proven to be incredibly popular. Sales of HnB products in Japan are massive, leading to an analyst predicting that HnB products will account for a quite astonishing 29% of Japan’s tobacco market this year – up from 16% in 2017. Japan Tobacco did release the Ploom Tech Mevius in mid-2017, but obviously they are not putting too much faith in that or they wouldn’t be aiming to bring out another similar product so soon afterwards.

One of the reasons that Heat Not Burn products are so popular in Japan is because of Japan’s crazy attitude towards e-cigarettes, which are to all intents and purposes banned. There could be many reasons for this absolute madness, including the fact that the government owns at least one third of Japan Tobacco, and they don’t want to lose even more revenue to those pesky e-cigarettes.

Things can only get better

Here at Heat Not Burn UK we think it is great that there is potential for another HnB product to be released, because we believe that the more devices there are on the market the more this competition will drive forward innovation. Just like in the early days of e-cigarettes, when most of the products were bloody awful, the technology will only get better as time goes by, exactly as it has done in the global vaping market. Will this new Japan Tobacco device be better than the iQOS or Glo? Currently we don’t know the answer to that question, as details are extremely scant, but Japan Tobacco have said they will be investing a staggering $917 million on the development and production of reduced risk products (RRP) over the next three years, so you would expect it to be pretty good, wouldn’t you?

One thing for sure is that we are going to be in for some very interesting times, seeing the big players all bringing out new devices; it can only enhance the whole HnB experience for the consumer, which is a very good thing, and we will be here as usual bringing you all the very latest info.

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Glo safety update – good news on DNA trials

DNA trials

Anti-nicotine zealots chose safety as their main battleground on e-cigarettes, and it didn’t work out too well for them. Now they seem to be doing the same again with Heat not Burn. Will it be more effective this time? Probably not.

We’ve already seen a lot of research from PMI on the safety of their iQOS device. Now British American Tobacco have released their own work on Glo, which is currently on sale in Japan and South Korea. Glo works on the same concept as iQOS, delivering vapour from heated tobacco that’s held in a cigarette-like stick, and the only real difference in the technology is that Glo heats its sticks to a lower temperature. That means we wouldn’t expect to see a huge difference in its vapour compared to iQOS – and, sure enough, we don’t.

Science and smoking

What BAT were interested in was the potential of Glo vapour to cause DNA changes in human cells. Damage to DNA can kill a cell – but, even worse, it can also cause cancer by making the cell grow and divide abnormally. Smoking is known to cause damage to thousands of genes; the question is, how does Glo compare?

Recently there’s been a lot of criticism of studies that use human cell cultures to measure the effects of e-cigarette vapour. This criticism is well aimed, because while the cells might be the same as the ones in a real human body, they don’t benefit from all the body’s layers of defence systems and repair capabilities. In a living body, damaged cells are quickly repaired or ejected; this doesn’t happen in a petri dish.

For their own trials BAT decided they could do better than that. Instead of a simple culture they used an actual simulation of a human airway. Known as MucilAir, it’s grown in a laboratory from cloned human cells and it replicates the body’s own defence mechanisms. The culture can produce mucus, to clear away contamination, and is covered in hair-like cilia like the ones human airways use to expel dust and particulates.

With the experimental tissues set up, BAT’s scientists then programmed a smoking machine to mimic the way people actually use Glo. This is another frequent problem with research into reduced-risk tobacco products – researchers set up their equipment to work in unrealistic ways. Several studies on e-cigs have turned out worthless because the machinery took puffs that were too long and too close together, producing dry hits and high levels of toxic substances that no real vaper would ever experience.

To carry out the actual experiment the machine produced vapour from the Glo and exposed the cells to it continuously for one hour; as a control, a second sample was exposed to smoke from a standard cigarette. Then, 24 hours after the experiment, cells were harvested and broken down to extract their DNA; which was then examined for changes. The process was repeated after another 24 hours to check for damage that took longer to show up. Then the results for Glo were compared with those for the cigarette.

Does Glo cause cancer?

The difference was dramatic. After 24 hours cigarette smoke had caused observable changes in 2,206 genes; Glo vapour had affected one. By 48 hours 2,727 genes were showing a reaction to the smoke, while all genes from the Glo sample were normal. After the researchers adjusted the figures to get a worst-case scenario Glo was still only affecting two genes, while smoke affected 2.809.

It’s obvious from this that Glo’s heated tobacco vapour has much less effect on DNA than cigarette smoke does – in fact, it would be interesting to see a comparison between Glo vapour and city air. So why are BAT insisting that “these results do not necessarily mean this product is less harmful than other tobacco products”? The reality is that’s exactly what these results mean, but heat not burn is in a complicated legal position just now. Philip Morris are still hoping their iQOS will be classed as a reduced risk product by the US FDA, which would allow them to advertise it as less harmful; Glo hasn’t reached that stage yet. Until it does we can expect BAT to be very cautious about what they say, to avoid any damaging legal challenges.

The reality, however, is that this is great news for heat not burn. The gene changes caused by cigarette smoke are known to be linked to lung cancer, as well as fibrosis and inflammation of lung tissue. The new research – which has been peer reviewed, and will be published in the medical journal Scientific Reports – shows that Glo is not causing these changes.

While the health effects of cigarettes are complicated, some things are quite simple. If Glo isn’t causing the gene changes that lead to cancer, it’s not going to give you that type of cancer. That doesn’t mean there are no health risks at all – we can’t say that about anything – but what we can say is that many of the ways cigarettes cause cancer just aren’t possible with Glo.

Earlier research into Glo shows that levels of toxic substances in the vapour are between 90% and 95% lower than in cigarette smoke. That fits together well with the new study. There isn’t a simple relationship between levels of a chemical and the effects it has. Some people make wild claims, such as “There’s no safe level of cigarette smoke!”, but the truth is there’s a safe level of anything. There’s a safe level for things like cyanide and arsenic. It might be a very low safe level, but it exists.

We’re probably fine

My guess – and it is a guess, but a reasonably informed one – is that the level of toxic chemicals in Glo vapour is low enough that it’s below the threshold where it’s going to do any harm. It seems reasonable to believe, based on the evidence we have so far, that using Glo or a similar product is going to eliminate most of the risks of smoking. Common sense backs this up; it isn’t nicotine or even tobacco that kills smokers – it’s smoke. Glo isn’t producing any smoke, so it’s sensible to assume we’re not going to see the same problems.

The last thing to say about this research is that it’s going to be attacked because of who carried it out. We’ve seen that already with research on iQOS, just because PMI paid for it – they didn’t even do the work themselves. BAT have tested Glo in their own labs, but they’ve handed over the data for peer review and it’s been approved of by experts. That won’t stop people attacking it, but they’ll attack the source because they can’t attack the data itself. So far the science is looking good for heated tobacco products, and that’s what counts.

Selling iQOS and HEETS

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FDA vote is a setback – but not a disaster – for iQOS

Yesterday was an important day for PMI’s iQOS device, and for the whole future of Heat not Burn in the USA. Following a long bureaucratic process an FDA advisory panel discussed, then voted on, PMI’s claim that iQOS is a Modified Risk Tobacco Product (MRTP), a decision that could decide whether or not it goes on sale in the United States. It went better than it might have done, but unfortunately the results were still disappointing.

PMI submitted their MRTP application in December 2016; the reason it’s taken so long to come to a vote is that the application came to over a million pages of data. Achieving MRTP status would be a significant advantage for iQOS; it would allow PMI to market the product as less harmful than cigarettes, and to alter the warning labels on packaging to make clear that it’s a safer alternative. The final decision on granting MRTP status will be made by senior FDA management, probably some time in the next few months – and, while they’re free to ignore the recommendations of the advisory panel, they rarely do.

What was decided?

Yesterday’s panel voted on three issues. Firstly, have PMI proven that switching to iQOS will cut the risk of developing a smoking related disease? Secondly, is using iQOS healthier than continuing to smoke? Finally, does switching to iQOS reduce exposure to harmful and potentially harmful chemicals? In a slightly confusing mixed decision the panel rejected the first two claims, but voted strongly in favour of the third.

On the first question, reducing the risk of smoking-related disease, eight of the panel’s nine members voted that PMI hadn’t provided evidence for this; the last member abstained. The main issue seems to be that most of PMI’s clinical testing was carried out on rats, and the panel want to see results from human tests. To be blunt about it, this is not very reasonable. iQOS is a relatively new product, so there hasn’t been time for long-term trials on humans.

However, when it comes to the chemicals involved in iQOS vapour, this isn’t exactly a leap into the scientific unknown. All the potentially harmful substances found in iQOS vapour are also found, at much higher levels, in cigarette smoke – and of course the most harmful ingredients of smoke, carbon monoxide and tar, aren’t found at all.

On its own the panel’s rejection of this claim isn’t too surprising, although it’s certainly not justifiable. The FDA has a huge institutional hostility to tobacco products; even Swedish snus, which appears to pose no health risks at all, hasn’t been able to make its way through the MRTP process yet. However, put the decision into context with the FDA’s finding that PMI are right about iQOS users being exposed to fewer, and less abundant, toxins and it makes no sense at all. After all, it’s exposure to these chemicals that causes smoking-related disease, so if the chemicals are reduced or eliminated the risk of disease will fall. That’s basic toxicology – “The dose makes the poison”. This isn’t exactly a radical idea either; it’s been universally accepted since Paracelsus wrote it in 1538.

Exactly the same applies to the panel’s decision that using iQOS hasn’t been proven healthier than continuing to smoke. If they accept that the vapour is far less toxic than cigarette smoke – and they did, by eight votes to one – then why not also accept that inhaling vapour is much less risky than inhaling smoke?

So what’s going on?

On the face of it the panel rejecting two of PMI’s claims, but accepting a third that backs up the first two, doesn’t make any sense. After all the reduction in harmful chemicals is the whole point of iQOS, and the reason behind it is to reduce risks.

It does start to make sense if you look at it from an ideological, rather than a scientific, perspective. The panel can’t really argue with the fact that iQOS vapour has a fraction of the problematic chemicals found in tobacco smoke; that’s hard data, collected by independent labs and published in peer-reviewed journals. It cannot be disputed. Denying it is equivalent to Flat Earthism, so it’s actually impressive that only one member of the panel went down that road.

On the other hand, the claims about reduced risks to health are tentative. They’re based on the best analysis of the data, but – hypothetically, at least – they could be wrong. They aren’t, of course; that would require what tobacco control expert Clive Bates called “a novel and implausible theory of the human body”. But, nevertheless, the panel seem to have seized the chance to show how much they hate the tobacco industry.

Now what?

As annoying as it is, the panel’s conclusions aren’t the end of the road for iQOS. When the FDA makes its final decision there are still two open questions. One is whether or not to grant MRTP status anyway, despite the vote. Recommendations from the advisory panel carry a lot of weight, but the agency can disregard them. It’s definitely possible that under director Scott Gottlieb, who at least on paper is committed to harm reduction, they’ll decide to grant it.

Even if they don’t award MRTP, the FDA can decide to let iQOS go on sale anyway. In that scenario the packaging would have to carry standard health warnings and PMI wouldn’t be able to market it as a safer option, but word would get round anyway and we could expect to see a lot of smokers make the switch. iQOS is demolishing the cigarette market in Japan at an impressive rate and there’s no reason why it couldn’t do the same in the USA; it would be hard for even the USA to object to that.

The worst case scenario is that Gottlieb decides not to allow iQOS to be sold in the USA. That seems unlikely, but if it does happen the result is likely to be disastrous for HnB in America. PMI have spent a vast amount of money preparing this application, and if it’s rejected on openly ideological grounds it’s hard to see other companies lining up to apply. There’s a lot of lives hanging on the FA’s decision, so let’s hope that unlike their advisory panel they get it right.